Psoriatic Arthritis and Raynaud’s Syndrome: The Link – Healthline

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Raynauds syndrome, also known as Raynauds phenomenon, is a condition that affects body extremities such as the fingers.

In response to a trigger like cold air or emotional stress, blood vessels become narrow and normal circulation is cut off. This can make your fingers very pale or blue, tingly, or numb. Raynauds can also sometimes affect other areas like your toes, nose, and ears.

Raynauds syndrome has been associated with certain autoimmune diseases.

Psoriatic arthritis (PsA) is a chronic, inflammatory autoimmune condition. It affects the joints and surrounding areas where the bone connects to ligaments and tendons. It can occur at any age but often develops between ages 30 and 50.

If you have PsA, you may be wondering if you should be looking out for signs of Raynauds syndrome. Read on for more information about the two conditions.

While PsA is a type of autoimmune disease, research supporting a direct correlation between PsA and Raynauds is limited. Theres not much evidence to show that the two conditions are related.

However, its possible to have both conditions.

If you experience symptoms of cold intolerance and color changes of your fingers or toes, a rheumatologist can perform tests to determine whether or not those symptoms are consistent with Raynauds.

This diagnostic process may include:

Certain factors can increase your chance of developing Raynauds phenomenon. They include:

Raynauds syndrome has been linked to another inflammatory type of arthritis called rheumatoid arthritis. Still, Raynauds is less common in rheumatoid arthritis compared with other types of rheumatic diseases, such as lupus.

Raynauds phenomenon is a type of vasculitis. The sudden narrowing of the arteries in your fingers or other extremities is called vasospasm, and it happens in response to triggers like cold and anxiety.

Over time, people who have been living with rheumatoid arthritis may develop vasculitis. Where rheumatoid arthritis affects the joints, vasculitis causes inflammation in the blood vessels. This affects blood flow to certain areas of your body.

Vasculitis can cause artery walls to become inflamed, which narrows the passage through which your blood travels.

PsA treatment depends on the frequency and severity of symptoms you experience. Mild, intermittent PsA symptoms can be treated with nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, taken as needed.

More severe cases of PsA are treated with stronger medications like disease-modifying anti-rheumatic drugs (DMARDs) and biologics, or even surgery.

Treatment for Raynauds is different from PsA treatment and depends on the type. There are two types of Raynauds: primary and secondary.

Known as Raynauds disease, the primary form of Raynauds occurs without any associated medical conditions. Blood work is often normal with no indicators that anything is out of the ordinary.

Primary Raynauds can usually be managed with self-care measures. These include:

In some cases, Raynauds is the first sign that another underlying condition is present. Known as Raynauds syndrome or phenomenon, the secondary form of Raynauds is thought to occur as the result of an autoimmune-related condition, such as:

Secondary Raynauds is often more severe and can require more intervention to manage. It can cause pain and even result in complications like skin ulcers and gangrene. Its less common than primary Raynauds and usually occurs in people over 30 years of age.

Secondary Raynauds can benefit from lifestyle changes as well. However, its often most improved when the underlying condition is treated.

Other treatments specifically for Raynauds aim to prevent tissue damage like ulcers. These include:

PsA is an inflammatory, autoimmune type of arthritis that can accompany psoriasis. Raynauds phenomenon is a type of vasculitis, or narrowing of the blood vessels.

Both conditions are a result of an overactive immune system, which triggers inflammation in the body.

Research supporting a direct link between PsA and Raynauds is limited, but its possible to have both conditions. If you experience Raynauds symptoms, talk to your rheumatologist.

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Psoriatic Arthritis and Raynaud's Syndrome: The Link - Healthline

Common types of arthritis: Location, causes, treatment, and more – Medical News Today

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Arthritis is a painful rheumatic condition that causes joint inflammation. There are many different types of arthritis that can affect the joints and other areas of the body and cause similar symptoms, such as pain, swelling, and stiffness.

There are more than 100 different types of arthritis. Some common types of arthritis include osteoarthritis (OA), rheumatoid arthritis (RA), and psoriatic arthritis (PsA).

Below, we explore these conditions, as well as other diseases that can present with arthritis. We also discuss potential treatment and when to seek medical guidance.

According to the Centers for Disease Control and Prevention (CDC), OA affects over 32.5 million adults in the United States.

Symptoms of OA include:

People often experience OA symptoms in the hips, hands, and knees.

The following increase the likelihood of developing OA:

Learn more about OA here.

RA is an autoimmune condition that causes painful swelling and inflammation in the joints. It typically affects the hands, wrists, and feet.

RA does not only affect joints. It can also cause problems in other organs of the body, including the heart, lungs, and eyes.

While some people experience a sustained progression of the disease, the intensity of symptoms usually comes and goes. Symptoms may include:

Another characteristic of RA is symmetrical involvement. This means pain and signs of inflammation occur on both sides of the body and in the same joints.

RA can cause lasting tissue damage, which can lead to:

Some people who have RA may also need assistance walking.

Some RA risk factors include:

Learn more about RA here.

PsA is an autoimmune condition.

Symptoms of PsA include:

PsA joint involvement is asymmetric, affecting different joints on either side of the body.

This type of arthritis can develop in people with a skin condition called psoriasis, which causes scaly, flushed, or silvery patches of skin. These patches can look different depending on a persons skin color.

Learn more about psoriasis on black skin here.

Researchers still do not fully understand what causes this form of arthritis. However, having a family history of PsA may increase a persons risk of developing this condition.

Learn more about PsA here.

Gout is a type of arthritis that causes painful swelling, often in a single joint at a time.

Symptoms of gout can flare up and go away quickly. They include:

Swelling is common in the big toe. Often, it also affects the knee or ankle joint.

A person may be at higher risk of developing gout if they:

Health conditions that may lead to gout include:

Gout may also occur due to metabolic syndrome, which is not a condition in itself. It refers to a number of characteristics, diseases, or habits that can make a person more likely to experience other health conditions, such as heart disease, stroke, or diabetes.

Learn more about gout here.

This chronic illness is an autoimmune condition that commonly affects females aged 1544 years.

Lupus is not a type of arthritis in itself. However, arthritis is one of the most common symptoms of this condition.

One symptom of lupus is the characteristic butterfly rash that can develop on the face. Other rashes can also develop on the arms, hands, and face. Rashes can worsen after sun exposure.

While symptoms may differ from person to person, they generally include:

Learn more about lupus here.

Juvenile arthritis, also known as childhood arthritis, affects children or even infants.

Symptoms of juvenile arthritis include:

There is no known cause of childhood arthritis. It appears to affect children regardless of race, age, or background.

Learn more about juvenile arthritis here.

Reaching a definitive diagnosis may take time, because many types of arthritis are similar or resemble other conditions.

Typically, a doctor will first check a persons medical and family history. They will also ask about symptoms and perform a physical exam. They may run tests such as:

Arthritis management depends on the type of arthritis. There are different forms of treatment available.

Medical treatment for arthritis may involve:

Surgery may not be necessary for everyone with arthritis. However, it can benefit certain complications of arthritis that result in malalignment of joints and functional limitations due to damaged joints. It can also help with intractable pain, which is when a person experiences pain that is difficult to treat or manage.

Common surgeries for arthritis include:

Physical therapy can be a great option for people with arthritis. It can help ease pain or increase activity.

Behavioral changes that can help with arthritis may include:

Some people find certain home remedies helpful in relieving pain and swelling from certain types of arthritis. These may include:

If a person has experienced joint symptoms that last more than 3 days, they should seek treatment from a healthcare professional.

Similarly, if a person has joint symptoms at different times within a month, they should also contact a doctor.

Medications and other treatments can help a person manage chronic symptoms, such as pain and swelling.

Pain will come and go with many types of arthritis. However, even if the pain resolves, a person should still seek treatment.

It is important to treat arthritis early. If left untreated, some types of arthritis may worsen over time and cause permanent disability.

Arthritis is a painful condition that causes joint inflammation.

Different types of arthritis can cause similar symptoms. It is vital to get the correct diagnosis, as it can help determine most effective treatment options.

The right treatment may also prevent future complications and help a person live a more active life.

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Common types of arthritis: Location, causes, treatment, and more - Medical News Today

Almirall announces a new publication in the British Journal of Dermatology of ILUMETRI (tildrakizumab) as the first anti-IL23p19 treatment for which…

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- The British Journal of Dermatology has publishedevidence of sustained efficacy in tildrakizumab responders and a favourable long-term safety profile with total tildrakizumab exposure of over 5400 patient-years through 5 years (256 weeks)[1]

- The full complete pooled dataset demonstrates long-term psoriasis control with tildrakizumab with a consistent long-term safety profile through 5 years (256 weeks)[1]

- This is the first and longest complete pooled dataset published in a medical journal on an anti-IL23p19 inhibitor

BARELONA, Spain, Feb. 9, 2021 /PRNewswire/ -- Almirall, S.A. (BME: ALM), a global biopharmaceutical company focused on skin health, announced today that the British Journal of Dermatology (BJD) has published a full 5-year pooled data analysis from two phase III clinical studies, reSURFACE 1 and reSURFACE 2 of Ilumetri (tildrakizumab), an IL-23p19 inhibitor for the treatment of moderate-to-severe plaque psoriasis, and can be found in the BJD online library. These data provide evidence of sustained efficacy in tildrakizumab responders and in patients switched from etanercept to tildrakizumab at week 28, and a favourable long-term safety profile with total tildrakizumab exposure of over 5400 patient-years. During this period, PASI and PGA response rates were maintained in a large proportion of patients[1]. This is the first and longest complete dataset published in a medical journal on an anti-IL23p19 inhibitor.

Long-term efficacy and safety: up to 5-year results from reSURFACE 1 and reSURFACE 2[1]

Results of the 5-year pooled data from reSURFACE 1 and reSURFACE 2demonstrated long-term control of psoriasis, with a large proportion of patients who responded at week 28 maintaining efficacy by both relative and absolute PASI. Absolute PASI <3 at week 244 for tildrakizumab 100mg and 200mg were 78.8% and 82.6% respectively. PGA 0/1 at week 244 for tildrakizumab 100mg and 200mg were 68.5% and 74.2%, respectively (multiple imputation for missing data). Results show a favourable long-term safety profile with a total tildrakizumab exposure of over 5400 patient-years. Both 100mg and 200mg doses weregenerally well tolerated with low rates of serious adverse events and adverse events of special interest through 5 years.

"In our study, patients who responded to tildrakizumab maintained a clinically significant response over 5 years. Control of psoriasis was sustained with a reassuring safety profile. This tildrakizumab study confirms the role that the IL23p19 class can play in achieving long term control for our psoriasis patients," stated Prof Diamant Thai, Director of the Comprehensive Centre for Inflammation Medicine at Lbeck University in Germany, the first author of the study.

Safety was further explored in different analyses examining incidence rates of severe infections, malignancies, and major adverse cardiovascular events, as well as overall safety in patients over 65 years of age. No new reported signals were found in any of the sub-groups.

About tildrakizumab[2]

Tildrakizumab is a humanized monoclonal antibody that targets the p19 subunit of interleukin-23 (IL-23) and inhibits the release of proinflammatory cytokines and chemokines with limited impact on the rest of the immune system. Indicated for the treatment of adults with moderate-to-severe plaque psoriasis who are candidates for systemic therapy. Tildrakizumab demonstrated superiority vs placebo and etanercept in the phase 3 reSURFACE programme. Significantly more tildrakizumab patients achieved PASI 75 at Week 12 vs. placebo in both studies [re-SURFACE-1/2: 64%/61% (100 mg), 62%/66% (200 mg) vs 6%/6% (PBO), p<0.0001] and vs. etanercept [reSURFACE-2: 61% (100 mg, p=0.001), 66% (200 mg, p<0.0001) vs 48%]. Significantly more tildrakizumab patients achieved a PGA score of 'clear' or 'minimal', with 2-grade reduction from baseline at Week 12 in both studies vs. placebo [re-SURFACE-1/2: 58%/55% (100 mg), 59%/59% (200 mg) vs 7%/4% (PBO), p<0.0001], TIL 200 mg (59%, p=0.0031) and TIL 100 mg (55%, p=0.0663) vs. ETA (48%). The incidence of severe infections, malignancies, and major adverse cardiovascular events seen in the clinical trials were low and similar across treatment groups, with the most common AE being nasopharyngitis. Tildrakizumab was administered as 100 or 200 mg injection(s) at week 0 and 4 in the induction phase and then every 12 weeks thereafter for maintenance. DLQI 0/1 at week 12 was achieved by 42% of patients (n=309); by week 28 it was achieved by 52% of the patients (n=299) with patients reporting that psoriasis no longer affected their lives. By week 52, 64% of the responders at week 28 achieved DLQI 0/1 (n=113).

Almirall in-licensed Tildrakizumab from Sun Pharmaceutical Industries Ltd. (Sun Pharma) in July 2016. The agreement is for development and commercialization of tildrakizumab in Europe. So far, tildrakizumab has been launched in Germany, United Kingdom, Switzerland, Austria, Denmark, Spain, Italy and France.

References

1. Thai D, Piaserico S, Warren RB, et al. Five-year efficacy and safety of tildrakizumab in patients with moderate to severe psoriasis who respond at week 28: pooled analyses of two randomised phase 3 clinical trials (reSURFACE 1 and reSURFACE 2). Br J Dermatol. 2021 Feb 5. doi: 10.1111/bjd.19866.

2. IlumetriI (tildrakizumab) Summary of Product Characteristics.

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https://www.almirall.com/

SOURCE Almirall, S.A.

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Almirall announces a new publication in the British Journal of Dermatology of ILUMETRI (tildrakizumab) as the first anti-IL23p19 treatment for which...

Highmark expands access to Freespira’s DTx, Almirall and Happify developing digital mental health program for European psoriasis patients and more…

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Highmark, a Blue Cross Blue Shield-affiliated health insurer, will expand access to Freespira's digital therapeutic for PTSD, panic disorder, panic attacks and other panic symptoms.

In addition to bringing the treatment to members living in Pennsylvania, Delaware and West Virginia, the agreement will also provide remote coaching on how to use Freespirato those not already receiving support from a behavioral health professional, according to the announcement.

"We are pleased with the clinical and financial outcomes achieved for our health plan members through the use of Freespira," Demetrios C. Marousis, director of behavioral health at Highmark, said in a statement.

"This breakthrough, drug-free treatment has reduced the impact of symptoms associated with panic attacks, resulting in reduced use of medications and other healthcare costs for symptom management. Freespira adds value to our members' plans and helps us to create a remarkable health care experience, freeing people to be their best."

Barcelona-based biopharma company Almirall and New York-based Happify Health will be working together to develop an international version of Claro, a digital treatment that addresses the mental health of psoriasis patients. This product would be designed for psoriasis patients living in Spain, Italy, France and the U.K., and would be deployed later this year through the Almirall patient support program.

"Since mental health events act as stressors that can trigger psoriasis flare ups, Happify is excited to work with a European leader like Almirall in this condition to address the mental and physical health symptoms of these patients," Chris Wasden, head of digital therapeutics at Happify Health, said in a statement.

"Our digital therapeutic solution acts as a complement to Almirall's commitment to psoriasis patients to empower people with psoriasis to live full lives through meaningful behavior change. Together, we can help psoriasis patients, one patient at a time, and at scale."

Kaiser Permanente has signed a multi-year collaboration with Accenture and Microsoft to bring more of its digital ecosystem to the cloud. The healthcare provider said that the partnership will enable new capabilities for Kaiser Permanente members and clinicians alike for more personalized and accessible care.

This collaboration will help Kaiser Permanente better serve our members by providing our care teams with increased access to cloud-based services, which will enable them to deliver personalized digital experiences and make more data-informed decisions, Diane Comer, SVP and interim CIO for Kaiser Permanente, said in a statement.

Boehringer Ingelheim's representatives will be using air quality data from BreezoMeter when speaking with clinicians about their patients' respiratory health, the pharma company announced last week. By tapping both real-time and historical data, Boehringer would be able to help predict when and whether environmental stressors could exacerbate symptoms of asthma, COPD and other conditions, and thereby raise awareness among providers.

"We complement our commitment to developing innovative therapies by developing innovative digital solutions with the goal of supporting healthcare providers in managing chronic conditions, Jim Boushie, executive director of business transformation at Boehringer Ingelheim, said in a statement.

To improve respiratory health and treatment plans, we utilize BreezoMeters data to help expose the effects of high pollution and pollen. Their air quality analytics empower our teams and will continue to inform how we collaborate with physicians to improve patient outcomes.

Otsuka Pharmaceutical's Development & Commercialization arm has partnered with Spencer Health Solutions, the maker of an at-home medication adherence platform, to further evaluate and deploy direct-to-patient services through the device. In particular, the pharma company said it will be considering the device's medication adherence and patient engagement capabilities in upcoming traditional and decentralized clinical trials.

Our commitment to the democratization of clinical trials, patient engagement and leveraging technology to improve diversity and inclusion in clinical research helps drive our success at Otsuka, Dr. Christoph Koenen, EVP and chief medical officer at Otsuka Pharmaceutical Development & Commercialization, said in a statement.

The spencersmart hub will be an asset in our efforts to improve treatment plans for people living with challenging health conditions.

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Highmark expands access to Freespira's DTx, Almirall and Happify developing digital mental health program for European psoriasis patients and more...

Tips to prevent cold weather skin issues | News, Sports, Jobs – The Express – Lock Haven Express

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Dr. Mikita

Our skin is one of our hardest working organs. It not only protects all the other organs in our bodies, and can repair itself, but it also regulates body temperature and detects and fights off infection. Healthy skin is an essential part of your overall health and wellness, yet most of us take our skin for granted, especially in the winter.

Winters

Effects

on Skin

Frequent hand washing and sanitizer use may already be taking a toll on your hands as the pandemic continues, but as temperatures and humidity levels continue to drop, other body parts can also get itchy, cracked, and irritated.

The harsh weather can strip the skins natural protective barrier, creating gaps in the outer most layer, allowing water to escape promoting dehydration and irritants to get in. The dry environment may be responsible for that uncontrollable itch, as the inflammatory response kicks in and releases histamines. It can exacerbate inflammatory skin diseases such as rosacea, eczema, ichthyosis, and psoriasis, which suffer an impaired barrier function.

Tips to Avoid a Painful

Season

If you are not prepared, the changes to your skin can make for a long winter. Knowing how your skin typically reacts to cold weather can help you create a routine ahead of time and keep your skin from reacting negatively to fall and winter.

Know Your Skin: As winter approaches, try to remember how your skin changed during past winters. Maybe your skin stayed the same as it did in the summer. This could be because of the routine you have in place. If your skin changed and became dryer than usual, this may mean you need to better prepare your skin for winter.

If you know your skin is prone to drying out from cold weather, a way to prepare your skin before and during the winter is to stick to short and warm showers. Long, hot showers can feel great after a cold day, but can strip your skin of important oils, leaving it dry.

Its All About Moisture: Find a good moisturizer and use it before the cold weather hits and throughout the cold weather season. A moisturizer does exactly what its name implies: moisturizes. Moisturizing your skin in preparation for the cold weather and during the winter can help your skin from becoming dried out. An oil-free moisturizer that contains glycerin is best to help keep skin hydrated.

Some Conditions Require Special Treatment: If you have eczema or psoriasis, you will have to do more than simply slather on extra lotion and drink more water.

In the case of eczema, your body overreacts to an external trigger, such as dust mites or perfumes in cosmetics and soaps. Eczema develops as itchy, red skin, often in areas where skin touches skin, such as in the bends of the arms or knees. If you have eczema, its important to use fragrance-free, hypoallergenic soap and moisturizers, as fragrances can cause allergies and further trigger itchiness and inflammation. One over-the-counter cream that may help provide relief from symptoms. You should also use scent-free hypoallergenic laundry detergent for the same reason. Certain fabrics, such as those made with wool, may be irritating to delicate skin as well.

In the case of psoriasis, a hyperactive immune response causes new skin cells to proliferate more quickly than old ones can be shed. The result is that cells pile up on top of each other, causing red patches with silvery scales. Psoriasis almost always requires prescription treatment because of the underlying autoimmune disease, but the best option varies depending on how much of the skin is impacted. Lack of sun exposure during winter months can also have an effect on psoriasis so your provider may consider phototherapy, a treatment that essentially involves using a light box to expose skin to controlled amounts of UV light in order to dampen inflammation.

Preparation Can Go a Long Way

Dry skin can make for an uncomfortable winter which is why preparation is key as we continue through the cold winter months. If youre having trouble managing your skin care, talk to a dermatologist. Your dermatologist can help you develop a routine and care plan to meet your skins unique needs. If youre experiencing severely dry or chapped skin, or if youve recently developed a rash thats not improving, talk to your doctor as these could be signs of a dermatologic condition or symptoms of more serious illness or allergic reaction.

Dr. Sabrina Mikita is a dermatologist with UPMC seeing patients at SH Dermatology located at 1205 Grampian Blvd., Suite 1A, Williamsport. For more information or to schedule an appointment, call 570-326-8060.

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Tips to prevent cold weather skin issues | News, Sports, Jobs - The Express - Lock Haven Express

UPMC doctor: tips to prevent cold weather skin issues – NorthcentralPa.com

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Our skin is one of our hardest working organs. It not only protects all the other organs in our bodies, and can repair itself, but it also regulates body temperature and detects and fights off infection. Healthy skin is an essential part of your overall health and wellness, yet most of us take our skin for granted, especially in the winter.

Winters Effects on Skin

Frequent hand washing and sanitizer use may already be taking a toll on your hands as the pandemic continues, but as temperatures and humidity levels continue to drop, other body parts can also get itchy, cracked, and irritated.

The harsh weather can strip the skins natural protective barrier, creating gaps in the outer most layer, allowing water to escape promoting dehydration and irritants to get in. The dry environment may be responsible for that uncontrollable itch, as the inflammatory response kicks in and releases histamines. It can exacerbate inflammatory skin diseases such as rosacea, eczema, ichthyosis, and psoriasis, which suffer an impaired barrier function.

Tips to Avoid a Painful Season

If you are not prepared, the changes to your skin can make for a long winter. Knowing how your skin typically reacts to cold weather can help you create a routine ahead of time and keep your skin from reacting negatively to fall and winter.

Know Your Skin: As winter approaches, try to remember how your skin changed during past winters. Maybe your skin stayed the same as it did in the summer. This could be because of the routine you have in place. If your skin changed and became dryer than usual, this may mean you need to better prepare your skin for winter.

If you know your skin is prone to drying out from cold weather, a way to prepare your skin before and during the winter is to stick to short and warm showers. Long, hot showers can feel great after a cold day, but can strip your skin of important oils, leaving it dry.

Its All About Moisture: Find a good moisturizer and use it before the cold weather hits and throughout the cold weather season. A moisturizer does exactly what its name implies: moisturizes. Moisturizing your skin in preparation for the cold weather and during the winter can help your skin from becoming dried out. An oil-free moisturizer that contains glycerin is best to help keep skin hydrated.

Some Conditions Require Special Treatment: If you have eczema or psoriasis, you will have to do more than simply slather on extra lotion and drink more water.

Preparation Can Go a Long Way

Dry skin can make for an uncomfortable winter which is why preparation is key as we continue through the cold winter months. If youre having trouble managing your skin care, talk to a dermatologist. Your dermatologist can help you develop a routine and care plan to meet your skins unique needs. If youre experiencing severely dry or chapped skin, or if youve recently developed a rash thats not improving, talk to your doctor as these could be signs of a dermatologic condition or symptoms of more serious illness or allergic reaction.

Dr. Sabrina Mikita is a dermatologist with UPMC seeing patients at SH Dermatology located at 1205 Grampian Blvd., Suite 1A, Williamsport. For more information or to schedule an appointment, call (570) 326-8060

Excerpt from:

UPMC doctor: tips to prevent cold weather skin issues - NorthcentralPa.com

If Youre Going to Follow Any Pandemic-Era Skin Care Advice, Derms Say to Make It This – Well+Good

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Having lived through a global pandemic for going on a year now, weve learned a lot, like that face masks are important, toilet paper is a hot commodity, and the world of exotic animals is far wilder than we could have possibly imagined. And while all (*gestures wildly*) of that was going on, we still managed to learn a lot about skin care while social distancing at home as well.

As many of us used the time at home to recalibrate our beauty routines, we relied on some of our favorite dermatologists to help us do it properly. Over the course of the pandemic, Well+Good has published hundreds of stories about skin care, ranging from how to deal with maskne (a word none of us had ever even heard before 2020) to how to treat psoriasis with a $10, over-the-counter lotion. To find out which tips have made the biggest difference in our skin during this unusual year, keep on scrolling.

Cleansing oil is known to be one of the gentlest, most effective types of face wash that works for all skin types, but in order to reap its full benefits, youve got to use it properly. According to derms, you should start by applying it to dry skin, which will better help it pick up the makeup, dirt, and oil from your pores, massage it in circular motions, then rinse it off entirely with warm water (never cold, because it will solidify the oil) to ensure it gets off all the gunk.

Adult acne is very much a thing, which means that when youre trying to treat it, you also may be trying to treat fine lines and wrinkles. The fix, according to board-certified dermatologist Joshua Zeichner, MD, is to use a simple two-ingredient combo. You need to make sure that the acne products are in line with other aesthetic needs of the patients, he says. Thats where topical retinoids are really helpful, and ingredients like salicylic acid, because they both give exfoliating benefits, and skin brightening and evening benefits, and retinoids can also help to stimulate collagen production.

There are plenty of effective hydrating ingredients out there (in the video above, board-certified dermatologist Mona Gohara, MD, names five of them), but the one that unquestionably deserves a spot in any no-frills routine is glycerin. Humectants attract water to the skin, explains Dr. Gohara, adding that glycerin and other fan-fave hydrator hyaluronic acid both fall into this category. And glycerin is not only so great at drawing water into the skin, but its also super gentle, which is why youll see it in a ton of products. I personally think that glycerin is the one ingredient thats good for everyone. Its no bells and whistles, we know it works, and everybody should have it.

There are certain serumslike the Skinceuticals legendary vitamin C serumthat are worth spending big bucks on. But others? Not so much. According to Dr. Gohara, its A-okay to skimp on other spots in your routine. When it comes to splurging, think about antioxidants, retinol, and any specific skin concern that you may have, she says. But I definitely think a gentle cleanser, a sunscreen, or even a moisturizer are places where you can save. This way, you can save up for one whizzbang treatment that really works.

Toner is one of the skin-care worlds most confusing routine steps, and derms have differing opinions on whether you really need it or not. The trick to getting the most out of it? Only apply it to certain spots. If you feel like you need it, just use it on areas where you may need a little extra love on your skin, says Dr. Gohara. If you have dry patches, look for a hydrating toner with hyaluronic acid, like Vichy Puret Thermale ($18) and if youre oily in certain spots, use an exfoliating AHA-packed option, like Glossier Solution ($24)

Last year gave us a swift introduction to the trials and tribulations of maskne, but (thankfully) also taught us how to treat it. Wearing masks is essential, but so is taking care of your skin, because thats the barrier between us and whats happening in the outside world, says Dr. Gohara. So to whatever extent you can, keep it gentle and basic. She suggests using a hydrating cleanser, likeLa Roche-Posay Toleriane Hydrating Gentle Face Cleanser ($15) to keep your skin extra clean, then applying an emollient moisturizer like Vaseline($2) orCerave Healing Ointment ($10) to the bridge of your nose, around your ears, jawline, cheekbones, and anywhere else where the mask might be rubbing.

Dont pick your skin is the skin-care advice dermatologists dish out on the reg and that most of us constantly ignore. If you are going to go all-in on your blackheads (which, same), Dr. Gohara says theres only one right way to go about it. One of the most important ways to get rid of blackheads is to extract them out, says Dr. Gohara. Im not giving you the carte blanche to go at them with your nails, but I definitely think there are ways we need to extract blackheads. Shes a fan of using at-home comedone extractors, like this one, which are a whole lot safer for your skin than your own fingers.

Considering this year forced us to spend time away from our dermatologists offices, we had to find at-home solutions for the treatments we often rely on them on. And in the case of Botox, we turned to collagen-stimulating peptides to help keep our skin plump. Peptides are small amino acids, which are the building blocks of collagen, explains Dr. Gohara. Kind of like a grape is to wine, peptides are to collagen. They wake up the collagen, shake it up a little bit, so it knows it has to produce itself more. The result? Smoother, juicier skinno needles required.

2020 was the year that I learned that those little pimple-looking spots on my butt werent actually pimples at all. One of the most common things that my patients come in forwhich can be very distressingare pimple-like lesions on the butt. Or, buttne, says Dr Gohara. But in reality, it aint buttne at all. While the blemishes on your behind maylook like red, angry, inflamed zits, theyre actually something different entirely. These arent true pimplestheyre inflamed hair follicles, explains Dr. Gohara. To deal with them, she suggests using a 1.5 or two percent benzoyl peroxide wash in the shower, like Panoxyl Acne Foaming Wash ($9). If that doesnt work, it may be time to take a trip to the dermatologist for a more intense prescription treatment.

Treating psoriasis can be frustrating, but it doesnt have to be expensive. According to Dr. Gohara, the best OTC treatment will only run your $10. Her go-to?Eucerin Advanced Repair Lotion($10). It has a smidge of exfoliators in it, so its a nice compromise between total exfoliation and just moisturizing, she says. Its made with lactic acid, which will help to gently slough away flakes, andceramides, which work to strengthen your skin barrier. I think that would be a very nice choice for somebody who has psoriasis on their skin, says Dr. Gohara.

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Scientists to explore whether anti-inflammatory drugs control blood sugar Washington University School of Medicine in St. Louis – Washington…

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New grant to fund research into drugs that showed promise in small study of people with Crohns disease

Meals prepared for scientific studies of metabolism and nutrition stand ready for distribution at Washington University School of Medicine in St. Louis. Researchers at the School of Medicine are studying whether drugs to treat inflammatory conditions such as Crohn's disease also could help control blood sugar levels.

Inflammation and metabolic disorders are deeply intertwined. For example, people with inflammatory conditions such as Crohns disease and psoriasis are at risk of developing metabolic disorders such as insulin resistance and diabetes. However troubling that connection might seem, it also might point to some promising news.

Researchers at Washington University School of Medicine in St. Louis have received a Catalyst grant from the National Institutes of Diabetes and Digestive and Kidney Diseases (NIDDK) to investigate whether immunosuppressive drugs prescribed for inflammatory bowel disease (which includes Crohns disease and ulcerative colitis) or psoriasis also can control blood sugar levels. If they do, such drugs could provide a way to improve control of blood sugar in people with inflammatory diseases, thereby reducing the risk of serious complications such as diabetes. Catalyst grants are meant to support scientists of exceptional creativity who propose pioneering and possibly transformative approaches important to the mission of the NIDDK.

The idea for the study emerged from an unexpected observation. Gwendalyn Randolph, PhD, the Emil R. Unanue Distinguished Professor of Immunology and a professor of medicine, was investigating how people with Crohns disease handle fat in their diet by feeding participants a carefully designed milkshake and monitoring the levels of different kinds of fat in their blood over time. As part of the study, the researchers also collected data on blood sugar levels. The primary result of that study was negative: People with Crohns and healthy participants processed fat much the same. But an odd pattern in the data caught Randolphs eye: The five Crohns patients who happened to be taking the anti-inflammatory drug ustekinumab maintained normal blood sugar levels after a meal, unlike other participants with Crohns disease who were taking other medications. Their glucose levels strayed higher and normalized more slowly than healthy controls.

It was really just a side observation; the study was not designed to address the question of blood glucose levels, said Randolph, the principal investigator on the $500,000 NIH grant. But this new grant will help us check it out and see if it has merit. Its an exciting hypothesis because people with inflammatory bowel disease (IBD) are at higher risk of developing metabolic disorders including type 2 diabetes, and there are not great medications to treat glucose problems linked to inflammatory disease.

As a drug that might control blood sugar, ustekinumab may be a dark horse. Scientists have speculated for years that suppressing pro-inflammatory molecules known as cytokines might help control blood sugar in people with chronic inflammation. But there are dozens of cytokines, and none of them have panned out in clinical trials. The two cytokines suppressed by ustekinumab IL-12 and IL-23 have never been high enough on the list of likely targets to warrant a study.

The serendipitous observation suggests that IL-12 and IL-23 may have previously unrecognized effects that could shine light on the complicated relationship between metabolism and inflammation.

We caught a glimpse of something, in the previous study, related to how metabolism is modified in the setting of inflammation, said co-investigator Parakkal Deepak, MBBS, an assistant professor of medicine in the Division of Gastroenterology. As a member of the medical faculty of the Inflammatory Bowel Disease Center, Deepak sees patients with IBD on the Washington University Medical Campus. With further investigation into this area, we one day may be able to select therapy for people with inflammatory diseases based on the underlying metabolic profile and the effect of specific treatments on that metabolic profile.

The researchers plan to study patients who have inflammatory diseases and already are taking drugs that target IL-12 or IL-23. With the help of the Center for Human Nutrition, the researchers will monitor levels of blood sugar and other biomolecules while participants are fasting and after meals. Bettina Mittendorfer, PhD, a professor of medicine in the Division of Geriatrics and Nutrition Sciences and an expert on glucose metabolism, is helping to design the study in people.

The researchers also are planning mouse studies to see if neutralizing IL-12, IL-23 or both improves glucose and insulin tolerance.

The implications are much larger than diabetes alone, said co-investigator Matthew Ciorba, MD, an associate professor of medicine in the Division of Gastroenterology and director of the IBD Center. There are several other important complications of IBD linked to glucose metabolism, notably nonalcoholic fatty liver disease. Understanding if current therapies can modify glucose and other metabolic complications has the potential to impact millions of patients across the world.

Washington University School of Medicines 1,500 faculty physicians also are the medical staff of Barnes-Jewish and St. Louis Childrens hospitals. The School of Medicine is a leader in medical research, teaching and patient care, ranking among the top 10 medical schools in the nation by U.S. News & World Report. Through its affiliations with Barnes-Jewish and St. Louis Childrens hospitals, the School of Medicine is linked to BJC HealthCare.

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Spondyloarthritis: Types, symptoms, treatment, and more – Medical News Today

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Spondyloarthritis is an umbrella term that describes different types of arthritis. These types mainly affect the spine, but they can also cause symptoms in other parts of the body.

There has been some debate about whether spondyloarthritis is an autoimmune condition or an autoinflammatory condition. However, recent research suggests that spondyloarthritis is indeed an autoimmune condition.

This article will explore spondyloarthritis in detail. Specifically, it will examine the different types, symptoms, and treatment options associated with the condition.

There are several subtypes of spondyloarthritis. Each can involve a different part of the body.

The following sections will look at some of these types in more detail.

Ankylosing spondylitis is the most common form of spondyloarthritis. It involves ligaments, tendons, and joint capsules attaching to bones in the spine and peripheral joints.

It can cause the bones in the spine to fuse together, leading to stiffness and immobility.

Learn more about ankylosing spondylitis here.

This type of spondyloarthritis primarily involves the joints in the spine and pelvis.

Axial spondyloarthritis causes back pain and affects around 5.5 million people in the United States.

Like axial spondyloarthritis, the non-radiographic form also affects the spine and causes lower back pain.

However, the effects of non-radiographic spondyloarthritis are not visible on X-rays. They are only visible on more sensitive imaging tests, such as MRI scans.

Peripheral spondyloarthritis describes a number of spondyloarthritis subsets.

It mainly affects the hands and feet. However, it can also cause inflammation in the:

Both rheumatoid arthritis and spondyloarthritis are very common. Although they share some similarities, the conditions also have significant differences.

Spondyloarthritis tends to be more common in males, whereas rheumatoid arthritis is more common in females.

Rheumatoid arthritis symptoms typically start appearing when a person is around 4050 years of age. The symptoms of spondyloarthritis usually occur earlier than this.

The early symptoms of rheumatoid arthritis usually affect the hands and feet. The early symptoms of spondyloarthritis usually start with back pain.

Learn more about the early signs and symptoms of rheumatoid arthritis here.

People often develop spondyloarthritis in their teenage years or 20s. Those with the following characteristics may be more likely to experience spondyloarthritis:

It is important to note that spondyloarthritis is notoriously difficult to diagnose in females. This could mean that it is more common in females than some statistics may show.

Lower back or hip pain is a common early symptom. However, symptoms can vary depending on the type of spondyloarthritis a person has.

Inflammation elsewhere in the body is a symptom of spondyloarthritis. It can especially affect the:

Spondyloarthritis-related inflammation can cause:

Another symptom of spondyloarthritis and the swelling it causes is psoriatic rashes. These may appear differently depending on a persons skin color.

Learn more about psoriasis on black skin here.

These symptoms may be particularly painful first thing in the morning or after periods of rest.

Untreated spondyloarthritis could lead to a person developing the following conditions:

A person who is experiencing symptoms of spondyloarthritis should contact a doctor to treat the condition. This may help prevent these complications.

If a person has had chronic lower back pain since before the age of 40 years, they may have spondyloarthritis. People often assume that they simply have back pain due to poor posture or other mechanical issues.

Because the pain can come and go, some people may assume that the pain is not important. However, not seeking treatment for spondyloarthritis can lead to complications later on.

A person who suspects that they have spondyloarthritis should contact a doctor. They should provide the doctor with details about their pain onset and whether or not they have other inflammatory symptoms that might suggest the presence of spondyloarthritis.

A doctor will diagnose spondyloarthritis by taking a persons medical history and performing a physical exam.

Imaging can help confirm a diagnosis. The doctor may request an MRI scan if an X-ray does not show damage but a person has symptoms that suggest the presence of spondyloarthritis.

A blood test is also available for the HLA-B27 gene, which is a gene associated with the condition. However, testing positive for the gene does not necessarily mean that a person has spondyloarthritis.

The doctor can also perform ESR tests or CRP tests on the blood in order to determine if swelling is present in the body. This can also help diagnose spondyloarthritis.

The doctor may also choose to carry out a complete blood count, to diagnose anemia, or a metabolic panel, to analyze a persons kidney and liver function.

Sometimes, medical professionals can mistake spondyloarthritis for other similar conditions, which can delay diagnosis and treatment. This is especially the case among females.

There is currently no cure for this condition. However, treatment can help relieve the symptoms and slow the progress of the condition.

Some treatment options include:

Biologics are very effective but expensive. These drugs can also increase a persons risk of infection.

Also, physical therapy can help restore range of motion in the affected joints.

One 2020 study involved putting 100 people with axial spondyloarthritis, non-radiographic axial spondyloarthritis, or psoriatic arthritis with axial involvement on physical therapy treatment programs.

The therapy significantly improved the pain that the condition caused, including among those with secondary conditions such as fibromyalgia.

Occupational therapy can also help a person improve or maintain their ability to perform day-to-day activities. An occupational therapist can provide recommendations and assistive devices to help prevent further injury.

Living with spondyloarthritis can make performing certain everyday tasks more difficult, but it is possible to manage the symptoms. Also, the condition does not usually affect a persons life expectancy significantly.

Symptoms such as pain and fatigue may come and go, and treatments can help a person live with this condition.

Some behavioral changes can also make living with spondyloarthritis easier. These changes include:

There are also spondyloarthritis support groups available for people who may need additional support.

Not seeking treatment for spondyloarthritis can lead to complications. Joints can fuse, for example, which may cause severe stiffness or immobility.

The symptoms of spondyloarthritis can come and go. However, even if a person does not constantly experience symptoms, they should still contact a doctor.

Not seeking treatment can lead to more complications of the condition. For example, it could become increasingly painful.

With the right treatment, people with spondyloarthritis can live an active life. Although there is no way to cure the condition, it is possible to manage the symptoms and prevent disease progression.

Making certain behavioral changes and trying medical treatments can make the pain and inflammation of spondyloarthritis more manageable.

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Adoption By Emerging Economies To Bolster The Systemic Psoriasis Therapeutics Market Atlantic Financial Management – Atlantic Financial Management

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Psoriasis is an autoimmune skin disease that causes scaling, skin redness and irritation. Psoriasis causes red, scaly patches that are generally found on the elbows, fingernails, scalp, palms, knees, face, feet and inside the mouth.

Factors that can trigger psoriasis include infections, heavy alcohol consumption, cold weather, certain medications, smoking, stress and injury to the skin such as bug bite, cut and sever sunburn. The signs and symptoms of psoriasis vary from person to person which includes dry, cracked skin that may bleed, red patches of skin covered with silvery scales, small scaling spots, itching, burning, swollen and stiff joints.

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Psoriasis may be classified into various types such as plaque psoriasis, scalp psoriasis, pustular psoriasis, psoriatic arthritis, guttate psoriasis, nail psoriasis, erythrodermic psoriasis and inverse psoriasis. Various treatments for psoriasis are oral medication, topical medication and biologics injections.

Psoriasis can also be treating by phototherapy treatment which includes ultraviolet light therapy, laser treatment, tanning beds, psoralen +UVA and sunlight treatment. Psoriasis can occur in any part of the body and it is associated with other health conditions such as heart disease, diabetes and depression.

North America, followed by Europe, has the largest market for systemic psoriasis therapeutics due to emergence of novel therapies and rise in treatment seeking population in the region. Asia is expected to show high growth rate in the systemic psoriasis therapeutics market in next few years due to increase in the awareness of disease in the region.

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Technological advancement, rise in number of psoriasis patients, development of novel drugs, increasing disease awareness and improvement in diagnostic methods are some of the key factors driving the growth for global systemic psoriasis therapeutics market.

In addition, long-term treatment involving continuous uptake of biologics are expected to drive the market for systemic psoriasis therapeutics. However, adverse side effects associated with psoriatic drugs and economic downturns are some of the key factors restraining the growth for global systemic psoriasis therapeutics market.

Growing demographics and economies in the developing countries such as India and China are expected to offer high growth in systemic psoriasis therapeutics market in Asia. In addition, growing demand of novel therapies for psoriasis treatment is expected to develop good opportunity for global systemic psoriasis therapeutics market.

However, safety concern associated with systemic psoriasis therapeutics is expected to lead a challenge for systemic psoriasis therapeutics market. Some of the major trends that have been observed for systemic psoriasis therapeutics market are increasing use of combination therapies for treating psoriasis, emergence of non-invasive psoriasis treatment and technological advancement in the field.

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Some of the major companies operating in the global systemic psoriasis therapeutics market are AbbVie Inc., Stiefel Laboratories, Inc., Biogen Idec, Novartis AG, CELGENE CORPORATION, Takeda Pharmaceutical Company Limited, Pfizer Inc., Amgen Inc., Janssen Biotech, Inc. and Eli Lilly and Company.

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Adoption By Emerging Economies To Bolster The Systemic Psoriasis Therapeutics Market Atlantic Financial Management - Atlantic Financial Management

Phototherapy Equipment Market 2020 Size, Share, Analysis, Growth Driver and Industry Segments by 2027 KSU | The Sentinel Newspaper – KSU | The…

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Phototherapy, also known as light therapy, involves exposing the skin to ultraviolet light under medical supervision. Narrow-band UVB (NBUVB), Ultraviolet A (UVA)/NBUVB (in combination), and PUVA (psoralen + UVA) are the common types of phototherapy used. The choice of the type of phototherapy is dependent on the type of skin condition. However, narrow-band UVB is most widely opted due to its versatility and effectiveness for treating psoriasis, eczema, and mycosis fungoides patients across the world.

Furthermore, narrow-band UVB removes redundant and harmful UV rays by emitting wavelengths of 311-312 nm. Phototherapy equipment includes LED phototherapy equipment, fiber-optic phototherapy equipment, and conventional phototherapy equipment.

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Rising number of psoriasis cases are expected to boost growth of the phototherapy equipment market in the near future. For instance, according to the International Federation of Psoriasis Associations (IFPA), around 150,000 new cases are reported in the U.S every year and 3% of people are affected with some form of psoriasis around the world. Furthermore, increasing number of other skin diseases is increasing the demand for LED-based phototherapy equipment such as high intensity gallium nitric blue light emitting diode, which is very effective in lowering bilirubin by providing much higher irradiance for intensive phototherapy in the treatment of neonatal jaundice. According to the National Center for Biotechnology Information (NCBI), around 13 million babies are afflicted with jaundice globally, each year. This in turn is expected to boost growth of the phototherapy equipment market size. However, high cost of the equipment is hindering growth of the market.

Some of the key players profiled in the study are Atom Medical Corporation, Natus Medical Incorporated, Daavlin, Phoenix Medical Systems Pvt. Ltd, Philips Lighting Holding B.V., Solarc Systems, Inc., and GE Healthcare, Inc.

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Market Taxonomy:

The global phototherapy equipment market is segmented into devices, application, end user, and geography

On the basis of devices, the global phototherapy equipment market is segmented into:

On the basis of application, the global phototherapy equipment market is segmented into:

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Browsers, trackers, and cookies – ACS

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You are being watched.

Everything you do online is being captured, stored and analysed in order to determine your personality, preferences, and predict your behaviour.

In this special 3-part Information Age series, we look at the ways your online activity is being tracked and some of the steps you can take to control your personal data.

Part I: Browsers, trackers, and cookies

The first step in taking back control of your data is learning more about who is looking at what and when.

Lets start with cookies.

These small packets of data are stored locally on your device and get passed between web applications for all sorts of good reasons like authentication.

Remember Netscape? It patented the cookie in 1995 as a method and apparatus for transferring state information between a server computer system and a client computer system after employee Lou Montulii invented the process.

Cookies were an important solution to early web problems such as the ability to make shopping carts that keep a persistent list of chosen items during a browsing session and remain an integral part of internet use to this day.

Cookies created by the website you are actually visiting are known as first party cookies.

These are useful for things like keeping you logged in, remembering your site preferences, and shopping.

The problem with cookies comes when third parties like advertisers use them to gather data on people without their express knowledge or consent.

Digital advertisers have long used cookies to make ads on websites relevant to you. Cookies are the reason you get haunted by shoe ads in the week after shopping around for a new pair of Nikes.

Suppose your favourite online store is ReallyCheapThings.com.au. When you landed on the site in search of bargain Nikes, not only did ReallyCheapThings.com.au create cookies on your computer, but so did its advertising partners.

These third-party cookies get passed around and analysed so that when you visit another site such as a blog or news website its advertising partners cross-reference your cookies and bombard you with ads for shoes.

Clearing cookies

Because cookies are stored locally, you can see this in action.

First clear your browser cookies but beware! This will log you out of most sites.

On Google Chrome, these settings can be found at this link or by clicking the three vertical dots in the browsers top right corner, navigating down to Settings, and selecting Privacy and Security.

After you have cleared your cookies, make sure Allow all cookies is enabled.

Heres what an empty cookies folder looks like in Chrome:

And heres what that cookies folder looks like after 10 minutes of day-to-day browsing with third party cookies enabled:

Thankfully you now have more options for controlling who uses your cookies.

Google Chrome has an option to disable third-party cookies in the Privacy and Security section of browser settings, as does Microsoft Edge.

In fact, Google is planning to phase out third-party cookies in favour of its Privacy Sandbox a system that logs browser activity and lumps users into large groups for advertising, rather targeting individual interests.

Regulators are already looking into whether the tech giants proposals will inherently favour its own ads services over other companies.

Fingerprinters and trackers

Third party cookies are only part of the way your everyday internet browsing is used to monitor you and sell advertisements.

Many web pages incorporate other forms of tracking and fingerprinting technologies designed to identify users based unique features such as their device, location, and software configuration.

By combining different metrics, services can follow you around the internet without needing cookies.

Tools like the browser extension uBlock Origin block trackers disabling the code of known tracking processes from web pages before they load.

An open source extension, uBlock Origin leverages community-updated public lists of web processes that it filters out and makes your browsing a little more private.

To help its users understand and debug the extension, uBlock Origin features a unified logger you can use to better see behind what founder Raymond Hill calls the privacy-invading apparatus that enters your web browser on most sites.

View the uBlock Origin logger by opening the uBlock Origin extension and clicking the small window above the version number.

With this window open you can see things like the Google Analytics scripts sitting behind the Information Age front page that we use in order to know things like how many people visit individual stories each week.

Click on an article and you will see uBlock Origin filter trackers that are part of other features on Information Age like social media sharing buttons and comment moderation service Disqus which those platforms use to track their users across the web.

Head to a monetised news site like News.com.au or The Guardian and uBlock Origins logger will show you various scripts and beacons used to track their readers and deliver advertising campaigns.

While not expressly designed as an ad-blocker, uBlock Origin does also tend to remove ads as an added bonus.

Privacy browsers

Since uBlock Origin is maintained by one person who refuses to receive donations, theres no way of knowing how long it will remain as a useful blocking tool.

Thankfully, there are all-in-one privacy-focused browsers that disable known trackers and third-party cookies by default.

Mozilla Firefox is arguably the most well-established privacy browser.

Owned and operated by the non-profit Mozilla Foundation, Firefox is designed as a simple way to let people access the internet without having their data mined.

Another slightly more complex privacy-focused browser is the Tor Browser which is also run by a non-profit, the Tor Project.

Like Firefox, Tor keeps third-party cookies away and blocks common tracking processes but it also aims to limit fingerprinting by making all Tor users appear exactly the same, regardless of location, hardware, or software configuration.

It also natively supports the Tor network that uses different relays to hide obfuscate traffic. More on that next week.

Finally theres Brave a browser that cookies, ad tracking, can run on the Tor network, and also features an alternative economic model for the internet.

Brave blocks native advertisements and lets users opt-in to receive advertisements in the form of occasional pop-ups.

As a reward for viewing ads, users receive Brave Attention Tokens which they can pay forward to participating content producers, trade into crypto or fiat currencies, or hold in their wallets.

In Part II: Metadata, VPNs and Tor.

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Browsers, trackers, and cookies - ACS

I fought the dark web and the dark web won | News | albanyherald.com – The Albany Herald

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Your application for unemployment benefits has been approved, stated the letter from the Illinois unemployment bureau a few weeks back. That was perplexing, since I never applied and wasnt unemployed. So I immediately told my (part-time) employer and the state unemployment agency.

Turns out somebody had stolen my personal information again. [Insert grimace emoji here.]

I wasnt alone. Fraudulent jobless claims are a rampant scam across the country that accelerated during the COVID crisis as jobless benefits increased. More than a third of a million people in my state alone were also victims of the scam, including several people I knew. Although national tallies are still under way, the unemployment fraud is massive: California estimates more than $11 billion was stolen. All told, tens of millions of people couldve been scammed in this way.

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Since this was the third time Id been a victim of identity theft and fraud, I was steamed and wanted to know how thieves kept getting my information and conducted their grifting. If I knew where they got my information, maybe I could change some of my online behavior or take better precautions. I spent a lot of time on the phone giving my state unemployment agency my details. They were so swamped, it took them weeks to get back to me after I left a voicemail reporting the fraud.

I realized I would have to take matters into my own hands. This led to a month-long odyssey that included interviews with security experts and law enforcement officials and some frightening insights about the modern thieves market called the dark web. It was also a dispiriting trek as I was reminded how helpless we can be in the face of global technology that makes life easier for both the law abiding and the criminal.

I dont consider myself an easy mark, although Im certainly not an expert on cybersecurity. As a financial reporter and experienced identity theft victim, I take almost every precaution. My credit files with the three major credit reporting firms have been frozen for more than a year (triggered by an unrelated scam). I use a search engine that doesnt track or store queries. I regularly sweep my computer for viruses and I send all financial information via secure fax instead of vulnerable email. My spam filters are pretty diligent. I even leave my fax machine hooked up to my only landline to frustrate frequent robo-callers. I dont even open video links sent by friends. Still, like any online consumer, once I pass personal information to a third party, I cant bring it back.

This caution helps protect me from the efforts of cybercriminals to exploit the growing number of workers online by increasing their attacks through phishing (stealing information through email inquiries).

Unfortunately, we are not the only ones in possession of our key pieces of information, from our date of birth and Social Security numbers to banking and credit card numbers. Like most people who do nearly all of their work, shopping and communications on the web or through email, I know I compromise my privacy on a daily basis. Every time I do an online transaction, search or register on a Web site, some entity on the other end has my important personal information. Information is valuable currency these days; my data is used to market me more stuff every time I log on. In most cases, I had to trust that vendors cybersecurity systems were robust. I try to be careful, but I know I really have no control over my data once it leaves my keyboard and flows into cyberspace.

Data breaches, instances where digital information is stolen by outside actors, are at an all-time high. Last year, more than 737 million data files were ripped off, according to hacked.com, which described last years digital pilferage as a digital pandemic. With millions working remotely on their computers during the pandemic, the FBI recorded a 400% increase of cybercrime reports. The recent mega-hack of corporate and government systems, suspected to be conducted by Russian intelligence operatives, is a case in point.

Sometimes hackers want to mess up or shut down government or corporate systems or just want to see if they can break in. Its a challenge. Its their version of triathlons. But the vast majority of breaches are pure theft thats where the money is to quote bank robber Willie Sutton. The Verizon 2020 Data Breach Investigations Report, which analyzed more than 32,000 security incidents across the globe, found that 86% of the data breaches were for financial gain up from 71% in 2019. Government and corporate and other data-rich systems like health care databases are prime targets. Lately theyve been raiding school districts and municipal systems.

Thieves probably snagged the identifying details used to file my bogus unemployment claim from one such data breach. I know from sorry experience how they do it. But tracking down who stole the data and getting it back is not easy. It helps to know where your information was stolen from: Data breaches are usually made public, although there are tens of thousands of them. The range of systems being compromised is vast from Target to the giant credit file company Equifax. A West African fraud ring, for example, reportedly used data stolen in the Experian breach to steal more identities.

According to Edward Garb, a security researcher at Atlas VPN, a digital privacy company, finding out the company that breached your data is the easy part. Now, you need to explore the dark web to find a vendor who sells records from that data breach. This might or might not be possible.

My next step was clear: I had to scour the dark web to try and retrieve and remove my information. But this was almost impossible.

The dark web is a section of the Internet thats not accessible through conventional search engines. Its a subterranean level of the Internet, something akin to a series of unlabeled subbasements. You have to know exactly where youre going, although even then its not neatly indexed like the surface web. Sites on the darknet mostly have a .onion suffix, instead of .com, .net, or .org on the regular web.

You cant simply browse the darknet. Garb adds. You have to know what you are looking for. You must know the address of the website you want to access, or at least a place where you can find those addresses. To do so, people turn to Reddit or closed forums on the surface web. Probably the most famous place is Redditsdarknet subforum, with more than 146,000 users.

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Complicating matters, I learned that having a dark web address only gets you to the front door; you need to be invited to a dark web site, which is accessible by specialized software such as theTOR browser, also known as an onion router, which makes searchers anonymous as they explore deeper layers of the web.

Not surprisingly, TOR, originally designed to hide the identities of government agents, was developed by the same Pentagon agency that developed the Internet (DARPA).

If the government designed and built the Internet and its wayward cousin the dark web, why cant law enforcement agencies shut it down or at least grab a few major perpetrators? I put this question toJoe Koletar, a fraud expert and former Army intelligence officer. He also served for the FBI for 25 years.

FBI has a lot of horsepower devoted to the digital world, Koletar said. But [the dark web is] distributed like a virus. There are too many small players. Any attempt to attack it, changes it.

Koletar said that, like a lot of digital criminality, dark web data crooks are often paid inbitcoin, a digital currency. Bitcoin is a terrorist, blackmailer or crooks dream, Koletar adds. It cant be traced and isnt anchored in anything.

Further frustrating law enforcement efforts to crack down on dark web stolen-data marketplaces is that the darknet is a grouping of websites that are not run by one entity. Communication occurs in private messaging and most users use the TOR browser together with a virtual private network (VPN) service, which makes them completely untraceable, even to their Internet service provider or other third parties, Garb adds.

In short, it is hard to track down the criminals because the users IP address is hidden and changed, browsing data is encrypted, and they send and accept payments with bitcoins. The main idea of the darknet was obfuscating important information and identities, which it does extremely well, but cybercriminals found that it is a perfect place for them to trade illegal goods and services.

When I prepared to search for my stolen information on the dark web, I asked a close friend who manages cybersecurity for a large company where I could look for the identity robbers who used my name to apply for jobless benefits.

He made some helpful suggestions I should use TOR on a spare computer and set up a VPN to ensure privacy. He also warned me against the hunting expedition.

Be extra careful, because as a known author, once you publish you are a target, he advised.That made me rather squeamish since I didnt want to become bait for a cyberattack. I do nearly all of my work online and my articles and email are posted in countless locations. Even though I have two backup computers, they are on the same network. If I wasnt fully able to cloak my IP address the signature for my network I would be roadkill for any hacker. So I demurred on going any deeper with a dark web dive. I was way out of my league.

So much for my data search and rescue mission. Instead, I searchedhttps://haveibeenpwned.com/to see if my email had been pawned. The site, which provides imprecise information on data breaches where your informationmayhave been stolen, confirmed that my email address was lifted. Of the 17 data breaches identified, one stood out: It was a site hit by a massive hack in 2014 (Forbes.com). All told, though, there was little more to do, since my email couldve been in no less than 10 billion data files, the site noted. I also received notification from my browser security that some 200 passwords had been compromised on sites I visited.

My search left me feeling disappointed and exposed protecting my identity and identifying the criminals seemed an impossible task. I was also confused.

About a week receiving the unemployment letter from my state, a debit card with my first weeks benefits arrived in the mail (which I shredded). It seemed puzzling. If you would go to the trouble of stealing a benefit with a card loaded with money, wouldnt you send it to another address? But I was told its likely this set of thieves was just using me to probe the state computer system for weaknesses.

Once again, I was just a pawn in someone elses game.

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I fought the dark web and the dark web won | News | albanyherald.com - The Albany Herald

The Top 5 Best VPNs for the Dark Web in 2021 Browse Tor Sites While Staying 100% Safe! – TechNadu

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Visiting the dark web isnt as difficult as you might think. But only relying on Tor to do that isnt smart. On its own, its just not very secure, which is why you pair it up with a VPN. But how do you know what are the best VPNs for the dark web?

Well, its simple well tell you all about them you in this article. Well also include a step-by-step guide showing you how to use the VPN to surf the dark web, and answer some FAQs.

Not all VPNs support Tor traffic or offer secure features. To save you time, we ran some tests and found the best five VPNs for the dark web:

Editor's Pick

Servers 3000+

Countries 94

Parallel Connections 5

Live Chat Yes

What we really like about ExpressVPN is that all its servers support Tor traffic. You wont see this mentioned in their marketing copy, but we confirmed it with their support reps.

Another reason we consider ExpressVPN the best VPN to access the dark web is because of its proprietary Lightway protocol. Its not really a big secret that VPNs can slow down your speeds, and that Tor is very slow too. So it helps to have a speedy protocol like Lightway on your side. Dont expect lighting-fast speeds when using Tor, but theyll still be better than what other VPNs offer. Plus, it takes you a fraction of a second to connect to a VPN server.

Other than that, ExpressVPN has top-notch security thanks to its powerful encryption, zero-log policy, and kill switch (called Network Lock) which protects you from traffic leaks. Whats more, ExpressVPNs servers are RAM-only, meaning any stored data is wiped with every reboot. Also, they dont write any data to the hard drive, meaning you get more privacy.

And if you ever have any questions or issues, ExpressVPNs support team is just a live chat message away (theyre available 24/7). Best of all you buy with zero risk since ExpressVPN has a no-questions asked 30-day refund policy.

Want to find out more about this provider? Check out the full ExpressVPN review.

Servers 5,500+

Countries 59

Parallel Connections 6

Live Chat Yes

All of NordVPNs servers support Tor traffic, but this provider has a special category of servers optimized just for Tor. Theyre called Tor over VPN servers. When you use them, you dont need to connect to a regular server and use Tor to browse .onion sites. Instead, you can do that directly in your browser (Opera, Chrome, or Firefox)!

Their iOS app also has a Dark Web Monitor. Its a feature that alerts users if their login credentials were exposed on the dark web.

The speeds are relatively smooth thanks to NordVPNs modified version of WireGuard (NordLynx). Also, your data should be 100% safe since this provider uses strong encryption, doesnt store any logs, has a kill switch, and uses diskless servers (RAM-only).

Whats more, NordVPN has a cool security feature called CyberSec. It works like an ad blocker, but it also blocks connections to malicious domains. We reached out to them, and they confirmed that CyberSec can also block malicious .onion sites.

And like ExpressVPN, you also get 24/7 live chat support (with really friendly reps) and a 30-day money-back guarantee.

To find out more about NordVPN, please read our review.

Servers 6,700+

Countries 90

Parallel Connections 7

Live Chat Yes

CyberGhost VPN supports Tor traffic on all its servers. But if you want to get top-notch privacy, you can use specific servers that are fully optimized to secure it: the NoSpy servers. Not only do they support Tor traffic, but theyre also under CyberGhost VPNs complete control. Only their staff has access to them. These servers are also based in Romania, a country with no laws that enforce data gathering.

Furthermore, the NoSpy servers are particularly fast thanks to extended bandwidth and a dedicated uplink.

Besides that, its worth mentioning that CyberGhost VPNs servers are RAM-only (much better privacy). Also, this provider has a kill switch, a feature that blocks ads and malicious domains, and reliable encryption. Oh, and they dont keep any logs either.

To wrap things up, we should also say that CyberGhost VPN has professional 24/7 live chat support, and a very generous 45-day money-back guarantee (only available for long-term subscriptions, though).

If youd like to read more about this provider, just follow this link.

Servers 475+

Countries 42

Parallel Connections 5

Rating 7.8/10

ProtonVPN is committed to being fully transparent, and it shows. Theyre one of the few providers to have open-sourced all their apps. So if you dont trust their privacy claims (zero logs), you can check them out for yourself.

ProtonVPN also has an interesting Tor integration. It works similar to NordVPNs Onion servers. You connect to a Tor VPN server, and you can use .onion sites on regular web browsers.

Other great features include strong privacy, Secure Core (protection against DDoS attacks), NetShield (DNS that protects you from ads and malware), a kill switch, FDE (full-disk encryption) and physical servers in a former Swiss army fallout shelter thats 1,000 meters (roughly 3,280 feet) underground.

Like other VPNs, ProtonVPN has a 30-day refund policy. Unfortunately, they dont offer live chat support.

If youd like to find out more about ProtonVPN, heres our hands-on review.

Servers 3200+

Countries 65

Parallel Connections

Live Chat Yes

All of Surfsharks servers support Tor traffic. Other than that, they offer more or less the same privacy features like all the other VPNs on this list: a kill switch, ad-blocking and protection from malicious domains (CleanWeb), reliable encryption, and a zero-log policy.

But what makes Surfshark stand out is their support for unlimited parallel connections. Most VPN providers offer only up to five or seven simultaneous connections. Surfshark says no thanks to that, and lets you use their service on as many devices as you want!

So, this is a great pick if you for some reason need to browse Tor sites with a VPN on tons of devices at the same time. Or if you want to save money by sharing the VPN subscription with your friends and family (without always having to wait for someone else to log out of the account before you can use it).

Support-wise, Surfsharks reps are available through live chat round-the-clock. This provider also has a 30-day money-back guarantee.

Interested in finding out more about Surfshark? Check out our in-depth review then.

AstrillVPN has great and convenient Tor integration like NordVPN and ProtonVPN. Basically, as long as you use AstrillVPN, you can browse .onion sites in any browser you want. No need to install and use the Tor browser anymore!

AstrillVPN also has its own protocols: OpenWeb and Stealth VPN. This provider developed both of them with online censorship in mind (specifically how to bypass it). OpenWeb is particular interesting because its connectionless, so it takes little time to connect to a server.

AstrilVPN also has a kill switch, strong encryption, and doesnt keep any logs. So why isnt it on the main list with the other VPNs?

Well, despite its great Tor support, AstrillVPN has some noticeable drawbacks:

If youd like to take a closer look at AstrillVPN, please read our review.

We already have a lengthy article that discusses how to stay safe on the dark web. Besides making sure Tors privacy and security settings are enabled and using a VPN, heres what else you could do:

Here are some answers to the most common questions we saw people asking about Tor and using VPNs with it. If you have more questions, no problem just leave them in the comments, and well try to answer them ASAP.

You can, but you have to be careful which one you use. Definitely dont pick a random free VPN you find on the Google Play store. It could expose you to malware or log your traffic.

To find a reliable free VPN, please use our guide. Just keep in mind free VPNs come with limitations slower speeds, less servers, and bandwidth caps. Tor over VPN browsing will already be slow, so the slowdowns caused by free VPNs could be a problem.

This can be a bit tricky. The best thing you can do is ask on Reddit. Subreddits like r/TOR and r/onions are your best friends. Just post a question asking about .onion sites. Alternatively, google list of Tor sites or something like that, and you should find plenty of helpful resources.

For example, this guide tells you about different ways to find .onion domains. And this GitHub link has a very long list of Tor sites.

This method isnt as secure as using Tor over VPNs. If you connect to Tor and then to a VPN, youll mainly rely on Tor for security.

While Tor isnt a bad privacy tool, its not ideal either. Before your traffic reaches the VPN server, it passes through one last Tor server. If a malicious actor is running it (anyone can do that), they could expose your traffic to malware or just log it (it wont be encrypted when it leaves the Tor server).

Tor also had issues with leaked IPs in the past. And theres also the fact that the US government might have created Tor (it probably did since it funds it), and that the CIA uses it. Not great for your privacy, to be honest.

If you use Tor over VPN, youll be much safer. Even if Tor leaks your IP or some exit server eavesdrops on your traffic, that wont compromise your privacy since the VPN will hide your IP and encrypt your traffic.

No at least as far as we know. We havent heard of any countries outright making the dark web illegal.

However, what you do one the dark web can be illegal depending where you live. For example, its definitely illegal to buy illicit drugs and weapons over the dark web. Or take part in online forums that involve death threats, doxxing, and hate speech.

These two terms are often used interchangeably, but thats not very accurate. The dark net is not the deep web. Its just a part of it. Heres what we mean:

VPNs can slow down your speeds, but its usually not by a lot (provided your original speeds arent too slow). But the main issue is Tor its very slow. On average, we get around 2-4 Mbps.

Why?

Because there are way too few Tor servers (over 6,000) for how many users there are (a little over two million). Plus, Tor encrypts and decrypts your data at least three times.

We used Ookla Speedtest, a US server from ExpressVPN, and the providers proprietary Lightway protocol (which is very fast) to see what kinds of speeds wed get using Tor. For reference, the tester is from Romania, and has around 500 Mbps speeds.

We cant say we expected something else.

Using a nearby server (Hungary) improved our speeds a bit, but not by much. They jumped from 7-8 Mbps to 11-12 Mbps. Pages did load a bit faster, though.

Of course, not all VPNs have a fast proprietary protocol like Lightway. And most of you will probably want to use OpenVPN. So we ran a few speed tests using OpenVPN over UDP with ExpressVPN and the other providers on this list. These were our average speeds:

Scroll to the left Scroll to the right

Yeah, not looking too good. Bottom line dont use Tor over VPN connections to watch videos or download large files. Just stick to reading articles and browsing sites.

There are ways to speed up your VPN speeds, but we cant say how efficient they are when using Tor. Heres our guide if youd like to try them.

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The Top 5 Best VPNs for the Dark Web in 2021 Browse Tor Sites While Staying 100% Safe! - TechNadu

Conspiracy theories of QAnon find fertile ground in an unexpected place the yoga world – Minneapolis Star Tribune

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During the pink-salt-lamp-lit evening classes she'd conduct at Yess Yoga in Minneapolis, Marnie Bounds frequently shared a mixture of metaphysical philosophies about the "subtle body," a person's energetic layers that transcend the physical, while folding in her own astrological interpretations.

After the pandemic started, Bounds' classes moved online and she added a weekly info session "What on Earth Is Happening?" that brought something new to the mix: QAnon.

QAnon is the movement that falsely believes former President Donald Trump has been working to destroy a child sex-trafficking cabal of Satanists run by prominent Democrats and celebrities. Its adherents include a handful of Minnesota politicians along with members of the mob that stormed the U.S. Capitol on Jan. 6, including horn-helmeted, self-declared shaman Jake Angeli.

But the QAnon movement also has found a surprising foothold in the yoga and alternative-medicine community.

Julia Szilagyi, a yoga teacher in Naples, Fla., noticed a spike in QAnon-influenced yoga teachers last spring, around the same time that people started wearing masks. She believes QAnon influencers observed the yoga community's focus on freedom and authenticity, and then lured in vulnerable yogis via social media.

"I started hearing things like, 'QAnon encourages me to think outside the box,' from people I've known and worked with for a long time," Szilagyi said.

QAnon believers are typically anti-vaccine, a view shared by some practitioners of alternative medicine.

"The anti-vax part of QAnon is deeply embedded in libertarian beliefs about the body/individual as self-property and the needle as invasion," said Jack Bratich, a professor at Rutgers University and expert on conspiracy theories. "It can connect to 'body as temple' [theories] in Western versions of yoga, where more 'natural' health beliefs also circulate.

"QAnon takes this a step further to say vaccinations are part of a deep state plan to control people through microchips."

That was precisely the view voiced by Twin Cities teacher Bounds in a YouTube video she posted in November. Bounds opined that people who got the COVID-19 vaccine might get a chip implanted under their skin. She also stated that COVID is "hugely important ... for our evolutionary process."

Since May, she has crafted regular 60- to 90-minute informational sessions for her YouTube channel, "The Time Is Now: Teachings for the Great Awakening", which has more than 170 subscribers.

Bounds and Yess Yoga did not respond to repeated requests for comment.

E. Romero, a yoga teacher in Tucson, Ariz., said she became concerned when she heard an offhand comment made by Bounds during an online yoga class, implying that protesters were somehow less enlightened than those in the know.

"That really worried me as a BIPOC person," said Romero. "There were some things she was saying that sounded almost Trumpian. I started to think, 'That's not possible I am in a yoga space.'"

How did some people in the yoga community, which uplifts care, connectedness and a holistic approach to the environment and humanity, come to embrace QAnon?

Los Angeles-based yoga teacher Seane Corn and other wellness community influencers first noticed QAnon beliefs spreading among yoga followers via social media. They called it out in a joint message posted last September. (Corn has 109,000 followers on her Instagram account.)

"Conspirituality," a podcast focused on the intersection of far-right extremism and New Age spirituality, compiled a list of nearly 50 prominent yoga and wellness community influencers who espouse QAnon theories.

The followers of QAnon claim to receive information from "Q," a self-proclaimed, mysterious "government insider" with a supposed high-level security clearance.

Since 2017, "Q" has posted cryptic messages ("Q drops") to online boards. According to QAnon, the "Great Awakening" would happen when Trump won the 2020 election. An apocalyptic showdown would ensue, destroying the aforementioned child sex-trafficking cabal and transforming America.

Neither happened, but QAnon persists.

Facebook continues to shut down QAnon pages, calling the conspiracy theory a "militarized social movement." The FBI labeled QAnon a domestic terrorist threat but Trump has said its followers "basically believe in good government."

Following President Joe Biden's inauguration, some QAnon believers have tried to rationalize the transfer of power, convincing themselves that Biden is part of Trump's plan to take down the global cabal.

Rutgers professor Bratich said QAnon's stance against masking and surveillance makes it attractive to "the influencers community around lifestyle. I think yoga becomes part of that."

He said QAnon is as much a religious movement as a political one: "QAnons are developing a sort of holy war/spiritual warfare around good and evil. Trump is good, and he's going to destroy the evil Satan-worshiping cabal. It's pretty classic Christian demonology."

QAnon's presence in the yoga community sounded an alarm for Minneapolis-based teacher Serita Colette, who was born in Kerala, India, a renowned center for the spiritual practice.

"These people sound very lost and disassociated from the tradition," she said. It's an example, Colette said, of the ways that yoga has become subject to cultural appropriation. At the same time, she said, QAnon is creating "a deeper distaste for communities of color, which, by and large, have not been met with great experiences in the white-dominant [American] yoga world."

For longtime yogis, QAnon's presence disrupts the core of yoga.

"If you are going to honor yoga's philosophy and roots in the practice, you are either one or the other either a yoga teacher or a QAnon person," said Szilagyi. "They can't exist together."

@AliciaEler 612-673-4437

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Conspiracy theories of QAnon find fertile ground in an unexpected place the yoga world - Minneapolis Star Tribune

Speaking for our canine patients: How to find and communicate signs of chronic pain – DVM 360

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Veterinarians are keenly aware that many patients present with signs of pain that may be unrecognized or misinterpreted by the owner as normal aging. During a recent Fetch dvm360 virtual conference, Michael Petty, DVM, owner of Arbor Pointe Veterinary Hospital and Animal Pain Centerin Canton, Michigan, discussed how veterinarians could better detect pain in their canine patients and communicate this pain to owners. Owners see their dog every single day, and many painful behaviors can become the norm for that owner to observe, he said.

There are many reasons why owners may not realize their dog is in pain, and it is the veterinarians responsibility to show them what we are seeing. Petty started by dispelling common myths surrounding pain in dogs.

Many veterinarians have heard owners say that their older dog can no longer do a particular activity, such as jump on the couch, followed by, Well, at least theyre not in pain because the dog is not vocalizing. But, as we watch the dog walk around our exam room with a stiff gait or struggle to rise, we know the truth. Silence does not signify the absence of pain. Although dogs will vocalize in an acutely painful situation, they rarely convey when pain is chronic.

Another common misconception is that the dog is just getting old. Petty noted that old dogs can still do the same activities as younger ones. They lose muscle mass over time, just like humans, so they must do these activities at a lower level, but many older dogs still want to run and jump and go for walks. Chronic pain is what keeps many of these dogs from doing activities they previously enjoyed.

In some cases, owners are aware that their pet is in pain, but worry that medications arent safe for older pets. This is our chance to educate clients that many medications are, in fact, safe but that alternative therapies exist as well, such as physical therapy and acupuncture, Petty said.

Finally, some owners are concerned about their budget and whether they can afford to treat their dogs pain. According to Petty, there are 4 budgets that we deal with in each case: emotional, physical, time, and money. One of the great things about veterinary medicine is that we can often do something for the pet to help ease its pain and stay within the owners financial constraints.

Before we can show an owner that their pet is in pain, we must find it. Detecting pain starts as soon as the patient arrives at the clinic, and all members of the veterinary team play a role. When patients enter the clinic, team members should observe how they walk. Do their hind feet scuff on the floor? Do they lag behind the owner? How do they take a step, such as over a curb in the parking lot? Team members can pass this information on to the veterinarian prior to the exam.

The next step is to screen for pain using chronic pain scales. It is always important because pain might not be obvious to the client or to you, said Petty. It is always obvious to the dog or cat in pain, but they may not care to show it.

Several validated pain scales exist. Veterinarians should select a scale that is easy to use and designed specifically for dogs in chronic pain situations, such as the Canine Brief Pain Inventory1 or Liverpool Osteoarthritis in Dogs.2 The client questionnaire portions of these scales can be used to screen for signs of pain that may not be observed in the clinic. Veterinarians can use pain scales along with the examination as a part of the new Canine OsteoArthritis Staging Tool,3 which allows them to assess for early risk factors and monitor patients throughout their life for the advancement of disease and assessment of therapy.

Once initial observations and screening questionnaires are completed, the veterinarian can perform a thorough pain examination. Once the veterinarian becomes skilled at this exam, it can usually be performed in a matter of minutes as part of a thorough physical. Petty offered several tips for how to perform a pain exam on canine patients:

Except in the case of very small dogs, pain examinations are best performed with the patient on the floor.

Observe the patients stance and how they rise from the floor. A nonpainful dog will jump up with all 4 limbs nearly simultaneously. A dog with hind end pain will stand with front limbs first, then pull the rest of the body to a standing position.

Many dogs will shake their body after rising. A normal dog will shake from nose to tail, whereas a dog in pain will stop shaking their body at the painful location.

Start by petting the dog to help it relax and to generally feel for areas of heat or sensitivity.

Assess passive range of motion in each limb. Multiple joints can be assessed together by moving the limb, and placing a hand or finger over the joint can allow you to feel for the presence of crepitus.

Dont forget to check the toes and look for signs of scuffing in the hindlimbs. This will be most notable on the nails of the middle digits, which may be worn down.

Check for spine and neck pain. An easy way to assess neck pain is to hold a treat, move it around, and watch how the patient moves its neck and head to follow the treat.

If a patient is too aggressive to examine, reschedule for a day when an oral premedication can be given. It is also okay to perform the exam and radiographs under full sedation, but there are some pain responses you wont be able to assess in these cases.

The final step in confirming pain in canine patients is diagnostics.

Radiographs are the number one diagnostic tool we have to find a problem, confirm our clinical impression, and convince the owner that their pet is painful, Petty said. He encouraged veterinarians to show the client the radiographs, point out abnormalities, and even consider sending them a copy of the image with markings on it to show concerning areas along with a written explanation of the findings.

It is in our patients best interest that we identify pain early so we can intervene and improve quality and quantity of life. By building confidence in our skills to detect pain and communicate it clearly with owners, we can discuss treatment options. By treating our painful patients, we will not only improve the quality of their life but also the strength of the bond they share with their owners.

Kate Boatright, VMD, a 2013 graduate of the University of Pennsylvania, is a practicing veterinarian and freelance speaker and author in western Pennsylvania. She is passionate about mentorship, education, and addressing common sources of stress for veterinary teams and recent graduates. Outside of clinical practice, Boatright is actively involved in organized veterinary medicine at the local, state, and national levels.

References

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Speaking for our canine patients: How to find and communicate signs of chronic pain - DVM 360

Will Massage Therapy Help Recovering COVID-19 Patients? – Massage Magazine

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Well also share valuable resources to support your own professional learning and decision-making processes. And finally, we will present two ongoing research projects that explore how the pandemic has affected, on the one hand, massage therapists in their personal and professional lives and, on the other hand, massage therapy clients and their interest in seeking treatment during times of social distancing.

As the COVID-19 pandemic holds the world in its grip, many questions are on the table that have not yet been answered. We are confronted with much uncertainty; and it is often difficult to know which data, claims and guidelines are based on trustworthy scientific resources and what is unfounded speculation or even misinformation.

The swirling mixture of facts and fiction spread by different sources requires us to be diligent in our discernment of the information we receive so we can make appropriate therapeutic and clinical decisions for our clients and for our own best practices as we navigate these extraordinary times.

We will start out by summarizing some of the symptoms of COVID-19 based on a report from the Harvard School of Medicine. Then, we will review three protocols for systematic review that have been proposed to analyze existing evidence-based data on the effectiveness of massage therapy for different client populations and how massage therapy may help alleviate specific COVID-related symptoms.

What we know with certainty is that COVID-19 presents itself in a variety of rather perplexing ways, affecting different people and populations via entirely different means. According to the Harvard Medical School,1 symptoms observed in people infected with the COVID-19 virus range from such common flu-like symptoms as fever, body aches, dry cough, fatigue, chills, headaches, sore throat, and loss of taste or smell, to more severe symptoms such as high fever, severe cough and shortness of breath, which often indicates pneumonia.

In addition, COVID-19 can cause a range of such neurological symptoms as muscle weakness, tingling or numbness in hands and feet, confusion, dizziness, brain fog, delirium, seizures and even strokes. Some COVID-19 patients can also experience such gastrointestinal (GI) symptoms as diarrhea, vomiting, nausea and loss of appetite, as well as abdominal pain and discomfort. Symptoms can appear to be mild for some time and then worsen rapidly; and these symptoms can also appear in any type of combination, such as, some people only experience neurological or GI symptoms without showing any type of respiratory symptoms.

There is some indication that the immune system of a person infected with COVID-19 can overreact and release too many immune messengers, called cytokines, into the bloodstream, which causes the body to attack its own tissues, potentially causing long-lasting harm. These cytokine storms trigger an exaggerated inflammatory response that could damage organs in the body and result in blood clot formations.

The topic of blood clots is especially important for us, as massage therapists; and it is advised to educate yourself on this matter as new research and updated information become available. Ruth Werner has written an excellent article on the topic of COVID-19-Related Coagulopathy.2

As the number of COVID-19 cases increases around the world, more patients are recovering from this disease, often dealing with many persistent symptoms and potentially long-lasting effects on their bodies that are not yet fully understood. Many convalescent patients are being treated within a traditional medical framework of care, and they are also seeking complementary therapies, including massage therapy.

What, however, do we know about the effects of massage therapy on recovering COVID-19 patients? To answer some of the questions, three research studies have been proposed to explore how massage therapy can support recovering COVID-19 patients from different populations presenting with a variety of specific symptoms.

The first article by Wu L. et al., The effect of massage on the quality of life in patients recovering from COVID-19: A systematic review protocol,3 presents a study conducted as a systematic research protocol.

For this project, all published randomized controlled trials (in English and Chinese languages) related to the topic of the effects of massage on COVID-19 patients available in a chosen number of databases will be analyzed according to primary and secondary outcome criteria.

The primary outcome is defined as the influence of massage on the quality of life of convalescent patients, and the secondary outcomes are defined as accompanying symptoms, average hospitalization time, clinical curative effect, and negative COVID-19 results rate on two consecutive occasions. The authors aim to provide a high-quality synthesis of current evidence for researchers in the field of alternative health care.

The second research article by Zhou Ke-Lin et al., Tuina (massage) therapy for diarrhea in COVID-19: A protocol for systematic review and meta-analysis,4 proposes a systematic review of the existing evidence of the effectiveness and safety of massage therapy for diarrhea symptoms in coronavirus patients.

The chosen outcomes that this database research and analysis will focus on are defined as the improvement of diarrhea symptoms and adverse effects. The study aims to explore how Tuinaas one of the most widely used alternative medicine interventions worldwidecan affect the digestive system and help alleviate aversive diarrhea symptoms caused by COVID-19.

In the third research article, the authors, Zhou Ke-Lin et al., propose yet another protocol for systematic review and meta-analysis; in this case, focused on the pediatric population and pulmonary symptoms caused by COVID-19. The authors state that there is an urgent need for alternative medicine treatments to help relieve symptoms related to COVID-19 in children during self-quarantine, supporting their chances of survival and recovery from the virus.

In their article, Pediatric massage therapy for restoring pediatric lung function from COVID-19: A protocol for systematic review and meta-analysis,5 Zhou and his co-authors propose a systematic review of a number of electronic databases, including Pubmed, MEDLINE, EMBASE, CNKI and CINAHl to evaluate the role of pediatric massage therapy on the effectiveness and safety in pulmonary function of COVID-19 convalescent children based on the outcomes improvement of pulmonary function and adverse effects.

As therapists navigating this pandemic, it is part of our responsibility to look at research data and discern what we need to know in order to practice safely. In addition to the scientific and medical side of COVID-19, there are also the human, emotional and personal sides.

How are you as a practitioner and health care provider doing personally? How are you dealing with the restrictions, limitations, uncertainties and heartbreak? Do you have a support network that helps you cope with the situation?

You may be interested to learn that there is a research study currently going on that strives to understand and document the experience of the COVID-19 pandemic for health care professionals. Ann Blair Kennedy, PhD, assistant professor at USC Greenville, South Carolina, and Smith Heavner-Sullivan, RN, from Prisma Health, Greenville, South Carolina, have created Project COPE: Share Your Story. Originally starting out as an observation study of COVID-19-induced burnout and the impact of the pandemic on nurses and doctors in the ER, the project has now been expanded to include such other groups of health care professionals as massage therapists.

In a Research Perch interview with Doug Nelson, president of the Massage Therapy Foundation (MTF),6 Kennedy and Heavner-Sullivan discuss the different experiences of health care workers whose services are deemed essential versus non-essential and how being allowed to work or not work during the shutdown affects their moral distress. Participants in this study are invited to fill out weekly surveys as well as upload video logs to document their personal experiences.

This combination of collecting both quantitative and qualitative data during an ongoing crisis is a unique opportunity since most studies exploring the effects of disasters on health care workers have been conducted after the events took place. Participation in this research study is still possible. If you would like to contribute your unique experience as a health care professional during the pandemic, please visit the website to learn more.

To bring our exploration of research related to COVID-19 and massage therapy full circle, it is important to also include the experiences of massage therapy clients. How are they feeling about massage during times where social distancing is recommended? Do they continue to seek treatments, perhaps look for complementary treatments for the first time, or are they staying away from massage therapy altogether? How do their decisions affect their health and well-being, emotional state and mood?

In another episode of Research Perch,7 Nelson interviews Niki Munk, PhD, LMT, associate professor at Indiana University School of Health and Human Sciences, Indianapolis, Indiana, and her student, Mica Rosenow, about their currently ongoing study, Assessing Affective Measures in the 2020 Pandemic. This research project focuses on exploring affective characteristics (mood) in massage therapy clients and how they navigate and manage their emotions during the time of the pandemic.

Munk and Rosenow encourage massage therapists to invite their clients to participate in this survey-based study to share their individual experiences. The more data that can be collected, the more valuable insights for our work as massage therapists can be gained so that we ultimately can better understand the people we are treating and help them reach their personal goals more efficiently. Please visit massagetherapyfoundation.org/iu-study-2020-pandemic-survey to learn more about this ongoing research study.

COVID-19, with its many expressions and often perplexing presentations, has certainly turned our world upside down. In addition to the hardships and heartbreaks we have experienced, this pandemic has also opened the doors to new insights and learning opportunities that are explored by the many research projects currently underway.

If you are interested in getting involved in research and helping our professional field grow during this time of crisis, we invite you to visit the website of the Massage Therapy Foundation, listen to the Research Perch podcasts, and participate in the two above-noted research studies.

Another great resource to receive information about COVID-19 is the International Journal of Therapeutic Massage & Bodywork, an open-access, peer-reviewed publication housed on massagetherapyfoundation.org that features articles presenting research on COVID-19 and related symptoms. The Massage Therapy Foundation offers many valuable resources to help practitioners support their clients and also guide educators on how to teach students about how to put that research into practice. Take advantage of the wealth of support and information available to you through these extraordinary resources.

We sincerely hope that there is a silver lining for you in these challenging times as we learn and grow together, discern facts from fiction, and collect valuable data through evidence-based research so we can make confident decisions for our best practices and the well-being of ourselves and our clients.

About the author

Andrea Winzer, M.Sc., LMT, BCTMB, holds a masters degree in ecology and is a board certified massage and bodywork therapist. She practices CranioSacral Therapy and offers a variety of holistic treatment modalities with a focus on the integration of body-mind-spirit, release of physical and emotional trauma from the body, and supporting mental health therapies through trauma-sensitive bodywork. She wrote this article on behalf of the Massage Therapy Foundation.

Footnotes

1. Harvard Health Publishing, COVID-19 basics: Symptoms, spread and other essential information about the new coronavirus and COVID-19. Harvard Medical School; 2020. (health.harvard.edu/diseases-and-conditions/covid-19-basics). Accessed November 2020.

2. Werner, Ruth. COVID-19-Related Coagulopathy. Massage & Bodywork. July/August 2020.

3. Wu, L, Dong, Y, Li, J, Huang, J, Wen, D, Peng, T, Luo, J. The effect of massage on the quality of life in patients recovering from COVID-19. Medicine. June 5, 2020;99(23):e20529.

4. Zhou, K, Dong, S, Fu, G, Cui, S, Guo, S. Tuina (massage) therapy for diarrhea in COVID-19: A protocol for systematic review and meta-analysis. Medicine (Baltimore). 2020; Jul 10; 99(28):e21293.

5. Zhou, K, Dong, S, Wang, K, Fu, G, Niu, Y, Xie. Xoap, Guo, S. Pediatric massage therapy for restoring pediatric lung function from COVID-19: A protocol for systematic review and meta-analysis. Medicine (Baltimore). 2020; Aug 14; 99(33):e21581.

6. Massage Therapy Foundation. Update on Project Cope: Share Your Story. Research Perch; University of South Carolina School of Medicine Greenville, Prisma Health, Clemson University, and Indiana University; accessed November 2020; massagetherapyfoundation.org/update-on-project-cope-share-your-story-research-perch.

7. Massage Therapy Foundation. Assessing Affective Measures in the 2020 Pandemic. Research Perch; Indiana University Study;. accessed November 2020; massagetherapyfoundation.org/iu-study-2020-pandemic-survey.

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Will Massage Therapy Help Recovering COVID-19 Patients? - Massage Magazine

Protecting Traditional Chinese Medicine Products in the United States and China – IPWatchdog.com

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In theory, product claims provide the strongest patent protection because they are not limited to the use or preparation of the Traditional Chinese Medicine (TCM) product. In reality, however, infringement assessment often involves looking at the methods used to prepare the TCM product.

Traditional Chinese Medicine, or TCM, is a subset of herbal medicine. TCM patent applications generally fall into four categories.

These categories reflect the main objectives of TCM patent protection: namely, to protect the formula, craft, original materials, and commercial products.

Method Claims

Method claims are useful when the TCM products preparation, purification, or extraction process is innovative, but the final composition is unclear. Its important to define the claim form based on the characteristics of raw materials, the process, and dosage. Raw materials should include all components and proportions used to prepare the TCM product. The process should include all steps and conditions, such as temperature, pressure, time, etc. The dosage can be broadly described as medicament, if a person skilled in the art could understand what that means in light of the patent; otherwise, the dosage needs to be specific. Below is an example of a TCM method claim:

A method for producing a medicine for postpartum treatment, prepared from:20-30 parts by weight of motherwort, 3-9 parts by weight of angelica, 1-6 parts by weight of ginseng, 6-12 parts by weight of astragalus, and 5-13 parts by weight of Polygonum multiflorum, Peach kernels 4-7 parts by weight, Cyperus rotundus 6-9 parts by weight, mixed with water and decocted twice, the amount of water added each time is 10 times the amount of raw materials, and the decoction is 1-3 hours each time. The decoction is combined, filtered, and the filtrate is concentrated into a clear paste with a relative density of 1.25 to 1.28, 40 to 70 parts by weight of brown sugar and 5 to 10 parts by weight of dextrin are added to make granules, which are dried into granules.

A method claims scope extends to the product obtained by the method. Article 11 of Chinas Patent Law provides that after the invention patent right is granted, unless otherwise provided in this law, no entity or individual may exploit the invention without the permission of the patentee, that is, not use, promise to sell, sell, or import products directly obtained in accordance with the patented method.

Use Claims

Use claims are useful when the TCM products application is innovative.The Examination Guidelines provides this basic formula: The application of substance X in the preparation of therapeutic drug Y. Further, if effective ingredients are known, the claim can be written as [t]he application of substance X in the preparation of therapeutic drug Y, where the effective ingredients are Z.

A use claims scope, however, is limited to the claimed use.Therefore, obtaining a corresponding method claim is advantageous when applicable to protect the preparation, packaging, and promotion of the TCM products.

Product Claims

Lastly, product claims are useful when the TCMs final composition is known. In theory, they provide the strongest patent protection because they are not limited to the use or preparation of the TCM product. In reality, however, infringement assessment often involves looking at the methods used to prepare the TCM product. The bottom line is that there needs to be sufficient evidence that a product prepared by a different method is the same product prepared by the inventor.

As discussed before, method claims are useful when the TCM products preparation, purification, or extraction process is innovative, but the final composition is unclear. Most TCM patents fall under this category and these patents present some unique challenges in litigation.

For example, Beijing Yadong Biopharmaceutical Co., Ltd. (Yadong) and Guizhou Kangna Shengfang Pharmaceutical Co., Ltd. (Kangna) were involved in a TCM patent dispute in the Beijing No. 1 Intermediate Peoples Court. [(2006)??????8603?.] The Court found that claim 3 of Patent No. ZL02134148.6 was different from Yadongs TCM capsules. Specifically, the Court found that in claim 3, Fructus corni is decocted three times with waterdrug residue plus 5 times the amount of 90% ethanol for reflux extraction twice, 1 hour each time, where Yadongs capsule was Fruit Cornus plus ethanol refluxed for a second timedrug residue for use, which constituted a significant difference.Therefore, the prescription and preparation method of Yadongs capsules did not fall within the protection scope of claim 3.

Another example includes the appeal of a patent infringement dispute between Guizhou Baixiang Pharmaceutical Co., Ltd. (Baixiang) and the patent owner Zhao Shusheng. [(2011)???????6?.] Baixiang, the defendant, obtained drug registration approval and disclosed its preparation method in the drug label. The most significant difference is that the asserted patent recites using two ethanol reflux and the defendant adopted the technique of three ethanol refluxes, and the time of each reflux was also different.

The plaintiff argued that three-reflux and two-reflux are technologically equivalent. The Court disagreed for two reasons. First, although three-reflux and two-reflux both extract the active ingredients from yantuo, the plaintiff did not provide sufficient evidence that they achieve the same extraction results. Second, the defendant showed that three-reflux had far better extraction results than two-reflux. Plaintiffs witnesses also admitted that increasing the number of refluxes was more efficient.

These are typical examples of TCM patent disputes where the active ingredients are mostly characterized by extraction and preparation methods, making it difficult to enforce patent rights.

TCM, as a subset of herbal medicine, has similar patent protection principals and challenges in the United States. Composition claims are useful when the active ingredients are known and can be limited to a specific use. For example, Frisun, Inc. (Wuhan, China) obtained U.S. Patent No. 7,575,772 on Process and composition for syrup and jam from Luo Han Guo fruit that brings all the advantages of Luo Han Guo together to meet todays market demand for a natural, sugar-free sweetener. In TCM research, Luo Han Guo (or Monk fruits) is known to have the potential to be natural sweetener with a low glycemic index and can therefore be an alternative to sugar for diabetic populations. See, e.g., Ying. Z., Yan. Z., Jeff. E., Chi-Fu. H., Insulin secretion stimulating effects of mogroside V and fruit extract of Luo Han Kuo (Siraitia grosvenori Swingle) fruit extract., Acta Pharmaceutica Sinica., 44 (11): 1252-1257 (2009).

The number of patent acquisitions for herbal medicines has grown significantly.From 1976 to 2003, the U.S. Patent and Trademark Office (USPTO) granted a total of 1,968 herbal patents. [Surge in US patents on botanicals, NATURE BIOTECHNOLOGY VOLUME 22 NUMBER 6 JUNE 2004.] Since 2019, the USPTO has received more than 4,000 herbal patent applications since 2019. This number is fairly conservative, because many new application forms have not yet been made public.Below are a few:

Patent protection for TCM can present many challenges because of the various types of TCM products and the uncertainty of the active ingredients. As herbal medicine patents become more popular, we can expect to see similar challenges in enforcing patent rights in herbal medicine technology.

Shui Li is an intellectual property lawyer with Robins Kaplan. Her experience is in cross-border disputes, and she has worked with a variety of technology industries, including medicinal chemistry, biotechnology, video streaming, telecommunication, and semiconductors.

Yongfeng Zheng is General Counsel of Tasly Holding Group Co. Ltd. He holds a Doctor of Law, Master of Medicine, and is Vice-President of China Patent Protection Association.

Chunxuan Li is a partner and patent attorney at the Beijing Lifang Law Firm.

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Protecting Traditional Chinese Medicine Products in the United States and China - IPWatchdog.com

Alternative and Complementary Medicine Market Overview, Global Analysis Market Size, Share, Top Trends, Growth and Forecast 2017 2025 – Atlantic…

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Global Alternative and Complementary Medicine Market: Snapshot

Complementary and alternative medicine (CAM) refers to medical products and practices that are not part of mainstream practices. While complementary medicine can be used along with mainstream medical practices, alternative medicine are used in place of standard medical treatments. Some CAM therapies have been found to be safe and effective unlike some that have been found to be ineffective or possibly harmful.

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Complementary and alternative medicine includes a host of botanicals and nutritional substances such as herbal supplements, dietary supplements, and vitamins. A large number of CAM products are regarded to be safe as they are produced by nature or are present in nature. However, this may not be necessarily true for all natural products. In addition, some naturally sourced medicines may affect the action of other medicines. For instance, St. Johns wort a herb which is used for depression may interfere with the way certain anticancer drugs work.

Herbal supplements can have unwanted effects when used on their own, in combination with other drugs, or in large doses. Vitamins can also be harmful on the body. Too much of vitamin can be detrimental on health, even in a healthy person. Supplements do not need approval from federal government before being commercially available.

Patients of chronic diseases who are considering using complementary or alternative medicine need to talk to their doctor or nurse. This is because some therapies of complementary and alternative medicine may interfere with mainstream medicine or can be also be harmful. The claims of efficacy of complementary and alternative medicine therapy needs to be ascertained before bringing into use.

Global Alternative and Complementary Medicine Market: Overview

The global market for alternative and complementary medicines is projected to experience substantial growth in the next few years. The rising expenditure of the healthcare facilities is considered as the major factor that is likely to encourage the growth of the overall market in the coming years. In addition, the increasing number of initiatives being taken by Governments across the globe to promote alternative and complementary medicines is projected to accelerate the markets growth. Thanks to these factors, the global alternative and complementary medicine market is likely to exhibit a promising growth rate in the near future.

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Global Alternative and Complementary Medicine Market: Key Trends

A significant rise in the number of initiatives by NGOs and government organizations to encourage the use of alternative and complementary medicines is estimated to bolster global market in the near future. In addition to this, technological advancements in this field and the rising inclination of consumers towards these medicines and practices are likely to offer lucrative growth opportunities for the leading players operating in the alternative and complementary medicine market across the globe. However, the lack of scientific results is expected to hamper the overall growth of the market in the next few years.

Global Alternative and Complementary Medicine Market: Market Potential

Alternative and complementary medicines make use of several tradition methods to help the patients, most of which are not completely supported scientifically. As a result, the use of these medicines in several developed economies is comparatively less. Nonetheless, with a rising focus on research and development activities in order to find clinical support and the emergence of new methods and medicines are anticipated to encourage the growth of the global alternative and complementary medicine market throughout the forecast period.

Global Alternative and Complementary Medicine Market: Regional Outlook

From a regional perspective, Europe is considered as one of the leading segment, thanks to the significant revenue contribution in the last few years. This region is expected to account for a large share of the global alternative and complementary medicine market with the rising use of botanicals. In addition to this, the increasing awareness among consumers regarding the availability of effective alternative and complementary medicines and the benefits they offers are expected to encourage the growth of the Europe market in the coming years.

Furthermore, with the rising popularity of medical tourism, the alternative and complementary medicine market in Asia Pacific is projected to witness a steady growth in the next few years. Moreover, the presence of a large number of new players operating in this region is likely to offer promising growth opportunities over the forecast period. The Middle East and Africa segment is anticipated to experience a healthy growth in the alternative and complementary medicine market in the near future.

Global Alternative and Complementary Medicine Market: Competitive Analysis

The global market for alternative and complementary medicines is presently at a highly competitive stage and is predicted to experience an intense level of competition among the leading players in the coming years. The prominent players in the market are focusing on the expansion of the product portfolio so as to attract a large number of consumers across the globe. This is likely to help them in creating a brand name and acquiring a leading position in the global market. Some of the leading players operating in the alternative and complementary medicine market across the globe are Herb Pharm, Yoga Tree, Quantum Touch Inc., Helio USA Inc., Pure encapsulations, Inc., Pacific Nutritional Inc., Deepure Plus, Herbal Hills, Iyengar Yoga Institute, The Healing Company, and Nordic Naturals.

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Alternative and Complementary Medicine Market Overview, Global Analysis Market Size, Share, Top Trends, Growth and Forecast 2017 2025 - Atlantic...

DVT Medication Recalled, Here’s What to Know Now – Healthline

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A medication commonly used to treat deep vein thrombosis, Enoxaparin Sodium Injection, USP, has been voluntarily recalled due to a packaging error in which the labels dont accurately list the correct dose.

The recall, which was issued by pharmaceutical company Apotex Corp. Tuesday, Feb. 2, states that syringe barrels containing 150 mg/mL are mislabeled as containing 100mg/mL, and vice versa.

Enoxaparin sodium is an anticoagulant used to treat pulmonary embolism, blood clotting disorders, and deep vein thrombosis (DVT) a condition in which blood clots form in veins located deep within the body.

When administered with aspirin, it can help prevent angina (chest pain) and heart attacks.

Taking the incorrect dose of the injection can lead to bleeding and clotting complications.

Incorrect syringe barrel marking could lead to miscalculation and inaccurate dose administration to patients, the recall states.

The affected products were produced in two batches: CS008 and CT003.

The batches were distributed by Apotex Corp. nationwide to wholesalers and warehousing chains.

If a patient prescribed a 150 mg/mL bottle received a mislabeled bottle that contained 100 mg/mL, they could receive 2 mg of enoxaparin rather than 2.5 mg of enoxaparin, the recall explains.

If a patient who typically uses a 100 mg/mL bottle received a mislabeled bottle that contained 150 mg/mL, they might end up taking 3.75 mg of enoxaparin instead of 3 mg of enoxaparin.

The prescribed dosing of enoxaparin sodium is based off of a persons age, weight, condition being treated, severity of the condition, overall health, and how well they tolerate the medication.

The injection is administered either once or twice a day.

Taking a higher dose of enoxaparin sodium can lead to bleeding complications.

Some patients could experience symptoms like bruises on mucosal or skin surfaces, blood in urine or stool, said Dr. Natalia Neparidze, a Yale Medicine hematologist and assistant professor of medicine at Yale School of Medicine.

Too low of a dose can lead to clotting.

Taking too little of the intended dose of the drug will result in suboptimal, inadequate anticoagulation, putting patients at risk for recurrent or worsening thrombosis, such as deep venous thrombosis or pulmonary embolism, Neparidze said.

Taking a lower dose may cause pain or swelling in the extremities in patients with deep vein thrombosis.

Dr. Britt Tonnessen, a Yale Medicine vascular and endovascular surgeon and associate professor of surgery at Yale School of Medicine, said the warning signs of a clot include shortness of breath or pain with breathing, racing heart, or stroke.

Its unlikely that someone could detect their dose is off, Tonnessen added.

According to Neparidze, very minor dosing differences may not cause significant bleeding or clotting complications. But if the incorrect dose is continually taken, complications may occur.

Because the dose is based on weight, people who are under or overweight may be more sensitive to changes in dosing.

While injecting a reduced dose on a single or a few occasions is unlikely to cause harm, continued use of a lower dose than prescribed could lead to a recurrence of blood clots, Tonnessen said.

Anyone with a syringe barrel from the affected batches should immediately talk with a doctor and have the medication replaced with the correct dose, Neparidze said.

Doctors dont recommend skipping a dose.

In the event that there will be a delay in receiving the new batch of medication, patients should contact their doctor to make arrangements for alternative treatment in the interim, Tonnessen said.

Anyone who received the affected medication should contact Inmar Rx Solutions at 1-855-667-8717 to arrange a return, the recall states.

Any adverse events should be reported to the FDAs MedWatch Adverse Event Reporting program.

A medication commonly used to treat deep vein thrombosis, Enoxaparin Sodium Injection, USP, has been voluntarily recalled due to a packaging error in which the labels dont accurately list the correct dose.

Taking the incorrect dose of the injection can lead to bleeding and clotting complications.

Doctors dont recommend skipping a dose, so if you have a bottle included in the recall, talk with your doctor immediately.

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DVT Medication Recalled, Here's What to Know Now - Healthline