Healthcare News and Research

[*Anya*]

Better Pain Control by...Cutting Back on Opioids?
Dr. Charles Argoff, Professor of Neurology at Albany Medical College and Director of the Comprehensive Pain Center at Albany Medical Center in Albany, New York.

Posted: 02/13/2012
I want to talk about a new approach to chronic pain care, based on a recent, exciting study.[1] I certainly see many people with chronic pain in my role as director of a pain center in an academic institution. Many patients do not respond to typically prescribed medications for osteoarthritis and for various neuropathic pain states. I am certain that those of you who are not working at pain centers also see patients who do not respond to available treatments that provide pain relief for other patients.
We are all concerned that sometimes we do not always have a treatment for each individual patient. We need new and improved analgesics and, absent those, at least a more creative way to benefit from what we have.

One approach to this quest has been to try to capitalize on the endocannabinoid system through the use of cannabinoids in various oral pharmacologic tactics. Some cannabinoid agents are available, but with marginal benefit. A second approach has been to develop a better, more effective, and safer way of using opioid analgesics.

The study I want to discuss, "Cannabinoid-Opioid Interaction in Chronic Pain," by Abrams and colleagues,[1] demonstrates how combining the 2 agents may provide promise. I live in New York State, where using marijuana is illegal, medically or otherwise; I am not speaking for or against this. I am merely reporting this particular study.

This study involved individuals with various chronic pain states, including musculoskeletal pain from osteoarthritis and other causes, neuropathic pain, sickle cell disease, and others. These patients were already using long-acting opioids: either time-released oxycodone twice daily at mean doses of 100 mg/day or time-released morphine twice daily at mean doses of about 120 mg/ day. More than 300 individuals were screened, and ultimately 21 of these participated in the study. Participants had to be stable on their opioid regimens before they were enrolled.

The 21 participants were managed as inpatients over 5 days. On the first day, they received 1 evening dose of vaporized cannabis; on days 2-4, they received 3 doses; and on day 5, they received a morning dose, in addition to their typical opioid regimens.

On average, these participants experienced an added 27% reduction in pain with the addition of vaporized cannabis. Pharmacokinetic studies demonstrated that although there was an effect on reducing absorption of morphine by the addition of vaporized cannabis, there was no change in the area under the curve. Therefore, the patients were exposed to a similar amount of morphine, although the peak concentration of morphine was also slightly reduced. Adding vaporized cannabis seemed to independently magnify the response the person was experiencing to the analgesia.

This brings to mind a couple of things. First, this was a limited, 5-day study; the investigators recognized this limitation. However, this shows a new and potentially very helpful combined approach to treatment that comes at an important time when we are searching for improved and novel analgesics that can provide us with additional relief for our patients, and also could spare opioid dosing.

Most important, we're looking for ways to safely treat patients who have chronic pain. This study of vaporized cannabis in addition to long-acting opioid found no significant changes in the plasma opioid level with the combination, even though it proved more effective than the opioid alone. This may be a gateway to future studies using lower doses of opioids in combinations with endocannabinoids or other agents that act on cannabinoid receptors -- or, in certain settings, use of cannabis itself.

Ultimately, this may point to a new way we can effectively treat outpatients.

References

1. Abrams DI, Couey P, Shade SB, Kelly ME, Benowitz NL. Cannabinoid-opioid interaction in chronic pain. Clin Pharmacol Ther. 2011;90:844-851. Abstract
Medscape Neurology © 2012 WebMD, LLC

[Corkey]

Wouldn't mind a pill form, as a reformed smoker just not gonna inhale.

[Rockinonahigh]

I quit smoking nearly a year and ahalf ago,if this came in pill form I could do that just not smokeing it cause I know it will put me on the path to ciggies again.Currently im takeing tramadole and useing flexerill to relax my back,recently ive been up in the amount of tramadols I can take a day but I ony take the extra pill if I really need it.I am so tired of floating thrue most of the day I just dont take anything at all dureing the day,just at bed time.

[Greyson]

You know, I am sure there are medical merits to using canabus. Personally, I am tired of the scamming encouraged by greed and for some addiciton in this medical marijuana wars.

Why don't the States that allow the sale of medical marijuana put it in a pharmacy? All of these "dispensarys" popping up under the planning/land use decisions and local (city) ordinances are not working. Make it accountable to the State, legalize it as a medical drug and sell it out of the Pharmacy. This is how it is done with other medical prescriptions.

[Toughy]

There is a pharmaceutical version of cannabinoids. It is FDA approved for treatment of nausea and vomiting during chemotherapy. It was approved in the early 90s. The generic name is 'dronabinol' and the brand name is 'marinol'. There are some other approved versions.

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0000403/

I tried it. Did not like it at all. Gave me a headache and I had no way to control how much I was taking. I think it came in 2 different doses. With smoked cannabinoids, I had control. I can take 1 or 2 tokes or smoke the whole joint depending on pain severity. I did not get the relaxed 'oh I feel better now' that I got by smoking. It didn't really get me loaded.....just a headache and maybe a tiny bit of pain relief.

Vaporized cannabis is very very different than smoking cannabis. It doesn't feel like smoke going in your lungs. I can't tell if I have actually had a dose. It has none of the problems with smoked cannabis. No tars, none of the evil nasty crap smoking gives you, no apparent risk for developing lung disease down the road.

[*Anya*]

Women at Midlife and Beyond Have Unique Health Needs

An Expert Interview With Ivy M. Alexander, PhD, APRN, ANP-BC, FAAN

"Hot Flashes and More: Midlife Women's Health and Beyond" was presented at the 14th Annual Nurse Practitioners in Women's Healthcare (NPWH) Premier Women's Healthcare Conference. We spoke with one of the presenters, Ivy M. Alexander, PhD, APRN, ANP-BC, FAAN.

Medscape: What percentage of women in midlife is living with symptoms related to menopause?

Dr. Alexander: Every single woman who lives long enough will experience menopause, and all of us will have some kind of symptoms; the biggest question is whether or not it is bothersome to them. All women experience vaginal atrophy over time. There are certain different symptoms that affect everybody; whether or not it is bothersome is a separate question.

Medscape: Do vasomotor symptoms associated with menopause consist only of hot flashes, or are there other symptoms as well?

Dr. Alexander: Some women get sweats and some women get chills. In Europe they call it 'hot flushes' instead of hot flashes, because their faces turn very red.

Medscape: What are some other consequences related to loss of estrogen?

Dr. Alexander: People can have psychosomatic symptoms, like mood swings, or they can have neurological symptoms like formication, where there's a sensation of bugs picking over the skin. Women sometimes have disbalance.

They can have genitourinary symptoms; they can have musculoskeletal symptoms; some women have gastrointestinal symptoms. The receptors for estrogen and progestogen are all over the body, and so symptoms can occur anyplace, in areas where those receptors become unbalanced, during and after menopause.

There are other physiologic changes that aren't so much symptoms as they are physiologic changes like loss of bone mass and increase of cardiovascular disease, although that's not really related directly to loss of estrogen — it's probably more related to estrogen-testosterone balance, or imbalance.

Medscape: What are some of the risks and benefits associated with use of hormone therapy, and which women would be considered the best candidates for it?

Dr. Alexander: We talked a lot during the session about the history of hormone therapy, and how it has swung like a pendulum over time: first it was in favor, then swung out of favor, then swung into favor, and then swung out of favor.

The most recent evidence-based (data) that we are working with include the HERS study and the WHI study. These studies have indicated that contrary to what was suggested in prior population-based observational studies, hormone therapy, estrogen therapy, or estrogen plus progesterone therapy do not confer cardiac protection, especially if taken a chunk of time after menopause.

We don't really have good data yet whether or not there might be any kind of benefit toward that if hormone therapy is started at the time of the woman transitioning towards menopause. It looks like there are a couple of theories that are evolving, if you look at one more data and start to analyze subgroups. That has suggested 2 different theories related to when one should initiate using hormone therapy; one of them was the "gap" theory, which looks at breast cancer risk, and there's some question about whether there might be a decrease in breast cancer risk if a woman holds off on starting hormone therapy for that 5 years post menopause.

The news is starting to suggest that if we start hormone therapy right at the time when a woman becomes postmenopausal, it helps to decrease, delay, or put off their risk of developing cardiovascular disease.

Now, it is very controversial; there's a lot of good data that's available. Some of the results from various different studies are rather controversial and confusing, and so it's important for people to really look hard to make sure they remain abreast of these developments.

The most immediate information that we have is what I've just described, and it's looking more and more like we really need to individualize care…if the greatest risk for her is related to heart disease, you might want to think about hormone care sooner than later if in fact she's a good candidate. If the risk factors are higher for breast cancer, you might want to wait.

Medscape: Are there any alternative therapies that you currently favor, and what are some of the risks and benefits of those, particularly when compared to hormone therapy?

Dr. Alexander: There are some alternative therapies, and nonhormonal prescription medications that can be used to try to allay symptoms related to menopause: selective serotonin reuptake inhibitors (SSRIs), selective neurotonin reuptake inhibitors (SNRIs), and the like.

The good thing is that we really have a lot of choices and we're learning a lot more about potential risks and benefits, and I think that's incredibly important. We do know that hormone therapy, estrogen therapy, or estrogen plus progesterone therapy are the single most effective for menopause-related symptoms, but it's not a good choice for every person, and it's not something that every woman feels comfortable taking because of some of the risk factors that we're learning about.

Some of the things that might be most beneficial [with hormone replacement therapy] are things like: A) when a hot flash is coming on, the woman can try to decrease its intensity, or B) possibly stop it from happening.

There are a couple of different products on the market that are available, and some of them suggest benefits that may not be borne out when we do larger head-to-head clinical trials. The other thing is that there are many different things that can trigger hot flashes, and it is really important for women to recognize that there are triggers, and if something is coming on, that they might be able to stop it…if they start to feel that hot flash, by using paced breathing.

The data [related to acupuncture] is kind of all over the place. I think the most recent meta-analysis suggested that it probably didn't have a very strong effect… The benefit of acupuncture is that it's a very well-known, well-proven, safe alternative therapy and it certainly increases relaxation and decreases pain, so if it helps lower someone's stress level and anxiety, it may help to decrease hot flashes — not so much because it's having an impact on the hot flashes directly, but more because it is decreasing some things that are possibly triggering the hot flashes to begin with.

Medscape: Which women would be considered good candidates for alternative therapies?

Dr. Alexander: Anybody.

Medscape: What screening tests should be done on all women at midlife and beyond, regardless of whether they are experiencing symptoms of menopause?

Dr. Alexander: We recommend colonoscopy for women starting at age 50 or younger if there's a family history of colon cancer that is identified before the age of 50; regular female Pap smears and annual internal exams; clinical breast exams and mammography; blood sugar and lipid screening at least every 5 years or more frequently in women at risk; PSA [prostate-specific antigen] sometime around age 40 or 50; hemoglobin around age 50; flu shots annually, pneumothorax depending on their health risk at 65, herpes zoster vaccine every 10 years; tetanus vaccine, and if there's any travel, they should have appropriate immunizations for that.

Osteoporosis is very important; some women need to be measured on a stadiometer every single year to be sure that you actually have an accurate height. Bone density screening should be done at the age of 65, unless experiencing other risk factors earlier.

For women who are experiencing menopause-related symptoms and for whom various different therapies might be being considered, there are some screenings that we do that are separate from that: clotting factor, blood cancer risk, heart disease risk, and so forth.

Medscape: Do you have any special tips for examining women at midlife and beyond?

Dr. Alexander: It's important that you maintain an open differential because even though a woman is 52 and hasn't had a menstrual period in 8 months, and has symptoms that sound like they are related to menopause, it doesn't behoove the patient or the clinic to just decide, "Those are menopause-related symptoms." You need to really make sure you go through an appropriate history and a complete physical exam and really maintain your open mind to a broad differential and potential basis for the symptoms.

Women who are at midlife are at higher risk for diabetes, just like men are, and the waxing and waning of blood sugar levels can sometimes mimic menopause-related symptoms such as hot flashes, and it's important to make sure that you screen for those other health conditions.

Dr. Alexander disclosed that she is on the speaker's bureau for Amgen.

National Association of Nurse Practitioners in Women's Healthcare (NPWH) 2011 Annual Meeting. October 12-15, 2011.

Medscape Medical News © 2012 WebMD, LLC

[Slowpurr]

Available at: http://www.medscape.com/viewarticle/408896.

Can Exercise Offset Impact of Estrogen Loss?

Physical activity, so vital to good health and well being, takes on even greater importance at menopause; as the ovaries shut down, a woman loses estrogen's protective effects against bone loss. The years surrounding the menopause, which occurs at an average age of 52, when a woman undergoes the transition from a reproductive to a postreproductive state, are termed the climacteric period. Regular exercise can prevent or lessen the impact of many of the changes women experience at this time. Exercise also can decrease morbidity and mortality after menopause by lowering a woman's risk of bone fracture.

Exercise can attenuate some of the effects of aging as well as the physical changes linked to a sedentary lifestyle. Regular physical activity can reduce the symptoms and risks of cardiovascular disease, osteoporosis, obesity, and other chronic diseases such as diabetes, which become more prevalent in the postmenopausal period.[1] There is some evidence that symptoms often associated with the hormonal changes of menopause, such as hot flashes, insomnia, and depression, can also be alleviated by exercise.[2] Despite the growing body of evidence for the benefits of exercise at any age, it is estimated that only 38% of females over the age of 19 exercise regularly.[3] The public health burden of inactivity, with its associations to coronary heart disease (CHD) and all-cause mortality, is high. All women should be encouraged to exercise regularly, and clinicians should reinforce the particular benefits of exercise to patients in their menopausal and postmenopausal years.


Authors and Disclosures

Margaret Burghardt is Staff Physician at the Fowler-Kennedy Sports Medicine Clinic, University of Western Ontario Faculty of Medicine, London, Ontario, Canada. She holds a diploma in sports medicine from the Canadian Academy of Sports Medicine (CASM).

Burghardt M. Exercise at Menopause: A Critical Difference. MedGenMed 1(3), 1999. [formerly published in Medscape Women's Health eJournal 4(1), 1999].

[*Anya*]

SAMHSA News Release
Date: 2/16/2012 12:05 AM
From: Substance Abuse and Mental Health Services Administration (SAMHSA)
Telephone: 240-276-2130

A new report shows 7.5 million children under age 18 (10.5 percent of this population) lived with a parent who has experienced an alcohol use disorder in the past year. According to the report by the Substance Abuse and Mental Health Services Administration (SAMHSA) 6.1 million of these children live with two parents—with either one or both parents experiencing an alcohol use disorder in the past year.
The remaining 1.4 million of these children live in a single-parent house with a parent who has experienced an alcohol use disorder in the past year. Of these children 1.1 million lived in a single mother household and 0.3 million lived in a single father household. This study is done in conjunction with Children of Alcoholics Week, February 12-18, 2012.

“The enormity of this public health problem goes well beyond these tragic numbers as studies have shown that the children of parents with untreated alcohol disorders are at far greater risk for developing alcohol and other problems later in their lives,” said SAMHSA Administrator Pamela S. Hyde. “SAMHSA and others are promoting programs that can help those with alcohol disorders find recovery – not only for themselves, but for the sake of their children. SAMHSA is also playing a key role in national efforts to prevent underage drinking and other forms of alcohol abuse.”

SAMHSA offers an on-line treatment locator service that can be accessed at www.samhsa.gov/treatment or by calling 1-800-662-HELP (4357).

There are many resources available to help children with a parent who has an alcohol problem. The National Association for Children of Alcoholics ( http://www.nacoa.org ) provides information and resources for professionals who may be in a position to help these children and their families. More resources are available at: http://www.samhsa.gov/prevention .

The report entitled, Data Spotlight: Over 7 Million Children Live with a Parent with Alcohol Problems, is based on data analyzed from SAMHSA’s 2005-2010 National Survey on Drug Use and Health (NSDUH). NSDUH is a scientifically conducted annual survey of approximately 67,500 people throughout the country, aged 12 and older. Because of its statistical power, it is the nation’s premier source of statistical information on the scope and nature of many substance abuse and behavioral health issues affecting the nation. http://www.samhsa.gov/data/spotlight/Spot061ChildrenOfAlcoholics2012.pdf .

For more information about SAMHSA visit: http://www.samhsa.gov.


SAMHSA is a public health agency within the Department of Health and Human Services. Its mission is to reduce the impact of substance abuse and mental illness on America’s communities.


Last updated: 2/15/2012 4:16 PM

[*Anya*]

Joanna Broder
February 17, 2012 — Strong social support may help protect gay, lesbian, bisexual, and transgender (LGBT) youth against suicidal thoughts, new research suggests.

The first longitudinal prospective study to examine factors predictive of suicidal ideation and self-harm in this vulnerable, high-risk population indicates that support from friends and family may offer the greatest protection.

"Our research shows how critical it is for these young people to have social support and for schools to have programs to reduce bullying," senior author Brian Mustanski, PhD, a clinical psychologist and associate professor of medical social sciences at Northwestern University Feinberg School of Medicine in Chicago, Illinois, said in a release.

"I think it really informs us as to what sort of avenues we can take to help reduce suicide in gay youth," he told Medscape Medical News.

The study is published in the March issue of the American Journal of Preventive Medicine.

Suicide More Common in Gay Youth

Suicide is the third-leading cause of death among adolescents. However, LGBT youth are at least twice as likely to attempt suicide as their heterosexual counterparts. Contemplating suicide is a precursor of suicide attempts, prior research shows.

Understanding the risk factors for suicidal ideation is "crucial for improving prevention and treatment strategies," the authors write.

The investigators examined suicide risk factors such as depression and feelings of hopelessness in a general adolescent population along with a variety of LGBT-specific risk factors such as gay-specific victimization and gender nonconformity.

The study followed an ethnically diverse cohort of 246 Chicago-area LGBT youth aged 16 to 20 years at baseline for 2.5 years. The study population was not randomized. Participants self-identified their sexual orientation; they were recruited from a variety of sources, including flyers distributed in LGBT-identified neighborhoods and group listservs. Each participant completed a baseline interview, then 4 follow-up interviews were conducted 6 months apart.

Researchers chose to focus on suicidal ideation and self-harm as the main outcome measures, rather than suicide attempts, because different people mean different things by the phrase "suicide attempt," Dr. Mustanski said.

"By focusing specifically on these precursors that we can define much more clearly, it really gives us a much better window into what the risk and protective factors are," he said.

Self-Harm Risk

At baseline, participants were asked whether they had ever attempted suicide. They were also asked about their level of gender nonconformity, impulsivity, and sensation seeking.

During follow-up interviews, participants were asked about suicidal ideation, feelings of hopelessness, self-harm, bullying due to their sexual orientation, and level of support from family and friends.

Hierarchic linear modeling was used to examine between-person differences and within-person changes in suicidal ideation and self-harm over time.

Results showed that a history of attempted suicide (P = .05), impulsivity (P = .01), prospective LGBT victimization (P = .03), and low social support (P = .02) were all associated with an increased risk for suicidal ideation.

Prior suicide attempts (P < .01), sensation seeking (P = .04), female gender (P < .01), childhood gender nonconformity (P < .01), prospective hopelessness (P < .01), and victimization (P < .01) were all associated with greater self-harm.

On average, each experience of LGBT victimization was associated with a 2.5-fold increased risk for self-harm behavior.

"Well Done"

Commenting on the findings for Medscape Medical News, Anthony D’Augelli, PhD, a clinical and community psychologist and professor of human development and family studies at Pennsylvania State University in University Park, Pennsylvania, described the study as "extremely well done."

"There are a few longitudinal studies of this population, but none that have studied the issue of suicidality over time, so it makes it quite distinctive in that sense," said Dr. D'Augelli.

"Being LGBT as a young person is extremely stressful...the need for support is pretty intense," he added.

The other message for mental health professionals, said Dr. D'Augelli, is not to be judgmental and to use gender-neutral language when engaging with LGBT patients.

The authors and Dr. D'Augelli have disclosed no relevant financial relationships.

Am J Prev Med. 2012;42:221-228. Full article

Medscape Medical News © 2012 WebMD, LLC
Send comments and news tips to news@medscape.net.

[*Anya*]

Norgestimate and Ethinyl Estradiol Tablets: Recall - Packaging Error, Potential for Incorrect Dosing Regimen

AUDIENCE: OB/GYN, Pharmacy, Patient

ISSUE: Glenmark Generics Inc. issued a nationwide, consumer-level recall of seven (7) lots of Norgestimate and Ethinyl Estradiol Tablets USP (0.18 mg/0.035 mg, 0.215 mg/0.035 mg, 0.25 mg/0.035 mg), because of a packaging error where select blisters were rotated 180 degrees within the card, reversing the weekly tablet orientation and making the lot number and expiry date visible only on the outer pouch. As a result of this packaging error, the daily regimen for these oral contraceptives may be incorrect and could leave women without adequate contraception, and at risk for unintended pregnancy.

BACKGROUND: Norgestimate and Ethinyl Estradiol Tablets are used as an oral contraceptive, indicated for the prevention of pregnancy in women. The product was distributed to wholesalers and retail pharmacies nationwide between September 21, 2011 and December 30, 2011.

RECOMMENDATION: Consumers exposed to affected packaging should begin using a non-hormonal form of contraception immediately. Patients who have the affected product should notify their physician and return the product to the pharmacy. See the Press Release for a listing of affected lot numbers, expiration dates, and product photos.

Read the MedWatch safety alert, including a link to the Press Release, at:

http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm293385.htm

You are encouraged to report all serious adverse events and product quality problems to FDA MedWatch at www.fda.gov/medwatch/report.ht

[*Anya*]

Diet is inextricably linked to conditions such as heart disease, obesity, and diabetes. However, what we consume also seems to have significant implications for the brain: Unhealthy diets may increase risk for psychiatric and neurologic conditions, such as depression and dementia, whereas healthy diets may be protective. Based primarily on recent Medscape News coverage, the following slideshow collects some of the more prominent investigations on nutrition and the brain into a single resource to aid in counseling your patients.

Make for Malta in Depression, Stroke, and Dementia

A 2009 study published in Archives of General Psychiatry found that people who follow Mediterranean dietary patterns -- that is, a diet high in fruits, vegetables, nuts, whole grains, fish, and unsaturated fat (common in olive and other plan oils) -- are up to 30% less likely to develop depression than those who typically consume meatier, dairy-heavy fare.[1]The olive oil-inclined also show a lower risk for ischemic stroke[2,3] and are less likely to develop mild cognitive impairment and Alzheimer disease, particularly when they engage in higher levels of physical activity.[4,5]

Fat: The Good and the Bad

A study conducted in Spain[6,7] reported that consumption of both polyunsaturated fatty acids (found in nuts, seeds, fish, and leafy green vegetables) and monounsaturated fatty acids (found in olive oil, avocados, and nuts) decreases the risk for depression over time. However, there were clear dose-response relationships between dietary intake of trans fats and depression risk, whereas other data support an association between trans fats and ischemic stroke risk.[8] Trans fats are found extensively in processed foods.

Fish Oil to Fend Off Psychosis?

Thanks to their high levels of polyunsaturated fatty acids, namely omega-3 fatty acids, fish can help fend off numerous diseases of the brain. A 2010 study correlated fish consumption with a lower risk for psychotic symptoms,[10] and concurrent work suggested that fish oil may help prevent psychosis in high-risk individuals.[11] Although data are conflicting, new research shows that the omega-3 fatty acids eicosapentaenoic acid and docosahexaenoic acid are beneficial in depression and postpartum depression, respectively, and other research suggests that omega-3 deficiency may be a risk factor for suicide.[12-16] Oily, cold-water fish, such as salmon, herring, and mackerel, have the highest omega-3 levels.

Berries for Oxidative Stress

Polyphenols, namely anthocyanins, found in berries and other darkly pigmented fruits and vegetables may slow cognitive decline through antioxidant and anti-inflammatory properties. A study in rats from 2010 showed that a diet high in strawberry, blueberry, or blackberry extract leads to a "reversal of age-related deficits in nerve function and behavior involving learning and memory."[17] In vitro work by the same group found that strawberry, blueberry, and acai berry extracts -- albeit in very high concentrations -- can induce autophagy, a means by which cells clear debris, such as proteins linked to mental decline and memory loss.[18] Berry anthocyanins may also reduce cardiovascular disease risk by reducing oxidative stress and attenuating inflammatory gene expression.

What Not to Eat?

Saturated fats and refined carbohydrates have highly detrimental effects on the immune system, oxidative stress, and neurotrophins, all factors that are known to play a role in depression. The study by Akbaraly and colleagues cited previously[22] showed that a diet rich in high-fat dairy foods and fried, refined, and sugary foods significantly increases risk for depression. Similar findings were seen in another study from Spain,[7] showing that intake of such foods as pizza and hamburgers increased the risk for depression over time, and in another study, women with a diet higher in processed foods were more likely to have clinical major depression or dysthymia.[17] Research published last year[37] also showed for the first time that quality of adolescents' diets was linked to mental health: Healthier diets were associated with reduced mental health symptoms and unhealthy diets with increased mental health symptoms over time. Excess salt intake has been long known to increase blood pressure and stroke risk[38,39]; however, recent data also correlate high salt intake, as well as diets high in trans or saturated fats, with impaired cognition.[40,41]

PLEASE NOTE:

**Studies and references available if interested. Did not list as there are 41 separate citations!

[*Anya*]

From Pharmacotherapy

Comparison of Prescription Drug Costs in the United States and the United Kingdom: Statins

Hershel Jick, M.D.; Andrew Wilson, M.P.H.; Peter Wiggins, M.B.; Douglas P. Chamberlin, B.A.

Boston Collaborative Drug Surveillance Program, Boston University School of Medicine, Lexington, Massachusetts (Dr. Jick and Mr. Chamberlin); the Tufts Center for the Study of Drug Development, Boston, Massachusetts (Mr. Wilson); and Castlemilk Group Practice, Glasgow, UK (Dr. Wiggins).

Posted: 02/19/2012; Pharmacotherapy. 2012; 32(1):1-6. © 2012 Pharmacotherapy Publications

Abstract

Study Objective To compare the annual cost of statins in the United States and in the United Kingdom.

Design Matched-cohort cost analysis.

Data Sources U.K. General Practice Research Database (GPRD), and MarketScan Commercial Claims and Encounters Database, a large, U.S. self-insured medical claims database.

Study Population We initially identified 1.6 million people in the GPRD who were younger than 65 years of age in 2005. These people were then matched by year of birth and sex with 1.6 million people in the U.S. database. From this matched pool, we estimated that 280,000 people aged 55–64 years from each country in 2005 were prescribed at least one drug. Of these, 91,474 (33%) in the U.S. were prescribed a statin compared with 68,217 (24%) in the U.K. After excluding those who did not receive statins continuously or who switched statins during the year, there remained 61,470 in the U.S. and 45,788 in the U.K. who were prescribed a single statin preparation continuously during 2005 (annual statin users). We estimated and compared drug costs (presented in 2005 U.S. dollars) separately in the two countries.

Measurements and Main Results Estimated drug costs were determined by random sampling. Estimated annual costs/patient in the U.S. ranged from $313 for generic Lovastatin to $1428 for nongeneric simvastatin. In the U.K., annual costs/patient ranged from $164 for generic simvastatin to $509 for nongeneric Atorvastatin. The total annual cost of the continuous receipt of statins in the U.S. was $64.9 million compared with $15.7 million in the U.K. In June 2006, after our study results were analyzed, the U.S. Food and Drug Administration approved generic simvastatin. We thus derived cost estimates for simvastatin use during 2006 and found that more than 60% of simvastatin users switched to the generic product, which reduced the cost/pill by more than 50%.

Conclusion The cost paid for statins in the U.S. for people younger than 65 years, who were insured by private companies, was approximately 400% higher than comparable costs paid by the government in the U.K. Available generic statins were substantially less expensive than those that were still under patent in both countries.

For reprints, visit http://caesar.sheridan.com/reprints/redir.php?pub=10089&acro=PHAR. For questions or comments, contact Hershel Jick, M.D., Boston Collaborative Drug Surveillance Program, Boston University School of Medicine, 11 Muzzey Street, Lexington, MA 02421; e-mail: hjick@bu.edu.

[*Anya*]

New Position Statement from NAMS on Hormone Therapy
Reassuring News for Many Women
JoAnn E. Manson, MD, DrPH

This Dr. JoAnn Manson, Professor of Medicine at Brigham and Women's Hospital and Harvard Medical School. I would like to talk with you today about a new position statement on hormone therapy from the North American Menopause Society (NAMS) that was just published in the journal Menopause.[1] This position statement is freely available on the NAMS Website, and it also is accompanied by a patient education handout that can be downloaded and may be very helpful for patient care. I would like to acknowledge that I served in the writing group for this position statement and also that I am currently serving as president of NAMS.

What is new in this 2012 position statement? First, the statement does reaffirm that hormone therapy is the most effective treatment for vasomotor symptoms and other symptoms of menopause. However, now with a decade of research findings since publication of the first results from the Women's Health Initiative (WHI), it has become clear that there are important distinctions between estrogen plus progestin and estrogen alone in terms of benefits and risks. Furthermore, the benefit/risk profile of hormone therapy can vary by a woman's age, time since menopause and her personal risk-factor profile.

One of the reasons that previous guidelines have recommended avoiding treatment with hormones for more than 5 years is that estrogen plus progestin is linked to an increased risk for breast cancer after 3-5 years. This has been seen in many types of studies. Estrogen therapy alone was associated with no increase in the risk for breast cancer in the WHI Estrogen-Alone Trial, with an average of 7 years of treatment and up to 11 years of follow-up. These findings suggest that there may be more flexibility in terms of the duration of treatment of women with hysterectomy who are taking estrogen alone.

Overall, it is suggested that treatment with hormone therapy should be individualized -- that it will depend on the severity of a woman's symptoms, impairment of quality of life, her personal risk-factor status, and her personal preferences. Women who have early surgical or natural menopause may be treated until the average age of natural menopause, around age 51, in the absence of contraindications, and even longer if necessary for symptoms. This is also highlighted in the position statement.

Evidence has been increasing that different formulations and routes of delivery (for example, transdermal or low-dose estrogen) may have different benefits and risks. Overall, we need much more research on the role of formulation and route of delivery of estrogen, but we have some evidence that the transdermal route of delivery may have some advantages, especially for women who are at increased risk for thrombosis.

The NAMS statement reaffirms that estrogen therapy (ET) represents the most effective treatment for the dryness and dyspareunia caused by genital atrophy. When the only indication for use of HT is genital atrophy, vaginal ET, including 2 marketed creams, the 2-mg estradiol 3-month ring, and 10-µg estradiol slow-release tablets, represent appropriate therapy and can be used safely as long as needed to relieve symptoms.

Vaginal ET is approved to treat genital atrophy only; however, vaginal ET also helps to prevent recurrent urinary tract infections, and the 2-mg estradiol vaginal ring in particular has been noted to benefit women with overactive bladder. Although use of a progestin to protect the endometrium is, in general, not recommended while vaginal ET is used, any bleeding that occurs during use should be evaluated.

http://www.menopause.org/psht12.pdf

http://www.medscape.com/viewarticle/759409

Menopause: The Journal of The North American Menopause Society
Vol. 19, No. 3, pp. 257/271
DOI: 10.1097/gme.0b013e31824b970a
* 2012 by The North American Menopause Society

[Kobi]

Study Links Cat Litter Box to Increased Suicide Risk

A common parasite that can lurk in the cat litter box may cause undetected brain changes in women that make them more prone to suicide, according to an international study.

Scientists have long known that pregnant women infected with the toxoplasma gondii parasite -- spread through cat feces, undercooked meat or unwashed vegetables -- could risk still birth or brain damage if transmitted to an unborn infant.

But a new study of more than 45,000 women in Denmark shows changes in their own brains after being infected by the common parasite.

The study, authored by University of Maryland School of Medicine psychiatrist and suicide neuroimmunology expert Dr. Teodor T. Postolache, was published online today in the Archives of General Psychiatry.

The study found that women infected with T. gondii were one and a half times more likely to attempt suicide than those who were not infected. As the level of antibodies in the blood rose, so did the suicide risk. The relative risk was even higher for violent suicide attempts.

"We can't say with certainty that T. gondii caused the women to try to kill themselves, but we did find a predictive association between the infection and suicide attempts later in life that warrants additional studies," said Postolache, who is director of the university's Mood and Anxiety Program and is a senior consultant on suicide prevention.

"There is still a lot we don't know," he told ABCNews.com. "We need a larger cohort and need a better understanding of the vulnerabilities that certain people have to the parasite."

Suicide is a global public health problem. An estimated 10 million attempt suicide and 1 million are successful, according to Postlache's work.

More than 60 million men, women, and children in the United States carry the toxoplasma parasite, according to the Centers for Disease Control and Prevention, but very few have symptoms.

Toxoplasmosis is considered one of the "neglected parasitic infections," a group of five parasitic diseases that have been targeted by CDC for public health action.

About one-third of the world is exposed to T. gondii, and most never experience symptoms and therefore don't know they have been infected. When humans ingest the parasite, the organism spreads from the intestine to the muscles and the brain.

Previous research on rodents shows that the parasite can reside in multiple brain structures, including the amygdala and the prefrontal cortex, which are responsible for emotional and behavioral regulation.

Rat Study Showed Parasite Changes the Brain
A 2011 study on rats infected by the parasite showed that their fear of cats disappeared. Instead, the parts of their brains associated with sexual arousal were activated. Researchers theorized that the mind-manipulating T. gondii ensures that the parasite will reach and reproduce in the gut of a cat, which it depends upon for its survival.

"The parasite does actually alter the brain of its host," Stanford University study co-author Patrick House told ABCNews.com last year. "The fact that a parasite can get into an organism, target its brain, stay there without killing the host and alter the circuitry of the brain -- we've seen this is insects and fungi, but it's the first time we've seen it in a mammalian host."

It was this and other research that led Postolache to investigate the relationship between the parasite and biological changes in the brain that might lead to suicide. He was also intrigued by studies on allergies and research that showed a connection between toxoplasmosis and schizophrenia.

"I was interested in the neuron aspects of suicide and intrigued by low-grade activation in patients who attempted suicide, as well as victims," he said. "Other studies had looked at the brain and suicide risk and impulsivity. The next question was, what could be the triggers that perpetuate this level of heightened activation in the brain?"

Postolache collaborated with Danish, German and Swedish researchers, using the Danish Cause of Death Register, which logs the causes of all deaths, including suicide. The Danish National Hospital Register was also a source of medical histories on those subjects.

They analyzed data from women who gave birth between 1992 and 1995 and whose babies were screened for T. gondii antibodies. It takes three months for antibodies to develop in babies, so when they were present, it meant their mothers had been infected.

The scientists then cross-checked the death registry to see if these women later killed themselves. They used psychiatric records to rule out women with histories of mental illness.

Postolache said there were limitations to the study and further research is needed, particularly with a larger subject group.

Dr. J. John Mann, a psychiatrist from Columbia University, said Postolache's research mirrors his work in the field of suicidal behavior.

"The relationship of the brain to the immune system is more complex than it may appear," said Mann. "The brain regulates the stress response system, which impacts the immune response."

Scientists already know that steroids like cortisone can affect the immune response. Some antibodies whose goal is to kill off cancer can also affect the brain. Oftentimes the first symptom of pancreatic cancer is depression, he said.

Research also shows that streptococcus bacteria can trigger obsessive-compulsive disorder (OCD) in some children. Sydenham's chorea, the loss of motor control that can occur after acute rheumatic fever, may also be an immune response affecting the brain, according to Mann.

Maryland researcher Postolache suspects that some individuals have a predisposition to these neurological changes.

He speculates that the parasite may disrupt neurological pathways in those who are vulnerable, so that projections of fear and depression from the amygdala are not tempered or controlled by the "braking" function of the prefrontal cortex.

But, Postolache warns that even if a direct cause were found, no antibiotics for T. gondii yet exist and it could be a decade before effective vaccines or other agents that might stop the neurological damage are developed.

Right now, the most effective weapon against T. gondii is education about handwashing, the proper cooking of food, and not using a knife exposed to raw meat on cooked meat.

He also cautions against trendy food production techniques that let animals roam free. "The risk of infection could go up," he said, "and increase the rate of toxoplasmosis."

http://gma.yahoo.com/study-links-cat-litter-box-increased-suicide-risk-194116398--abc-news-health.html

[Kobi]

Brian Kearney was an angry teenager.

"There were lots of holes in my bedroom wall," said 21-year-old Kearney, recalling the "superhuman strength" that sent his VCR clear across the room. "I would say I was a little on edge."

For Kearney, who also struggled with an eating disorder in his teens, anger was a way release the pressure of high school.

"I didn't develop appropriate coping mechanisms," Kearney said.

Nearly two-thirds of American teenagers admit to having "anger attacks" that that involve destroying property, threatening or engaging in violence, a new study found. And one in 12 has intermittent explosive disorder, characterized by chronic, uncontrollable fits of rage.

"It's an enormous problem that mental health professionals have not taken seriously," said Ronald Kessler, a psychiatric epidemiologist at Harvard Medical School in Boston and lead author of the study, published Monday in the journal Archives of General Psychiatry. "I think it's clear from this study that needs to change."

"Without a really good reason, people all of a sudden feel very fearful, or very angry, and do something excessive," he said. "It's either fight or flight."

For Kearney, one wrong look could trigger a "vicious" reaction.

"I can't explain how I felt when I was in one of those fits of rage," he said. "It's almost like I would black out."

Kessler said Kearney's situation is too common to ignore.

"One in 12 kids has this problem. And people very often continue to have this problem into adulthood, affecting their education, jobs and marriages," he said. "Not to mention the criminal implications."

Although IED is listed in the American Psychiatric Association's Diagnostic and Statistical Manual, its cause – and how best to treat it – remain unknown.

"It bears studying, because what we currently know remains speculative," said Dr. Bela Sood, chair of child and adolescent psychiatry at VCU Medical Center in Richmond, Va.

Sood said IED can be hard for patients – and their parents – to handle.

"During an episode, a person goes from zero to 60," she said. "Afterward they often feel remorseful, but the deed is done."

Kearney said he would apologize to his parents after an attack but admitted the anger took a heavy toll.

"It definitely affected our relationship," he said. "But in the end I'm closer to them than I ever was."

Kearney, now a junior at Rowan University in Glassboro, N.J., patched up his relationships – and the holes in his wall – and left his troubled teenage years behind. He credits talk therapy for his victory over anger, as well as Xanax that helps quell his anxiety.

"Everything I've gone through has shaped me into the person I am today," he said. "And I think I'm a pretty good person."

http://abcnews.go.com/Health/MindMoodNews/anger-attacks-rampant-us-teens/story?id=16694231

[*Anya*]

References

1. Dean L, Meyer I, Robinson K, et al. Lesbian, gay, bisexual, and transgender health: findings and concerns. J Gay Lesbian Med Assoc. 2000;4(3):101–151.
2. Neville S, Henrickson M. Perceptions of lesbian, gay and bisexual people of primary healthcare services. J Adv Nurs. 2006;55(4):407–415.
3. Institute of Medicine. Lesbian Health: Current Assessment and Directions for the Future. Washington, DC: National Academy Press; 1999. http://books.nap.edu/openbook.php?record_id_6109&page_1. Accessed April 3, 2012.
4. Hutchinson M, Thompson A, Cederbaum J. Multisystem factors contributing to disparities in preventive health care among lesbian women. J Obstet Gynecol Neonatal Nurs. 2006;35(3):393–402.
5. Spinks VS, Andrews J, Boyle J. Providing health care for lesbian clients. J Transcult Nurs. 2000;11(2):137–143.
6. Mravcak S. Primary care for lesbians and bisexual women. Am Fam Physician. 2006;74(2):279–286.
7. O'Hanlan KA, Dibble SL, Hagan HJJ, Davids R. Advocacy for women's health should include lesbian health. J Womens Health (Larchmt). 2004;13(2):227–234.
8. Seaver MR, Freund KM, Wright LM, Tjia J, Frayne SM. Healthcare preferences among lesbians: a focus group analysis. J Womens Health (Larchmt). 2008;17(2):215–225.
9. Dibble SL, Roberts SA, Robertson PA, Paul SM. Risk factors for ovarian cancer: lesbian and heterosexual women. Oncol Nurs Forum. 2002;29(1):E1-E7.
10. The Joint Commission. Advancing effective communication, cultural competence, and patient- and family-centered care: a roadmap for hospitals. 2010. http://www.jointcommission.org/Advancing_Effective_Communication. Accessed April 3, 2012.
11. Gay and Lesbian Medical Association. Healthy People 2010 Companion Document for Lesbian, Gay, Bisexual and Transgender (LGBT) Health. 2001. http://www.nalgap.org/PDF/Resources/HP2010CDLGBTHealth.pdf.
12. Gay and Lesbian Medical Association. Lesbian, gay, bisexual, and transgender health: overview. Healthy People 2020 Web site. http://healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid_25. Updated November 18, 2011. Accessed November 21, 2011.
13. Bjorkman M, Malterud K. Lesbian women's experience with health care: a qualitative study. Scand J Prim Health Care. 2009;27(4):238–243.
14. Platzer H, James T. Lesbians' experiences of healthcare. Nurs Times Res. 2000;5(3):194–202.
15. Nursing Council of New Zealand. Guidelines for cultural safety, the treaty of Waitangi, and Maori health in nursing education and practice. 2005. Amended and reprinted March 2009. http://www.nursingcouncil.org.nz/download/97/cultural-safety09.pdf. Accessed February 5, 2011.
16. Roberts SJ. Health care recommendations for lesbian women. J Obstet Gynecol Neonatal Nurs. 2006;35(5):583–591.
17. Boehmer U, Bowen DJ. Examining factors linked to overweight and obesity in women of different sexual orientations. Prev Med. 2009;48(4):357–361.
18. Marrazzo JM, Koutsky LA, Kiviat NB, Kuypers JM, Stine K. Papanicolaou test screening and prevalence of genital human papillomavirus among women who have sex with women. Am J Public Health. 2001;91(6):947–952.
19. Cochran SD, Mays VM. Burden of psychiatric morbidity among lesbian, gay, and bisexual individuals in the California Quality of Life Survey. J Abnorm Psychol. 2009;118(3):647–658.
20. Matthews AK, Hughes TL, Johnson T, Razzano LA, Cassiday R. Prediction of depressive distress in a community sample of women: the role of sexual orientation. Am J Public Health. 2002;92(7):1131–1139.
21. Marshal MP, Dietz LJ, Friedman MS, et al. Suicidality and depression disparities between sexual minority and heterosexual youth: a meta-analytic review. J Adolesc Health. 2011;49(2):115–123.
22. Mustanski BS, Garofalo R, Emerson EM. Mental health disorders, psychological distress, and suicidality in a diverse sample of lesbian, gay, bisexual, and transgender youths. Am J Public Health. 2010;100(12):2426–2432.
23. Haas AP, Eliason M, Mays VM, et al. Suicide and suicide risk in lesbian, gay, bisexual, and transgender populations: review and recommendations. J Homosex. 2011;58(1):10–51.
24. Lehavot K, Simoni JM. The impact of minority stress on mental health and substance use among sexual minority women. J Consult Clin Psychol. 2011;79(2):159–170.
25. Blosnich JR, Horn K. Associations of discrimination and violence with smoking among emerging adults: differences by gender and sexual orientation. Nicotine Tob Res. 2011;13(12):1284–1295.
26. Centers for Disease Control and Prevention. HIV/AIDS among women who have sex with women. 2006. http://www.cdc.gov/hiv/topics/women/resources/factsheets/wsw.htm. Accessed March 1, 2011.
27. Marrazzo JM, Coffey P, Bingham A. Sexual practices, risk perception and knowledge of sexually transmitted disease risk among lesbian and bisexual women. Perspect Sex Reprod Health. 2005;37(1):6–12.
28. O'Hanlan KA. Health policy considerations for our sexual minority patients. Obstet Gynecol. 2006;107(3):709–714.
29. Zeidenstein L. Health issues of lesbian and bisexual women. In: Varney's Midwifery. Varney H, Kriebs JM, Gegor CL, eds. 4th ed. Sudbury: Jones and Bartlett Publishers; 2004:299–311.
30. McManus A. Creating an LGBT-friendly practice: practical implications for NPs. Am J Nurse Pract. 2008;12(4):29–38.
31. Anderson T. Nursing profession development: scope and standards of practice (2010). Nebr Nurse. 2011;44(3):8–9.
32. Makadon HJ, Mayer KH, Potter J, Goldhammer H, eds. Fenway Guide to Lesbian, Gay, Bisexual and Transgender Health. Philadelphia: American College of Physicians Press; 2007.

[*Anya*]

Part II

It is difficult to accurately capture the full effect of marginalization, discrimination, and stigmatization on the mental health of an individual or minority group. LGBT persons "are subject to unique social stressors such as prejudice, stigmatization, and antigay violence that may precipitate mental distress, mental disorders, suicidal ideation, and self-harm."[6] Matthews et al[20] studied the role of sexual orientation in predicting depressive distress in a sample of women. Their sample (N 5 829) showed "51% of lesbians and 38% of heterosexual women reported seriously considering suicide at some point in the past."[20] Also, "more than twice as many lesbians as heterosexual women in this age group (15–19) reported suicide attempts."[20]

Although research is limited, LGBT youth may also be at increased risk for suicide attempts compared to their heterosexual counterparts. Marshal et al[21] found that there is a higher rate of suicidality in sexual minority youth compared with heterosexual youth. However, in the study of LGBT youth by Mutanski et al,[22] there were similar rates of suicidality compared with youth of the same geographical areas. They also noted that mental health disorders were higher among the LGBT youth group compared with national data samples but similar when compared with ethnic/minority urban youth samples. Haas et al[23] said, "Over the last 2 decades, an increasing body of empirical research in the US and other countries has pointed to significantly elevated suicide risk among LGBT compared to heterosexual people."

Although there is limited research describing reasons for increased risk in the WSW population, it may be that many mental health issues are associated with the consequences of being a WSW living in a "heterosexual-oriented society."[7] "Heteronormativity denotes how the social life of Western culture is constructed on the assumption that all people are heterosexual, assuming the heterosexual nuclear family
norm to be natural and universal, and thereby making homosexuality socially invisible and second class."[13] It is important to understand that marginality of any kind can be a risk factor for mental health issues. Lehavot and Simoni[24] suggest screening (and referring as needed) for minority stress and the presence/absence of "coping resources" among sexual minority women.

Substance Abuse

Spinks et al[5] said, "Accurate estimates of the prevalence of substance abuse in lesbians are not available due to the marginalization and hidden nature of the population."[5] The rate of alcohol abuse in WSW is unclear and data are conflicting. Dean et al[1] identify that early studies on the gay and lesbian population recruited subjects in bars "which, not surprisingly, showed higher rates of heavy alcohol and drug use than the general population."

Many reports discussed by Roberts[16] indicate that there is more alcohol use in the lesbian community. "Data from the Women's Health Initiative study and other, smaller studies indicate that tobacco use is higher among lesbians than among the general female population."[6] This finding is in contrast with the Dibble study mentioned above. Roberts[16] said, "Reviews have concluded that smoking rates for adolescent and adult lesbians are higher than their national comparison groups, with adolescents being highest for both groups."

Blosnich and Horn[25] examined discrimination/violence and associated smoking among young adults and found that sexual minorities were more likely to experience discrimination and violence and are twice as likely to smoke when compared with heterosexuals in the same age group. It appears that there may be increased substance abuse among WSW in comparison to heterosexual women, but this, too, needs further research. Many factors may put WSW at higher risk for substance abuse or mental health issues, including social stigma, societal pressures, internalized homophobia, the "coming out" process, and discrimination.[5,6,16]

STDs and Reproductive Health/Services

Women who describe themselves as having same sex orientation may identify themselves as lesbian. However, sexual behavior is not the same as sexual orientation, and these should not be confused.[4] Obtaining an accurate sexual history is important to identify risk factors for STDs and safe sex practices. Sex practices of WSW vary widely and the most important thing a provider can do is refrain from making assumptions.

The risk for STD transmission in WSW changes based on sexual practices and the STD organism.[4] Little is known about transmission of STDs between 2 women. "Transmission of some STDs between women is known to occur; for other STDs, transmission between women is possible in theory but has not been proven."[6] Mravcak[6] provides a table in her article showing known transmission of STDs between women to include herpes simplex, genital warts associated with HPV, and trichomoniasis. Included in the table is the description of theoretical STD transmission between WSW: chlamydia, gonorrhea, syphilis, hepatitis B, and HIV.[6] Bacterial vaginosis, while not an STD, is commonly found in the WSW and their female partners[6,16] and is believed to be transmitted between women.[16]

As identified earlier in this article, most WSW have a history of male sexual partners. This fact increases STD risk for these women and their partners. However, Mravcak[6] said, "Lesbians are less likely than bisexual or heterosexual women to be tested regularly for STDs."[6] Many WSW may not believe that they are at risk for acquiring STDs and may even delay treatment when symptoms arise.[4] In addition, NPs may have inaccurate information about the risks of STDs for WSW and assume that they are not engaging in heterosexual intercourse.[4] This assumption may result in the provider choosing to omit needed routine screening for these patients.[4]

NPs need to teach safe sex practices for WSW. Some recommendations given by Mravcak[6] are to avoid contact with any visible genital lesions, cover sex toys that penetrate more than one person's vagina or anus with a new condom for each person, use a barrier during oral sex, and use latex or vinyl gloves and lubricant for any manual sex that might cause bleeding. The Centers for Disease Control and Prevention[26] (CDC) determined, "No barrier methods for use during oral sex have been evaluated as effective by the Food and Drug Administration. However, natural rubber latex sheets, dental dams, condoms that have been cut and spread open, or plastic wrap may offer some protection from contact with body fluids during oral sex and thus may reduce the possibility of HIV transmission."

The CDC[26] also suggests the importance of knowing a partner's HIV status since there is a potential for HIV transmission through menstrual blood. For WSW at this time, oral sex does not require barrier methods if performed with a monogamous partner whose HIV status is negative and has no lesions or other risk factors.[26] Jeanne Marrazzo, MD, MPH, is a leader in infectious diseases and STD prevention and epidemiology. She and her colleagues[27] said WSW should be educated about possible STD transmission between women and education should be centered on common sex practices between WSW.

Reproductive health services are important topics to discuss with WSW patients. In the US, approximately 6 to 14 million children have parents who are lesbian or gay.[6] WSW may have children from previous relationships with men or may choose to become pregnant through a sperm bank, known donor, or heterosexual intercourse. Adoption and foster care are also options for WSW in many states. Other than dealing with societal stigma, studies have shown that children of lesbians have comparable development and life skills adjustment to children in heterosexual families.[16] "The American Psychological Association, the American Academy of Pediatricians, and the North American Council on Adoptable Children have each endorsed foster parenting, adoption, and parenting by same-gender couples, with the reassurance that their review of all the research on these children show that they develop normally."[28]

Even so, the process of starting a family can be emotionally, mentally, and financially challenging for WSW because of social stigma, discrimination, legal issues, and isolation. Zeidenstein[29] said the birth mother has unique challenges as she may have to "come out" again after becoming pregnant and once again as a lesbian mother. Zeidenstein[29] also identified that the comother can experience pain when her role as a parent is not recognized by the people in her life. Furthermore, state laws vary greatly. Legal action is required in most states for the nonbiological parent to be granted parental rights.[6] While legal implications are not within the scope of this article, it is important for NPs to encourage WSW to seek assistance from lawyers to ensure their wishes are granted and to ensure the comother has the rights of parenting she deserves. As an NP, referring WSW to agencies that are known to be nondiscriminatory can also be very helpful.[5]

Improving Practice Through Cultural Safety

NPs are responsible for creating a safe and caring atmosphere for each patient. A "safe" environment is defined by the patient. Key factors to a safe and caring context are reflection, environment, language, and knowledge. Context includes all the "in-betweens" of these 4 key factors. Most of context is made up of what is not said with words or language. A truly safe and caring health care context cannot be achieved by omitting any of the 4 elements. For example, a clinician who provides a safe environment but does not use inclusive language is not providing safe care.

Reflection of one's own feelings and possible biases about the WSW population is the first step in establishing a caring and safe patient-provider relationship. Acknowledging these feelings and examining personal biases is a necessary part of providing a safe and caring environment. McManus[30] said, "Awareness of how one's own attitudes affect clinical judgment and the development of a non-homophobic attitude are important steps in providing culturally competent care."[30] Reflection is an ongoing assessment of one's own feelings, reactions, and motivations. It cannot be done once as a single exercise; it is always evolving based on new experiences and interactions. The process of self-reflection is a personal mission of growth and development that requires continual self-evaluation.

Environment is the first factor that a WSW patient will experience. The waiting room can be a significant indicator of the level of acceptance a WSW patient can expect. The presence/absence of a posted nondiscriminatory policy, the art/pictures displayed, and the kinds of reading material available are all examples of environmental factors that a WSW patient will notice immediately. An example of a nondiscriminatory statement is: "This office appreciates the diversity of women [and men] and does not discriminate based on race, age, religion, ability, marital status, sexual orientation, gender, or perceived gender."[7]

The environment will likely affect the WSW patient's openness about her sexuality. "If the environment is perceived as completely unsafe, questioning by the provider will elicit an inaccurate history."[29] Many waiting rooms and clinics have brochures, posters, and educational materials that "reflect heterosexual experience."[29] Including posters or pictures depicting same-sex couples, brochures available that include same-sex experiences, a visible nondiscriminatory policy, and a visible symbol that the WSW population will recognize as a sign of safety are all ways to make an environment more welcoming to them.[4-6,16,30]

McManus[30] gives examples of symbols that health care providers can display to demonstrate a safe environment for the LGBT population:

**pink triangle (symbol of homosexuality in the concentration camps of Nazi Germany)
**A rainbow flag (an icon for the LGBT community since 1978, when it was first used in the San Francisco Gay Pride Parade)
**The Human Rights Campaign's equality symbol (a blue square with a yellow equal sign [5], which is well known to LGBT persons as a sign of acceptance)

Language used by the provider, staff, and in brochures and history/intake forms is also a strong indicator of safety for the WSW patient. Using inclusive, nonjudgmental, and open-ended questions are important to convey caring and safety. This provides a space for each patient to be as open as she chooses to be. A few examples of open-ended and nonjudgmental language include, "Do you have a partner or a spouse?" instead of "Do you have a husband?" or "Are you married?" Also asking, "Do you, or have you had, sexual relations with men, women, both, or none?"[4–6,16,30] This question is more likely to end with an honest response in comparison to simply asking the patient if she is sexually active.[30] "By taking a little time and asking a few sensitive questions, health care providers can create an environment of trust and inclusion."[5]

Knowledge and competency are associated with caring practice.[31] Understanding the health risks for WSW that are different than heterosexual women is valuable and necessary to provide quality care. The ability to refer patients to other providers who are known to be open and nondiscriminatory is helpful[6] and will enable patients to further trust their provider. The availability of information and resources ( Table 1 ) on WSW-specific health considerations is essential when providing care to this population.

Implications for NPS

In a qualitative study by Bjorkman and Malterud[13] on lesbian experiences with health care, 3 essential qualities were described as necessary for the health care provider: awareness, attitudes, and medical knowledge. This study reinforces the importance of personal attributes that play a role in developing a safe and caring patient-provider relationship.

Some suggestions given in the literature for providing a safe and caring health care context for the WSW population include health questionnaires that are inclusive of same-sex relationships or sexual practices, educational materials or brochures that are inclusive of same-sex relationships and sexual practices, open-ended questions from providers, a nonjudgmental approach to questions, images or posters with same-sex couples, and a nondiscriminatory statement.[6,16,30] While it is important to understand the common health disparities found in the WSW population, the population itself is full of unique individuals from every walk of life. Each individual will present a unique set of health issues and needs. Understanding the uniqueness and diversity of each woman allows the opportunity to provide individually tailored health care and best practices for this population.

In compliance with national ethical guidelines, the authors report no relationships with business or industry that would pose a conflict of interest.

[*Anya*]

Part I

Creating a Safe and Caring Health Care Context for Women Who Have Sex with Women
Posted: 07/12/2012; Journal for Nurse Practitioners. 2012;8(6):464 © 2012 Elsevier Science, Inc.

The purpose of this article is to introduce the concept of cultural safety as it relates to women who have sex with women and offer nurse practitioners who work with this population an integrated literature review regarding relevant research and recommended practices.

Introduction

Women who have sex with women (WSW) are a population that has long been stigmatized and marginalized within our society. Commonly, WSW are referred to as lesbian or bisexual. However, many WSW do not self-identify this way, so using the term WSW is more inclusive. This article will use WSW and lesbian interchangeably and will mention people of other sexual minorities: lesbian, gay, bisexual, and transgender (LGBT) to be compatible with references and citations.

There has been incremental improvement in the United States toward societal acceptance of the LGBT population, yet there is still stigma associated with living anything other than a heterosexual lifestyle.[1,2] Neville and Henrickson[2] posit that consequences of these attitudes lead to violence, homophobia, and heterosexism that affect the mental and physical health of the LGBT population. "Although homosexuality has been removed from the list of diagnoses in the diagnostic manual of the American Psychiatric Association, the relationship between homosexuality and sickness has proved more enduring in the minds of many providers."[1]

It is difficult to accurately estimate the size of the LGBT or WSW populations because of poor research methods, nonstandardization of terms, and the historical invisibility of the population. Different estimates are given in the literature, all of which are relatively low. The Institute of Medicine[3] (IOM) sentinel report on lesbian health from 1999 lists the estimated percentage at 2%–10% of the population. The range of 1%–10% is reflected in other references.[4–8]

Dibble et al[9] said, "Lesbians are a diverse group of women from every ethnic, religious, economic, cultural, and age group." Some agencies have brought attention to the health disparities and consequent need for culturally safe care, including the Joint Commission,[10] Healthy People 2010 and 2020,[11,12] and the IOM.[3]

Many nurse practitioners (NPs) are educated in the specific health and cultural needs of the WSW population and provide exemplary care for this group. However, although many NPs provide culturally safe care for WSW, there are also accounts of discrimination, abuse, assumptions, voyeurism, lack of knowledge, and substandard care toward the WSW population in health care.[4,5,13,14] Some WSW report that, after coming out to their health care provider, they were treated with physical roughness during their exam.[13] Some women have been denied care after their providers found out about their sexual orientation.[5] According to Bjorkman and Malterud,[13] since many health care providers assume that women are heterosexual, a woman who self-identifies as lesbian has to "choose to actively intervene and inform the professional about her lesbian orientation or passively pass as heterosexual." They also point out that the pressure to disclose sexuality is particularly present during gynecologic exams, when the provider doesn't understand when the patient reports being sexually active but not using contraception and having no possibility of being pregnant.[13]

Much of the literature on WSW identifies gaps in providing culturally safe care for this population. Cultural safety is defined as "the effective nursing practice of a person or family from another culture, and is determined by that person or family."[15] The purpose of this article is to introduce the concept of cultural safety as it relates to WSW and offer NPs who work with this population an integrated literature review regarding relevant research and recommended practice.

Literature Review

The literature review is organized by common health issues found among WSW. The issues discussed are obesity and cardiovascular disease (CVD), cancer and screening, mental health and substance abuse, and sexually transmitted diseases (STDs) and reproductive health.

Obesity and Risk for Cardiovascular Disease

Many sources suggest that WSW may tend to have higher rates of obesity than heterosexual women.[6,9,16] "Lesbians are more likely than heterosexual women to have high body mass index, waist circumference, and waist-to-hip ratio; however, they are also more likely to engage in regular exercise."[6] Boehmer and Bowen[17] also found more obesity in women of sexual minority compared to women with a male partner.

There is conflicting information on the risk of CVD for the WSW population. Roberts[16] said, "Research has found increased risk for CVD in lesbians." On the other hand, Mravcak[6] said, "There is no proven increase in the risk of CVD among lesbians and bisexual women." Risk factors for CVD in the WSW population provided by Roberts include "higher rates of obesity, smoking, alcohol use, and less intake of fruits and vegetables."[16]

Cancer and Screening

Cervical Cancer and Dysplasia. Hutchinson et al[4] said, "All women, regardless of sexual preference, are at risk for cervical cancer." Many providers are under the assumption that WSW do not need regular Papanicolaou (Pap) smears because of perceived low risk of cervical dysplasia and cancer.[6,7] This belief may also be held by many WSW themselves.[16] However, human papillomavirus (HPV), the believed cause for 90% of cervical dysplasia, can be transmitted between women.[5] Cervical neoplasia has been found in WSW with no reported history of male partners.[18] In addition, most WSW do report a history of male sexual partners.[4-7]

There has been evidence that WSW have lower rates of cervical cancer screening than do heterosexual comparison groups.[16] One study of 7,000 lesbians cited by Hutchinson et al[4] reported, "Lesbians had higher rates of abnormal Pap results than rates reported in the general US population." Clearly, best practices suggest that WSW should not be excluded from regular cervical cancer screening. Moreover, NPs may need to educate WSW that they need this screening.

Breast Cancer. Several reasons are identified in the literature why WSW may be at a higher risk to develop breast cancer than heterosexual women. It is believed that WSW do not seek preventive mammograms as often as heterosexual women, citing reasons of mistrust of health care providers, negative past experiences, and perceived homophobia in the health care setting.[4] However, the data suggesting that WSW do not receive screening mammography as much as heterosexual women is not consistent. Mravcak[6] said, "Rates of mammogram screening in lesbians and bisexual women are similar to those in heterosexual women." Also discussed in the literature are lower rates of breast self-exam (BSE) among the lesbian population.[5]

It is commonly believed that many WSW are at a higher risk for developing some cancers as a result of higher rates of nulliparity, smoking, alcohol use, and obesity.[4,16] O'Hanlan et al[7] identify these risks and the use of menopausal hormone replacement therapy as a risk. This information is not well researched and needs further study. As Spinks et al[5] pointed out, "Current research has not accurately identified the incidence of breast cancer in lesbians; however, simply being female places lesbian clients at risk." NPs need to encourage WSW to perform monthly BSE, have regular cancer screening visits with a health care provider, and screening mammograms by following the guidelines for best practices as suggested for all women.

Ovarian Cancer. There is little research available about the occurrence of ovarian cancer in WSW compared to the general population of women. Dibble et al[9] performed a study on risk factors for ovarian cancer for lesbians and heterosexual women. This study of over 1,000 women found, "As expected from previous reports, the lesbians had significantly fewer pregnancies, miscarriages, and abortions and lower use of birth control pills. These variables place lesbians at a higher risk for developing ovarian cancer."[9] "Whether women are at increased risk for ovarian cancer secondary to exposure to HRT [hormone replacement therapy] is not clear. The prevalence of HRT usage among lesbians is unknown."[9] In addition, the authors suggest it would be helpful to include sexual orientation in tumor registry data.[9]

Mental Health

Mravcak[6] said, "Most lesbians and bisexual women are emotionally healthy and well-adjusted." However, mental illness, especially depression, occurs in the WSW population. Depression is the most common mental illness reported in WSW[16] and has shown in some studies to occur in higher rates in WSW than in heterosexual women.[19]

[*Anya*]

By Reshma Jagsi, MD, DPhil; Kent A. Griffith, MS; Abigail Stewart, PhD; Dana Sambuco, MPPA; Rochelle DeCastro, MS; Peter A. Ubel, MD
[+] Author Affiliations

JAMA. 2012;307(22):2410-2417. doi:10.1001/jama.2012.6183
ABSTRACT
Objectives: To determine whether salaries differ by gender in a relatively homogeneous cohort of physician researchers and, if so, to determine if these differences are explained by differences in specialization, productivity, or other factors.

Design and Setting: A US nationwide postal survey was sent in 2009-2010 to assess the salary and other characteristics of a relatively homogeneous population of physicians. From all 1853 recipients of National Institutes of Health (NIH) K08 and K23 awards in 2000-2003, we contacted the 1729 who were alive and for whom we could identify a mailing address.

Participants: The survey achieved a 71% response rate. Eligibility for the present analysis was limited to the 800 physicians who continued to practice at US academic institutions and reported their current annual salary.

Main Outcome Measures A linear regression model of self-reported current annual salary was constructed considering the following characteristics: gender, age, race, marital status, parental status, additional graduate degree, academic rank, leadership position, specialty, institution type, region, institution NIH funding rank, change of institution since K award, K award type, K award funding institute, years since K award, grant funding, publications, work hours, and time spent in research.

Results: The mean salary within our cohort was $167 669 ($158 417-$176 922) for women and $200 433 ( $194 249-$206 617) for men. Male gender was associated with higher salary (+$13 399) even after adjustment in the final model for specialty, academic rank, leadership positions, publications, and research time. Peters-Belson analysis (use of coefficients derived from regression model for men applied to women) indicated that the expected mean salary for women, if they retained their other measured characteristics but their gender was male, would be $12 194 higher than observed.

Conclusion: Gender differences in salary exist in this select, homogeneous cohort of mid-career academic physicians, even after adjustment for differences in specialty, institutional characteristics, academic productivity, academic rank, work hours, and other factors.

http://jama.jamanetwork.com/article.aspx?articleid=1182859

[*Anya*]

July 23, 2012

Robin W. Simon, PhD

Professor of Sociology, Wake Forest University, Winston-Salem, NC

First published in Psychiatry Weekly, Volume 7, Issue 14, July 23, 2012

Introduction
The connection between social relationships and mental health is a fundamental component of both the sociological and psychiatric literatures. Robin W. Simon, PhD, is a sociologist whose work has focused on social relationships—especially marriage—and mental health for 25 years.

Why is Marriage Associated with Mental Health?
“Sociologists have long been interested in the link between social relationships and mental health,” explains Dr. Simon. “Let’s take marriage as an example. At this point, hundreds of studies document a robust relationship between marriage and improved mental health: married people report significantly fewer symptoms of depression and are significantly less likely to abuse substances than their non-married counterparts. This is because marriage provides social support—including emotional, financial, and instrumental support. Also, married people have greater psychosocial (or coping) resources than the non-married—higher self-esteem and greater mastery. Social support and psychosocial resources not only increase emotional well-being but also buffer the negative emotional effects of stressors that people experience during the life course.”

There are, of course, many nuances in this narrative. For instance, poor marital quality can lead to lower levels of well-being among the married than the non-married, because marital conflict is highly stressful. However, although it was believed for decades that men derive greater benefit from marriage than women, Dr. Simon’s 2002 study1 and other sociological research show that the mental health advantage of marriage is evident among both genders. At the same time, it appears that marriage is less beneficial for individuals with a mentally ill than an emotionally healthy spouse.2

The Direction of the Relationship Between Marriage and Mental Health
The psychiatric literature recognizes the protective effects of marriage for mental illness. For example, among adults with schizophrenia, being in a marital or cohabiting relationship is associated with a 5-year delay in experiencing a first episode of psychosis (FEP) and higher quality of life, and is a significant predictor of symptom remission within 1 year of FEP.3,4

There is a debate about whether a person’s depression increases the risk of marital loss through divorce, or whether a marital loss itself (including cases where a spouse dies) is largely responsible for depression onset.

The former scenario fits into the hypothesis known as social selection, which states—to summarize it roughly—that healthy individuals gravitate toward intimate relationships and are seen as desirable partners. This view assumes that people who marry are more likely to have better mental health, anyway, and that “the healthiest, most robust people select into marriage,” says Dr. Simon. The alternative hypothesis—the perspective that most sociologists embrace—is social causation, which holds that marriage wards off mental illness and improves mental health by virtue of its built-in support system.

In a 2002 study1 Dr. Simon analyzed longitudinal data from a large nationally representative sample to examine, among other things, both the social causation and selection hypotheses of the relationship between marital status and mental health.

“In this study I examined whether a change in marital status between study onset and endpoint caused a change in mental health,” explains Dr. Simon. “I found that people who became divorced and widowed during the study experienced a significant decline in mental health between data points, which supports the social causation hypothesis. But those who divorced also reported more symptoms before the actual divorce. This latter finding could be interpreted as evidence that people who experience mental health problems are more likely to get divorced (in agreement with the social selection hypothesis). I argued, however, that some of these people might have been experiencing marital conflict at study onset, increasing symptoms of depression and alcohol abuse. In terms of marital gain, people who got married during the study reported a significant decrease in symptoms of depression and alcohol abuse, but there was no evidence that mentally robust people are more likely to marry than their less healthy peers.”

In an era where cohabitation and state-sanctioned same-sex marriage are increasingly common, do the mental health benefits of marriage apply exclusively to heterosexual marriages?

Unfortunately, there are no existing national data sets that would allow us to answer this question. Studies addressing this issue are underway, however, and Dr. Simon predicts that there would be no difference in the mental health benefits of marriage between individuals in heterosexual and same-sex marriages. “If anything,” she says, “marriage may be even more protective for people in same-sex marriages, because they fought long and hard for their partnerships to be recognized by the state.” As for cohabitation, Dr. Simon says that studies show that cohabitation, too, is good for mental health, “though not as good as marriage.”

“We still have much to learn about why marriage in particular, and social relationships in general, improve mental health,” concludes Dr. Simon, “but sociological research on this topic is clear; having a deep emotional connection with another person provides individuals with social support and coping resources, a sense of purpose and meaning in life, an important social identity, and feelings of social integration and mattering—which are all important for both the development and maintenance of mental health.”Disclosure: Dr. Simon reports no affiliations with, or financial interests in, any organization that may pose a conflict of interest.

References:

1. Simon RW. Revisiting the relationships among gender, marital status, and mental health. AJS. 2002;107:1065-1096.

2. Lam D, Donaldson C, Brown Y, Malliaris Y. Burden and marital and sexual satisfaction in the partners of bipolar patients. Bipolar Disord. 2005;7:431-440.

3. Nyer M, Kasckow J, Fellows I, et al. The relationship of marital status and clinical characteristics in middle-aged and older patients with schizophrenia and depressive symptoms. Ann Clin Psychiatry. 2010;22:172-179.

4. Álvarez-Jiménez M, Gleeson JF, Henry LP, et al. Road to full recovery: longitudinal relationship between symptomatic remission and psychosocial recovery in first-episode psychosis over 7.5 years. Psychol Med. 2012;42:595-606.

5. Bulloch AG, Williams JV, Lavorato DH, Patten SB. The relationship between major depression and marital disruption is bidirectional. Depress Anxiety. 2009;26:1172-1177.

[*Anya*]

Topol on 5 Devices Physicians Need to Know About
Eric J. Topol, MD

I'm Dr. Eric Topol, Director of the Scripps Translational Science Institute and Editor-in-Chief of Medscape Genomic Medicine and theheart.org. In this series I will detail the driving forces behind what I believe is the biggest shakeup in the history of medicine.

What I'll be doing in these segments is outlining the parts of my book that represent the digital revolution occurring in the practice of medicine and how this revolution can radically improve the healthcare of the future. In this segment, I'd like to play the role of Dr. Gizmodo and show you many of the devices that I think are transforming medicine today. These devices represent an exciting opportunity as we move forward in the practice of medicine.

Let me just run through some of these. This is 2012, obviously, and this is something that we're going to build upon. You're used to wireless devices that can be used for fitness and health, but these are now breaking the medical sphere. One device you may have already noticed turns your smartphone into an electrocardiogram (ECG). The ECG adaptor comes in the form of a case that fits on the back of a smartphone or in a credit card-size version. Both contain 2 sensors. With the first model, you put the smartphone into the case and then pull up the app -- in this case I'm using the AliveCor app -- and put 2 fingers on each of the sensors to set up a circuit for the heart rhythm. Soon you'll see an ECG. What's great about this is you don't just get a cardiogram, which would be like a lead II equivalent; using the "credit card" version, you get all the V-leads across the chest as well. I have found this to be really helpful. It even helped me diagnose an anterior wall myocardial infarction in a passenger on a flight. It was supposed to be a nonstop flight, but, because of my diagnosis, it wound up stopping along the way. As an aside, after the passenger was taken off the plane to get reperfusion catheter-based therapy at a hospital, the pilots and flight attendants all wanted to have their cardiograms checked.

The second device I will show you is another adaptation of the smartphone, but this one is for measuring blood glucose. Obviously we do that now with finger-sticks, but the whole idea is to get away from finger-sticks. I'm wearing a sensor right now that can be worn on the arm. It also can be worn on the abdomen. What's nice about this is that I can just turn on my phone, and every minute I get an update of my blood glucose right on the opening screen of the phone. It's a really nice tool, because then I can look at the trends over the course of 3, 6, 12, or even 24 hours. It plays a big behavioral modification type of a role, because when you're looking at your phone, as you would be for checking email or surfing the Web, you also are integrating what you eat and your activity with how your glucose responds. This is going to be very helpful for patients -- not only those with diabetes, but also those who are at risk for diabetes, have metabolic syndrome, or are considered to be in the prediabetic state.

The third device I'd like to talk about is another device from the cardiovascular arena that comes in the form of an adhesive patch. It's called the iRhythm, and I tried this out on myself. It's really a neat device, because the results are sent by mail to the patient. You put it on your chest for 2 weeks, and then you mail it back. It's the Netflix equivalent of a cardiovascular exam. The company then sends the patient 2 weeks' worth of heart rhythm detection. I think it's a far better, practical way, as compared to the Holter monitor wireless device. It's not as time-continuous as the ECG or glucose device, but it's in that spectrum.

I want to now explain a fourth device, which I use on my iPad. This device allows physicians the ability to monitor patients in the intensive care unit on their iPads. I use it to monitor patients at the Scripps ICU. You can use it for any ICU that allows for the electronic transmission of data. Right now, I'm monitoring 4 patients simultaneously. You can change the field to monitor up to 8 patients simultaneously. This is a great way to monitor patients in the ICU because you can do it remotely and from anywhere in the world where you have access to the Web. This is just to give you a sense of what this innovative software sensor can do to change the face of medicine.

Finally, I wanted to describe is something that I've become reliant upon, and that's this high-resolution ultrasound device known as the Vscan. I use this in every patient to listen to their heart. In fact, I haven't used a stethoscope for over 2 years to listen to a patient's heart. What's really striking about this is that it's a real stethoscope. "Scope" means look into. "Steth" is the chest. And so now I carry this in my pocket, and it's just great. I still need a stethoscope for the lungs, but for the heart this is terrific. You just pop it open, put a little gel on the tip of the probe, and get a quick, complete readout with the patient looking on as well. I'm sharing their image on the Vscan while I'm acquiring it and it only takes about a minute. We validated its usefulness in an Annals of Internal Medicine paper, in July 2011,[1] describing how it compares favorably to the in-hospital ultrasound echo lab-type image. This could be another very useful device in emergency departments, where the wireless loops could be sent to a cardiologist. Another application it could be used for is detecting an abdominal aortic aneurysm. Paramedics who are out in the field, or at a trauma case, could use this to wirelessly send these video loops to get input from a radiologist or expertise from any physician for interpretation.

These are just a few of the gadgets that give you a feel for the innovative, transformative, and really radical changes that will be seen going forward in medicine. We'll be back soon with more on The Creative Destruction of Medicine. Until next time, I'm Dr. Eric Topol.

http://www.medscape.com/viewarticle/765017?src=ptalk

[*Anya*]

www.medscape.com
From Heartwire

Polypill for Primary Prevention: Largest-Yet Reductions in BP, Cholesterol in Small UK Trial

Lisa Nainggolan
July 19, 2012 (London, United Kingdom) — Results of the first trial to look at the effects of a polypill given to people solely on the basis of age for the primary prevention of CVD have shown the largest reductions in blood pressure and cholesterol levels of any polypill study to date [1].

On average, participants--who were aged >50--experienced a 12% reduction in BP and 39% fall in LDL cholesterol during the 12-week study, achieving levels typical of people aged 20, says lead author Dr David S Wald (Wolfson Institute of Preventive Medicine, London, UK), who together with colleagues, report the findings in PLoS One. "The health implications of our results are large. If people took the polypill long term from age 50, an estimated 28% would avoid or delay a heart attack or stroke during their lifetime and gain, on average, 11 years of life free of cardiovascular events," he told heartwire .

If people took the polypill long term from age 50, an estimated 28% would avoid or delay a heart attack or stroke during their lifetime.

Wald says the vision of his group at the Wolfson Institute is that everyone over a certain age, say 50 or 55 years, will take the polypill without necessarily having to see a doctor. They hope to file for UK regulatory approval for this use of their polypill, manufactured by the Indian company Cipla, within a year or so, once two further ongoing trials in India are completed.

The notion of a polypill for CVD prevention has been much debated since it was first proposed by Drs Nicholas Wald (a coauthor of the current study) and Malcolm Law (Wolfson Institute of Preventive Medicine) in 2003. A number of different formulations have been tested, in both primary and secondary prevention populations, and there are a handful of groups working on this concept worldwide. The idea is not without its detractors, however, with some arguing that the approach to give a polypill to all, as suggested by Wald et al, is far too radical. Many others working in the field believe the polypill is best placed as a treatment for secondary prevention, because those people would already be taking the individual components of a polypill. But critics feel that the global polypill approach is altogether misplaced and argue that individual risk assessment and reduction are the cornerstones of preventive cardiology.

Unique Crossover Design Gives the Most Accurate Results to Date

Wald says the polypill used in their study is three-layered and "easy to swallow"; it contains three BP-lowering medications--a calcium channel blocker, amlodipine 2.5 mg; an angiotensin-receptor blocker, losartan 25 mg; and a diuretic, hydrochlorothiazide 12.5 mg--along with the lipid-lowering simvastatin 40 mg.

Inventors Have Patents, Would License Polypill

Wald says there are four main groups working on the polypill worldwide, including his in London. The others are groups led by Dr Salim Yusuf (McMaster University, Hamilton, ON), who are working with another Indian company, Cadila Pharmaceuticals; an Australian consortium led by Dr Anthony Rodgers (George Institute for Global Health, Sydney, Australia), who are developing the red heart pill with a third Indian firm, Dr Reddy's Laboratories; and a Spanish team, led by Dr Valentin Fuster (Mount Sinai Medical Center, New York, NY), who are working with the Spanish company Ferrer Pharmaceuticals.

The inventors of the polypill, Nicholas Wald and Law, have a patent granted in Europe and Canada, and one pending in the US, that covers all formulations currently being tested by other groups, says David Wald.

"So, in terms of approvals and marketing, any other polypill would need to seek a license from us or they would be infringing the patent in those markets," he explains. "But in all other countries, there is freedom to operate, and that was always our intention, that the intellectual property would remain free to developing countries." He told heartwire that he and Nicholas Wald have invested in development of the polypill and would hope to recover that investment, "but our overwhelming motivation is the public health objective."

Wald explains why aspirin was not included in their formulation: "We took a decision to leave aspirin out of a CVD prevention polypill because it is the only component that runs a reasonable chance of serious harm. Of course it's also useful in preventing heart attacks and strokes, but once you have achieved the large BP and cholesterol reductions that we have shown in our trial, the residual benefit you get from aspirin does not justify its risk in CVD prevention."

Aspirin is the only component of a polypill that runs a reasonable chance of serious harm.

In total, 86 participants who were already enrolled in a CVD-prevention program at the Wolfson Institute and had previously been taking the individual components of the polypill were randomized to the polypill or placebo for 12 weeks. They then crossed over and took the other treatment. Mean within-person differences in BP and LDL cholesterol at the end of each 12-week period were determined, and 84 of 86 participants completed the study.

The mean systolic BP reduction was 17.9 mm Hg, diastolic BP fell by 9.8 mm Hg, and LDL was cut by 1.4 mmol/L; these results are almost identical to those predicted when the polypill was first proposed by Wald and Law, say the researchers.

Although the trial was too short to assess the impact on CV events, sustained reductions in BP and cholesterol of this magnitude would reduce ischemic heart disease events by 72% and stroke by 64%, they estimate.

The fact that this is the only crossover trial of a polypill is an important design issue, says Wald, "because it has allowed us to produce highly accurate estimates of effectiveness, with a relatively small number of participants." Previous trials that used a parallel-group design have shown smaller effects, he notes, with as many as a quarter of participants in such trials not adhering to the allocated treatment. "We believe that our results are the most accurate, direct, observations of the use of a polypill to date," he notes.

We believe that our results are the most accurate, direct, observations of the use of a polypill to date.

However, the trial design also means there are some limitations, he says. First, the high adherence rate observed (98%) is likely a result of those in the trial previously having taken the individual components of the polypill and, as such, this adherence rate cannot be used to estimate compliance in the general population. Second, "the results on tolerability cannot be used to estimate the prevalence of side effects in people who have not previously taken polypill components," he says.

Side effects were more frequent with the polypill than placebo (29% vs 13%, p=0.01), although none were serious enough to cause discontinuation. Myalgia was more common with the polypill compared with placebo (11% vs 1.2%, respectively).

'No-Fuss' Approach Starting to Be Embraced by Medics

"Scientifically, age is the dominant risk factor in predicting whether somebody will or won't have a heart attack or stroke, so it makes sense to use it in the selection of people who are offered the polypill," Wald commented. "Information on a person's BP and cholesterol adds very little extra information and is not worth the cost and complexity."

I do not believe that everybody would choose to take [the polypill], but it's really up to the regulatory agencies to make it clinically available and the medical profession.

The idea that a polypill could be an acceptable treatment offered purely on the basis of age "is one that was initially rejected by the medical community, but now it is starting to be embraced," he notes. "People like the idea of a no-fuss approach to having access to preventive treatment that does not necessarily involve going to your doctor and certainly does not involve being labeled as a patient."

"I do not believe that everybody would choose to take [the polypill], but it's really up to the regulatory agencies to make it generally available, and the medical profession to provide people with the information on its effectiveness and the possibility of its side effects, then let individuals choose for themselves," he concludes.

Nicholas Wald jointly holds European and Canadian patents (EU1272220 priority date April 10, 2000) for a combination pill for CVD prevention (pending in the USA) and, together with David Wald, has an interest in its development. Cipla provided the pills used in their crossover trial free of charge.

References

1. Wald DS, Morris JK, Wald NJ. Randomized polypill crossover trial in people aged 50 and over. PLoS ONE 2012; 7:e41297. Available here.
Heartwire © 2012 Medscape

[Kobi]

Topol on 5 Devices Physicians Need to Know About
Eric J. Topol, MD

I'm Dr. Eric Topol, Director of the Scripps Translational Science Institute and Editor-in-Chief of Medscape Genomic Medicine and theheart.org. In this series I will detail the driving forces behind what I believe is the biggest shakeup in the history of medicine.

What I'll be doing in these segments is outlining the parts of my book that represent the digital revolution occurring in the practice of medicine and how this revolution can radically improve the healthcare of the future. In this segment, I'd like to play the role of Dr. Gizmodo and show you many of the devices that I think are transforming medicine today. These devices represent an exciting opportunity as we move forward in the practice of medicine.

http://www.medscape.com/viewarticle/765017?src=ptalk

This is so cool. I no longer feel odd for having advocated computer chips in peoples bodies to house their medical information for ready access.

I also no longer feel odd for saying......health care needs one of those wand things like Dr. McCoy had in Star Trek. Who knew the wand thing was actually a combo smartphone/ipod/netflix thingy.

I promise to buy one of those fancy phones as soon as there is an app for a defibrillator.

[Kobi]

Two cases of people in Louisiana who died after contracting "brain-eating amoeba" infections from their own household water systems are prompting health officials to warn about a popular home remedy for treating sinus problems and allergies.

People who use neti pots to irrigate their nasal passages and sinuses should use only water that has been boiled, filtered or distilled, said the researchers at the Centers for Disease Control and Prevention who investigated the unrelated cases, which occurred months apart in 2011 in different parts of Louisiana.

The cases are the first evidence reported in the U.S. of municipal, disinfected tap water used in nasal irrigation causing infections of Naegleria fowleri, as the amoebas are properly called. The infections which pass into the brain from the nose are almost always deadly, with only one report of a survivor ever documented in the U.S., according to the CDC.

Infections have only been known to occur in cases in where water is forced up the nose, Yoder said. There have not been any cases where people contracted the infections by bathing or showering, and "there is certainly not a risk with drinking water," he said.

Pass it on: Neti pot users should use only sterile water, which has been boiled, distilled or filtered, the CDC says.

http://news.yahoo.com/brain-eating-amoeba-infections-prompts-warning-neti-pots-111807585.html

[Kelt]

I'm not sure if this thread is the best place for this, but I couldn't think of where else would be.

I just found out that the "shingles" vaccine age limit has been lowered from 60 to 50. If you don't know what it is, check into it (zoster virus). If you have ever had chickenpox you carry the virus in your system. It usually only affects people who are over 60 years of age or have some compromise in their immune system.

Even if you do not fit into this group you can get it. I have had it twice, both times in my forties, five years apart and had no other health issues. You don't want to get it. Check with your health care provider to see if it would be a good idea for you.

This change was made in March 2011, I have been told by two different pharmacies since then that the age was still 60. This is incorrect, you can now get it a participating Costco pharmacies (and probably others). Check your insurance, because this one isn't cheap without it. $188.00 Ouch.

Not giving medical advice, just encouraging folks to check into it this vaccine season and learn about it.

[Toughy]

I think this is the best place for this tidbit of happy information.

I get my health care at the San Francisco Veterans Administration Medical Center. Today at the VA it was Transgender Awareness Day and there was a half day mini conference (with CME/CEU) on Transgender Health with 3 presentations.It was a great conference and I talked about all of it in the Trans News thread, but I wanted to post this part here for a wider audience....

Marci Bowers, MD is probably the best known surgeon who does Sex Reassignment Surgery was one of the presenters. The best and most interesting thing I heard from her had to do with female genital mutilation/female circumcision. It seems the damage can be repaired and a woman will end up with normal looking and functioning genitalia. Yes it can be fixed with what she called 'a simple surgery'.The clitoris works and they can have vaginal penetration and even deliver a baby. She is the only surgeon (she knows about) in the US that is doing this surgery and she does every one of them pro bono. There are surgeons who Europe who do it and she went to Paris and trained. I was stunned and so were the rest of the audience.

[*Anya*]

Op Ed piece in NYTimes today, May 14, 2013:

Angelina Jolie's doctors estimated that She had an 87 percent risk of breast cancer and a 50 percent risk of ovarian cancer, although the risk is different in the case of each woman.

She recently underwent a double mastectomy to try to proactively beat the odds due to having an inherited gene mutation. Those with a defect in BRCA1 have a 65 percent risk of getting breast CA, on average. Her mom died of breast CA at age 56.


http://www.nytimes.com/2013/05/14/opinion/my-medical-choice.html?_r=3&

[*Anya*]

Dementia rates drop sharply, as predicted

By Gina Kolata

A new study has found that dementia rates among people 65 and older in England and Wales have plummeted by 25 percent over the past two decades, to 6.2 percent from 8.3 percent, a trend that researchers say is probably occurring across developed countries and that could have major social and economic implications for families and societies.

Another recent study, conducted in Denmark, found that people in their 90s who were given a standard test of mental ability in 2010 scored substantially better than people who had reached their 90s a decade earlier. Nearly one-quarter of those assessed in 2010 scored at the highest level, a rate twice that of those tested in 1998. The percentage of subjects severely impaired fell to 17 percent from 22 percent.

The British study, published on Tuesday in The Lancet, and the Danish one, which was released last week, also in The Lancet, soften alarms sounded by advocacy groups and some public health officials who have forecast a rapid rise in the number of people with dementia, as well as in the costs of caring for them. The projections assumed the odds of getting dementia would be unchanged.

Yet experts on aging said the studies also confirmed something they had suspected but had had difficulty proving: that dementia rates would fall and mental acuity improve as the population grew healthier and better educated. The incidence of dementia is lower among those better educated, as well as among those who control their blood pressure and cholesterol, possibly because some dementia is caused by ministrokes and other vascular damage. So as populations controlled cardiovascular risk factors better and had more years of schooling, it made sense that the risk of dementia might decrease. A half-dozen previous studies had hinted that the rate was falling, but they had flaws that led some to doubt the conclusions.

Researchers said the two new studies were the strongest, most credible evidence yet that their hunch had been right. Dallas Anderson, an expert on the epidemiology of dementia at the National Institute on Aging, the principal financer of dementia research in the United States, said the new studies were “rigorous and are strong evidence.” He added that he expected that the same trends were occurring in the United States but that studies were necessary to confirm them.

“It’s terrific news,” said Dr. P. Murali Doraiswamy, an Alzheimer’s researcher at Duke University, who was not involved in the new studies. It means, he said, that the common assumption that every successive generation will have the same risk for dementia does not hold true.

The new studies offer hope amid a cascade of bad news about Alzheimer’s disease and dementia. Major clinical trials of drugs to treat Alzheimer’s have failed. And a recent analysis by the RAND Corporation — based on an assumption that dementia rates would remain steady — concluded that the number of people with dementia would double in the next 30 years as the baby boom generation aged, as would the costs of caring for them. But its lead author, Michael D. Hurd, a principal senior researcher at RAND, said in an interview that his projections of future cases and costs could be off if the falling dementia rates found in Britain held true in the United States.

Dr. Marcel Olde Rikkert of Radboud University Nijmegen Medical Center in the Netherlands, who wrote an editorial to accompany the Danish study, said estimates of the risk of dementia in older people “urgently need a reset.”

But Maria Carrillo, vice president of medical and scientific relations at the Alzheimer’s Association, an advocacy group, was not convinced that the trends were real or that they held for the United States.

The studies assessed dementia, which includes Alzheimer’s disease but also other conditions that can make mental functioning deteriorate. Richard Suzman, the director of the division of behavioral and social research at the National Institute on Aging, said it was not possible to know from the new studies whether Alzheimer’s was becoming more or less prevalent.

The British researchers, led by Dr. Carol Brayne of the Cambridge Institute of Public Health, took advantage of a large study that tested 7,635 randomly selected people, ages 65 and older, for dementia between 1984 and 1994. The subjects lived in Cambridgeshire, Newcastle and Nottingham. Then, between 2008 and 2011, the researchers assessed a similar randomly selected group living in the same areas.

“We had the same population, the same geographic area, the same methods,” Dr. Brayne said. “That was one of the appeals.”

But Dr. Carrillo questioned the data because many subjects had declined to be assessed: the researchers assessed 80 percent of the group it approached in the first round and 56 percent of those approached in the second. Her concern is reasonable, Dr. Brayne said, but the researchers addressed it by analyzing the data to see if the refusals might have skewed the results. They did not.

In the Danish study, Dr. Kaare Christensen of the University of Southern Denmark in Odense and his colleagues compared the physical health and mental functioning of two groups of elderly Danish people. The first consisted of 2,262 people born in 1905 who were assessed at age 93. The second was composed of 1,584 people born in 1915 and assessed at age 95. In addition to examining the subjects for physical strength and robustness, the investigators gave them a standard dementia screening test, the mini-mental exam and a series of cognitive tests.

The investigators asked how many subjects scored high, had scores indicating dementia and were in between. The entire curve was shifted upward among the people born in 1915, they discovered.

Dr. Anderson, of the National Institute on Aging, said the news was good.

“With these two studies, we are beginning to see that more and more of us will have a chance to reach old age cognitively intact, postponing dementia or avoiding it altogether,” he said. “That is a happy prospect.”

This article has been revised to reflect the following correction:

Correction: July 16, 2013

An earlier version of this article misspelled the name of the medical center where Dr. Marcel Olde Rikkert works. It is the Radboud University Nijmegen Medical Center in the Netherlands, not Nigmegen.

Published in the NYTimes.

[Greyson]

Jul 15, 8:28 PM EDT

STUDY: LATER RETIREMENT MAY HELP PREVENT DEMENTIA

BY MARILYNN MARCHIONE
AP CHIEF MEDICAL WRITER

BOSTON (AP) -- New research boosts the "use it or lose it" theory about brainpower and staying mentally sharp. People who delay retirement have less risk of developing Alzheimer's disease or other types of dementia, a study of nearly half a million people in France found.

It's by far the largest study to look at this, and researchers say the conclusion makes sense. Working tends to keep people physically active, socially connected and mentally challenged - all things known to help prevent mental decline.

"For each additional year of work, the risk of getting dementia is reduced by 3.2 percent," said Carole Dufouil, a scientist at INSERM, the French government's health research agency.


Read more:
http://hosted.ap.org/dynamic/stories/U/US_MED_RETIREMENT_DEMENTIA?SITE=AP&SECTION=HOME&TEMPLATE=DEFAULT&CTIME=2013-07-15-20-28-50

[Kobi]

Jul 15, 8:28 PM EDT

STUDY: LATER RETIREMENT MAY HELP PREVENT DEMENTIA

BY MARILYNN MARCHIONE
AP CHIEF MEDICAL WRITER

BOSTON (AP) -- New research boosts the "use it or lose it" theory about brainpower and staying mentally sharp. People who delay retirement have less risk of developing Alzheimer's disease or other types of dementia, a study of nearly half a million people in France found.

It's by far the largest study to look at this, and researchers say the conclusion makes sense. Working tends to keep people physically active, socially connected and mentally challenged - all things known to help prevent mental decline.

"For each additional year of work, the risk of getting dementia is reduced by 3.2 percent," said Carole Dufouil, a scientist at INSERM, the French government's health research agency.


Read more:
http://hosted.ap.org/dynamic/stories/U/US_MED_RETIREMENT_DEMENTIA?SITE=AP&SECTION=HOME&TEMPLATE=DEFAULT&CTIME=2013-07-15-20-28-50



I don't know that the researchers proved working in ones later years influences dementia related diseases. I'm not fond of studies that use records (as opposed to interviewing people) as the source of their data. There are too many unknown and unaccounted for variables.

What they have reproven (ad nauseum) is that "being physically active, socially connected and mentally challenged - all things known to help prevent mental decline."

Baby boomers are proving one doesn't have to work to stay physically active, socially connected, and mentally challenged. :)

[Greyson]

What they have reproven (ad nauseum) is that "being physically active, socially connected and mentally challenged - all things known to help prevent mental decline."

Baby boomers are proving one doesn't have to work to stay physically active, socially connected, and mentally challenged. :)



Kobi, I tend to agree with you. There was another article posted at the same site that talked about retirees can stay active physically and mentally. Many are doing it through volunteer work, social activism, part-time employment, etc.

Reading many of your posts, I don't think you have to worry about dementia. You still got it. :glasses:

[Kobi]

Kobi, I tend to agree with you. There was another article posted at the same site that talked about retirees can stay active physically and mentally. Many are doing it through volunteer work, social activism, part-time employment, etc.

Reading many of your posts, I don't think you have to worry about dementia. You still got it. :glasses:

Greyson, you are always the gentleman. My giant, invisible bunny friend Harvey and I thank.......oooo look a squirrel. :jester:

Disclaimer: It is 2:30am. The mind goes weird places.

[*Anya*]

11 Reasons You Should Be Having More Orgasms

The Huffington Post | By Renee Jacques

Posted: 11/05/2013 1:54 pm EST | Updated: 11/05/2013 3:05 pm EST

Orgasm Health Benefits

Clearly, we don't need to convince you to have sex. It's hard-wired into our brains to propagate the species. And anyway, it feels pretty awesome. But here's more good news: Having an orgasm could help improve your health.

One of the main reasons orgasm feels so good is because your brain releases the pleasure hormone oxytocin when you climax. Oxytocin is also called the "love hormone" because of its important role in facilitating social bonding between humans. Most of the following points revolve around the release of oxytocin. Read on to discover eleven ways achieving an orgasm can make your life so much better...

1. Orgasms relieve stress.

In sexologist Beverly Whipple's book, "The Orgasms Answer Guide," she cites a study done by Carol Rinkleib Ellison in 2000, in which Ellison interviewed 2,632 women between the ages of 23 and 90 and found that 39 percent of those who masturbate reported that they do it in order to relax. Whipple says this is all because of oxytocin. When someone orgasms, she explains in her book, "the hormone oxytocin is released from nerve cells in the hypothalamus (a region of the brain) into the bloodstream."

"Orgasm relives tension as oxytocin stimulates feelings of warmth and relaxation," Ellison herself wrote in an informational report compiled by Planned Parenthood.

Additionally, research gathered in a study by scientists at Groningen University in the Netherlands found that when women experience an orgasm, the amygdala, the part of the brain associated with fear and anxiety, shows little to no activity.

2. An orgasm could make your significant other less likely to cheat.

Researchers in Germany decided to conduct an experiment in 2012 testing the power of oxytocin. They believed that high doses of the "love hormone" would cause men to consider going outside of their relationships, so they gave oxycotin to a group of (heterosexual) men and introduced them to a very attractive woman. The subjects were asked to determine when the attractive woman was at an "ideal distance" or an "uncomfortable distance."

Those who took oxycotin and were in monogamous relationships ended up distancing themselves about four to six inches farther than those who took oxytocin and were single. The researchers hypothesized that instead of oxytocin causing coupled men to cheat, it instead compelled them to hold on tighter to the bond they have already formed with their girlfriends.

3. The female orgasm could make men focus better.

There is so much power in the orgasm that an organization in San Francisco, called One Taste, is devoted to the practice of "orgasmic meditation," in which two partners focus on achieving the female orgasm. Recently, actress and former Playmate, Karen Lorre, revealed to HuffPost Live that she has 11 orgasms a day due to One Taste's new meditation practices. Even men have claimed that they receive health benefits by just pleasuring a woman. In a New York Times article on One Taste, a man confessed that "fixing his attention on a tiny spot of a woman's body improves his concentration at work."

4. Orgasms could help with insomnia.

Would you rather take a sleeping pill or have a mind-blowing orgasm to help you catch some Zzs? We think we know the answer. In her book, Whipple cites another study done by Ellison in which she reported that 32 percent of 1,866 U.S. women said they masturbate in order to facilitate falling asleep.

Why? No one knows for sure, though some researchers and sex therapists theorize that the release of other neurochemicals, like endorphins, can have a sedative effect, reported Self.

5. A man's orgasm could (maybe) make a woman less depressed.

A controversial study of college students in relationships at the State University of New York in Albany showed that women who had sex without condoms had fewer signs of depression than women who used condoms or refrained from sex, even when researchers controlled for relationship status and other personal factors.

What does this mean? Semen, resulting from the male orgasm, could be an effective antidepressant for women. That said, unprotected sex is NOT something we'd recommend -- after all, an STD or unplanned pregnancy can surely also contribute to depression, along with other medical and social risks.

The lead psychologist of the study, Gordon Gallup, told New Scientist that he believes the reason semen has the potential to lift a woman's mood is because of the several mood-altering hormones found in it. Gallup said that most of these hormones were found in the women's blood shortly after ejaculation.

6. Orgasms help alleviate pain.

“There is some evidence that orgasms can relieve all kinds of pain -- including pain from arthritis, pain after surgery and even pain during childbirth,” Lisa Stern, a nurse practitioner who works with Planned Parenthood, told Woman's Day. That's thanks to pain-relieving oxytocin and endorphins, reported MSNBC contributor Brian Alexander. Alexander cited research from Beverly Whipple, who found that women's pain tolerance and pain detection increased by 74.6 percent and 106.7 percent respectively, when those women masturbated to orgasm.

7. They could help men get over their colds faster.

A study at a German university studied 11 men who were asked to masturbate until completion. Blood was drawn continuously throughout the process, and it was discovered that sexual arousal and orgasm increased the number of "killer" cells called leukocytes. This means that when men are sick, an orgasm could initiate components of their immune system that could help them get over that bug sooner.

8. Steady orgasms could help you live longer.

In 1997, a group of researchers in Wales decided to look into the relationship between orgasms and mortality. They studied the sexual frequency of 918 men between the ages of 45 and 59. They evaluated those who died from coronary heart disease and discovered that those who had two or more orgasms a week died at a rate half of those who had orgasms less than once a month. The researchers concluded that "sexual activity seems to have a protective effect on men's health."

While women's orgasms have not been studied as extensively, Howard S. Friedman, PhD, and author of "The Longevity Project: Surprising Discoveries for Health and Long Life," decided to look into research conducted on couples. He cited a marital satisfaction study conducted by Stanford psychologist Lewis Terman in 1941, looking at the sex lives of 1,500 Californian couples. Terman recorded the frequency of orgasms these women had. Twenty years later, Friedman and his colleagues studied the death certificates of each of the women in Terman's study. What they discovered was that the women who reported a frequency of orgasm during intercourse tended to live longer than those who reported being less sexually fulfilled.

9. Orgasms will also stimulate your brain.

Orgasms sure get your blood flowing, and that doesn't exclude blood flow to your brain. In August, Rutgers researchers Barry Komisaruk and Nan Wise, asked female subjects to masturbate while lying in a MRI machine that measured blood flow to the brain. When the females orgasmed, it increased blood flow to all parts of the brain while allowing nutrients and oxygenation to all parts of the brain.


10. Orgasms could keep you looking young.

Forget Botox, just have an orgasm. Dr. David Weeks, a British consultant clinical psychologist and former head of old age psychology at the Royal Edinburgh Hospital, spent 10 years quizzing thousands of men and women of differing ages about their sex lives. He discovered that those between the ages of 40 and 50 who reported having sex 50 percent more than other respondents looked younger. While this study does not explicitly state the specifics as to why orgasms could make you look younger, Weeks says this could be because intercourse releases the human growth hormone, which makes skin look more elastic.

11. They just get better as you age.

There's no reason to stop having sex when you get older. In fact, you are more likely to enjoy it even more as you enter old age. A study in The American Journal of Medicine found that sexual satisfaction in women increases with age. Researchers from the University of California studied 806 women living in a planned community home.

The study measured the sexual activity of these women who had a median age of 67 and were all postmenopausal. The findings reported that sexually satisfaction actually increased with age, with approximately half of the women over 80 years old reporting sexual satisfaction almost always or always.

So, never stop having orgasms!

http://www.huffingtonpost.com/2013/11/05/orgasm-health-benefits_n_4143213.html?utm_hp_ref=mostpopular

[*Anya*]

Dog and human brain link revealed, pet dogs took part in the MRI scanning study

Last updated Feb 20, 2014, 4:52 PM PST

By Rebecca Morelle

Science reporter, BBC World Service

Devoted dog owners often claim that their pets understand them. A new study suggests they could be right.

By placing dogs in an MRI scanner, researchers from Hungary found that the canine brain reacts to voices in the same way that the human brain does.

Emotionally charged sounds, such as crying or laughter, also prompted similar responses, perhaps explaining why dogs are attuned to human emotions.

The work is published in the journal Current Biology.

Lead author Attila Andics, from the Hungarian Academy of Science's Eotvos Lorand University in Budapest, said: "We think dogs and humans have a very similar mechanism to process emotional information."

Eleven pet dogs took part in the study; training them took some time.

"We used positive reinforcement strategies - lots of praise," said Dr Andics.

"There were 12 sessions of preparatory training, then seven sessions in the scanner room, then these dogs were able to lie motionless for as long as eight minutes. Once they were trained, they were so happy, I wouldn't have believed it if I didn't see it."


The canine brain reacted to voices in the same way that the human brain does
For comparison, the team looked at the brains of 22 human volunteers in the same MRI scanners.

The scientists played the people and pooches 200 different sounds, ranging from environmental noises, such as car sounds and whistles, to human sounds (but not words) and dog vocalisations.

The researchers found that a similar region - the temporal pole, which is the most anterior part of the temporal lobe - was activated when both the animals and people heard human voices.

"We do know there are voice areas in humans, areas that respond more strongly to human sounds that any other types of sounds," Dr Andics explained.

"The location (of the activity) in the dog brain is very similar to where we found it in the human brain. The fact that we found these areas exist at all in the dog brain at all is a surprise - it is the first time we have seen this in a non-primate."


The team used a variety of techniques to train the dogs
Emotional sounds, such as crying and laughter also had a similar pattern of activity, with an area near the primary auditory cortex lighting up in dogs and humans.

Likewise, emotionally charged dog vocalisations - such as whimpering or angry barking - also caused a similar reaction in all volunteers,

Dr Andics said: "We know very well that dogs are very good at tuning into the feelings of their owners, and we know a good dog owner can detect emotional changes in his dog - but we now begin to understand why this can be."

However, while the dogs responded to the human voice, their reactions were far stronger when it came to canine sounds.

They also seemed less able to distinguish between environmental sounds and vocal noises compared with humans.

About half of the whole auditory cortex lit up in dogs when listening to these noises, compared with 3% of the same area in humans.

Commenting on the research, Prof Sophie Scott, from the Institute of Cognitive Neuroscience at University College London, said: "Finding something like this in a primate brain isn't too surprising - but it is quite something to demonstrate it in dogs.

"Dogs are a very interesting animal to look at - we have selected for a lot of traits in dogs that have made them very amenable to humans. Some studies have show they understand a lot of words and they understand intentionality - pointing."

But she added: "It would be interesting to see the animal's response to words rather than just sounds. When we cry and laugh, they are much more like animal calls and this might be causing this response.

"A step further would be if they had gone in and shown sensitivity to words in the language their owners speech."

Dr Andics said this would be the focus of his next set of experiments.


BBC © 2014

[*Anya*]

Last updated Feb 23, 2014, 6:28 PM PST

By Toby Macdonald

With every decision you take, every judgement you make, there is a battle in your mind - a battle between intuition and logic.

And the intuitive part of your mind is a lot more powerful than you may think.

Most of us like to think that we are capable of making rational decisions. We may at times rely on our gut instinct, but if necessary we can call on our powers of reason to arrive at a logical decision.

We like to think that our beliefs, judgements and opinions are based on solid reasoning. But we may have to think again.

Prof Daniel Kahneman, from Princeton University, started a revolution in our understanding of the human mind. It's a revolution that led to him winning a Nobel Prize.

His insight into the way our minds work springs from the mistakes that we make. Not random mistakes, but systematic errors that we all make, all the time, without realising.

Prof Kahneman and his late colleague Amos Tversky, who worked at the Hebrew University of Jerusalem and Stanford University, realised that we actually have two systems of thinking. There's the deliberate, logical part of your mind that is capable of analysing a problem and coming up with a rational answer.

This is the part of your mind that you are aware of. It's expert at solving problems, but it is slow, requires a great deal of energy, and is extremely lazy. Even the act of walking is enough to occupy most of your attentive mind.

Daniel Kahneman's insights into the mind spring from the systematic errors we make all the time
If you are asked to solve a tricky problem while walking, you will most likely stop because your attentive mind cannot attend to both tasks at the same time. If you want to test your own ability to pay attention, try the invisible gorilla test devised by Chris Chabris, from Union College, New York, and Daniel Simons from the University of Illinois.

But then there is another system in your mind that is intuitive, fast and automatic. This fast way of thinking is incredibly powerful, but totally hidden. It is so powerful, it is actually responsible for most of the things that you say, do, think and believe.

And yet you have no idea this is happening. This system is your hidden auto-pilot, and it has a mind of its own. It is sometimes known as the stranger within.

Most of the time, our fast, intuitive mind is in control, efficiently taking charge of all the thousands of decisions we make each day. The problem comes when we allow our fast, intuitive system to make decisions that we really should pass over to our slow, logical system. This is where the mistakes creep in.

Our thinking is riddled with systematic mistakes known to psychologists as cognitive biases. And they affect everything we do. They make us spend impulsively, be overly influenced by what other people think. They affect our beliefs, our opinions, and our decisions, and we have no idea it is happening.

It may seem hard to believe, but that's because your logical, slow mind is a master at inventing a cover story. Most of the beliefs or opinions you have come from an automatic response. But then your logical mind invents a reason why you think or believe something.

Dr Laurie Santos studies monkeys to learn how deep seated our biases really are
According to Daniel Kahneman, "if we think that we have reasons for what we believe, that is often a mistake. Our beliefs and our wishes and our hopes are not always anchored in reasons".

Since Kahneman and Tversky first investigated this radical picture of the mind, the list of identified cognitive biases has mushroomed. The "present bias" causes us to pay attention to what is happening now, but not to worry about the future. If I offer you half a box of chocolates in a year's time, or a whole box in a year and a day, you'll probably choose to wait the extra day.

But if I offer you half a box of chocolates right now, or a whole box of chocolates tomorrow, you will most likely take half a box of chocolates now. It's the same difference, but waiting an extra day in a year's time seems insignificant. Waiting a day now seems impossible when faced with the immediate promise of chocolate.

According to Prof Dan Ariely, from Duke University in North Carolina, this is one of the most important biases: "That's the bias that causes things like overeating and smoking and texting and driving and having unprotected sex," he explains.

Confirmation bias is the tendency to look for information that confirms what we already know. It's why we tend to buy a newspaper that agrees with our views. There's the hindsight bias, the halo effect, the spotlight effect, loss aversion and the negativity bias.

This is the bias that means that negative events are far more easily remembered than positive ones. It means that for every argument you have in a relationship, you need to have five positive memories just to maintain an even keel.

We feel the pain of financial loss much more than the pleasure of a gain
The area of our lives where these cognitive biases cause most grief is anything to do with money. It was for his work in this area that Prof Kahneman was awarded the Nobel Prize - not for psychology (no such prize exists) but for economics. His insights led to a whole new branch of economics - behavioural economics.

Kahneman realised that we respond very differently to losses than to gains. We feel the pain of a loss much more than we feel the pleasure of a gain. He even worked out by how much. If you lose £10 today, you will feel the pain of the loss. But if you find some money tomorrow, you will have to find more than £20 to make up for the loss of £10. This is loss aversion, and its cumulative effect can be catastrophic.

One difficulty with the traditional economic view is that it tends to assume that we all make rational decisions. The reality seems to be very different. Behavioural economists are trying to form an economic system based on the reality of how we actually make decisions.

Dan Ariely argues that the implications of ignoring this research are catastrophic: "I'm quite certain if the regulators listened to behavioural economists early on we would have designed a very different financial system, and we wouldn't have had the incredible increase in the housing market and we wouldn't have this financial catastrophe," he says.

These biases affect us all, whether we are choosing a cup of coffee, buying a car, running an investment bank or gathering military intelligence.

Humans aren't the only species that shows loss aversion.

So what are we to do? Dr Laurie Santos, a psychologist at Yale University, has been investigating how deep seated these biases really are. Until we know the evolutionary origins of these two systems of thinking, we won't know if we can change them.

Dr Santos taught a troop of monkeys to use money. It's called monkeynomics, and she wanted to find out whether monkeys would make the same stupid mistakes as humans. She taught the monkeys to use tokens to buy treats, and found that monkeys also show loss aversion - making the same mistakes as humans.

Her conclusion is that these biases are so deep rooted in our evolutionary past, they may be impossible to change.

"What we learn from the monkeys is that if this bias is really that old, if we really have had this strategy for the last 35 million years, simply deciding to overcome it is just not going to work. We need other ways to make ourselves avoid some of these pitfalls," she explained.

We may not be able to change ourselves, but by being aware of our cognitive limitations, we may be able to design the environment around us in a way that allows for our likely mistakes.

Dan Ariely sums it up: "We are limited, we are not perfect, we are irrational in all kinds of ways. But we can build a world that is compatible with this that gets us to make better decisions rather than worse decisions. That's my hope."

HORIZON: How You Really Make Decisions is on Monday 24 February, 9pm, BBC2

BBC © 2014

[*Anya*]

Last updated Feb 27, 2014, 3:03 AM PST

By James Gallagher

Health and science reporter, BBC News

How the creation of babies using sperm and eggs from three people will be regulated in the UK has been announced.

The draft rules will be reviewed as part of a public consultation and could come into force by the end of 2014.

Doctors say three-person IVF could eliminate debilitating and potentially fatal diseases that are passed from mother to child.

Opponents say it is unethical and could set the UK on a "slippery slope" to designer babies.

Using the parents' sperm and eggs plus an additional egg from a donor woman should prevent mitochondrial disease.

Mitochondria are the tiny, biological "power stations" that provide energy to nearly every cell of the body.

One in every 6,500 babies has severe mitochondrial disease leaving them lacking energy, resulting in muscle weakness, blindness, heart failure and even death.

As mitochondria are passed down from mother to child, using an extra egg from a donor woman could give the child healthy mitochondria.

However, it would also result in babies having DNA from two parents and a tiny amount from the donor as mitochondria have their own DNA.

Scientists have devised two techniques that allow them to take the genetic information from the mother and place it into the egg of a donor with healthy mitochondria.

The Department of Health has already backed the technique and says this consultation is not about whether it should be allowed, but how it is implemented.

The regulatory body, the Human Fertilisation and Embryology Authority, will have to decide in each cases that there is a "significant risk" of disability or serious illness.

It is anticipated that only the most severely affected women - perhaps 10 cases per year - would go ahead.

The regulations suggest treating the donor woman in the same manner as an organ donor.

Any resulting children will not be able to discover the identity of the donor, which is the case with other sperm and egg donors.

Prof Doug Turnbull, who has pioneered research in mitochondrial donation at Newcastle University, said: "I am delighted that the government has published the draft regulations.

"This is very good news for patients with mitochondrial DNA disease and an important step in the prevention of transmission of serious mitochondrial disease."

The chief medical officer for England, Prof Dame Sally Davies, said: "Allowing mitochondrial donation would give women who carry severe mitochondrial disease the opportunity to have children without passing on devastating genetic disorders.

"It would also keep the UK at the forefront of scientific development in this area.

"I want to encourage contributions to this consultation so that we have as many views as possible before introducing our final regulations."

Dr David King, the director of Human Genetics Alert, said this was a decision of "major historical significance" which had not been debated adequately.

"If passed, this will be the first time any government has legalised inheritable human genome modification, something that is banned in all other European countries.

"The techniques have not passed the necessary safety tests so it is unnecessary and premature to rush ahead with legalisation.

"The techniques are unethical according to basic medical ethics, since their only advantage over standard and safe egg donation is that the mother is genetically related to her child.

"This cannot justify the unknown risks to the child or the social consequences of allowing human genome modification."

BBC © 2014

http://www.bbc.com/news/health-26367220

[*Anya*]

Last updated Mar 6, 2014, 3:55 AM PST

By James Gallagher

Health and science reporter, BBC News

HIV budding out of a T-cell, part of the immune system.

Doctors have used gene therapy to upgrade the immune system of 12 patients with HIV to help shield them from the virus's onslaught.

It raises the prospect of patients no longer needing to take daily medication to control their infection.

The patients' white blood cells were taken out of the body, given HIV resistance and then injected back in.

The small study, published in the New England Journal of Medicine, suggested the technique was safe.

Some people are born with a very rare mutation that protects them from HIV.

It changes the structure of their T-cells, a part of the immune system, so that the virus cannot get inside and multiply.

The first person to recover from HIV, Timothy Ray Brown, had his immune system wiped out during leukaemia treatment and then replaced with a bone marrow transplant from someone with the mutation.

Now researchers at the University of Pennsylvania are adapting patients' own immune systems to give them that same defence.

Millions of T-cells were taken from the blood and grown in the laboratory until the doctors had billions of cells to play with.

The team then edited the DNA inside the T-cells to give them the shielding mutation - known as CCR5-delta-32.

About 10 billion cells were then infused back in, although only around 20% were successfully modified.

When patients were taken off their medication for four weeks, the number of unprotected T-cells still in the body fell dramatically, whereas the modified T-cells seemed to be protected and could still be found in the blood several months later.

Replacement therapy?
The trial was designed to test only the safety and feasibility of the method, not whether it could replace drug treatment in the long term.


Prof Bruce Levine, the director of the Clinical Cell and Vaccine Production Facility at the University of Pennsylvania, told the BBC: "This is a first - gene editing has not to date been used in a human trial [for HIV].

"We've been able to use this technology in HIV and show it is safe and feasible, so it is an evolution in the treatment of HIV from daily antiretroviral therapy."

He says the aim is to develop a therapy that gets people away from expensive daily medication.

"What if we can now take the leap to an upfront treatment that can last for years?"

Such a treatment will be expensive so any benefit will depend on how long people could be freed from drugs and how long that protection would last.

Prof Levine argues this could be several years, which might save money in the long term.

Commenting on the findings, Prof Sharon Lewin from Monash University in Australia, told BBC News: "The idea of modifying a T-cell to make it resistant and showing it is feasible and they survive - that's exciting in itself.

"What most people are aiming for in HIV is a way you take treatment for a short period of time and that keeps the virus under control."

She said drug treatment would not be replaced by this, especially in the early stages of the infection.

But it might lead to people eventually replacing drugs with an immune upgrade, but "it's still a long way off".

[*Anya*]

March 27, 2014

The two human cases are linked to nine cases of Mycobacterium bovis infection in cats in Berkshire and Hampshire last year.

Both people were responding to treatment, PHE said.

It said the risk of cat-to-human transmission of M. bovis remained "very low"

Dr Dilys Morgan, Public Health England: These are the first documented cases of cat-to-human transmission...”

M. bovis is the bacterium that causes tuberculosis in cattle, known as bovine TB, and other species.

Transmission of M. bovis from infected animals to humans can occur by breathing in or ingesting bacteria shed by the animal or through contamination of unprotected cuts in the skin while handling infected animals or their carcasses.

Screening tests
The nine cases of M. bovis infection in cats in Berkshire and Hampshire were investigated by PHE and the Animal Health and Veterinary Laboratories Agency (AHVLA) during 2013.

The findings of the investigation are published in the Veterinary Record on Thursday

What is tuberculosis?

Tuberculosis (TB) is an infectious disease caused by a germ which usually affects the lungs.

Symptoms can take several months to appear and include

•Fever and night sweats

•Persistent cough

•Losing weight

•Blood in your phlegm or spit

Almost all forms of TB are treatable and curable, but delays in detection and treatment can be damaging.

TB caused by M. bovis is diagnosed in less than 40 people in the UK each year. The majority of these cases are in people over 65 years old.

Overall, human TB caused by M. bovis accounts for less than 1% of the 9,000 TB cases diagnosed in the UK every year.

Those working closely with livestock and/or regularly drinking unpasteurised (raw) milk have a greater risk of exposure.

Public Health England
Screening was offered to people who had had contact with the infected cats. Following further tests, a total of two cases of active TB were identified.

Molecular analysis showed that M. bovis taken from the infected cats matched the strain of TB found in the human cases, indicating that the bacterium was transmitted from an infected cat.

Two cases of latent TB were also identified, meaning they had been exposed to TB at some point, but they did not have the active disease.

PHE said it was not possible to confirm whether these were caused by M. bovis or something else.

No further cases of TB in cats have been reported in Berkshire or Hampshire since March 2013.

'Uncommon in cats'
Dr Dilys Morgan, head of gastrointestinal, emerging and zoonotic diseases department at PHE, said: "It's important to remember that this was a very unusual cluster of TB in domestic cats.

"M. bovis is still uncommon in cats - it mainly affects livestock animals.

"These are the first documented cases of cat-to-human transmission, and so although PHE has assessed the risk of people catching this infection from infected cats as being very low, we are recommending that household and close contacts of cats with confirmed M. bovis infection should be assessed and receive public health advice."

Out of the nine cats infected, six died and three are currently undergoing treatment.

Prof Noel Smith, head of the bovine TB genotyping group at the AHVLA, said testing of nearby herds had revealed a small number of infected cattle with the same strain of M. bovis as the cats.

However, he said direct contact between the cats and these cattle was unlikely.

"The most likely source of infection is infected wildlife, but cat-to-cat transmission cannot be ruled out."

Cattle herds with confirmed cases of bovine TB in the area have all been placed under movement restrictions to prevent the spread of disease.

http://www.bbc.com/news/health-26766006

[*Anya*]

Doctors implant lab-grown vagina

Last updated Apr 10, 2014, 5:45 PM PST

By James Gallagher

Health and science reporter, BBC News

Experts said the study, published in the Lancet, was the latest example of the power of regenerative medicine.

In each woman the vagina did not form properly while they were still inside their mother's womb, a condition known as vaginal aplasia.

Current treatments can involve surgically creating a cavity, which is then lined with skin grafts or parts of the intestine.

The scaffold is made of a biodegradable material

Doctors at Wake Forest Baptist Medical Centre in North Carolina used pioneering technology to build vaginas for the four women who were all in their teenage years at the time.

Scans of the pelvic region were used to design a tube-like 3D-scaffold for each patient.

A small tissue biopsy was taken from the poorly developed vulva and grown to create a large batch of cells in the laboratory.

Muscle cells were attached to the outside of the scaffold and vaginal-lining cells to the inside.

The vaginas were carefully grown in a bioreactor until they were suitable to be surgically implanted into the patients.

One of the women with an implanted vagina, who wished to keep her name anonymous, said: "I believe in the beginning when you find out you feel different.

"I mean while you are living the process, you are seeing the possibilities you have and all the changes you'll go through.

"Truly I feel very fortunate because I have a normal life, completely normal."

'An important thing'

All the women reported normal sexual function.

Vaginal aplasia can lead to other abnormalities in the reproductive organs, but in two of the women the vagina was connected to the uterus.

There have been no pregnancies, but for those women it is theoretically possible.

The scaffold is placed in an incubator

Dr Anthony Atala, director of the Institute for Regenerative Medicine at Wake Forest, told the BBC News website: "Really for the first time we've created a whole organ that was never there to start with, it was a challenge."

He said a functioning vagina was a "very important thing" for these women's lives and witnessing the difference it made to them "was very rewarding to see".

This is the first time the results have been reported. However, the first implants took place eight years ago.

'Most important questions'

Meanwhile, researchers at the University of Basel in Switzerland have used similar techniques to reconstruct the noses of patients after skin cancer.

The other side of the scaffold is coated with smooth muscle cells before it is incubated a second time

It could replace the need to take cartilage from the ribs or ears in order to rebuild the damage caused by cutting the cancer away.

Prof Martin Birchall, who has worked on lab-grown windpipes, commented: "These authors have not only successfully treated several patients with a difficult clinical problem, but addressed some of the most important questions facing translation of tissue engineering technologies.

The steps between first-in-human experiences such as those reported here and their use in routine clinical care remain many, including larger trials with long-term follow-up, the development of clinical grade processing, scale-out, and commercialisation."

BBC © 2014

[Kobi]

REDWOOD CITY, Calif. — Each morning around 6, Mary Ellen Snodgrass swallows a computer chip. It’s embedded in one of her pills and roughly the size of a grain of sand. When it hits her stomach, it transmits a signal to her tablet computer indicating that she has successfully taken her heart and thyroid medications.

“See,” said Snodgrass, checking her online profile page. With a few swipes she brings up an hourly timeline of her day with images of white pills marking the times she ingested a chip. “I can see it go in. The pill just jumped onto the screen.”

Snodgrass — a 91-year-old retired schoolteacher who has been trying out the smart pills at the behest of her son, an employee at the company that makes the technology — is at the forefront of what many predict will be a revolution in medicine powered by miniature chips, sensors, cameras and robots with the ability to access, analyze and manipulate your body from the inside.

As the size and cost of chip technology has fallen dramatically over the past few years, dozens of companies and academic research teams are rushing to make ingestible or implantable chips that will help patients track the condition of their bodies in real time and in a level of detail that they have never seen before.

Several have been approved by the Food and Drug Administration, including a transponder containing a person’s medical history that is injected under the skin, a camera pill that can search the colon for tumors, and the technology, made by Proteus Digital Health, that Snodgrass is using. That system is being used to make sure older people take their pills; it involves navigating a tablet and wearing a patch, which some patients might find challenging.

Scientists are working on more advanced prototypes. Nanosensors, for example, would live in the bloodstream and send messages to smartphones whenever they saw signs of an infection, an impending heart attack or another issue — essentially serving as early-warning beacons for disease. Armies of tiny robots with legs, propellers, cameras and wireless guidance systems are being developed to diagnose diseases, administer drugs in a targeted manner and even perform surgery.

But while the technology may be within reach, the idea of putting little machines into the human body makes some uncomfortable, and there are numerous uncharted scientific, legal and ethical questions that need to be thought through.

What kind of warnings should users receive about the risks of implanting chip technology inside a body, for instance? How will patients be assured that the technology won’t be used to compel them to take medications they don’t really want to take? Could law enforcement obtain data that would reveal which individuals abuse drugs or sell them on the black market? Could what started as a voluntary experiment be turned into a compulsory government identification program that could erode civil liberties?

In 2002, when silicon chips containing their medical records were injected into some Alzheimer’s patients, it was deeply unsettling to privacy advocates. Several states subsequently passed legislation outlawing the forced implantations, and the technology never took off.

Marc Rotenberg, executive director of the Washington-based Electronic Privacy Information Center, said he worries about the coercive use of the chips — whether they are implanted for a few months or permanently, or are swallowed and last in the body only about a day.

“There’s something very troubling about a chip being placed in a person that they can’t remove,” he said.

Proponents of the technology, however, say the devices could save countless lives and billions of dollars in unnecessary medical bills.

Eric Topol is the director of the Scripps Translational Science Institute in La Jolla, Calif., and has written a book about the digital revolution in health care. He said he believes the science is moving so quickly that many of these gadgets will be ready for commercial use within the next five years.

“The way a car works is that it has sensors and it tells you what’s wrong. Why not put the same type of technology in the body? It could warn you weeks or months or even years before something happens,” Topol said.

Refining the technology

The ingestible chip that Snodgrass is using — it was the first smart pill to be approved by the Food and Drug Administration and the European Union, in 2012 and 2010, respectively — is still being tested by a handful of doctors and hospitals, as the company continues to refine its software. Proteus officials say they hope to make it more widely available within the next year.

Britain’s National Health Service has begun using the technology with heart patients to figure out whether it can increase compliance with prescribed medication. Swiss pharmaceutical giant Novartis has said it would seek FDA clearance to use the Proteus chips in the medications it makes for transplant patients to minimize the chance of organ rejection.

In the United States, the focus has been the elderly.

Made entirely of edible ingredients, the one-square-millimeter chip has copper on one side and magnesium on the other, and it is activated when it comes into contact with stomach acids. It’s used in conjunction with a patch, which is shaped like a large Band-Aid and worn on the torso. For five minutes after being swallowed, the chip sends out a unique 16-digit code that is picked up by the patch, which in turn beams the information to a nearby smartphone or tablet — where it can be shared via the Internet with family members, doctors and the company.

The patch contains additional sensors that tracks things such as temperature, heart rate, movement (whether someone is standing, sitting or lying flat) and sleep.

George Savage, a co-founder and chief medical officer of Proteus, said studies show that 50 percent of patients do not take their medications as prescribed and that allowing doctors to see whether patients actually take the drugs — and their reactions to the medicine — could help them figure out better treatments.

“It may be wasteful for an oncologist to see a particular patient every few months. Maybe all they need is a nurse if everything is going well,” Savage said. “Or, maybe if they are not taking their medications, they need a psychologist or social worker instead.”

On a recent weekday, Snodgrass’ son, Doug Webb, a 62-year-old electrical engineer, brought up a Web page with his mother’s name and a slew of charts and numbers. Snodgrass is in good health for her age and pretty good about taking her medications, but she lives alone. Webb worries that she might accidentally skip some doses as she gets older.

“With all the traffic here, I can only make it down to see her once a week, so this is a way for me to check in on her more often,” Webb said.

His mother has been taking the smart pills since December, so Webb knows her schedule well. A few months ago, after Webb’s stepfather was diagnosed with stage 4 colon cancer, Webb could see the effects of that news in his mother’s data: She was sleeping irregularly and sometimes could not get in her daily walk around the golf course near her house because she didn’t want to leave his side. One day, she forgot to take her pills and didn’t realize it until Webb pointed out a gap in her data.

“Sometimes I see very strange numbers and I’ll call her up and say, ‘What’s going on?’ ” he said.

On this day, Webb could see that his mother has taken one set of pills shortly after 6 a.m. and another at 10 a.m. It looked like she had been reading in her chair in the morning as usual and had been pretty active the rest of the day, taking more than 5,000 steps. All in all, he thought, it looked like she had had a good day. But just to make sure, he made it a point to remind himself to call her during his commute home.

http://www.washingtonpost.com/national/health-science/smart-pills-with-chips-cameras-and-robotic-parts-raise-legal-ethical-questions/2014/05/24/6f6d715e-dabb-11e3-b745-87d39690c5c0_story.html

[ProfPacker]

Chicago, Illinois - The American Psychiatric Association (APA) has officially confirmed what many people thought all along: taking ‘selfies’ is a mental disorder.

The APA made this classification during its annual board of directors meeting in Chicago. The disorder is called selfitis, and is defined as the obsessive compulsive desire to take photos of one’s self and post them on social media as a way to make up for the lack of self-esteem and to fill a gap in intimacy.

APA said there are three levels of the disorder:

Borderline selfitis : taking photos of one’s self at least three times a day but not posting them on social media
Acute selfitis: taking photos of one’s self at least three times a day and posting each of the photos on social media
Chronic selfitis: Uncontrollable urge to take photos of one’s self round the clock and posting the photos on social media more than six times a day
According to the APA, while there is currently no cure for the disorder, temporary treatment is available through Cognitive Behavioral Therapy (CBT). The other good news is that CBT is covered under Obamacare.

Read more: http://adobochronicles.com/2014/03/31/american-psychiatric-association-makes-it-official-selfie-a-mental-disorder/

[*Anya*]

Chicago, Illinois - The American Psychiatric Association (APA) has officially confirmed what many people thought all along: taking ‘selfies’ is a mental disorder.

The APA made this classification during its annual board of directors meeting in Chicago. The disorder is called selfitis, and is defined as the obsessive compulsive desire to take photos of one’s self and post them on social media as a way to make up for the lack of self-esteem and to fill a gap in intimacy.

APA said there are three levels of the disorder:

Borderline selfitis : taking photos of one’s self at least three times a day but not posting them on social media
Acute selfitis: taking photos of one’s self at least three times a day and posting each of the photos on social media
Chronic selfitis: Uncontrollable urge to take photos of one’s self round the clock and posting the photos on social media more than six times a day
According to the APA, while there is currently no cure for the disorder, temporary treatment is available through Cognitive Behavioral Therapy (CBT). The other good news is that CBT is covered under Obamacare.

Read more: http://adobochronicles.com/2014/03/31/american-psychiatric-association-makes-it-official-selfie-a-mental-disorder/


Taking Too Many Selfies? Don’t Worry, It’s Not a Disorder
By JOHN M. GROHOL, PSY.D.

A news article was recently published that described how the American Psychiatric Association had classified taking too many selfies as a new mental disorder.

The only problem? It wasn’t true.

Showing that far too many people don’t ever bother to check to see what kind of website they’re on, thousands of people tweeted and posted links to the fake news article. Nobody stopped for a minute to ask, “Hey, is this true? How come no other news website is reporting it?”

Don’t worry — taking too many selfies isn’t a mental disorder.

Selfies are photographs a person takes of oneself, usually with one’s mobile phone. They’ve become all the rage since the advent of smartphones which often have a camera facing the user. This makes taking a self-portrait in-the-moment easy to do.

The fake news article was published to a parody news website ala “The Onion” based in the Philippines called the Adobo Chronicles at the end of March 2014. It began:

The American Psychiatric Association (APA) has officially confirmed what many people thought all along: taking ‘selfies’ is a mental disorder.

The APA made this classification during its annual board of directors meeting in Chicago. The disorder is called selfitis, and is defined as the obsessive compulsive desire to take photos of one’s self and post them on social media as a way to make up for the lack of self-esteem and to fill a gap in intimacy.

Thousands of people read the article, didn’t bother to understand they were reading a parody site, and then tweeted (or retweeted) and posted the link to their Facebook page. The social media mania effect then ensued.

Very few of those people ever got the update or news that the article — and its claim about selfies — was fake.

As regular readers of our site know, the American Psychiatric Association only updates its list of official diagnoses — in the Diagnostic and Statistical Manual of Mental Disorders (DSM) — once every decade or two. It’s a lengthy process and certainly isn’t something decided at a “board of directors meeting.”

Will Selfitis Be a Future Disorder?
All of which begs the question — is there any research into this phenomenon? Could taking too many photographs of oneself actually be a sign of some mental disorder?

The good news is, not any time soon. PsycINFO, the psychology research database, returned zero results for the term “selfie,” meaning not a single research study has been published yet on this phenomenon. ScienceDirect returned 10 results on the term, most of which having to do with space cameras (go figure). PubMed returned a single result, with nothing to do with selfies. Related phrases also turned up nada.1

Since the DSM is only updated upon evidence of a large and confirmatory research base, it’s highly unlikely that we will see a disorder about selfies or called selfitis in the next few decades.

Is there any harm in taking too many photographs of oneself? For most people, probably not. If, however, it’s feeding into one’s pre-existing narcissism or narcissistic tendencies, then yes, it may be only reinforcing those kinds of negative traits.

http://psychcentral.com/blog/archives/2014/05/28/taking-too-many-selfies-dont-worry-its-not-a-disorder/

[ProfPacker]

It was a joke but the APA did go off the deep end by creating the DSM 5

[Kobi]

Proponents of a surgical tool used for a common uterine procedure will argue at a hearing next month that the device's benefits—facilitating a less-invasive operation—make it too important to take it off the market.

But opponents say the device's cancer-spreading risks make it too dangerous, especially for an elective procedure for which there are clear alternatives.

The debate about the tool will come to a head at the Washington-area hearing, where a Food and Drug Administration advisory panel will weigh whether to ban the device—a drastic move the agency has made only once before.

In April, the FDA discouraged gynecologists from using the tool, called a power morcellator, estimating that 1 in 350 women undergoing the procedure have a hidden cancer that can be spread by the instrument.

Morcellators are used in an estimated 50,000 minimally invasive hysterectomies a year in the U.S. to remove often-painful growths called fibroids. The tools slice up the tissue so it can be extracted through tiny incisions.

"There is a real person attached to that number, that 1 in 350 number, and we don't want other women to meet the same fate," said Margaret Jacobson, a doctor and hospice director in Bellingham, Wash., who plans to argue for a ban at the FDA meeting.

Her sister, lawyer Elizabeth Jacobson, died in January 2013 at age 55 after a morcellator was used during her hysterectomy, records show. She had been diagnosed with fibroids but turned out to have cancer.

Others are calling for a more nuanced approach, highlighting the balancing act the FDA faces.

Gynecology groups plan to argue that with more stringent patient selection by doctors, the instrument remains a valuable tool. For instance, women under 35 have an extremely low chance of having uterine sarcoma masquerading as a fibroid, said Hal Lawrence, executive vice president of the American College of Obstetricians and Gynecologists, which puts the overall risk of hidden sarcoma at 1 in 500 women undergoing surgery to remove fibroids.

"It's critical that we not severely restrict treatment options for women who would benefit from minimally invasive gynecology surgery while minimizing the risk for the small number of women who may have an occult or hidden cancer," he said.

Banning an approved medical device involves a protracted regulatory process and is considered a radical move, said lawyers for device makers. The FDA has done it only once, for artificial hair implants.

Nearly all recalls are voluntarily done by manufacturers, though often in response to behind-the-scenes pressure from the agency.

The FDA cleared power morcellators for sale in the 1990s through an expedited process that allows devices similar to ones already on the market to be approved without clinical trials to show safety and effectiveness.

In addition to removing morcellators from the market, as some want, the FDA could take other steps. It said it also will consider reclassifying morcellators as high risk instead of moderate risk, a rare move that would require makers of existing devices to conduct trials to keep their products on the market.

"It could easily just kill the device," said Jeffrey K. Shapiro, a director at Hyman, Phelps & McNamara PC, a Washington, D.C., law firm that represents device manufacturers. Some of these companies wouldn't find it economically worthwhile to do trials, he said.

Johnson & Johnson, JNJ -0.51% by far the largest U.S. manufacturer of power morcellators, halted sales of the device globally in April and says it is awaiting further guidance from the FDA.

The FDA's Obstetrics and Gynecology Devices Panel, which is scheduled to hold the hearing July 10-11, also will explore whether containment bags—used in the body to prevent the spread of harmful tissue—would reduce the risk of spreading cancer and whether to require enhanced warning labels on morcellators.

The FDA isn't obligated to follow the advice of the panel but gives heavy weight to its guidance. "The FDA's primary concern as it considers the continued use of these devices is the safety and well-being of patients," said agency spokeswoman Jennifer Rodriguez.

Underscoring the debate are questions about whether the device is necessary.

Morcellators are most often used in a procedure that spares the cervix, a technique that has been touted as offering sexual and urinary-function benefits. Although that theory has been largely dismissed, the technique is still easier for most physicians to perform than other minimally invasive approaches.

Doctors say that removing the cervix so the uterus can be brought through the vagina—which the main gynecology group considers the preferred method—is particularly challenging.

There are alternatives for fibroid removal, including traditional open surgery—still the most common type of hysterectomy—and other less-invasive techniques, including vaginal surgery and the mini-laparotomy, in which the tissue typically is removed through a small incision above the pubic bone. There also are nonsurgical options.

Some in the gynecological field worry that without morcellators, doctors who lack experience with other less-invasive techniques will turn to open abdominal surgeries, which are linked to bigger scars, longer recoveries and more complications, said Ray Wertheim, director of minimally invasive gynecology at Inova Fair Oaks Hospital in Fairfax, Va.

Dr. Wertheim, who was on a task force to write morcellator guidelines for his specialty's medical society, said the solution is more training for gynecologists. "That's the fine line we're walking here," said Dr. Wertheim, who doesn't use a morcellator. He supports its use only in a containment bag and said he wasn't speaking on behalf of the society.

http://online.wsj.com/articles/showdown-for-surgical-tool-1402958775?mod=WSJ_myyahoo_module

[*Anya*]

Experts: U.S. health care system well-prepared for Ebola
By Jacque Wilson, CNN
updated 10:34 PM EDT, Thu July 31, 2014

NEW: American aid workers are being evacuated from Liberia

NEW: At least one victim will be brought to Emory University near the CDC

American health care system well-prepared for Ebola patients, experts say

(CNN) -- It's not the type of plane either Kent Brantly or Nancy Writebol likely planned to take home.

But when health officials evacuate the two American aid workers infected with Ebola in west Africa, it will be the plane they take.

The Centers for Disease Control and Prevention has outfitted a Gulfstream jet with an isolation pod designed and built by the U.S. Defense Department, the CDC and a private company. The pod, officially called an Aeromedical Biological Containment System, is a portable, tentlike device that ensures the flight crew and others on the flight remain safe from an infectious disease.

Tracking Ebola patient's journey to U.S.

A U.S.-contracted medical charter flight left Cartersville, Georgia, Thursday afternoon, to evacuate the Americans, a source familiar with the travel plans told CNN. At least one of them will be brought to Emory University near the headquarters of the Centers for Disease Control and Prevention in Atlanta, Georgia, hospital officials told CNN's Dr. Sanjay Gupta.

The CDC raised its travel warning for Guinea, Liberia, and Sierra Leone from Level 2 to Level 3 on Thursday, warning against any nonessential travel to the region. Since 2003, the agency has only issued Level 3 alerts on two occasions: during the outbreak of SARS, severe acute respiratory syndrome, in 2003, and in the aftermath of the 2010 Haiti earthquake.

Could Ebola make its way to the U.S.?

The CDC is sending 50 additional personnel to the three countries, CDC director Dr. Tom Frieden said. They will be working to speed up laboratory testing, trace potentially infected people and strengthen the local health care systems.

Ebola is believed to have killed 729 people in Guinea, Liberia, Sierra Leone and Nigeria between March 1 and July 27, according to the World Health Organization. Stopping this particular epidemic could take months. It's like fighting a forest fire, Frieden says -- if you leave even one burning ember, the epidemic can start again.

"It's not going to be quick. It's not going to be easy. But we know what to do."
Evacuating Brantly and Writebol was ultimately up to the aid organizations they work for, Frieden said. Moving them could do more harm than the good that might come with better treatment options in a developed country.

"I can tell you that airplanes are tough environments," said Dr. Lee Norman, chief medical officer at The University of Kansas Hospital. Norman was a flight surgeon for 16 years in the Air Force. "You want to have the shortest trip possible for the best quality medical care. That is as available in Europe as it is in the U.S. It's a matter of how much flight they can handle."

The American health care system is well-prepared for Ebola patients, experts say.

"I think any major medical center can take care of any Ebola patient," said Dr. William Schaffner, an expert on infectious diseases at Vanderbilt University's School of Medicine. "We have isolation rooms we use all the time."

These isolation rooms are used for patients suspected to have tuberculosis, SARS, Middle East respiratory syndrome or another infectious disease. Schaffner said not much would be different for an Ebola patient, though more stringent precautions might be taken to ensure health care workers are following all protocols. "But all that is minor compared to the adjustments you have to make during influenza (season), for example," he said.

The CDC has quarantine stations around the country staffed 24/7. And most hospital staffs have been alerted and are on the lookout for Ebola symptoms, said Dr. Eric Legome, chief of emergency medicine at Kings County Hospital in New York. Symptoms include fever, headache, diarrhea and vomiting. Some patients have trouble breathing.

Doctors are asking patients with these symptoms if they have traveled recently to the three countries primarily affected by the Ebola outbreak: Guinea, Sierra Leone and Liberia. They're also asking if patients have been in contact with anyone else who has traveled to the region lately.

Legome said hospitals have a low threshold to isolate patients, meaning anyone who is even remotely suspected of being infected will immediately be put in an isolated ICU room so health officials can run tests.

"They would most likely be flying in civilian aircraft and seek care in civilian hospitals, urgent care clinics, physicians' offices and emergency departments," said Norman. "That is exactly why this awareness is important for all caregivers."

Ebola is not airborne, he said. It cannot be transmitted via coughs or sneezes. If an infected person is exhibiting symptoms, he or she can transmit the disease via bodily fluids such as blood, breast milk or semen. The virus does not die with a patient -- so deceased bodies can transmit the disease.

There is no specific treatment for Ebola. Doctors can only administer what they call "supportive therapy," which means supporting the patient's own immune system as it tries to battle the infection. This usually involves intravenous fluids to prevent dehydration and shock, said Christopher Mores, associate director of Louisiana State University's Center for Experimental Infectious Diseases. This therapy for Ebola patients could also include blood or platelet transfusions and oxygen therapy.

Ebola can last two to three weeks, Mores said, so patients would remain in isolation until their symptoms subside and tests come back negative for the virus.
CNN's Debra Goldschmidt contributed to this report.

http://www.cnn.com/2014/07/31/health/ebola-isolation-treatment/index.html?iid=article_sidebar

Amid fears that air travelers could spread Ebola to other countries, many are asking questions about the disease and how it is transmitted. Here's what you need to know about Ebola. The information comes from WHO and the U.S. Centers for Disease Control and Prevention.

What is Ebola?

Ebola virus disease, sometimes known as EVD, is a highly infectious, usually fatal virus that leads to flu-like symptoms and severe internal bleeding.

Just how deadly is Ebola?

The survival rate is very low. Somewhere between 60 percent and 90 percent of the people who develop Ebola will die.

What are the symptoms of Ebola?

Ebola is often characterized by the sudden onset of flu-like symptoms including fever, intense weakness, muscle pain, headache and sore throat. These are followed by vomiting, diarrhea, rash, impaired kidney and liver function, and sometimes internal and external bleeding.

http://www.cbsnews.com/news/ebola-q-a-what-you-need-to-know-about-the-deadly-virus/

[*Anya*]

LEADING ANTI-MARIJUANA ACADEMICS ARE PAID BY PAINKILLER DRUG COMPANIES
By Lee Fang Aug 27 2014

As Americans continue to embrace pot—as medicine and for recreational use—opponents are turning to a set of academic researchers to claim that policymakers should avoid relaxing restrictions around marijuana. It's too dangerous, risky, and untested, they say. Just as drug company-funded research has become incredibly controversial in recent years, forcing major medical schools and journals to institute strict disclosure requirements, could there be a conflict of interest issue in the pot debate?

VICE has found that many of the researchers who have advocated against legalizing pot have also been on the payroll of leading pharmaceutical firms with products that could be easily replaced by using marijuana. When these individuals have been quoted in the media, their drug-industry ties have not been revealed.

Take, for example, Dr. Herbert Kleber of Columbia University. Kleber has impeccable academic credentials, and has been quoted in the press and in academic publications warning against the use of marijuana, which he stresses may cause wide-ranging addiction and public health issues. But when he's writing anti-pot opinion pieces for CBS News, or being quoted by NPR and CNBC, what's left unsaid is that Kleber has served as a paid consultant to leading prescription drug companies, including Purdue Pharma (the maker of OxyContin), Reckitt Benckiser (the producer of a painkiller called Nurofen), and Alkermes (the producer of a powerful new opioid called Zohydro).

Kleber, who did not respond to a request for comment, maintains important influence over the pot debate. For instance, his writing has been cited by the New York State Association of Chiefs of Police in its opposition to marijuana legalization, and has been published by the American Psychiatric Association in the organization's statement warning against marijuana for medicinal uses.

Could Kleber's long-term financial relationship with drug firms be viewed as a conflict of interest? Studies have found that pot can be used for pain relief as a substitute for major prescription painkillers. The opioid painkiller industry is a multibillion business that has faced rising criticism from experts because painkillers now cause about 16,000 deaths a year, more than heroin and cocaine combined. Researchers view marijuana as a a safe alternative to opioid products like OxyContin, and there are no known overdose deaths from pot.

Other leading academic opponents of pot have ties to the painkiller industry. Dr. A. Eden Evins, an associate professor of psychiatry at Harvard Medical School, is a frequent critic of efforts to legalize marijuana. She is on the board of an anti-marijuana advocacy group, Project SAM, and has been quoted by leading media outlets criticizing the wave of new pot-related reforms. "When people can go to a ‘clinic’ or ‘cafe’ and buy pot, that creates the perception that it’s safe,” she told the Times last year.

Notably, when Evins participated in a commentary on marijuana legalization for the Journal of Clinical Psychiatry, the publication found that her financial relationships required a disclosure statement, which noted that as of November 2012, she was a "consultant for Pfizer and DLA Piper and has received grant/research support from Envivo, GlaxoSmithKline, and Pfizer." Pfizer has moved aggressively into the $7.3 billion painkiller market. In 2011, the company acquired King Pharmaceuticals (the makers of several opioid products) and is currently working to introduce Remoxy, an OxyContin competitor.

Dr. Mark L. Kraus, who runs a private practice and is a board member to the American Society of Addiction Medicine, submitted testimony in 2012 in opposition to a medical marijuana law in Connecticut. According to financial disclosures, Kraus served on the scientific advisory panel for painkiller companies such as Pfizer and Reckitt Benckiser in the year prior to his activism against the medical pot bill. Neither Kraus or Evins responded to a request for comment.

These academic revelations add fodder to the argument that drug firms maintain quiet ties to the marijuana prohibition lobby. In July, I reported for the Nation that many of the largest anti-pot advocacy groups, including the Community Anti-Drug Coalitions for America, which has organized opposition to reform through its network of activists and through handing out advocacy material (sample op-eds against medical pot along with Reefer Madness-style videos, for example), has relied on significant funding from painkiller companies, including Purdue Pharma and Alkermes. Pharmaceutical-funded anti-drug groups like the Partnership for Drug-Free Kids and CADCA use their budget to obsess over weed while paying lip-service to the much bigger drug problem in America of over-prescribed opioids.

As ProPublica reported, painkiller-funded researchers helped fuel America's deadly addiction to opioids such as OxyContin and Vicodin. These academics, with quiet funding from major pain pill firms, encouraged doctors to over-prescribe these drugs for a range of pain relief issues, leading to where we stand today as the world's biggest consumer of painkillers and the overdose capital of the planet. What does it say about medical academia today that many of that painkiller-funded researchers are now standing in the way of a safer alternative: smoking a joint.

http://www.vice.com/read/leading-anti-marijuana-academics-are-paid-by-painkiller-drug-companies

[Kobi]

Sperm cells have been created from a female human embryo in a remarkable breakthrough that suggests it may be possible for lesbian couples to have their own biological children.

British scientists who had already coaxed male bone marrow cells to develop into primitive sperm cells have now repeated the feat with female embryonic stem cells.

The University of Newcastle team that has achieved the feat is now applying for permission to turn the bone marrow of a woman into sperm which, if successful, would make the method more practical than with embryonic cells.

It raises the possibility of lesbian couples one day having children who share both their genes as sperm created from the bone marrow of one woman could be used to fertilise an egg from her partner.

Men and women differ because of what are called sex chromosomes. Both have an X chromosome. But only men possess a Y chromosome that carries several genes thought to be essential to make sperm, so there has been scepticism that female stem cells could ever be used to make sperm.

In April last year, Prof Karim Nayernia, Professor of Stem Cell Biology at Newcastle University, made headlines by taking stem cells from adult men and making them develop into primitive sperm.

He has now managed to repeat the feat of creating the primitive sperm cells with female embryonic stem cells in unpublished work.

The next step is to make these primitive sperm undergo meiosis, so they have the right amount of genetic material for fertilisation.

Prof Nayernia showed the potential of the method in 2006, when he used sperm derived from male embryonic stem cells to fertilise mice to produce seven pups, six of which lived to adulthood, though the survivors did suffer problems.

He is now optimistic about the prospect of lab-grown sperm from women.

“I think, in principle, it will be scientifically possible,” Prof Nayernia told New Scientist.

He said that he has applied for ethical approval from the university to use bone marrow stem cells from women to start experiments to derive female sperm.

“We are now writing the application form,” he said, adding that experiments will begin in Newcastle if and when they get approval.

However, Dr Robin Lovell-Badge, a stem cell and sex determination expert at the National Institute for Medical Research, Mill Hill, London, doubts it will work: “The presence of two X chromosomes is incompatible with this. Moreover they need genes from the Y chromosome to go through meiosis. So they are at least double-damned.”

In Brazil, a team led by Dr Irina Kerkis of the Butantan Institute in Saõ Paulo claims to have made both sperm and eggs from cultures of male mouse embryonic stem cells in the journal Cloning and Stem Cells.

The researchers have not yet shown that their male eggs can be fertilised to produce viable offspring, but they are thinking about possibilities for same-sex human reproduction.

If all these experiments pan out, then the stage would also be set for a gay man to donate skin cells that could be used to make eggs, which could then be fertilised by his partner’s sperm and placed into the uterus of a surrogate mother.

“I think it is possible,” says Kerkis, “but I don’t know how people will look at this ethically.”

The UK parliament is now debating changes to the 1990 Human Fertilisation and Embryology Act, and the government is under pressure to include an amendment that would allow the future use of eggs and sperm grown in the lab from stem cells.

However, a clause added to this amendment would restrict this to sperm from genetic males and eggs from genetic females.

http://www.telegraph.co.uk/science/science-news/3323846/Sperm-cells-created-from-female-embryo.html

-------------------------------

This fascinates me for 2 reasons.

First, MissTick and I had a conversation a couple of years ago about how the war on the reproductive rights of women and women in general was the result of the development (unbeknownst to us) of synthetic sperm.

Secondly, the feminist community is struggling with surrogacy as detrimental to women as it reduces women to sperm receptacles and baby making machines ala A Handmaid's Tale.

Funny how stuff fits together sometimes.

[*Anya*]

Health editor, BBC News website

Going up several skirt sizes in midlife could be a warning sign of increased cancer risk, research suggests.

Women who went up a skirt size every decade after their mid-20s had a 33% greater risk of breast cancer after the menopause, say researchers at University College London.

Watching your skirt size from your mid-20s onwards could be a simple way to track weight gain, they told BMJ Open.

Obesity is a known risk factor for cancer, particularly midriff fat.

Women are more likely to remember their skirt size when they were younger than their BMI”

Simon Vincent

Breakthrough Breast Cancer
Prof Usha Menon of the Department of Women's Cancer, who led the study, told BBC News: "If skirt size could be confirmed by others as a good predictor of breast cancer risk in older women, this would be a very simple and easy way to monitor weight gain."

Lifestyle factors
The study tracked more than 90,000 women in their 50s and 60s living in England.

During the three-year follow-up period, 1,090 women developed breast cancer.

The researchers found that a unit increase in UK skirt size every 10 years (for example from 12 to 14) between 25 and post-menopausal age was linked to a 33% increased risk of breast cancer.

Going up two skirt sizes in the same period was associated with a 77% greater risk, they report.

Commenting on the research, Simon Vincent of Breakthrough Breast Cancer said: "We know that 40% of breast cancers could be prevented by changes to lifestyle such as being regularly active and maintaining a healthy weight.

"This study highlights an easy way to monitor your weight gain over time. Women are more likely to remember their skirt size when they were younger than their BMI."

Limitations
The researchers said the study had some limitations - it relied on women being able to accurately recall their skirt size in their 20s.

But if the findings are confirmed, it could give women a simple and easy-to-understand message about the risks of obesity.

Tom Stansfeld of Cancer Research UK said the study could be unreliable as dress sizes had changed over the years and it relied on a woman being able to remember her skirt size several decades earlier.

"Evidence tells us the most important things you can do to reduce breast cancer risk, especially after the menopause, is to keep a healthy weight, be physically active as often as you can, and cut down on alcohol," he said.

"Keeping a healthy weight is important to help reduce breast cancer risk after the menopause, and looking at skirt sizes to help women understand this is interesting, but knowing if you're overweight is more important."

http://www.bbc.com/news/health-29351249

[*Anya*]

First womb-transplant baby born

Posted October 4, 2014

By James Gallagher
Health editor, BBC News

A woman in Sweden has given birth to a baby boy using a transplanted womb, in a medical first, doctors report.

The 36-year-old mother, who was born without a uterus, received a donated womb from a friend in her 60s.

The British medical journal The Lancet says the baby was born prematurely in September weighing 1.8kg (3.9lb). The father said his son was "amazing".

Cancer treatment and birth defects are the main reasons women can be left without a functioning womb.

If they want a child of their own, their only option is surrogacy.

Medical marvel

The identity of the couple in Sweden has not been released, but it is known the mother still had functioning ovaries.

He's no different from any other child, but he will have a good story to tell.”

The boy's father

The couple went through IVF to produce 11 embryos, which were frozen. Doctors at the University of Gothenburg then performed the womb transplant.

The donor was a 61-year-old family friend who had gone through menopause seven years earlier.

Drugs to suppress the immune system were needed to prevent the womb being rejected.

A year after the transplant, doctors decided they were ready to implant one of the frozen embryos and a pregnancy ensued.

The baby was born prematurely, almost 32 weeks into the pregnancy, after the mother developed pre-eclampsia and the baby's heart rate became abnormal.

Both baby and mum are now said to be doing well.

In an anonymous interview with the AP news agency, the father said: "It was a pretty tough journey over the years, but we now have the most amazing baby.

"He's no different from any other child, but he will have a good story to tell.

Two other medical teams have attempted womb transplants before.

In one case, the organ became diseased and had to be removed after three months. Another case resulted in miscarriages.

Prof Mats Brannstrom, who led the transplant team, described the birth in Sweden as a joyous moment.

"That was a fantastic happiness for me and the whole team, but it was an unreal sensation also because we really could not believe we had reached this moment.

"Our success is based on more than 10 years of intensive animal research and surgical training by our team and opens up the possibility of treating many young females worldwide that suffer from uterine infertility."

Liza Johannesson, a gynaecological surgeon in the team, said: "It gives hope to those women and men that thought they would never have a child, that thought they were out of hope."

However, there are still doubts about the safety and effectiveness of the invasive procedure.

Dr Brannstrom and his team are working with another eight couples with a similar need. The results of those pregnancy attempts will give a better picture of whether this technique can be used more widely.

Dr Allan Pacey, the chairman of the British Fertility Society, told the BBC News website: "I think it is brilliant and revolutionary and opens the door to many infertile women.

"The scale of it feels a bit like IVF. It feels like a step change. The question is can it be done repeatedly, reliably and safely."

The couple, fresh from celebrating the birth of their child, will soon have to decide if they want a second.

The drugs used to prevent the womb being rejected would be damaging in the long term - so the couple will either try again or have the womb removed.

http://www.bbc.com/news/health-29485996

[SleepyButch]

First womb-transplant baby born

Posted October 4, 2014

By James Gallagher
Health editor, BBC News

A woman in Sweden has given birth to a baby boy using a transplanted womb, in a medical first, doctors report.

The 36-year-old mother, who was born without a uterus, received a donated womb from a friend in her 60s.

The British medical journal The Lancet says the baby was born prematurely in September weighing 1.8kg (3.9lb). The father said his son was "amazing".

Cancer treatment and birth defects are the main reasons women can be left without a functioning womb.

If they want a child of their own, their only option is surrogacy.

Medical marvel

The identity of the couple in Sweden has not been released, but it is known the mother still had functioning ovaries.

He's no different from any other child, but he will have a good story to tell.”

The boy's father

The couple went through IVF to produce 11 embryos, which were frozen. Doctors at the University of Gothenburg then performed the womb transplant.

The donor was a 61-year-old family friend who had gone through menopause seven years earlier.

Drugs to suppress the immune system were needed to prevent the womb being rejected.

A year after the transplant, doctors decided they were ready to implant one of the frozen embryos and a pregnancy ensued.

The baby was born prematurely, almost 32 weeks into the pregnancy, after the mother developed pre-eclampsia and the baby's heart rate became abnormal.

Both baby and mum are now said to be doing well.

In an anonymous interview with the AP news agency, the father said: "It was a pretty tough journey over the years, but we now have the most amazing baby.

"He's no different from any other child, but he will have a good story to tell.

Two other medical teams have attempted womb transplants before.

In one case, the organ became diseased and had to be removed after three months. Another case resulted in miscarriages.

Prof Mats Brannstrom, who led the transplant team, described the birth in Sweden as a joyous moment.

"That was a fantastic happiness for me and the whole team, but it was an unreal sensation also because we really could not believe we had reached this moment.

"Our success is based on more than 10 years of intensive animal research and surgical training by our team and opens up the possibility of treating many young females worldwide that suffer from uterine infertility."

Liza Johannesson, a gynaecological surgeon in the team, said: "It gives hope to those women and men that thought they would never have a child, that thought they were out of hope."

However, there are still doubts about the safety and effectiveness of the invasive procedure.

Dr Brannstrom and his team are working with another eight couples with a similar need. The results of those pregnancy attempts will give a better picture of whether this technique can be used more widely.

Dr Allan Pacey, the chairman of the British Fertility Society, told the BBC News website: "I think it is brilliant and revolutionary and opens the door to many infertile women.

"The scale of it feels a bit like IVF. It feels like a step change. The question is can it be done repeatedly, reliably and safely."

The couple, fresh from celebrating the birth of their child, will soon have to decide if they want a second.

The drugs used to prevent the womb being rejected would be damaging in the long term - so the couple will either try again or have the womb removed.

http://www.bbc.com/news/health-29485996


I saw this yesterday and was just amazed that they had even tried it. I guess we can transplant many different types of organs so why not the uterus. The donor definitely didn't need it.

What surprises me is that the donor had gone through menopause already and with that, the uterus changes. I wonder what they did to make it more viable to host the embryo. I also wonder if the suppression drugs will have any long term affect on the little one. I hope not and that he continues to grow as healthy as he is now.

Again, I am just amazed. Thanks for posting!

[*Anya*]

20 October 2014 Last updated at 21:21 ET

Scientists say they have identified the underlying reason why some people are prone to the winter blues, or seasonal affective disorder (SAD).

People with SAD have an unhelpful way of controlling the "happy" brain signalling compound serotonin during winter months, brain scans reveal.

As the nights draw in, production of a transporter protein ramps up in SAD, lowering available serotonin.

The work will be presented this week at a neuropsychopharmacology conference.

"We don't yet know enough about how serotonin levels can be affected by light levels so this is quite an interesting, albeit small, study. We would welcome more research”

The University of Copenhagen researchers who carried out the trial say their findings confirm what others have suspected - although they only studied 11 people with SAD and 23 healthy volunteers for comparison.

Using positron emission tomography (PET) brain scans, they were able to show significant summer-to-winter differences in the levels of the serotonin transporter (SERT) protein in SAD patients.

The SAD volunteers had higher levels of SERT in the winter months, corresponding to a greater removal of serotonin in winter, while the healthy volunteers did not.

Winter depression
Lead researcher, Dr Brenda Mc Mahon, said: "We believe that we have found the dial the brain turns when it has to adjust serotonin to the changing seasons.

"The serotonin transporter (SERT) carries serotonin back into the nerve cells where it is not active - so the higher the SERT activity, the lower the activity of serotonin.

"Sunlight keeps this setting naturally low, but when the nights grow longer during the autumn, the SERT levels increase, resulting in diminishing active serotonin levels.

"Many individuals are not really affected by SAD, and we have found that these people don't have this increase in SERT activity, so their active serotonin levels remain high throughout the winter."

Prof Siegfried Kasper, of the European College of Neuropsychophar­macology, which this year is holding its annual congress in Berlin, said: "SERT fluctuations associated with SAD have been seen in previous studies, but this is the first study to follow patients through summer and winter comparisons.

"It seems to offer confirmation that SERT is associated with SAD."

Sam Challis, information manager at mental health charity Mind, said: "We don't yet know enough about how serotonin levels can be affected by light levels so this is quite an interesting, albeit small, study. We would welcome more research."

She said there was a range of treatments available for SAD, such as light therapy and cognitive behavioural therapy.

"We know that eating a balanced diet, cutting down on caffeine and getting some exercise can help, as can spending as much time as possible outdoors because - even when it's overcast - light will be higher than indoors."

SAD affects about two million people in the UK, and more than 12 million people across northern Europe.

http://www.bbc.com/news/health-29691479

[Kobi]

(Reuters) - Boston Scientific Corp on Monday was set to face its first federal trials in two courts over claims from women who say they were injured by the company’s transvaginal mesh devices.

One, in Charleston, West Virginia, involves allegations from four women over the company's Obtryx device, used to treat stress urinary incontinence. The other, in Miami, concerns women implanted with the Pinnacle, which treats pelvic organ prolapse.

Boston Scientific has been hit with more than 23,000 suits in U.S. state and federal courts over the devices in the six years since concerns were first publicly raised over the devices. Federal cases against it and six other companies have been consolidated before U.S. District Judge Joseph Goodwin in the Southern District of West Virginia.

Since then, transvaginal mesh has become one of the most sued-over medical devices in U.S. history. Goodwin has said he'll resort to creative tactics, like grouping similar plaintiffs for trial, to keep the cases from dragging on for decades, as litigation for other mass torts like asbestos and tobacco did.

It won't be easy. Together, the three biggest defendants - Boston Scientific, Johnson & Johnson's Ethicon Inc unit and C.R. Bard Inc - face more than 72,000 claims in federal and state courts, according to the companies' regulatory filings.

The U.S. Food and Drug Administration in April said it was considering requiring the makers of products used to treat pelvic organ prolapse to submit additional safety data to remain on the market.

Plaintiffs say the devices were poorly designed, made from substandard material and can lead to injuries ranging from infection and pain to bleeding and nerve damage.

Ethicon and Boston Scientific have both denied liability and said in statements to Reuters that they believe mesh is an important treatment option. C.R. Bard declined to comment.

The nine cases that have gone to trial so far, against Boston Scientific, Ethicon and C.R. Bard, have produced mixed results, with defendants winning some and plaintiffs others. One company, Endo International’s American Medical Systems, announced recently that it would set aside $1.6 billion to settle “substantially all” mesh claims.

The three trials faced by Boston Scientific in state courts have also led to varying outcomes. Two cases in Massachusetts resulted in wins for the company, while a third in Texas ended with a $73 million verdict for the plaintiff, which was later reduced to $34 million under a state law capping damages.

The group trials starting Monday are part of Goodwin's plan to speed up the cases' progress. He has also ordered Boston Scientific and C.R. Bard to each prepare hundreds of cases for trial in courts across the United States starting as early as next year.

While Goodwin originally scheduled a series of single-plaintiff bellwether, or test, trials for the federal litigation, he scrapped those plans earlier this year and instead consolidated claims from multiple women into a single trial. Doing so, he said, would help save courts' time and resources, and “may facilitate settlement” by giving Boston Scientific and plaintiffs a clearer picture of the strengths and weaknesses of their cases.

While not unprecedented, it is unusual for personal-injury cases involving medical devices to proceed with more than one plaintiff at a time, given that individuals may have different medical histories and product experiences.

Boston Scientific fought vigorously against the consolidated trial plan, saying in court filings that each woman’s issues would be obscured by the group setting and prejudice jurors against the company.

A company spokeswoman, Kelly Leadem, declined to comment specifically on the litigation but said in a statement that Boston Scientific is committed to patient safety.

Several plaintiffs’ lawyers for the women headed to trial Monday did not return requests for comment.

Fidelma Fitzpatrick, an attorney at Motley Rice who has represented plaintiffs in other mesh trials against Boston Scientific and Ethicon, said the outcome from the group trials could help Boston Scientific and plaintiffs move closer to a resolution.

“I think that Goodwin has been working hard to try to find an end game for this litigation,” Fitzpatrick said. “The reality is, one case at a time when you’re trying four or five cases a year against a manufacturer isn’t enough to truly put pressure on the defendants."

https://ca.news.yahoo.com/boston-scientific-faces-first-federal-transvaginal-mesh-trials-060340894--finance.html

[SleepyButch]

A third of Fortune 500 companies now cover transgender health care

A new report highlights dramatic changes in how corporations treat trans employees.

By Liz Goodwin


The number of Fortune 500 companies willing pay for sex reassignment surgeries and other transgender-related healthcare has gone from zero in 2002 to 169 this year, according to a new report from the Human Rights Campaign.


The report, which ranks corporations on their treatment of gay, lesbian, bisexual and trans employees, also found that more than half of corporations with more than 500 employees that participated in the survey now cover the procedures. That’s 418 firms.

Some of the biggest names in corporate America are among those who have signed up to cover the procedures, at up to $75,000 per employee. Facebook Inc., Visa, Starbucks Corp., CVS Health Corp. and Anheuser-Busch Companies Inc. are just some of the firms that decided this year to begin covering the procedures for their workers for the first time.

“The jump in terms of employers adopting transgender benefits has been the most dramatic of any single aspect of the Corporate Equality Index in its entire history,” said Deena Fidas, the director of the Human Rights Campaign’s Workplace Equality Program, which has been producing the report for more than a decade.

Ratings in the Corporate Equality Index are derived from a look at five major areas, including: recruiting efforts, whether firms have explicit gender identity and sexual orientation anti-discrimination protections, and if they have extended health care and other benefits to same-sex partners.

While the vast majority of Fortune 500 companies now have nondiscrimination policies that explicitly protect employees from being fired for their gender identity or orientation, companies have moved much more slowly when it comes to covering transgender health care

“Across a lot of the businesses, very well-meaning people were quite anxious about these benefits,” Fidas said. “They wondered if there’d be murmurings among the workforce.”

It took many “uphill conversations” to convince some big employers that transition-related health care is not elective or cosmetic for transgender people, Fidas said.

Such health care can include: sex reassignment surgery, breast augmentation or mastectomy, hormone therapy, short-term leave and counseling.

The vast majority of health insurance plans explicitly ban the coverage of any transition-related care, grouping those procedures with elective cosmetic surgery.

This has slowly begun to change as mainstream medical organizations, including the American Medical Association, have announced new positions in recent years stating that sex reassignment surgery is not elective for some transgender people. (The American Medical Association said in 2008 that “gender dysphoria” is a “serious medical condition” that can result in “suicidality and death” without proper treatment.)

“Transition-related care is absolutely essential to trans people who are seeking to be themselves,” said Lisa Mottet, deputy executive director of the National Center for Transgender Equality. “In many cases, this care is actually life-saving.”

Not every transgender person wants surgery, but having it as an option is crucial, she said.

Some state officials are also beginning to move in that direction. Eight states have banned insurance companies from explicitly excluding surgeries for transgender people, and a handful of states even offer coverage for the procedures through Medicaid.

The Human Rights Campaign says that businesses that have decided to provide the care have not had to increase insurance premiums. The cost has been “so small it’s not quantifiable,” Fidas said. That might be in part because so few people in the country are transgender. The Williams Institute at UCLA estimates the transgender population at one third of one percent.

“There’s not one number that will tell you how many people are transgender in corporate America,” Fidas said. “We’re on the brink of seeing more people being able to be visible in their jobs and to be able to be more open about the fact that they’re transgender.”

Nancy Kelly, the director of compensation and benefits at the Federal Reserve Bank of Atlanta, said larger companies can no longer remain competitive if they are not offering transgender benefits. The bank decided this year to begin to cover transition-related health care services as of Jan 1. Kelly said she is not sure if any of the bank’s 1,200 employees are transgender or will want to access the new benefits when they become available. The Federal Reserve banks of Boston, Cleveland and Richmond also decided to offer the benefits this year.

“It was not a particular employee request, it was more about diversity and inclusion and being a competitive employer,” Kelly said.

A CVS spokeswoman said the company changed its health coverage to include sex reassignment surgery to "provide all colleagues with meaningful choices regarding their health care."


http://news.yahoo.com/a-third-of-fortune-500-companies-now-cover-transgender-health-care-142740785.html

[*Anya*]

Lisa Kaplan Gordon

A common antimicrobial agent called triclosan causes liver fibrosis and cancer in laboratory mice through mechanisms also relevant to humans, researchers at the University of California, San Diego School of Medicine have found

Triclosan's broad use in consumer goods -- including liquid hand soaps, toothpastes, shampoos, cosmetics, plastics, yoga mats, cutting boards and ice cream scoops -- presents "a very real risk of liver toxicity for people, as it does in mice," said Robert H. Tukey, a UC-San Diego professor and co-author of the study, published Monday in Proceedings of the National Academy of Sciences.

Triclosan, a synthetic, broad-spectrum antibacterial chemical, is coming under fire because of its links to endocrine disruption that could cause infertility, impaired muscle function and now increased cancer risks.

It's All Around

The UC-San Diego study showed that mice exposed to triclosan for six months (roughly equivalent to 18 human years) had more and larger chemical-induced liver tumors than mice not exposed to the antimicrobial. Researchers believe triclosan may interfere with the protein responsible for detoxifying foreign chemicals in the body, thereby causing liver cells to proliferate and, over time, become cancerous tumors.

Studies have found traces of triclosan in 97 percent of breast milk samples from lactating women and in the urine of nearly 75 percent of people tested, according to a statement by UC San Diego Health System. Triclosan is also one of the seven most frequently detected compounds in streams across the United States, the statement says.

"We could reduce most human and environmental exposures by eliminating uses of triclosan that are high-volume, but of low-benefit, such as inclusion in liquid hand soaps," said Bruce D. Hammock, professor at University of California, Davis. "Yet we could also for now retain uses shown to have health value -- as in toothpaste, where the amount used is small."

Colgate-Palmolive (CL) recently came under fire because its Total toothpaste contains triclosan. A recent Care2 petition, asking Colgate to remove triclosan from its toothpaste, so far has received almost 68,000 signatures.

Triclosan is already under scrutiny by the U.S. Food and Drug Administration. On its website, the FDA says, "Triclosan is not currently known to be hazardous to humans. But several scientific studies have come out since the last time FDA reviewed this ingredient that merit further review."

http://www.dailyfinance.com/2014/11/21/hand-soap-could-cause-liver-cancer-new-study-says/
__________________________________________________ ______________

National Biomonitoring Program

Triclosan

Triclosan is a chemical with antibacterial properties. For more than 30 years, it has been used in consumer products such as detergents, soaps, skin cleansers, deodorants, lotions, creams, toothpastes, and dishwashing liquids. Triclosan can be added to other materials, such as textiles, to make them resistant to bacterial growth.

How People Are Exposed to Triclosan
People may be exposed to triclosan when they use consumer products containing triclosan. When using these products, a person can absorb small amounts of triclosan through the skin or the mouth.

How Triclosan Affects People's Health
The human health effects from exposure to low environmental levels of triclosan are unknown. Skin products containing triclosan rarely have caused irritation. More research is needed to assess the human health effects of exposure to triclosan.

Levels of Triclosan in the U.S. Population
In the Fourth National Report on Human Exposure to Environmental Chemicals (Fourth Report), CDC scientists measured triclosan in the urine of 2,517 participants aged six years and older who took part in the National Health and Nutrition Examination Survey (NHANES) during 2003–2004. By measuring triclosan in urine, scientists can estimate the amount of triclosan that has entered people's bodies.

Triclosan was detected in the urine of nearly 75% of the people tested.

Finding measurable amounts of triclosan in urine does not imply that the levels of triclosan cause an adverse health effect. Biomonitoring studies on levels of triclosan provide physicians and public health officials with reference values so that they can determine whether people have been exposed to higher levels of triclosan than are found in the general population. Biomonitoring data can also help health scientists plan and conduct research on exposure and health effects.

http://www.cdc.gov/biomonitoring/Triclosan_FactSheet.html

Additional Resources

Environmental Protection Agency Triclosan Facts

http://www.epa.gov/oppsrrd1/REDs/factsheets/triclosan_fs.htm

[*Anya*]

Yale researchers reverse type 2 diabetes and fatty liver disease in rats

By Ziba Kashef

February 26, 20

Yale researchers developed a controlled-release oral therapy that reversed type 2 diabetes and fatty liver disease in rats, according to a study published on Feb. 26 by Science.

Existing therapies for type 2 diabetes, and the closely associated conditions of nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH), have had limited success at treating the root causes of these diseases.

Building on earlier research, the Yale team — led by Dr. Gerald I. Shulman, the George R. Cowgill Professor of Physiological Chemistry, and professor of medicine and cellular & molecular physiology at Yale School of Medicine — decided to investigate whether an agent that had originally been used for weight loss more than 70 years ago could be reformulated to safely treat NAFLD/NASH and type 2 diabetes in rodent models of these diseases.

Based on their earlier studies, the researchers determined that toxicity associated with the agent — mitochondrial protonophore 2,4-dinitrophenol (DNP) — was related to its peak plasma concentrations. They discovered that DNP’s efficacy in reducing liver fat and liver inflammation could be achieved with plasma concentrations that were more than a 100-fold less than the toxic levels.

“Besides reversing fatty liver disease in a rodent model of NALFD, a low-dose intragastric infusion of DNP that was 100-fold lower than toxic levels also significantly reduced blood glucose, triglyceride, and insulin concentrations in a rodent model of NAFLD and type 2 diabetes”, said Shulman, who is also an investigator with the Howard Hughes Medical Institute.

In the next phase of the study, Shulman and his team developed a new oral, controlled-release form of DNP, known as CRMP, which maintained the drug at concentrations that were more than a 100-fold lower than the toxic threshold. Administered once daily, CRMP delivered similar positive results, reversing fatty liver, insulin resistance, and hyperglycemia in rat models of NAFLD and type 2 diabetes, as well as liver inflammation and liver fibrosis in a rodent model of NASH, with no adverse effects.

“Given these promising results in animal models of NAFLD/NASH and type 2 diabetes we are pursuing additional preclinical safety studies to take this mitochondrial protonophore approach to the clinic” said Shulman.

Other Yale authors include Rachel J. Perry, Dongyan Zhang, Xian-Man Zhang, and James L. Boyer.

This research was supported by grants from the National Institutes of Health (R01 DK-40936, R24 DK-085638, U24 DK-059635, T32 DK-101019, P30 DK-45735, P30 DK-34989 and UL1 TR-000142) and the Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark.

Citation: Science

http://news.yale.edu/2015/02/26/yale-researchers-reverse-type-2-diabetes-and-fatty-liver-disease-rats

[*Anya*]

HealthDay News -- A new study finds that treating moderate to severe depression with antidepressants may have an added bonus: reducing cardiovascular risks.

People who took antidepressants alone had a 53% lower risk of death, coronary artery disease, and stroke over three years than those who did not take antidepressants or statins, according to Heidi May, PhD, MSPH, a cardiovascular epidemiologist at the Intermountain Medical Center Heart Institute in Salt Lake City. She and colleagues analyzed health data from 5,311 people in Utah with moderate to severe depression.

Taking a statin, either alone or with antidepressants, did not significantly reduce the risk, the researchers found. The level of depression appeared to be key, May said in an ACC news release. Although antidepressant therapy didn't seem to boost the heart health of people with little or no depression, it did have an effect on those with more serious depression.

The study couldn't prove that the use of antidepressants helped cause a lowering of cardiovascular risks. However, depression is a known risk factor for heart disease, May said.

Her team also did not examine how antidepressants might prevent heart disease. But May theorized that as depressive symptoms ease, people's behaviors might change in ways that help their hearts.

"For example, people who are having depressive symptoms may not be as inclined to exercise, practice good health habits, or comply with health advice," she said. "Using an antidepressant to reduce depressive symptoms might also help people better take care of their heart health."

The findings are scheduled to be presented March 15 at the annual meeting of the American College of Cardiology (ACC), held from March 14 to 16 in San Diego.

http://www.clinicaladvisor.com/treating-depression-helps-reduce-cardiovascular-risk/article/402142/

[*Anya*]

The fight over Medicaid funding for Planned Parenthood moved to Texas this week.

Three days after Gov. Greg Abbott announced his decision to end Medicaid funding for Planned Parenthood, state health department investigators showed up on Thursday at Planned Parenthood health centers in Houston, Dallas, San Antonio and Brownsville with orders to turn over thousands of pages of documents, including patients’ records and employees’ home addresses and telephone numbers.

Some, but not all, of the extensive records sought by the state related specifically to abortion.

For example, Planned Parenthood South Texas was told to produce five years of records — whether electronic, paper or ultrasound — concerning any patients billed to Medicaid who had an abortion in which any part of the fetus was removed or preserved for research use. Planned Parenthood Gulf Coast was to turn over a complete copy of certain patients’ records, including doctors’ orders, nursing notes and lab tests, as well as the center’s appointment books, patient sign-in sheets and contracts.

“We’re concerned about the breadth and depth of what they’re asking for,” said Sarah Wheat, a spokeswoman for Planned Parenthood of Greater Texas.


Rest of article found at:

http://www.nytimes.com/2015/10/24/us/in-planned-parenthood-fight-texas-searches-records-unrelated-to-abortion.html

[*Anya*]

Health | Thu Nov 12, 2015 4:40am ESTRelated: HEALTH
U.S. maternal mortality rate is twice that of Canada: U.N
GENEVA | BY TOM MILES

Women are twice as likely to die from causes related to pregnancy or childbirth in the United States than in Canada, a new global survey of maternal mortality published by the United Nations and the World Bank showed on Thursday.

The United States was also one of only 13 countries to have worse rates of maternal mortality in 2015 than in 1990 - a group that also includes North Korea, Zimbabwe and Venezuela.

The survey, led by the World Health Organization, aims to track progress against the U.N. Millennium Development Goals. It estimated there would be 303,000 maternal deaths globally this year, down from 532,000 in 1990.

The U.N. target is to get the global average number of maternal deaths below 70 per 100,000 live births by 2030, with no country averaging worse than 140.

The United States and other developed countries are already far ahead of the target, but the U.S. average has slipped from 12 deaths to 14 per 100,000 live births over the past 25 years, while Canada's is where it was in 1990, at seven.

Over the same period Belarus has cut its maternal death rate from 33 to four, making it one of the safest places to have a baby, just behind the world leaders - Iceland, Finland, Poland and Greece - where only three mothers die for every 100,000 births.

The world average is 216 deaths, ranging from 12 in rich countries to 546 in sub-Saharan Africa.

http://www.reuters.com/article/2015/11/12/us-health-pregnancy-idUSKCN0T10LO20151112#wrldzzC0OG4OzBic.97

[*Anya*]

Antidepressants taken during pregnancy increase risk of autism by 87 percent

14th December 2015

Researchers came to their conclusion after reviewing data from the outcomes of 145,456 pregnancies.

The study published today in JAMA Pediatrics used data from the Quebec Pregnancy Cohort and studied 145,456 children between the time of their conception up to age ten. The study accounted for a number of other factors that have known links to autism, including genetic predisposition to autism (i.e., a family history of it), maternal age, depression itself, and certain socio-economic factors such as being exposed to poverty. Exposure to antidepressants was defined as the mother having had one or more prescription for antidepressants filled during the second or third trimester of the pregnancy.

Researchers suspect that because serotonin is involved in numerous pre- and postnatal developmental processes, antidepressants that inhibit serotonin (particularly selective serotonin reuptake inhibitors known as SSRIs) will have a negative impact on the ability of the brain to fully develop in-utero.

We spoke with study senior author Professor Anick Bérard, Université de Montréal and the CHU Sainte-Justine Research Centre about the study. The full research team includes: Odile Sheehy, CHU Sainte-Justine, Laurent Mottron, Hôpital Rivière-des-Prairies, and Takoua Boukhris, Université de Montréal.
The study published today in JAMA Pediatrics used data from the Quebec Pregnancy Cohort and studied 145,456 children between the time of their conception up to age ten. The study accounted for a number of other factors that have known links to autism, including genetic predisposition to autism (i.e., a family history of it), maternal age, depression itself, and certain socio-economic factors such as being exposed to poverty. Exposure to antidepressants was defined as the mother having had one or more prescription for antidepressants filled during the second or third trimester of the pregnancy.

Researchers suspect that because serotonin is involved in numerous pre- and postnatal developmental processes, antidepressants that inhibit serotonin (particularly selective serotonin reuptake inhibitors known as SSRIs) will have a negative impact on the ability of the brain to fully develop in-utero.

We spoke with study senior author Professor Anick Bérard, Université de Montréal and the CHU Sainte-Justine Research Centre about the study. The full research team includes: Odile Sheehy, CHU Sainte-Justine, Laurent Mottron, Hôpital Rivière-des-Prairies, and Takoua Boukhris, Université de Montréal.

ResearchGate: What were your results?

Anick Bérard: Using antidepressants, especially selective serotonin reuptake inhibitors (SSRI), during the 2nd/3rd trimesters of pregnancy increases the risk of having a child with autism (87 percent increased risk of autism with any antidepressants; more than doubling the risk with SSRI use specifically) – this risk is above and beyond the risk associated with maternal depression alone (maternal depression was associated with a 20 percent increased risk of autism in our study). Given the mounting evidence showing increased risk of adverse pregnancy outcome with antidepressant use during pregnancy, our study shows that depression should be treated with other options (other than antidepressants) during this critical period.

Indeed, 80-85 percent of depressed pregnant women are mildly to moderately depressed; exercise and psychotherapy have been shown to be efficacious to treat depression in this sub-group. Therefore, we acknowledge that depression is a serious condition but that antidepressants are not always the best solution.

RG: We normally think of the first trimester as being the riskiest time for the fetus, but this study was actually in the second and third trimesters. Why is the risk greater later in pregnancy?

AB: 1st trimester exposure is problematic for embryogenesis; 2nd/3rd trimesters are critical for brain development. Hence, the critical time-window for our study was the later part of the pregnancy.

NOTE: Rest of this important article at research gate, link below:

https://www.researchgate.net/blog/post/antidepressants-taken-during-pregnancy-increase-risk-of-autism-by-87-percent

[*Anya*]

8th December 2015

Long-work hours and stress have potentially dangerous consequences – for doctors and patients.

Researchers analyzed 50+ studies that looked for symptoms of depression in more than 17,500 medical residents. They found that 29 percent of physicians in training had signs of depression. The results of the study published in the Journal of the American Medical Association (JAMA) are worrying for both doctors themselves and their patients.

We speak with the study’s senior author, Srijan Sen, Associate Professor of Psychiatry, University of Michigan who worked with lead author Douglas Mata, of Harvard University to analyze the studies.

ResearchGate: What made you want to study depression among doctors?

Srijan Sen: Going through the experience of physician training ourselves, we noted how stressful the experience was and how many of our colleagues seemed to be suffering from depression.

RG: What were your results?

Sen: In our meta-analysis across 50+ studies, we found that 29 percent of residents screened positive for depression. We also found evidence of a small but significant increase in depression over time, with higher levels of depression among recent residents compared to those who trained decades ago.

RG: What are the signs of depression in new doctors?

Sen: After they start residency training, new doctors experience an increase in a range of depressive symptoms, including low mood and motivation, fatigue, concentration problems and, most concerning, suicidal thoughts.

RG: What do you think leads to depression in doctors?

Sen: There are a number of factors that are likely involved. In particular, the long hours, heavy workload, insufficient and inconsistent sleep and medical errors seem to be playing important roles.

RG: How does depression affect a doctor’s work?

Sen: There is growing evidence from both physicians and the general population that depression strongly affects work functioning. The evidence suggests that doctors who are depressed are substantially more likely to commit medical errors. In turn, medical errors increase the risk of depression in doctors.


RG: Are new doctors working today at a higher risk of depression than previous generations? If not, why?

Sen: The rate of depression appears slightly higher for the current generation of doctors. We do not know the factors behind this increase over time.

RG: What can be done? What should I as a patient do if I suspect that my doctor is depressed?

Sen: At a minimum, we should provide residents and training directors with evidence-based tools that have been shown to be effective in preventing the onset of depression and better access to treatment after depression has developed. To make a more dramatic impact on depression, more systematic changes in the medical education system may be necessary.

https://www.researchgate.net/blog/post/one-in-four-early-career-doctors-have-signs-of-depression

[*Anya*]

I should have added this to the post I made earlier on the article being published in JAMA.

I try to only post studies from reputable, peer reviewed journals or if simply an article, one from an established news source.

That the study referenced by research gate, had over 145 thousand children from conception up to age 10, from the Quebec Pregnancy Cohort and published in JAMA Pediatrcs; is critically important and this information will be difficult to overlook by the naysayers.

[*Anya*]

Medscape Medical News

FDA Campaign Aims to Help Young LGBT Adults Stop Smoking

Pauline Anderson
May 02, 2016

The US Food and Drug Administration (FDA) has launched a smoking prevention campaign aimed at young adult lesbian, gay, bisexual, and transgendered (LGBT) persons who are occasional users of tobacco.

Young adult LGBT persons are nearly twice as likely to use tobacco as other young adults, said Mitch Zeller, JD, director, Center for Tobacco Products (CTP), FDA, during a press briefing to announce the campaign, called This Free Life.

Of the more than 2 million LGBT persons aged 18 to 24 years in the United States, more than 800,000 are occasional or so-called social smokers, according to Dr Zeller.

"Unfortunately, research tells us that LGBT young adults often don't consider themselves to be smokers and don't understand the associated health risks."

The campaign, said Dr Zeller, "is aimed at making LGBT young adults aware that there is no safe amount of smoking and that even an occasional cigarette can have serious health implications and lead to addiction."

The range of negative health outcomes from smoking, such as cancer, heart disease, and respiratory illnesses, can disproportionately affect minority groups such as the LGBT community, said Richard Wolitski, PhD, acting director of the Office for HIV/AIDS and Infectious Disease Policy, US Department of Health and Human Services, during the briefing.

Dr Wolitski, a gay man living with HIV, said he has worked for 30 years to improve gay men's health and prevent HIV, sexually transmitted diseases, and hepatitis infections.

"I have lost too many people to HIV in my life, and I don't want to lose any more due to tobacco use."

The impact of smoking has hit close to home for him ― his husband's father died from lung cancer as a consequence of smoking.

Coming Out

Research shows that LGBT youth "come out" at about the age of 18 years. The coming out process can be stressful and "contribute to actual or perceived social stigma, discrimination, and anxiety," said Dr Wolitski.

"It's a period of increased vulnerability, which can lead to tobacco use and other behaviors with negative health consequences."

Many LGBT young adults find a sense of community at LGBT bars and clubs that sometimes provide an environment conducive to tobacco use. Also, some influential LGBT persons, community bloggers, and YouTube personalities openly promote smoking, "establishing tobacco use as a norm within the LGBT community," said Dr Wolitski.

partnered with persons of influence in the community to challenge the perception that tobacco use is a necessary part of LGBT culture, said Dr Zeller.

The $35.7 million campaign, which will use digital and social media and will include some dating sites, will target 12 markets across the United States in which there is a high concentration of LGBT young adults and where the prevalence of smoking is relatively high.

The $35.7 million campaign is being funded by user fees collected from the tobacco industry, not by taxpayer dollars.


http://www.medscape.com/viewarticle/862738

http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm498544.htm

[Jesse]

Oops didn't mean to post this here. lol I'll move it.

[*Anya*]

The superbug that doctors have been dreading just reached the U.S.

By Lena H. Sun and Brady Dennis May 27 at 1:50 PM

CRE, a family of bacteria pictured here, is considered one of the deadliest superbugs because it causes infections that are often resistant to most antibiotics. (Centers for Disease Control and Prevention/Reuters)
For the first time, researchers have found a person in the United States carrying bacteria resistant to antibiotics of last resort, an alarming development that the top U.S. public health official says could mean “the end of the road” for antibiotics.

The antibiotic-resistant strain was found last month in the urine of a 49-year-old Pennsylvania woman. Defense Department researchers determined that she carried a strain of E. coli resistant to the antibiotic colistin, according to a study published Thursday in Antimicrobial Agents and Chemotherapy, a publication of the American Society for Microbiology. The authors wrote that the discovery “heralds the emergence of a truly pan-drug resistant bacteria.”

Colistin is the antibiotic of last resort for particularly dangerous types of superbugs, including a family of bacteria known as CRE, which health officials have dubbed “nightmare bacteria.” In some instances, these superbugs kill up to 50 percent of patients who become infected. The Centers for Disease Control and Prevention has called CRE among the country’s most urgent public health threats.

Health officials said the case in Pennsylvania, by itself, is not cause for panic. The strain found in the woman is still treatable with other antibiotics. But researchers worry that its colistin-resistance gene, known as mcr-1, could spread to other bacteria that can already evade other antibiotics.

It’s the first time this colistin-resistant strain has been found in a person in the United States. In November, public health officials worldwide reacted with alarm when Chinese and British researchers reported finding the colistin-resistant strain in pigs and raw pork and in a small number of people in China. The deadly strain was later discovered in Europe and elsewhere.

“It basically shows us that the end of the road isn’t very far away for antibiotics — that we may be in a situation where we have patients in our intensive care units, or patients getting urinary-tract infections for which we do not have antibiotics,” CDC Director Tom Frieden said in an interview Thursday.

“I’ve been there for TB patients. I’ve cared for patients for whom there are no drugs left. It is a feeling of such horror and helplessness,” Frieden added. “This is not where we need to be.”

Separately, researchers at the Agriculture Department and the Department of Health and Human Services reported that testing of hundreds of livestock and retail meats turned up the same colistin-resistant bacteria in a sample from a pig intestine in the United States. USDA said it is working to identify the farm the pig came from.

CDC officials are working with Pennsylvania health authorities to interview the patient and family to identify how she may have contracted the bacteria, including reviewing recent hospitalizations and other health-care exposures. The CDC hopes to screen the patient and her contacts to see if others might be carrying the organism. Local and state health departments also will be collecting cultures as part of the investigation.

The woman was treated in an outpatient military facility in Pennsylvania, according to a Defense Department blog post about the findings. Samples were sent to the Walter Reed National Military Medical Center for initial testing. Additional testing was done by a special Defense Department system that tracks multi-drug-resistant organisms.

Thursday’s study did not disclose further details about the Pennsylvania woman or the outcome of her case. The authors could not be reached for comment. A spokesman at the Pennsylvania Department of Health was not immediately available to comment on the case.

NOTE: rest of article can be found with link



https://www.washingtonpost.com/news/to-your-health/wp/2016/05/26/the-superbug-that-doctors-have-been-dreading-just-reached-the-u-s/?tid=pm_national_pop_b

[*Anya*]

Journal of Clinical Psychopharmacology:
June 2015 - Volume 35 - Issue 3 - p 273–278
doi: 10.1097/JCP.0000000000000300


Post-SSRI Sexual Dysfunction: Clinical Characterization and Preliminary Assessment of Contributory Factors and Dose-Response Relationship

Contributors: Ben-Sheetrit, Joseph MD*; Aizenberg, Dov MD*†; Csoka, Antonei B. PhD‡; Weizman, Abraham MD*†; Hermesh, Haggai MD*†

Abstract:

Emerging evidence suggests that sexual dysfunction emerging during treatment with selective serotonin reuptake inhibitors (SSRIs) and/or serotonin-norepinephrine reuptake inhibitors (SNRIs) persists in some patients beyond drug discontinuation (post-SSRI sexual dysfunction [PSSD]). We sought to identify and characterize a series of such cases and explore possible explanatory factors and exposure-response relationship.

Subjects who responded to an invitation in a forum dedicated to PSSD filled out a survey via online software. Case probability was defined according to the following 3 categories of increasing presumed likelihood of PSSD. Noncases did not meet the criteria for possible cases.

Possible cases were subjects with normal pretreatment sexual function who first experienced sexual disturbances while using a single SSRI/SNRI, which did not resolve upon drug discontinuation for 1 month or longer as indicated by Arizona Sexual Experience Scale scores.

High-probability cases were also younger than 50-year-olds; did not have confounding medical conditions, medications, or drug use; and had normal scores on the Hospital Anxiety and Depression Scale.

Five hundred thirty-two (532) subjects completed the survey, among which 183 possible cases were identified, including 23 high-probability cases. Female sex, genital anesthesia, and depression predicted current sexual dysfunction severity, but dose/defined daily dose ratio and anxiety did not.

Genital anesthesia did not correlate with depression or anxiety, but pleasureless orgasm was an independent predictor of both depression and case probability.

Limitations of the study include retrospective design and selection and report biases that do not allow generalization or estimation of incidence.

However, our findings add to previous reports and support the existence of PSSD, which may not be fully explained by alternative nonpharmacological factors related to sexual dysfunction, including depression and anxiety.

http://journals.lww.com/psychopharmacology/pages/articleviewer.aspx?year=2015&issue=06000&article=00011&type=abstract

[*Anya*]

1 in 4 men have genital HPV infections that cause or are linked to cancer

Researchers suggest boosted vaccination as 45% of men overall had some type of HPV.

BETH MOLE - 1/20/2017, 11:31 AM

Nearly half of all men in the US have some type of genital human papillomavirus infection—and about 25 percent have a type linked to cancer, according to a study appearing Thursday in JAMA Oncology.

The study is the first to look at the prevalence of HPV among American men. Much of the past attention paid to HPV has focused on women, because the virus is the cause of nearly every case of cervical cancer in the US. For this reason, health experts have been recommending since 2006 that girls and young women get vaccinated against HPV.

Experts updated that recommendation to include boys and young men in 2011, but the new study shows that few are actually getting those shots—just 10 percent were vaccinated. But with the new prevalence data, the authors suggest that vaccinating men may not only prevent thousands of cancer cases, but it could also be key to stamping out cancer causing-HPV transmission overall.

In the US, HPV is the most common sexually transmitted infection, with 79 million estimated cases. The virus infects skin cells and mucus membranes around the mouth, throat, genitals, and anus. It’s known to cause skin warts and several types of cancer. These include, as mentioned, nearly all cases of cervical cancers. But it also causes vaginal, penile, anal, throat, and mouth cancers.

The tricky thing about HPV and studying its prevalence is that not all types cause cancer. In fact, many cases cause no symptoms at all and clear up on their own—usually between six to 18 months. A lot of people won't even know that they're infected.

Scientists have found more than 100 strains of the virus and only around 18 or so are known to cause or are associated with cancers. That bunch is designated as “high-risk” strains. The “low-risk” strains are those that either come and go without notice or stick around and show up as warts. The latest vaccine can protect against nine strains, seven behind the vast majority of cancers and two that cause 90 percent of all warts.

To get a better grasp at HPV prevalence and types among American men, researchers analyzed penile swabs from a representative group of 1,868 men between the ages of 18 and 59. The researchers, led by cancer experts at the Womack Army Medical Center at Fort Bragg, North Carolina, found that about 45 percent had at least one type of HPV. That represents 34.8 million men nationwide.

DNA tests showed that 25 percent were infected with at least one type of high-risk strain.

The men also showed an unexpected pattern of infection. Among girls and women, those under the age of 20 are the most likely to be infected, with cases dropping off in the older age groups. But for men, incidence increased with age. In fact, the youngest group, 18 to 22 year olds, had the lowest prevalence of just 28.9 percent. This suggests that older men, as well as younger men, would benefit from vaccination.

The study comes on the heels of reports of increases in incidence of mouth and throat cancers among men, which are largely attributed to HPV infections. Although the study only looked for genital infections (not mouth or throat infections), the new data could offer a useful baseline for gauging the success of vaccination campaigns.

Overall, the study authors conclude that “male HPV vaccination may have a greater effect on HPV infection transmission and cancer prevention in men and women than previously estimated." Additionally, “only when vaccination rates are significantly increased will progress be made in eradicating most HPV-related cancers in the United States.”

JAMA Oncology, 2017. DOI: 10.1001/jamaoncol.2016.6192 (About DOIs).

This post has been updated to add information about the current HPV vaccine.

BETH MOLE
Beth is Ars Technica’s health reporter. She’s interested in biomedical research, infectious disease, health policy and law, and has a Ph.D. in microbiology.

EMAIL beth.mole@arstechnica.com // TWITTER @Beth Marie Mole

http://arstechnica.com/science/2017/01/1-in-4-men-have-genital-hpv-infections-that-cause-or-are-linked-to-cancer/

[*Anya*]

NEWS RELEASES | RESEARCH | SOCIAL SCIENCE

February 13, 2017

New findings reveal health, aging experiences of LGBT older adults across nation

In a first-of-its-kind study, researchers from the University of Washington’s School of Social Work have released new findings this month on the health and aging of lesbian, gay, bisexual and transgender older adults in the U.S.

Approximately 2.7 million adults age 50 and older self-identify as lesbian, gay, bisexual or transgender. This number is expected to increase to more than five million by 2060, yet this population is critically understudied. UW researchers have been working to change that through the first longitudinal study of LGBT older adults, called Aging with Pride: National Health, Aging, Sexuality/Gender Study.

“It’s important to understand the health and well-being of LGBT older adults so we can take steps to reduce health disparities,” said principal investigator Karen Fredriksen-Goldsen, professor and director of the UW’s Healthy Generations Hartford Center of Excellence.

“This research highlights pathways to better understand health for all marginalized communities.”

New findings from the longitudinal study, published in a 2017 supplement of The Gerontologist, will increase understanding of the challenges, strengths and needs of this growing yet underserved population. Funded by the National Institute on Aging, the research will help develop community-based interventions to improve the health and well-being of at-risk LGBT older adults.

The team surveyed 2,450 adults aged 50 to 100, studying the impact of historical, environmental, psychological, social, behavioral and biological factors on LGBT adult health and well-being. The 10 articles that make up the supplement focuses on three themes: influence of life events; diversity and subgroup differences; and processes and mechanisms underlying health and quality of life.

The findings reported in the supplement revealed that LGBT older adults are both resilient and at-risk, with higher rates of disability, cardiovascular disease, depression and social isolation. The findings documented how key life events ― including coming out, work and relationships ― are associated with health and quality of life. Articles examined factors such as race/ethnicity, partnership status, resiliency among HIV-positive gay and bisexual men, and transgender older adults with prior military service. The role of social networks, mental health, high-risk alcohol consumption and health care engagement were also studied.

“The insights gleaned from this study of aging among LGBT older adults can deepen our understanding of the richness, diversity and resilience of lives across the life course,” Fredriksen-Goldsen said. “As we move forward in aging-related research, services and policies, it’s important to understand that these communities are diverse, and that unique groups face distinct challenges to their health.”

###

For more information, contact Fredriksen-Goldsen at fredrikk@uw.edu or 206-543-5722.

http://www.washington.edu/news/2017/02/13/new-findings-reveal-health-aging-experiences-of-lgbt-older-adults-across-nation/

[*Anya*]

http://i190.photobucket.com/albums/z144/APRNstudent/nursesweek.jpg

[*Anya*]

News Releases

Chance of Colon Cancer Recurrence Nearly Cut in Half in People Who Eat Nuts

May 17, 2017
Contact
Kelly Baldwin
571-483-1365
Kelly.Baldwin@asco.org

ASCO Perspective
“Basic healthy eating can often be overlooked during cancer treatment. This study shows that something as simple as eating tree nuts may make a difference in a patient’s long-term survival,” said ASCO President Daniel F. Hayes, MD, FACP, FASCO. “Nut consumption and a healthy diet are generally factors that clinicians and patients should perhaps pay attention to as they design the approach to treatment for colorectal cancer.”

ALEXANDRIA, Va. – An observational study of 826 patients with stage III colon cancer showed that those who consumed two ounces or more of nuts per week had a 42% lower chance of cancer recurrence and 57% lower chance of death than those who did not eat nuts.

A secondary analysis revealed the benefit of nut consumption was limited to tree nuts. Tree nuts include almonds, walnuts, hazelnuts, cashews, and pecans, among others. These findings will be presented at the upcoming 2017 ASCO Annual Meeting in Chicago.

“Numerous studies in the fields of heart disease and diabetes have shown the benefits of nut consumption, and we felt that it was important to determine if these benefits could also apply to colorectal cancer patients,” said lead study author Temidayo Fadelu, MD, a clinical fellow in medicine at Dana Farber Cancer Institute. “Patients with advanced disease who benefit from chemotherapy frequently ask what else they can do to reduce their chances of recurrence or death, and our study is an important contribution to the idea that modifying diet and physical activity can be beneficial.”

There was no associated reduction in cancer recurrence and death among patients who consumed peanuts or peanut butter. According to the authors, the reason may be that, being legumes, peanuts have a different metabolic composition than tree nuts. Peanuts are by far the most widely consumed nut in the U.S.

Patients with stage III colon cancer have up to a 70% chance of surviving three years after treatment, which typically includes surgery and/or chemotherapy. While numerous prior studies have looked at diet as a potential cancer prevention tool, this is one of the first in colon cancer to look at the role of nut consumption and its influence on recurrence and mortality, according to the authors.

About the Study
The researchers analyzed a questionnaire from a CALGB clinical trial of patients with stage III colon cancer that began in 1999. The questionnaire, which was given after completion of chemotherapy, asked about dietary intake, including whether or not patients ate nuts and what types of nuts they consumed.

Researchers were particularly interested in nut consumption because it has been linked to lower incidence of obesity, type 2 diabetes, and reduction in insulin resistance. These health conditions represent a state of excess energy and are each associated with a higher risk of recurrence and death from colon cancer.

Key Findings
The authors analyzed the associations between overall nut consumption, and just tree nut consumption, and the risk of cancer recurrence and death. Patients who consumed two or more ounces of all types of nuts per week (19% of all patients in the study) had a 42% lower chance of cancer recurrence and 57% lower chance of death than those patients who did not eat nuts after completion of their cancer treatment. The benefit of eating nuts was consistent across known factors that can influence cancer recurrence, including patient age, body mass index, gender, and common genomic changes in the tumor.

When looking at just tree nut consumption, the chance of recurrence was 46% lower and the chance of death was 53% lower for those that ate at least two ounces per week, than for those who did not. Given that there was no significant reduction in cancer recurrence or death for those that ate peanuts or peanut butter, the authors conclude that in this study, the benefit is likely limited to tree nuts. More research is needed to understand the lack of association with peanuts.

“It should be emphasized that the authors are not suggesting that eating nuts should be considered a substitute for standard chemotherapy and other treatments for colon cancer, which have dramatically improved survival,” said Dr. Hayes. “Rather, patients with colon cancer should be optimistic, and they should eat a healthy diet, including tree nuts, which may not only keep them healthier, but may also further decrease the chances of the cancer coming back.”

Next Steps
“We need to look at the potential positive impact of nut consumption on survival at other stages of colon cancer, particularly stage IV. Ultimately, we need to understand how nuts confer this protective effect, as well as possibly conduct a randomized, controlled clinical trial where diet recommendations are given at the start of the study to prove that tree nuts can reduce recurrence and death after treatment for colon cancer,” said Dr. Fadelu.

This study was funded by the National Cancer Institute, of the National Institutes of Health, and Pfizer.

View the full abstract.

For your readers:

Guide to Colorectal Cancer
Food and Cancer Prevention
View the disclosures for the 2017 ASCO Annual Meeting News Planning Team.

Disclosures for Daniel F. Hayes, MD, FACP, FASCO: Stock and Other Ownership Interests with OncoImmune and InBiomotion; Honoria from Lilly; Research Funding with Janssen Research & Development (Inst.), AstraZeneca (Inst.), Puma Biotechnology (Inst.), Pfizer (Inst.), Lilly (Inst.), and Merrimack Pharmaceuticals/Parexel International Corporation (Inst.); Patents, Royalties and Other Intellectual Property with royalties from licensed technology to Janssen Diagnostics regarding circulating tumor cells; Travel, Accommodations, Expenses from Janssen Diagnostics.

Disclosures for Bruce E. Johnson, MD, FASCO: Stock and Other Ownership Interests with KEW Group; Honoraria from Chugai Pharma and Merck; Consulting or Advisory Role with Amgen, AstraZeneca, Boehringer Ingelheim, Chugai Pharma, Clovis Oncology, Genentech, GlaxoSmithKline, KEW Group, Lilly, Merck, Novartis, and Transgene; Research Funding from Novartis (Inst.); Expert Testimony for Genentech.

ATTRIBUTION TO THE AMERICAN SOCIETY OF CLINICAL ONCOLOGY ANNUAL MEETING IS REQUESTED IN ALL COVERAGE.

###

About ASCO:
Founded in 1964, the American Society of Clinical Oncology, Inc. (ASCO®) is committed to making a world of difference in cancer care. As the world’s leading organization of its kind, ASCO represents more than 40,000 oncology professionals who care for people living with cancer. Through research, education, and promotion of the highest-quality patient care, ASCO works to conquer cancer and create a world where cancer is prevented or cured, and every survivor is healthy. ASCO is supported by its affiliate organization, the Conquer Cancer Foundation. Learn more at www.ASCO.org, explore patient education resources at www.Cancer.Net, and follow us on Facebook, Twitter, LinkedIn, and YouTube.

http://www.asco.org/about-asco/press-center/news-releases/chance-colon-cancer-recurrence-nearly-cut-half-people-who-eat

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[Kätzchen]

News Releases

Chance of Colon Cancer Recurrence Nearly Cut in Half in People Who Eat Nuts

May 17, 2017
Contact
Kelly Baldwin
571-483-1365
Kelly.Baldwin@asco.org

ASCO Perspective
“Basic healthy eating can often be overlooked during cancer treatment. This study shows that something as simple as eating tree nuts may make a difference in a patient’s long-term survival,” said ASCO President Daniel F. Hayes, MD, FACP, FASCO. “Nut consumption and a healthy diet are generally factors that clinicians and patients should perhaps pay attention to as they design the approach to treatment for colorectal cancer.”

ALEXANDRIA, Va. – An observational study of 826 patients with stage III colon cancer showed that those who consumed two ounces or more of nuts per week had a 42% lower chance of cancer recurrence and 57% lower chance of death than those who did not eat nuts.

A secondary analysis revealed the benefit of nut consumption was limited to tree nuts. Tree nuts include almonds, walnuts, hazelnuts, cashews, and pecans, among others. These findings will be presented at the upcoming 2017 ASCO Annual Meeting in Chicago.

“Numerous studies in the fields of heart disease and diabetes have shown the benefits of nut consumption, and we felt that it was important to determine if these benefits could also apply to colorectal cancer patients,” said lead study author Temidayo Fadelu, MD, a clinical fellow in medicine at Dana Farber Cancer Institute. “Patients with advanced disease who benefit from chemotherapy frequently ask what else they can do to reduce their chances of recurrence or death, and our study is an important contribution to the idea that modifying diet and physical activity can be beneficial.”

There was no associated reduction in cancer recurrence and death among patients who consumed peanuts or peanut butter. According to the authors, the reason may be that, being legumes, peanuts have a different metabolic composition than tree nuts. Peanuts are by far the most widely consumed nut in the U.S.

Patients with stage III colon cancer have up to a 70% chance of surviving three years after treatment, which typically includes surgery and/or chemotherapy. While numerous prior studies have looked at diet as a potential cancer prevention tool, this is one of the first in colon cancer to look at the role of nut consumption and its influence on recurrence and mortality, according to the authors.

About the Study
The researchers analyzed a questionnaire from a CALGB clinical trial of patients with stage III colon cancer that began in 1999. The questionnaire, which was given after completion of chemotherapy, asked about dietary intake, including whether or not patients ate nuts and what types of nuts they consumed.

Researchers were particularly interested in nut consumption because it has been linked to lower incidence of obesity, type 2 diabetes, and reduction in insulin resistance. These health conditions represent a state of excess energy and are each associated with a higher risk of recurrence and death from colon cancer.

Key Findings
The authors analyzed the associations between overall nut consumption, and just tree nut consumption, and the risk of cancer recurrence and death. Patients who consumed two or more ounces of all types of nuts per week (19% of all patients in the study) had a 42% lower chance of cancer recurrence and 57% lower chance of death than those patients who did not eat nuts after completion of their cancer treatment. The benefit of eating nuts was consistent across known factors that can influence cancer recurrence, including patient age, body mass index, gender, and common genomic changes in the tumor.

When looking at just tree nut consumption, the chance of recurrence was 46% lower and the chance of death was 53% lower for those that ate at least two ounces per week, than for those who did not. Given that there was no significant reduction in cancer recurrence or death for those that ate peanuts or peanut butter, the authors conclude that in this study, the benefit is likely limited to tree nuts. More research is needed to understand the lack of association with peanuts.

“It should be emphasized that the authors are not suggesting that eating nuts should be considered a substitute for standard chemotherapy and other treatments for colon cancer, which have dramatically improved survival,” said Dr. Hayes. “Rather, patients with colon cancer should be optimistic, and they should eat a healthy diet, including tree nuts, which may not only keep them healthier, but may also further decrease the chances of the cancer coming back.”

Next Steps
“We need to look at the potential positive impact of nut consumption on survival at other stages of colon cancer, particularly stage IV. Ultimately, we need to understand how nuts confer this protective effect, as well as possibly conduct a randomized, controlled clinical trial where diet recommendations are given at the start of the study to prove that tree nuts can reduce recurrence and death after treatment for colon cancer,” said Dr. Fadelu.

This study was funded by the National Cancer Institute, of the National Institutes of Health, and Pfizer.

View the full abstract.

For your readers:

Guide to Colorectal Cancer
Food and Cancer Prevention
View the disclosures for the 2017 ASCO Annual Meeting News Planning Team.

Disclosures for Daniel F. Hayes, MD, FACP, FASCO: Stock and Other Ownership Interests with OncoImmune and InBiomotion; Honoria from Lilly; Research Funding with Janssen Research & Development (Inst.), AstraZeneca (Inst.), Puma Biotechnology (Inst.), Pfizer (Inst.), Lilly (Inst.), and Merrimack Pharmaceuticals/Parexel International Corporation (Inst.); Patents, Royalties and Other Intellectual Property with royalties from licensed technology to Janssen Diagnostics regarding circulating tumor cells; Travel, Accommodations, Expenses from Janssen Diagnostics.

Disclosures for Bruce E. Johnson, MD, FASCO: Stock and Other Ownership Interests with KEW Group; Honoraria from Chugai Pharma and Merck; Consulting or Advisory Role with Amgen, AstraZeneca, Boehringer Ingelheim, Chugai Pharma, Clovis Oncology, Genentech, GlaxoSmithKline, KEW Group, Lilly, Merck, Novartis, and Transgene; Research Funding from Novartis (Inst.); Expert Testimony for Genentech.

ATTRIBUTION TO THE AMERICAN SOCIETY OF CLINICAL ONCOLOGY ANNUAL MEETING IS REQUESTED IN ALL COVERAGE.

###

About ASCO:
Founded in 1964, the American Society of Clinical Oncology, Inc. (ASCO®) is committed to making a world of difference in cancer care. As the world’s leading organization of its kind, ASCO represents more than 40,000 oncology professionals who care for people living with cancer. Through research, education, and promotion of the highest-quality patient care, ASCO works to conquer cancer and create a world where cancer is prevented or cured, and every survivor is healthy. ASCO is supported by its affiliate organization, the Conquer Cancer Foundation. Learn more at www.ASCO.org, explore patient education resources at www.Cancer.Net, and follow us on Facebook, Twitter, LinkedIn, and YouTube.

http://www.asco.org/about-asco/press-center/news-releases/chance-colon-cancer-recurrence-nearly-cut-half-people-who-eat

Related News Releases

More Cancers Diagnosed at Early Stage Following Increase in Health Insurance Coverage
May 17, 2017
Healthy Lifestyle After Colon Cancer Diagnosis Helps Patients Live Longer
May 17, 2017
Oral Chemotherapy Extends Survival by More Than a Year in Biliary Tract Cancer
May 17, 2017
HPV Vaccination May Reduce Oral HPV Infections – But Still Under-Utilized
May 17, 2017
Targeted Therapy Can Delay Recurrence of Intermediate-Stage Lung Cancer
May 17, 2017
Related Tags

This is awesome to read about Anya and I'm glad you found this article. I know personally, since expanding my own diet to include an variety of nuts (almonds, peanuts, Walnuts, cashews, hazelnuts and Brazil nuts), that eating nuts has really improved how my body works. Maybe the reason that nuts have such a positive impact on our general health is because of how rich nuts are in minerals, vitamins, fiber and protein? And maybe too, the fact that eating nuts aids in keeping your digestive health in optimal condition? Loved reading the article you found, thanks!

[*Anya*]

NewsHealth

HIV treatment breakthrough creates antibody that attacks 99 per cent of virus' strains

Pathogen kills more than one million people each year around the world

Tom Embury-Dennis @tomemburyd Friday 22 September 2017 19:30 BST

Picture of a cell infected by HIV particles

https://static.independent.co.uk/s3fs-public/styles/article_medium/public/thumbnails/image/2017/07/24/09/hiv-virus.jpg

An antibody that attacks 99 per cent of HIV strains has been developed by scientists for the first time.

The “exciting breakthrough” could eventually lead to treatment or even prevent transmission of the virus, with trials on humans due to get underway in 2018.

Experiments on 24 monkeys injected with HIV showed none developed the virus after first being given the new type of antibody, which attacks three critical parts of the disease.

The human immune system struggles to deal with HIV due to its ability to mutate and change appearance. Our bodies eventually become overwhelmed by the number of different strains of the virus.

But around one per cent of patients have the ability to develop “broadly neutralising antibodies”. These bind to structures on the surface of the pathogens known as “spikes”.

Spikes barely change and are identical among different strains, making it possible for these special antibodies to attack different mutations of the virus.

Now scientists have managed to combine three of these flexible antibodies into a powerful “tri-specific antibody”.

Dr Gary Nabel, chief scientific officer at pharmaceutical company Sanofi and one of the report authors, told the BBC the results were “impressive”.

“They are more potent and have greater breadth than any single naturally occurring antibody that's been discovered," he said.

"We're getting 99 per cent coverage, and getting coverage at very low concentrations of the antibody.”

An estimated 36.7 million people worldwide were living with HIV or AIDS at the end of 2015, with the majority in sub-Saharan Africa. Of these, only 60 per cent of people are aware they have it.

In 2015 alone 1.1 million people died from the disease.

The study was published in the journal Science, and is a collaboration between the US National Institutes of Health and Sanofi.

The research included contributions from scientists at Harvard Medical School, The Scripps Research Institute and the Massachusetts Institute of Technology.

http://www.independent.co.uk/news/health/hiv-antibody-treatment-aids-99-per-cent-virus-treatment-breakthrough-cure-prevention-science-a7962276.html

[*Anya*]

FDA OKs a blood sugar monitor that doesn't need fingerpricks

You just need to insert a tiny wire sensor under your skin.

Mariella Moon, @mariella_moon

4h ago in Medicine


https://o.aolcdn.com/images/dims?quality=100&image_uri=http%3A%2F%2Fo.aolcdn.com%2Fhss%2Fstorag e%2Fmidas%2F8f92624a12516eff4b7c53823232aec3%2F205 717923%2Ffreestyle-pro01.jpg&client=cbc79c14efcebee57402&signature=17cf60c7ba6db0197b62133505bef239e4aba185

A fingerprick isn't just a fingerprick when you have to do it all the time to test your blood sugar levels. Thankfully, the Food and Drug Administration has approved the first continuous glucose monitoring system for adults that doesn't require you to draw blood several times a day.

Abbott's FreeStyle Libre Flash Glucose Monitoring System works by inserting a tiny sensor wire below the surface of your skin. The wire needs 12 hours to start up, but once it's ready, you can simply pass a mobile reader over it to read your glucose levels. It even works for 10 days before you have to replace it.

FDA's Donald St. Pierre explained that the agency has always been welcome to new technologies that can help people manage chronic conditions. "This system," he said, "allows people with diabetes to avoid the additional step of fingerstick calibration, which can sometimes be painful, but still provides necessary information for treating their diabetes -- with a wave of the mobile reader."

Abbott already has a similar system available called the FreeStyle Libre Pro, but you need a doctor's help to use it and to activate the sensor wire under your skin. You don't need a doctor's help to determine if your sugar levels are too low, too high or just right with the Flash, but you have to be 18 and older to be able to get it.

Coverage: Reuters
In this article: abbott, freestylelibreflash, gear, GlucoseMonitoring, medicine

https://www.engadget.com/2017/09/28/fda-freestyle-libre-flash/

[*Anya*]

Aaron Hernandez suffered from most severe CTE ever found in a person his age

By Adam Kilgore November 9, 2017 at 3:50 PM

BOSTON — Aaron Hernandez suffered the most severe case of chronic traumatic encephalopathy ever discovered in a person his age, damage that would have significantly affected his decision-making, judgment and cognition, researchers at Boston University revealed at a medical conference Thursday.

Ann McKee, the head of BU’s CTE Center, which has studied the disease caused by repetitive brain trauma for more than a decade, called Hernandez’s brain “one of the most significant contributions to our work” because of the brain’s pristine condition and the rare opportunity to study the disease in a 27-year-old.

Hernandez, a former New England Patriots tight end, hanged himself with a bedsheet in April in a Massachusetts prison while serving a life sentence for the murder of his friend Odin Lloyd in 2013.

In a diagnosis that linked one of football’s most notorious figures with the sport’s most significant health risk, doctors found Hernandez had Stage 3 CTE, which researchers had never seen in a brain younger than 46 years old, McKee said. Because the center has received few brains from people Hernandez’s age, McKee could not say whether Hernandez’s brain was representative of a 27-year-old who had played football as much as Hernandez. But she found the advanced stage of CTE alarming.

“In this age group, he’s clearly at the severe end of the spectrum,” McKee said. “There is a concern that we’re seeing accelerated disease in young athletes. Whether or not that’s because they’re playing more aggressively or if they’re starting at younger ages, we don’t know. But we are seeing ravages of this disease, in this specific example, of a young person.”

At Thursday’s conference, McKee flipped through slides comparing sections of Hernandez’s brain to a sample without CTE. Hernandez’s brain had dark spots associated with tau protein and shrunken, withered areas, compared to immaculate white of the sample. His brain had significant damage to the frontal lobe, which impacts a person’s ability to make decisions and moderate behavior. As some new slides appeared on the projectors, some physicians and conference attendees gasped.

“We can’t take the pathology and explain the behavior,” McKee said. “But we can say collectively, in our collective experience, that individuals with CTE, and CTE of this severity, have difficulty with impulse control, decision-making, inhibition of impulses for aggression, emotional volatility, rage behaviors. We know that collectively.”

McKee said Hernandez had a genetic marker that makes people vulnerable to certain brain diseases and could have contributed to how aggressively he developed CTE.

“We know that that’s a risk factor for neurogenerative disease,” McKee said. “Whether or not that contributed in this case is speculative. It may explain some of his susceptibility to this disease.”

The condition of Hernandez’s brain, pristine because of his age and the adept handling of medical examiners, could lead to future breakthroughs and better understanding of CTE. For example, researchers could better study the interaction of inflammation and tau pathology through the use of fluorescent stains. It gave researchers their best view yet of a marker associated with CTE.

“We are able to understand this disease at the scientific level in a way that’s very rarely presented,” McKee said. “We’re very grateful to the family for making this donation. We’re hoping this will advance medical science in a very significant way. . . . This will really accelerate and advance our research going forward.”

Medical examiners delivered Hernandez’s brain, weighing 1,573 grams, to BU’s labs in April. From the outside, it looked like a typical brain — no lesions, no bruises, no abnormalities. When researches sliced the brain into sections, they discovered startling damage.

Ventricles were dilated, in response to the brain shrinking. Researchers determined Hernandez had lost brain tissue. Membranes that were supposed to be firm had grown “thin and gelatinous,” McKee said. There were abnormal, large holes in parts of Hernandez’s bran.

The hippocampus, which plays a key role in memory, had shrunk.

The fornix, which also contributes to memory function, had atrophied.

The frontal lobe, which is responsible for problem-solving, judgment, impulse control and social behavior, had been pockmarked with tau protein.

The amygdala, which produces emotional regulation, emotional behavior, fear and anxiety, had been severly affected.

The temporal lobes, which process sights and sounds, showed significant damage.

Together, they were “very unusual findings in an individual of this age,” McKee said. “We’ve never seen this in our 468 brains, except in individuals some 20 years older.”

The physical damage inside Hernandez’s brain provides another layer to the catastrophic and tragic downfall of Hernandez, a gifted player who caught a touchdown pass from Tom Brady in the 2012 Super Bowl.

Hernandez grew up a football star in Connecticut and fell in with a rough crowd at age 15, after his father died unexpectedly during a routine operation. He starred at Florida even as off-field trouble, in the form of drugs and violence, dogged him. The problems caused some teams to remove him from consideration in the NFL draft, and he lasted until the Patriots plucked him in the fourth round.

Hernandez formed a dominating tandem with fellow 2010 draftee Rob Gronkowski and convinced the Patriots he had straightened out his life. The Patriots signed him to a seven-year, $40-million contract after the 2012 season. Months later, in the summer of 2013, Lloyd was murdered in the summer of 2013, his body found in a gravelly field a mile away from Hernandez’s mansion in North Attleboro.

Hernandez’s estate filed a federal lawsuit against the Patriots in September, alleging the Patriots knew hits to the head could lead to brain damage and failed to protect him.

A jury convicted Hernandez of the killing in 2015. Hernandez hanged himself in his cell just four days after a jury had acquitted him of the murders of Daniel de Abreu and Safiro Furtado, two strangers whom the state argued Hernandez killed in 2012 after an altercation at a Boston club.

BU researchers say they have discovered CTE in more than 100 former NFL players, a handful of whom have committed suicide. The extent of damage in Hernandez’s brain represents another signpost in football’s ongoing concussion crisis. Thursday’s news conference coincided with the release of an NFL study consisting of video reviews of the 459 known concussions that occurred over the 2015 and 2016 seasons, from preseason games through the playoffs

The NFL has attempted to make the sport safer for its players, through rule changes, policies designed to remove concussed players and technologic advances. But brain trauma occurs when a football player’s brain accelerates or decelerates after it hits another player or the turf, bashing the sides of the head, an action a helmet is defenseless against.

“It happens inside the skull,” McKee said. “It’s an intrinsic component of football.”

https://www.washingtonpost.com/sports/aaron-hernandez-suffered-from-most-severe-cte-ever-found-in-a-person-his-age/2017/11/09/fa7cd204-c57b-11e7-afe9-4f60b5a6c4a0_story.html?tid=pm_pop&utm_term=.d7191a3753d1




https://img.washingtonpost.com/rf/image_480w/2010-2019/WashingtonPost/2017/11/09/Sports/Images/AH-brain1510254001.jpg?uuid=M6Cx3MWAEeeZIkFR9cphaA

Normal 27-year-old's brain and Aaron Hernandez's brain. (Boston University School of Medicine/Boston University School of Medicine)

[*Anya*]

No Excuses, People: Get the New Shingles Vaccine

By Paula Span NOV. 10, 2017

Medical researchers and government health policymakers, a cautious lot, normally take pains to keep expectations modest when they’re discussing some new finding or treatment.

They warn about studies’ limitations. They point out what isn’t known. They emphasize that correlation doesn’t mean causation.

So it’s startling to hear prominent experts sound positively excited about a new shingles vaccine that an advisory committee to the Centers for Disease Control and Prevention approved last month.

“This really is a sea change,” said Dr. Rafael Harpaz, a veteran shingles researcher at the C.D.C.

Dr. William Schaffner, preventive disease specialist at the Vanderbilt University School of Medicine, said, “This vaccine has spectacular initial protection rates in every age group. The immune system of a 70- or 80-year-old responds as if the person were only 25 or 30.”

“This really looks to be a breakthrough in vaccinating older adults,” agreed Dr. Jeffrey Cohen, a physician and researcher at the National Institutes of Health.

What’s causing the enthusiasm: Shingrix, which the pharmaceutical firm GlaxoSmithKline intends to begin shipping this month. Large international trials have shown that the vaccine prevents more than 90 percent of shingles cases, even at older ages.

The currently available shingles vaccine, called Zostavax, only prevents about half of shingles cases in those over age 60 and has demonstrated far less effectiveness among elderly patients.

Yet those are the people most at risk for this blistering disease, with its often intense pain, its threat to vision and the associated nerve pain that sometimes last months, even years, after the initial rash fades.

Almost all older Americans harbor the varicella zoster virus that causes shingles; they acquired it with childhood chickenpox, whether they knew they had the disease or not.

The virus stays dormant until, for unknown reasons, it erupts decades later. The risk rises sharply after age 50.

Shingles is hardly a minor menace. “A million cases occur in the United States each and every year,” Dr. Schaffner said. “If you’re fortunate enough to reach your 80th birthday, you stand a one-in-three to one-in-two chance of shingles.

Preventing the great majority of these cases — along with the risk of lingering and debilitating nerve pain, called postherpetic neuralgia — would represent a major advance in public health.

So while the old vaccine will remain on the market, the C.D.C. committee voted to make Shingrix the preferred vaccine and recommended it for all adults over age 50 — a group younger by a decade than those earlier encouraged to get Zostavax.

The committee also recommended Shingrix for adults who’ve previously gotten Zostavax, since a smaller study in people over age 65 demonstrated effectiveness and safety in those already vaccinated. The Food and Drug Administration approved Shingrix last month.

Once the C.D.C.’s director endorses the committee’s recommendations, and the agency publishes them, insurers — including Medicare and Medicaid — will start covering the vaccine.

“By early 2018, it should be broadly available to consumers in the U.S.,” said Dr. Thomas Breuer, chief medical officer of GSK Vaccines. (Canada has also approved Shingrix; it awaits approval in Australia, Japan and Europe.)

What makes the new vaccine so promising, especially for older adults?

* It provides better protection against shingles from the start. Though Zostavax, introduced in 2006, can reduce shingles cases by about half (and postherpetic neuralgia by two-thirds), that overall rate conceals big differences by age.

That vaccine’s effectiveness drops from 64 percent for people in their 60s to 38 percent among those over age 70, and falls still lower for people in their 80s.

But the new vaccine protects nearly as well in older groups as in the middle-aged. Shingrix racked up a 97 percent effectiveness rate in adults over age 50 and, in a separate study of people over age 70, prevented 90 percent of shingles in those 70 to well past age 80.

“In groups such as the elderly, who often don’t maintain vigorous responses to vaccines, this represents extremely strong disease protection,” said Dr. Kathleen Dooling, an epidemiologist at the C.D.C.

* Shingrix’s protection appears to last longer. Among seniors, the effectiveness of Zostavax wanes with disappointing speed. “After 11 years, the protection was close to zero,” Dr. Harpaz said.

Regulators don’t yet have 11 years of data on Shingrix, but in some samples, it remained effective for six years or longer, according to GSK. That should great reduce the incidence of postherpetic neuralgia, too, assuming the 42 million people in their 50s start getting vaccinated.

* The new vaccine may protect people with compromised immune systems.

A substantial number of older Americans have suppressed immunity because they’re undergoing chemotherapy or transplants, have H.I.V. or take steroids. For them, the previous vaccine was off-limits because it was made with a weakened live virus.

Yet immune suppression itself leaves the people vulnerable to shingles. Shingrix, a recombinant vaccine made from a glycoprotein and a combination of immunity boosters called adjuvants, doesn’t pose the same danger.

The C.D.C. committee held off on recommending Shingrix for the immunocompromised, because GSK is still running trials with these patients. But since the F.D.A. did not declare Shingrix contraindicated for them when approving it, they can get the vaccine once it’s available.

Public health advocates do foresee a couple of potential problems.

First, Shingrix requires two doses, administered at least two months apart. Prodding the older population to get a single shot has proved tough: barely 31 percent of those over age 60 have been vaccinated against shingles. How much harder will it be to persuade people to get two Shingrix injections?

Further, “it tends to be a bit of an ouch-y vaccine,” Dr. Schaffner cautioned.

In studies, most older recipients said they’d experienced pain, redness or swelling in their upper arms for a day or two after the shot, and 8.5 percent of those over age 70 deemed those symptoms uncomfortable enough to interfere with normal activities.

About half of those over age 70 reported more systemic side effects like fatigue, fever or aching joints, lasting one to two days. Physicians and pharmacists should prepare people for such reactions, Dr. Schaffner said.

“If people anticipate it, they’ll cope with it better. They’ll take a couple of Tylenol” — and not worry that something is seriously wrong.

They may feel pocketbook pain, too. Zostavax is the most expensive adult vaccine, and at $140 for each dose (plus the cost of administering the injection), Shingrix will be pricier still.

The 50- to 65-year-old cohort, many of whom have coverage under employee health plans, may not find that much of a barrier. At older ages, cost matters more.

Medicare will cover Shingrix under Part D (like its predecessor), not under Part B like the flu vaccine. That complicates reimbursement for those seeking vaccination in doctors’ offices, so Medicare patients will probably find it simpler to head for a pharmacy.

But not all Medicare recipients have Part D, and those that do could face co-payments.

Still, it’s no contest: The hazards of shingles and its complications dwarf any problems yet reported with Shingrix.

“Compared to shingles, a little arm pain for a day or so is a small price to pay,” Dr. Schaffner said. “If you know people who’ve had this illness, you’ll be first in line for this vaccine.”

Follow @NYTHealth on Twitter. | Sign up for the Science Times newsletter.

https://www.nytimes.com/2017/11/10/health/shingrix-shingles-vaccine.html?rref=collection%2Fsectioncollection%2 Fhealth&action=click&contentCollection=health&region=rank&module=package&version=highlights&contentPlacement=1&pgtype=sectionfront

[Kätzchen]

Funny that you post about this today! My BFF who has suffered an litany of shingles attacks? Her doctor gave her a shot for thus last week. We hope it helps to build up immunity to further attacks of the shingles!

No Excuses, People: Get the New Shingles Vaccine

By Paula Span NOV. 10, 2017

Medical researchers and government health policymakers, a cautious lot, normally take pains to keep expectations modest when they’re discussing some new finding or treatment.

They warn about studies’ limitations. They point out what isn’t known. They emphasize that correlation doesn’t mean causation.

So it’s startling to hear prominent experts sound positively excited about a new shingles vaccine that an advisory committee to the Centers for Disease Control and Prevention approved last month.

“This really is a sea change,” said Dr. Rafael Harpaz, a veteran shingles researcher at the C.D.C.

Dr. William Schaffner, preventive disease specialist at the Vanderbilt University School of Medicine, said, “This vaccine has spectacular initial protection rates in every age group. The immune system of a 70- or 80-year-old responds as if the person were only 25 or 30.”

“This really looks to be a breakthrough in vaccinating older adults,” agreed Dr. Jeffrey Cohen, a physician and researcher at the National Institutes of Health.

What’s causing the enthusiasm: Shingrix, which the pharmaceutical firm GlaxoSmithKline intends to begin shipping this month. Large international trials have shown that the vaccine prevents more than 90 percent of shingles cases, even at older ages.

The currently available shingles vaccine, called Zostavax, only prevents about half of shingles cases in those over age 60 and has demonstrated far less effectiveness among elderly patients.

Yet those are the people most at risk for this blistering disease, with its often intense pain, its threat to vision and the associated nerve pain that sometimes last months, even years, after the initial rash fades.

Almost all older Americans harbor the varicella zoster virus that causes shingles; they acquired it with childhood chickenpox, whether they knew they had the disease or not.

The virus stays dormant until, for unknown reasons, it erupts decades later. The risk rises sharply after age 50.

Shingles is hardly a minor menace. “A million cases occur in the United States each and every year,” Dr. Schaffner said. “If you’re fortunate enough to reach your 80th birthday, you stand a one-in-three to one-in-two chance of shingles.

Preventing the great majority of these cases — along with the risk of lingering and debilitating nerve pain, called postherpetic neuralgia — would represent a major advance in public health.

So while the old vaccine will remain on the market, the C.D.C. committee voted to make Shingrix the preferred vaccine and recommended it for all adults over age 50 — a group younger by a decade than those earlier encouraged to get Zostavax.

The committee also recommended Shingrix for adults who’ve previously gotten Zostavax, since a smaller study in people over age 65 demonstrated effectiveness and safety in those already vaccinated. The Food and Drug Administration approved Shingrix last month.

Once the C.D.C.’s director endorses the committee’s recommendations, and the agency publishes them, insurers — including Medicare and Medicaid — will start covering the vaccine.

“By early 2018, it should be broadly available to consumers in the U.S.,” said Dr. Thomas Breuer, chief medical officer of GSK Vaccines. (Canada has also approved Shingrix; it awaits approval in Australia, Japan and Europe.)

What makes the new vaccine so promising, especially for older adults?

* It provides better protection against shingles from the start. Though Zostavax, introduced in 2006, can reduce shingles cases by about half (and postherpetic neuralgia by two-thirds), that overall rate conceals big differences by age.

That vaccine’s effectiveness drops from 64 percent for people in their 60s to 38 percent among those over age 70, and falls still lower for people in their 80s.

But the new vaccine protects nearly as well in older groups as in the middle-aged. Shingrix racked up a 97 percent effectiveness rate in adults over age 50 and, in a separate study of people over age 70, prevented 90 percent of shingles in those 70 to well past age 80.

“In groups such as the elderly, who often don’t maintain vigorous responses to vaccines, this represents extremely strong disease protection,” said Dr. Kathleen Dooling, an epidemiologist at the C.D.C.

* Shingrix’s protection appears to last longer. Among seniors, the effectiveness of Zostavax wanes with disappointing speed. “After 11 years, the protection was close to zero,” Dr. Harpaz said.

Regulators don’t yet have 11 years of data on Shingrix, but in some samples, it remained effective for six years or longer, according to GSK. That should great reduce the incidence of postherpetic neuralgia, too, assuming the 42 million people in their 50s start getting vaccinated.

* The new vaccine may protect people with compromised immune systems.

A substantial number of older Americans have suppressed immunity because they’re undergoing chemotherapy or transplants, have H.I.V. or take steroids. For them, the previous vaccine was off-limits because it was made with a weakened live virus.

Yet immune suppression itself leaves the people vulnerable to shingles. Shingrix, a recombinant vaccine made from a glycoprotein and a combination of immunity boosters called adjuvants, doesn’t pose the same danger.

The C.D.C. committee held off on recommending Shingrix for the immunocompromised, because GSK is still running trials with these patients. But since the F.D.A. did not declare Shingrix contraindicated for them when approving it, they can get the vaccine once it’s available.

Public health advocates do foresee a couple of potential problems.

First, Shingrix requires two doses, administered at least two months apart. Prodding the older population to get a single shot has proved tough: barely 31 percent of those over age 60 have been vaccinated against shingles. How much harder will it be to persuade people to get two Shingrix injections?

Further, “it tends to be a bit of an ouch-y vaccine,” Dr. Schaffner cautioned.

In studies, most older recipients said they’d experienced pain, redness or swelling in their upper arms for a day or two after the shot, and 8.5 percent of those over age 70 deemed those symptoms uncomfortable enough to interfere with normal activities.

About half of those over age 70 reported more systemic side effects like fatigue, fever or aching joints, lasting one to two days. Physicians and pharmacists should prepare people for such reactions, Dr. Schaffner said.

“If people anticipate it, they’ll cope with it better. They’ll take a couple of Tylenol” — and not worry that something is seriously wrong.

They may feel pocketbook pain, too. Zostavax is the most expensive adult vaccine, and at $140 for each dose (plus the cost of administering the injection), Shingrix will be pricier still.

The 50- to 65-year-old cohort, many of whom have coverage under employee health plans, may not find that much of a barrier. At older ages, cost matters more.

Medicare will cover Shingrix under Part D (like its predecessor), not under Part B like the flu vaccine. That complicates reimbursement for those seeking vaccination in doctors’ offices, so Medicare patients will probably find it simpler to head for a pharmacy.

But not all Medicare recipients have Part D, and those that do could face co-payments.

Still, it’s no contest: The hazards of shingles and its complications dwarf any problems yet reported with Shingrix.

“Compared to shingles, a little arm pain for a day or so is a small price to pay,” Dr. Schaffner said. “If you know people who’ve had this illness, you’ll be first in line for this vaccine.”

Follow @NYTHealth on Twitter. | Sign up for the Science Times newsletter.

https://www.nytimes.com/2017/11/10/health/shingrix-shingles-vaccine.html?rref=collection%2Fsectioncollection%2 Fhealth&action=click&contentCollection=health&region=rank&module=package&version=highlights&contentPlacement=1&pgtype=sectionfront

[Kätzchen]

***** BUMPING Anya's article about Aaron Hernandez and Traumatic Brain Injury within the NFL ******

Thanks for the great article Anya! :bunchflowers:

Aaron Hernandez suffered from most severe CTE ever found in a person his age

By Adam Kilgore November 9, 2017 at 3:50 PM

BOSTON — Aaron Hernandez suffered the most severe case of chronic traumatic encephalopathy ever discovered in a person his age, damage that would have significantly affected his decision-making, judgment and cognition, researchers at Boston University revealed at a medical conference Thursday.

Ann McKee, the head of BU’s CTE Center, which has studied the disease caused by repetitive brain trauma for more than a decade, called Hernandez’s brain “one of the most significant contributions to our work” because of the brain’s pristine condition and the rare opportunity to study the disease in a 27-year-old.

Hernandez, a former New England Patriots tight end, hanged himself with a bedsheet in April in a Massachusetts prison while serving a life sentence for the murder of his friend Odin Lloyd in 2013.

In a diagnosis that linked one of football’s most notorious figures with the sport’s most significant health risk, doctors found Hernandez had Stage 3 CTE, which researchers had never seen in a brain younger than 46 years old, McKee said. Because the center has received few brains from people Hernandez’s age, McKee could not say whether Hernandez’s brain was representative of a 27-year-old who had played football as much as Hernandez. But she found the advanced stage of CTE alarming.

“In this age group, he’s clearly at the severe end of the spectrum,” McKee said. “There is a concern that we’re seeing accelerated disease in young athletes. Whether or not that’s because they’re playing more aggressively or if they’re starting at younger ages, we don’t know. But we are seeing ravages of this disease, in this specific example, of a young person.”

At Thursday’s conference, McKee flipped through slides comparing sections of Hernandez’s brain to a sample without CTE. Hernandez’s brain had dark spots associated with tau protein and shrunken, withered areas, compared to immaculate white of the sample. His brain had significant damage to the frontal lobe, which impacts a person’s ability to make decisions and moderate behavior. As some new slides appeared on the projectors, some physicians and conference attendees gasped.

“We can’t take the pathology and explain the behavior,” McKee said. “But we can say collectively, in our collective experience, that individuals with CTE, and CTE of this severity, have difficulty with impulse control, decision-making, inhibition of impulses for aggression, emotional volatility, rage behaviors. We know that collectively.”

McKee said Hernandez had a genetic marker that makes people vulnerable to certain brain diseases and could have contributed to how aggressively he developed CTE.

“We know that that’s a risk factor for neurogenerative disease,” McKee said. “Whether or not that contributed in this case is speculative. It may explain some of his susceptibility to this disease.”

The condition of Hernandez’s brain, pristine because of his age and the adept handling of medical examiners, could lead to future breakthroughs and better understanding of CTE. For example, researchers could better study the interaction of inflammation and tau pathology through the use of fluorescent stains. It gave researchers their best view yet of a marker associated with CTE.

“We are able to understand this disease at the scientific level in a way that’s very rarely presented,” McKee said. “We’re very grateful to the family for making this donation. We’re hoping this will advance medical science in a very significant way. . . . This will really accelerate and advance our research going forward.”

Medical examiners delivered Hernandez’s brain, weighing 1,573 grams, to BU’s labs in April. From the outside, it looked like a typical brain — no lesions, no bruises, no abnormalities. When researches sliced the brain into sections, they discovered startling damage.

Ventricles were dilated, in response to the brain shrinking. Researchers determined Hernandez had lost brain tissue. Membranes that were supposed to be firm had grown “thin and gelatinous,” McKee said. There were abnormal, large holes in parts of Hernandez’s bran.

The hippocampus, which plays a key role in memory, had shrunk.

The fornix, which also contributes to memory function, had atrophied.

The frontal lobe, which is responsible for problem-solving, judgment, impulse control and social behavior, had been pockmarked with tau protein.

The amygdala, which produces emotional regulation, emotional behavior, fear and anxiety, had been severly affected.

The temporal lobes, which process sights and sounds, showed significant damage.

Together, they were “very unusual findings in an individual of this age,” McKee said. “We’ve never seen this in our 468 brains, except in individuals some 20 years older.”

The physical damage inside Hernandez’s brain provides another layer to the catastrophic and tragic downfall of Hernandez, a gifted player who caught a touchdown pass from Tom Brady in the 2012 Super Bowl.

Hernandez grew up a football star in Connecticut and fell in with a rough crowd at age 15, after his father died unexpectedly during a routine operation. He starred at Florida even as off-field trouble, in the form of drugs and violence, dogged him. The problems caused some teams to remove him from consideration in the NFL draft, and he lasted until the Patriots plucked him in the fourth round.

Hernandez formed a dominating tandem with fellow 2010 draftee Rob Gronkowski and convinced the Patriots he had straightened out his life. The Patriots signed him to a seven-year, $40-million contract after the 2012 season. Months later, in the summer of 2013, Lloyd was murdered in the summer of 2013, his body found in a gravelly field a mile away from Hernandez’s mansion in North Attleboro.

Hernandez’s estate filed a federal lawsuit against the Patriots in September, alleging the Patriots knew hits to the head could lead to brain damage and failed to protect him.

A jury convicted Hernandez of the killing in 2015. Hernandez hanged himself in his cell just four days after a jury had acquitted him of the murders of Daniel de Abreu and Safiro Furtado, two strangers whom the state argued Hernandez killed in 2012 after an altercation at a Boston club.

BU researchers say they have discovered CTE in more than 100 former NFL players, a handful of whom have committed suicide. The extent of damage in Hernandez’s brain represents another signpost in football’s ongoing concussion crisis. Thursday’s news conference coincided with the release of an NFL study consisting of video reviews of the 459 known concussions that occurred over the 2015 and 2016 seasons, from preseason games through the playoffs

The NFL has attempted to make the sport safer for its players, through rule changes, policies designed to remove concussed players and technologic advances. But brain trauma occurs when a football player’s brain accelerates or decelerates after it hits another player or the turf, bashing the sides of the head, an action a helmet is defenseless against.

“It happens inside the skull,” McKee said. “It’s an intrinsic component of football.”

https://www.washingtonpost.com/sports/aaron-hernandez-suffered-from-most-severe-cte-ever-found-in-a-person-his-age/2017/11/09/fa7cd204-c57b-11e7-afe9-4f60b5a6c4a0_story.html?tid=pm_pop&utm_term=.d7191a3753d1




https://img.washingtonpost.com/rf/image_480w/2010-2019/WashingtonPost/2017/11/09/Sports/Images/AH-brain1510254001.jpg?uuid=M6Cx3MWAEeeZIkFR9cphaA

Normal 27-year-old's brain and Aaron Hernandez's brain. (Boston University School of Medicine/Boston University School of Medicine)

[*Anya*]

Bisexual people at higher risk of developingf mental health issues

They face pressures that others from straight and queer communities don’t

OLIVIA PETTER Thursday 7 September 2017 09:10 BST

Bisexual people experience more discrimination that other members in LGBTQ communities don’t, a new study has revealed.

Researchers from American University analysed data from 503 participants aged 18 to 64 who identified as being attracted to more than one gender.

They were asked questions that reflected how their bisexuality had affected their lives.

What it's like for women to date bisexual men
Whilst previous studies have shown that bisexual people are more at risk of experiencing anxiety, depression and suicidal thoughts, this new study published in Prevention Science, found that these risks are exacerbated because bisexual people feel as if they don’t belong in any one community.

“Bisexual people face double discrimination in multiple settings — bisexual people are often invisible, rejected, invalidated, [and] stigmatised in the heterosexual community as well as the traditional LGBTQ communities,” explained lead study author Ethan Mereish.

“Given that isolation and discrimination, bi people might be experiencing increase factors that might make them more lonely or isolated,” the professor told NBC News.

Company pedalled spyware to ‘find out if your son is gay’
The social isolation that many bisexual people face often limits their access to support and resources, the study found. Whilst there is a plethora of support available for the wider LGBTQ community, the study revealed that resources for bisexual people specifically are often lacking and this has a negative effect on their mental wellbeing, fostering feelings of bisexual invisibility and erasure.

In worst-case scenarios, this overriding sense of discrimination and ostracism can lead to poor mental health and suicidal thoughts.

In terms of addressing the problem, Mereish and his team believe that more should be done to distinguish bisexual people from other LGBTQ members, giving them a singular identity that can subsequently allow their mental health to be understood exclusively.

"This research highlights the unique stress experiences of bisexual individuals, with implications for addressing bisexual-specific stress in clinical settings as well as designing preventive interventions that increase access to bisexual-specific support and resources," the study concludes.

"Bisexual-specific experiences must be considered independently from the experiences of other sexual minority subgroups to address sexual orientation disparities in mental health."


http://www.independent.co.uk/life-style/bisexual-people-mental-health-risk-lgbt-heterosexual-issue-a7933806.html

Study:

http://go.redirectingat.com/?id=44681X1528610&xs=1&isjs=1&url=https%3A%2F%2Flink.springer.com%2Fepdf%2F10.10 07%2Fs11121-017-0804-2%3Fauthor_access_token%3DHmXzCxYOGPXlpyLFkEh2Sfe4 RwlQNchNByi7wbcMAY69fGsGy82K2F-qKswjcCp_4lquu_M_wYRCb68kZNDamLFIvZBapABKj2WauzK0Q wYj51DicENdDF4V1osJGNKNJ7f4EV4qD7AeKrzNK6d3Ww%3D%3 D&xguid=b0835a72c0cfa088052b6b5db87f3d57&xuuid=47a4805b6d11cc99c6411b1b16a53cfd&xsessid=318e5e3be9b6cb336d0866d03665435d&xcreo=0&xed=0&sref=http%3A%2F%2Fwww.independent.co.uk%2Flife-style%2Fbisexual-people-mental-health-risk-lgbt-heterosexual-issue-

[Kobi]

The NFL has attempted to make the sport safer for its players, through rule changes, policies designed to remove concussed players and technologic advances. But brain trauma occurs when a football player’s brain accelerates or decelerates after it hits another player or the turf, bashing the sides of the head, an action a helmet is defenseless against.

“It happens inside the skull,” McKee said. “It’s an intrinsic component of football.”




I snipped this cuz it is the most important part of understanding brain injuries regardless of how they occur.

There is no helmet made that protects your brain inside your skull. And knowing what happens to your brain inside your skull is both disgusting and fascinating.

If you have a weak stomach, dont read this.

If you are curious, read on.

People tend to think of the inside of your skull as a smooth bone structure. It is not. The bottom of your skull, on which the brain rests, is a bumpy and grooved surface. The brain is soft tissue and floats over and within this bone structure.

With trauma, either a singular event or repetitive events, the brain sloshes around inside the skull. Multiple types of damages can occur to the structure of the brain itself which in turn affects the cognitive areas which that part of the brain controls. Repetitive blows cause more and more injury to both the tissue itself and the areas of functioning it controls.

When you have trauma to the head what is happening is the bottom of the brain is sloshing over the bumpy surface of the bottom of the skull causing shearing of the tissue. Simultaneously, you have direct impact damage i.e. if your hit the front of your head the brain will slosh forward and bang against the front of the skull, and you have a contra coup injury to the back of the brain when it sloshes backwards.

Same dynamic with a side impact. If you hit the left side of your head, the brain will slosh left, hit your skull and then slosh right until it hits your skull.

The brain will continue sloshing and hitting the hard and rough surfaces back and forth until it regains its equilibrium.

That is a lot of potential for damage and that is just with one event.

Helmets may protect you from fracturing your skull but they will not stop your brain from sloshing around inside your skull.

And this phenomenon is not unique to sports. You can have the same dynamic if you fall off your bike or motorcycle and hit your head, or if you are punched in the face, or if you fall and hit your head.

Neuro-cogitive testing can diagnose closed brain injuries. Often people know themselves something isnt right or those who know them know they are not acting like themselves.

Ok I'm done.

[~ocean]

ty Kobi , now it makes sense that so many people have lost their minds .

[*Anya*]

Having older brothers increases men's likelihood of being gay

By Jen Christensen, CNN Updated 6:42 AM ET, Tue December 12, 2017

Story highlights:

Scientists say mothers who have more than one boy had higher concentrations of a certain protein
Earlier studies have noticed that gay men often have older brothers

(CNN) If you're a guy with an older brother, there's an increased chance you're gay.

Scientists have noticed this pattern in previous research, but now they think they have a biological explanation as to why, and it starts long before birth. The results were published in the journal PNAS on Monday.

The researchers say that if their findings can be replicated, we may know at least one of the biological reasons some men are gay.

Many factors may determine someone's sexual orientation, but in this case, researchers noticed a pattern that may be linked to something that happens in the womb. The phenomenon is related to a protein linked to the Y chromosome (which women do not have) that is important to male brain development.

Researchers think it's possible that when a woman gets pregnant with her first boy, this Y-linked protein gets into her bloodstream. The mother's body recognizes the protein as a foreign substance, and her immune system responds, creating antibodies. If enough of these antibodies build up in the woman's body and she gets pregnant with another a boy, they can cross the placental barrier and enter the brain of the second male fetus.

"That may alter the functions in the brain, changing the direction of how the male fetus may later develop their sense of attraction," said study author Anthony Bogaert, a Canadian psychologist and professor in the departments of psychology and community health sciences at Brock University.

Earlier research has shown that the more older brothers a boy has, the more of a chance that boy will be attracted to men. A 2006 study showed that with each brother, the chance that a man will be gay goes up by about a third, but the researchers didn't determine why that was.

Bogaert and his co-authors tested a small group of 142 women and 12 men ages 18 to 80 and found a higher concentration of antibodies to the protein, known as NLGN4Y, in blood samples from women than from men. They found the highest concentration of antibodies to the protein in women with gay younger sons who had older brothers, compared with women who had no sons or who had given birth to only heterosexual boys.

The study builds on research Bogaert and his co-authors have been exploring for more than 20 years. Since their initial research that noted the trend, other research -- although not all studies -- have detected the phenomenon, even across cultures.

One found that a man's chances of being gay increased even if he was raised apart from his older brother.

Researchers did not see a similar pattern in families with adopted brothers, so scientists started to think there must be a maternal developmental explanation.

The research does not give a biological explanation for why some men may be bisexual or may not be attracted to anyone at all, nor can it give a biological explanation for gay only children, gay oldest sons or women who are attracted to women.

J. Michael Bailey, a professor in the Department of Psychology at Northwestern University, thinks the latest research is important. "It is significant, and I believe science granting agencies should put a high priority into additional research to see if this is true," he said.

Bailey was not involved in the new study but has worked on studies that have found genetic factors that may explain some differences in sexual orientations.

Bailey's latest paper, published this month in the journal Nature Research, looked at people's genomes and found several regions with single-letter DNA changes that were more common among gay men than straight men and may be relevant to the development of sexual orientation. Bailey believes this new study may be even more significant than general genetic findings if the findings can be replicated:

"Our studies only show that there may be genes that matter in sexual orientation," he said. "It is not like this study, that shows there is a potential specific mechanism by which sexual orientation may have changed prenatally. This is important work and fascinating if it proves to be true."

Clarification: A previous version of this story referred to higher concentrations of the protein instead of higher concentrations of antibodies to the proteins when describing the findings of the study.

http://www.cnn.com/2017/12/11/health/men-older-brothers-gay-study/index.html

[*Anya*]

UTMB develops promising anti-obesity drug that shrinks fat without suppressing appetite

January 4, 2018

GALVESTON, Texas – Given the ever-increasing obesity epidemic, researchers from The University of Texas Medical Branch at Galveston have discovered a promising developing drug that has been shown to selectively shrink excess fat by increasing fat cell metabolism. The drug significantly reduces body weight and blood cholesterol levels without lowering food intake in obese mice, according to a recent study published in Biochemical Pharmacology.

Obesity is a major public health problem around that world that is a leading cause of healthcare costs and compromised quality of life. In the U.S., 40 percent of adults are obese and 30 percent are overweight, battling serious obesity-related chronic diseases. The estimated cost of obesity in the U.S. is about $150 billion each year.

“As fat cells grow larger, they begin to overexpress a protein that acts as a metabolic brake that slows down fat cell metabolism, making it harder for these cells to burn accumulating fat,” said senior author Stanley Watowich, UTMB associate professor in the department of biochemistry and molecular biology. “In addition, as the fat tissue expands, they secrete greater amounts of hormones and pro-inflammatory signals that are responsible for several chronic diseases, including type 2 diabetes and cardiovascular disease.”

The researchers discovered a molecule that blocks this metabolic brake from operating in obese white fat cells. By blocking this metabolic brake, they were able to increase the metabolism within white fat cells.

In the study, mice were fed a high-fat diet until they became obese and then received either the drug or a placebo. Following 10 days of drug treatment, researchers found that the obese mice receiving the actual drug lost more than seven percent of their total body weight and their white fat tissue mass and cell size decreased by 30 percent compared with the placebo group. In addition, blood cholesterol in drug-treated mice were lowered to normal levels, similar to those of non-obese mice.

On the contrary, placebo-treated mice continued to accumulate white fat and gain weight throughout the study. Interestingly, mice in both the drug-treated and placebo groups consumed the same amount of food during the course of the study period, showing that the fat loss was not due to appetite suppression.

“Blocking the action of the fat cell brake provides an innovative ‘fat’-specific mechanism to increase cell metabolism and reduce the size of white fat deposits, thereby treating a root cause of obesity and related metabolic diseases,” said senior author Harshini Neelakantan, a UTMB research scientist in the department of biochemistry and molecular biology. “These initial results are encouraging and support further development of this technology as a new and more effective approach to combating metabolic diseases.”

Other study authors include UTMB’s Virginia Vance, Michael Wetzel, Celeste Finnerty and Jonathan Hommel as well as Hua-Yu Leo Wang and Stanton McHardy from the University of Texas at San Antonio.

https://www.utmb.edu/newsroom/article11716.aspx

[Esme nha Maire]

I've just watched a fascinating Royal Institute lecture by a Canadian scientist on the role that the microbes that co-exist with us have on our health. From obesity to Alzhemers and Parkinsons, asthma and lactose tolerance, the effects of keeping a dog or overdoing it regarding hygiene, it's all covered, and some of it is seriously surprising. I'd particularly urge anyone thinking of having children or with very young children to watch this right through.

https://www.youtube.com/watch?v=xlEFI5A3QFM

All I can say is thank goodness I tend to like Italian food - but I am going to increase how many times I brush my teeth up to three times a day now, having seen this!

[Kätzchen]

For anyone who is licensed as a medical professional, in a variety of trades (nurse, physician, social worker/scientist, microbiologist, healing arts practitioner, etc), there are two great resources which provide a wealth of scientific based articles and supplemental information: Medscape (https://www.medscape.com/) & JAMA (https://jamanetwork.com/)(Journal of the American Medical Association)

Both Medscape and JAMA have entire sections devoted to the latest news about COVID 19, as well as peer reviewed journal articles on a wide variety of medical interests.

[Kätzchen]

One of the unintended consequences of having to wear gloves (masks, too) is that your skin is at risk. On my journey's at work, and because of revised safety protocols which demand that PPE be worn at all times while on campus, I *was* wearing nitrile gloves but had to quit wearing them because wearing these types of gloves for extended periods of time, sets up hazards for your skin (example: you can get contact dermatitis or fungal skin conditions).

I found an article online at ISHN (a website devoted to industrial complex issues, etc) about the hazards of wearing nitrile/latex gloves (for those interested in finding out more about this particular on-the-job safety issue).

LINK ~~~>>>> Sweaty Gloves Can Cause Health Problems (https://www.ishn.com/articles/107181-sweaty-gloves-can-cause-health-problems-limit-mobility)

I spent some time yesterday, searching local business outlets for alternative gloves. The best I could find were cotton/jersey gardening gloves (https://images.homedepot-static.com/productImages/3717642e-bb8c-4e4c-973e-0679fd3d5e17/svn/hands-on-gardening-gloves-ct7203-s-m-64_1000.jpg) (in lavender and pink) and high-visibility safety gloves (https://images.homedepot-static.com/catalog/productImages/1000/bf/bf47b14a-01b3-448d-bb07-d42e3a68238c_1000.jpg) - which help your hands to breathe and not get sweaty.

[Cin]

Bolstering Case for Single Payer, Study Shows For-Profit Insurer Plans Pay Hospitals Nearly 250% More Than Medicare

"There is no better system of cost control and universal care for employers than Medicare for All."

A new study released Friday by the RAND Corporation details the astronomical prices hospital systems across the U.S. charge private insurers and the more than 153 million patients who obtain health coverage through their employers—while Medicare proves to be a far more affordable option.

The findings make the case for expanding the Medicare system to all Americans, one prominent single-payer healthcare advocate said.

"There is no better system of cost control and universal care for employers than Medicare for All," policy analyst Michael Lighty, a leading expert on and organizer for Medicare for All, told Common Dreams.

Studying hospital systems in 49 states, RAND found that employers and insurers paid $20 billion more to hospitals between 2016 and 2018 than the government did through Medicare for the same healthcare services.

In hospitals across the country, according to the study, private insurers paid an average of 247% more for services than what hospitals would have received via the Medicare system. In six states, hospitals charge three times more than Medicare if a patient has private insurance, and at the most expensive hospitals, insurers may be charged four times the amount—ultimately leading to a financial strain on the patient.

"Hospitals like this are a tax on their community, harming economic growth and decreasing workers' take-home pay," tweeted philanthropist John Arnold.

"If we want to keep a private market in U.S. healthcare, it has to function," Elizabeth Mitchell, chief executive of the Pacific Business Group on Health told the New York Times. "It's really not functioning."

The Times reported that the study was likely to bolster the argument for a public option which would compete with for-profit health insurance, ultimately bringing down the cost of care.

Lighty told Common Dreams that the research actually "creates a much stronger argument for Medicare for All than for the public option."

"The primary payment method for hospitals under Medicare for All would be a 'global budget,' which ensures that each facility has the resources to provide patient care for their patient population and service area," Lighty said. "The public option simply introduces another 'plan design' into a system of plans that is causing the problem—the administrative complexity of network definitions and rate setting continues under a public option."

The Times claimed Medicare for All is a far more "controversial" solution than the public option—but both solutions are popular with the U.S. public. A survey by Kaiser Family Foundation in May found that 56% of Americans support Medicare for All, including eight in 10 Democratic voters. A separate poll taken by The Hill/HarrisX in April showed that 69% of respondents believe every American should be covered under the hugely popular Medicare program.

The Times article brings up the frequently-expressed concern of Medicare for All opponents that hospitals would be unable to operate if they are forced to accept Medicare rates and are unable to price their surgeries, overnight stays, and other services at exorbitant rates for insurance companies.

"We cannot survive in that kind of the world," Tom Nickels, an executive vice president at the American Hospital Association (AHA), told the Times. The trade group further pushed back against the RAND Corporation's findings on Friday, saying "the study again perpetuates erroneous suggestions that Medicare payments should be used as a benchmark for private insurers."

Lighty countered that the AHA has "literally no credibility" regarding efforts to keep hospitals running.

"They have been promoting a business model that closes 'unprofitable' hospitals in rural areas and inner cities for over two decades," Lighty told Common Dreams. "In South Carolina, eight hospitals have closed since 2010. Global budgets keep hospitals open, the present system of financing and contracting closes them."

https://www.commondreams.org/news/2020/09/18/bolstering-case-single-payer-study-shows-profit-insurer-plans-pay-hospitals-nearly

[Kätzchen]

Tonight, I surfed to The Journal of American Medical Association (JAMA) and read a very interesting article concerning the Covid-19 death toll.

Here is an brief excerpt from the article and I will leave a link too, because on the right side of the web page, JAMA has other tabs a reader can click on, which features other interesting facts and details about other Covid-19 impacts:

A tiny virus reverberates through the whole of society, and a pandemic such as COVID-19 disrupts lives; health and well-being; and schools, workplaces, travel, restaurants, conferences, exhibitions, musical events, and sporting contests. The economic losses are enormous, yet calculable, as clearly described in the Viewpoint by Cutler and Summers.10 According to the authors, the economic cost of COVID-19 thus far exceeds an estimated $16 trillion, nearly an entire year of the nation’s economic output. An estimated 47% of this total is due to lost gross domestic product and the remaining 53% to health loss. Notably reinforcing the message conveyed by Simon et al,9 the estimates by Cutler and Summers10 suggest that more than 18% of the health loss is due to mental health impairment.

Link to JAMA article found ~~~>>>>> Here (https://jamanetwork.com/journals/jama/fullarticle/2771759).

Link to Culter and Summers article found ~~~>>>>> Here (https://jamanetwork.com/journals/jama/fullarticle/2771764).


Check out the Op-Ed's on the second link, to the right of the page. I like how credible experts weigh in on fact vs fiction. Seriously good reading; I enjoyed a few articles featured on the Cutler and Summers page.

[Kätzchen]

G5o4ym5in_w

[Kätzchen]

For those of us keeping up with health care news and getting the best scientific news coverage, please visit JAMA’s new web portal online at:

https://jamanetwork.com/


There are several news worthy articles concerning Covid-19 and its impacts since 2019-2020. Three top stories examine how losing your home (eviction for renters and/or those with forced evictions via owning or trying to own your own home) is crazy serious stress which can kill you (imho, probably just as bad as losing your partner to divorce or death, etc).

:bunchflowers:

[Kätzchen]

Remember how Trump told people to drink Clorox to kill Covid 19? Remember how he didn’t care that hundreds upon thousands of people died from Covid but yet his good buddy 10-4 Putrid needed Covid swag tests to make sure there brotherhood oath to ruin America financially and use his GOP smear campaign to snuff out every agency we depend on???

Well, now he’s out to literally make sure nobody but the rich can afford to get healthcare. Trump knee capped NIH (isn’t this Dr Fauci’s place of research???). Cancer research is suspended indefinitely.


https://www.msnbc.com/all-in/watch/-who-voted-for-this-trump-admin-obstructs-cancer-research-funding-230130245610