Category Archives: Alternative Medicine

For concierge medicine physicians, while the pandemic was difficult and demanding, their professional survivability was never in question.

In Part One, we described the role concierge medicine plays in extending the active years of experienced, dedicated doctors and helping to significantly ease the looming physician shortage. Now we consider how concierge medicine has sustained the practices of independent primary care physicians who are rapidly becoming a vanishing breed in the U.S.

Among the pandemics many heartbreaking statistics is this one: In 2020 and 2021, more than 24,000 independent practices were reported permanently or temporarily closed. We now have an even clearer picture of the pandemics impact on private practitioners with new data from Avalere and the Physicians Advocacy Institute (PAI) showing that almost three quarters of U.S. doctors now work for hospitals, health systems or corporate entities. That represents an almost 20% jump since 2019.

"COVID-19 drove physicians to leave private practice for employment at an even more rapid pace than we've seen in recent years," according to Kelly Kenney, chief executive officer of PIA. This study underscores the fact that physicians across the nation are facing severe burnout and strain. Between the financial stress that the pandemic had on practices, because they certainly had little revenue for a while, and the stress that physicians have felt mentally, you can't overstate that."

While a sense of normalcy is thankfully returning to everyday life, for primary care physicians in traditional fee-for-service practices, the situation remains bleak. According to the most recent Primary Care Collaborative survey, more than half of physician say primary care is crumbling, over 40% report describe themselves as mentally and financially fragile, one third report they are currently denied and/or seriously overdue payments from insurers and health plans, and only 21% find the fee-for-service form of payment sufficient.

We have long understood that the traditional fee-for-service payment model is simply not sustainable. Consider that since 2001, Medicare physician payment has fallen 20%, adjusted for inflation, while the cost of running a medical practice has increased 39% in that same time period. Becoming a hospital-employed physician doesnt provide a neatly packaged solution either. As reported in a recent Forbes article, after acquiring a physician practice, prices for healthcare services increase by 14% and hospital revenues rise by nearly 20%. However, most physicians are not benefiting, but are in fact, earning 20% less than independent practitioners, according to a 2022 Medscape survey.

Most troubling, as a result of the myriad challenges with seemingly no end, 25% of the physicians surveyed by the Primary Care Collaborative expect to leave primary care in the next three years. A December 2021AMA surveyalso reported that one in five physicians said they would likely leave their current practice within two years. The impact of this physician exodus is an incalculable loss that will be felt for many years to come.

However, for concierge medicine physicians, while the pandemic was difficult and demanding, their professional survivability was never in question. A stunning zero percent of concierge medical practices were closed during the pandemic, and they continue to thrive in 2022, based on a solid foundation of revenues driven by membership fees. Freed from financial worries and overloaded patient panels, concierge physicians not only keep their doors open, but their minds and hearts as well.

At Specialdocs I am gratified that we are able to offer a remarkably effective solution with proven resilience throughout two decades of relentless change. Below is a sampling of comments from our physician clients who sustained their practices and restored their passion for patient care with a thoughtful transition to our membership medicine model.

Dr. N.M., Atlanta, GA: Before I made the change, I was burned out to the point where I knew I was done with medicine if this didnt work. I was so frustrated with the way things had continued to worsen over the last 15 years - I didnt want to end up like the proverbial lobster in a pot of gradually heated water that doesnt realize its being cooked until it was too late. Now I have a completely different practice and life and I cant imagine ever going back to the way things were.

Dr. M.S., Burbank, CA: My traditional practice had grown to the level where I was responsible for almost 4,000 patients and I was drowning. Appointments were always rushed and there was never enough time. I felt that it was inevitable that I was going to miss something or make a mistake and neglecting my personal health and family life was the price I was paying.Concierge medicine was, and still is, the best way to achieve a work-life balance that is rarely seen in a primary care practice.

Dr. I.K., Petoskey, MI: Despite surging demand for rheumatology specialty care, my private practice had become too challenging to sustain. The paperwork and administrative burdens for a solo rheumatologist had mushroomed in the last decade, requiring an inordinate amount of time for prior authorizations, step therapy and electronic health record documentation; concurrently reimbursements continued to decline. I recognize that while it may not be the answer for every doctor, changing to the concierge medicine model with Specialdocs was the only viable alternative to permanently closing my practice doors. It has proven to be a tremendous fit for my career. Patients are now able to get an appointment the same or next day. We have unrushed visits that are conducive to incorporating beneficial integrative medicine modalities such as dietary, exercise, and mind-body approaches as appropriate, in addition to state-of-the-art treatment. I also have more time to coordinate care and give patients prompt feedback on lab and study results. From the first night of transition, I was able to sleep well, knowing my patients were being better served, my staff was happier, and that I could continue to practice in a time of great change and challenge for rheumatology.

Dr. Z.C., Nanuet, NY:My change to concierge medicine early in 2020 was precipitated by years of practicing like a hamster on a particularly relentless wheel, seeing up to 40 patients each day, with non-stop calls and endless paperwork afterward. Among several, mostly unpalatable options, including employment by a hospital, grinding it out until retirement or leaving the profession altogether, only the change to a concierge medical practice offered a workable solution for me. Had I not begun my concierge practice shortly before the pandemic started, I would have been totally unprepared to face an empty waiting room and a dramatic drop-off in office visits. Even more importantly, my patients would not have received the unlimited time and attention I was profoundly thankful to provide.

Dr. B.B., Brookline, MA: Making the change to concierge medicine saved our entire organization, including many who had worked with us for their entire careers. In 2020, it became increasingly clear that the pandemic was going to result in our shuttering the practice. I was compelled to find a way to reinvent ourselves and preserve the practice we had built with the utmost care for more than 25 years. Our transition with Specialdocs allows us to offer an approach that benefits patients enormously with time to focus on non-invasive treatments, prevention and wellnessand has restored our joy in practicing medicine.

Terry Bauer is CEO ofSpecialdocs,a concierge medicine pioneer that has transformed physicians professional lives since 2002, empowering them to deliver personalized patient care

Original post:

The Physician Shortage, Part Two: Keeping the Doors Open with Concierge Medicine - Medical Economics

Tucson, AZ Regenerative medicine contains a broad category of non-surgical therapies that aim to stimulate the healing/repair of damaged tissue. To explore the solutions, individuals can visit QC Kinetix (Academy), a Tucson-based regenerative medicine clinic with the mission of providing natural pain treatments and restorative therapies. The Pain control clinic comprises a team of medical providers committed to improving the quality of life of their patients, allowing them to resume performing normal chores, playing with their children, or training for marathons.

The team utilizes minimally invasive procedures, natural treatment protocols, and advanced medical technology to improve pain, decrease inflammation, and repair degenerated tissues. With the knowledge that joint pain/musculoskeletal injuries are frustrating to deal with, the team provides personalized services throughout a patients clinical experience. They treat patients with the highest level of service and respect while also educating them about their pain, conditions, treatment options, and the most appropriate regenerative therapies.

Sports injuries are commonly treated/managed with rest, ice, compression, elevation, medication, surgery, steroids, or physical therapy. While they may get a patient through their injuries, regenerative medicine may prove to be a better option since it takes advantage of the bodys natural healing capabilities. The alternative therapies offer relief from tennis elbow, torn Achilles tendon, knee pain, golfers elbow, shoulder pain, tendon/ligament tears, ankle pain, torn rotator cuff, wrist pain, and low back pain. QC Kinetix (Academy) integrates traditional sports treatments with regenerative medicine to help athletes, weekend warriors, or avid adventurers recover quickly. This approach also strengthens existing tissues and reduces the risk of future injuries.

Most people in Tucson suffer from conditions that affect the ligaments, muscles, bones, and tendons as a result of trauma, jerking movements, falls/sprains, repetitive movements, or overuse. When traditional treatments for musculoskeletal pain such as painkillers, anti-inflammatories, massage, or physical therapy fail to provide the relief a patient needs, they can visit the regenerative medicine clinic for Tucson back pain treatment, low back pain treatment, and tendon/muscle/ligament pain treatment solutions.

Additionally, QC Kinetix (Academy) slows down the progression of arthritis pain using a variety of treatment methods that use the bodys existing healing mechanisms to decrease pain without invasive surgical procedures, medication, or extensive physical therapy. Many patients have discovered the clinic while searching for long-term solutions for inflamed, irritated, and worn-down cartilage, connective tissues, and bones caused by arthritis pain.

A first visit to the clinic includes a thorough examination where a provider evaluates a patients overall health history, goals, and needs before determining the most suitable alternative treatments for their joint pain or musculoskeletal injuries. Learn more about their Tucson office by calling (520) 497-4955 or visiting the clinics website. QC Kinetix (Academy) is located at 310 N Wilmot Rd, Suite 101, Tucson, AZ, 85711, US.

Media Contact

Company NameQC Kinetix (Academy)Contact NameScott HootsPhone(520) 497-4955Address310 N Wilmot RdSuite 101CityTusconStateAZPostal Code85711CountryUnited StatesWebsitehttps://qckinetix.com/tucson/academy

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QC Kinetix (Academy) is a Tucson Regenerative Medicine Clinic offering Alternative Treatments for Joint Pain - Digital Journal

DetailsCategory: AntibodiesPublished on Wednesday, 25 May 2022 09:50Hits: 58

Approval based on event-free survival benefit demonstrated in Phase 3 KEYNOTE-522 trial

This KEYTRUDA combination is the first immunotherapy option approved in the EU for high-risk early-stage TNBC

Decision marks fifth approval for KEYTRUDA in a breast or gynecologic cancer in the EU in less than one year

RAHWAY, NJ, USA I May 24, 2022 I Merck (NYSE: MRK), known as MSD outside the United States and Canada, today announced that the European Commission has approved KEYTRUDA, Mercks anti-PD-1 therapy, in combination with chemotherapy as neoadjuvant treatment, and then continued as monotherapy as adjuvant treatment after surgery for adults with locally advanced or early-stage triple-negative breast cancer (TNBC) at high risk of recurrence.

The approval is based on results from the pivotal Phase 3 KEYNOTE-522 trial, in which KEYTRUDA in combination with chemotherapy before surgery and continued as a single agent after surgery prolonged event-free survival (EFS), reducing the risk of EFS events or death by 37% (HR=0.63 [95% CI, 0.48-0.82]; p=0.00031) compared to neoadjuvant chemotherapy alone in this patient population. Median follow-up time for all patients was 37.8 months (range, 2.7-48).

KEYNOTE-522 was the first large, randomized Phase 3 study to report a statistically significant and clinically meaningful EFS result among patients with stage II and III TNBC. With this decision, this KEYTRUDA combination becomes the first immunotherapy option approved for patients in the European Union (EU) in this setting.

Triple-negative breast cancer has a high risk of recurrence within the first five years, so its meaningful for patients to have access to new therapies that can reduce the risk of disease progression, said Dr. Peter Schmid, lead, Centre for Experimental Cancer Medicine, Barts Cancer Institute in London, England. The approval of this KEYTRUDA regimen marks a turning point for patients with high-risk early-stage TNBC, as they now have an immunotherapy option in early stages of the disease that has demonstrated significant improvements in pathological complete response and event-free survival compared to neoadjuvant chemotherapy.

The safety of KEYTRUDA plus chemotherapy has been evaluated in 3,123 patients across tumor types. The incidence of Grade 3-5 adverse reactions in patients with TNBC was 80% for KEYTRUDA plus chemotherapy and 77% for chemotherapy.

KEYTRUDA was first approved in Europe to address an unmet need in certain patients with metastatic TNBC, and todays approval extends the use of KEYTRUDA to more patients facing this difficult-to-treat cancer this time in earlier stages of TNBC, said Dr. Gursel Aktan, vice president, global clinical development, Merck Research Laboratories. We are very proud that todays approval marks the fifth indication for KEYTRUDA in Europe for patients with breast or a gynecological cancer, an important area where patients need continued research and innovation.

This approval allows marketing of this KEYTRUDA regimen in all 27 EU member states plus Iceland, Lichtenstein, Norway and Northern Ireland. This is the second indication for KEYTRUDA in breast cancer in Europe. In October 2021, KEYTRUDA plus chemotherapy was approved for the first-line treatment of certain patients with locally recurrent unresectable or metastatic TNBC.

Merck is committed to delivering meaningful advances in gynecologic and breast cancers to patients around the world through its extensive clinical development program across its oncology portfolio of investigational and approved medicines. Within just the last year, KEYTRUDA has been approved in Europe for five new indications across breast, cervical and endometrial cancers as monotherapy and in novel combinations.

About KEYNOTE-522

The approval was based on data from KEYNOTE-522 (ClinicalTrials.gov, NCT03036488), a randomized, double-blind Phase 3 trial. The dual primary endpoints were pathological complete response rate, defined as pathological stage ypT0/Tis ypN0 at the time of definitive surgery, and EFS, defined as the time from randomization to the time of first occurrence of either disease progression that precluded definitive surgery, a local/distant recurrence, a second primary cancer or death from any cause. A key secondary endpoint was overall survival. The study enrolled 1,174 patients who were randomized 2:1 to receive either:

About triple-negative breast cancer (TNBC)

Triple-negative breast cancer is the most aggressive type of breast cancer, which has the highest risk of recurrence within the first five years after diagnosis and is associated with worse outcomes compared to other forms of breast cancer. Approximately 10-15% of patients with breast cancer are diagnosed with TNBC. While some breast cancers may test positive for estrogen receptors, progesterone receptors or overexpression of human epidermal growth factor receptor 2 (HER2), TNBC tests negative for all three. Triple-negative breast cancer tends to be more common in people who are younger than 40 years of age, who are Black or who have a BRCA1 mutation.

About Mercks early-stage cancer clinical program

Finding cancer at an earlier stage may give patients a greater chance of long-term survival. Many cancers are considered most treatable and potentially curable in their earliest stage of disease. Building on the strong understanding of the role of KEYTRUDA in later-stage cancers, Merck is studying KEYTRUDA in earlier disease states, with approximately 20 ongoing registrational studies across multiple types of cancer.

About KEYTRUDA (pembrolizumab) injection, 100 mg

KEYTRUDA is an anti-programmed death receptor-1 (PD-1) therapy that works by increasing the ability of the bodys immune system to help detect and fight tumor cells. KEYTRUDA is a humanized monoclonal antibody that blocks the interaction between PD-1 and its ligands, PD-L1 and PD-L2, thereby activating T lymphocytes which may affect both tumor cells and healthy cells.

Merck has the industrys largest immuno-oncology clinical research program. There are currently more than 1,700 trials studying KEYTRUDA across a wide variety of cancers and treatment settings. The KEYTRUDA clinical program seeks to understand the role of KEYTRUDA across cancers and the factors that may predict a patient's likelihood of benefitting from treatment with KEYTRUDA, including exploring several different biomarkers.

Selected KEYTRUDA (pembrolizumab) Indications in the U.S.

Melanoma

KEYTRUDA is indicated for the treatment of patients with unresectable or metastatic melanoma.

KEYTRUDA is indicated for the adjuvant treatment of adult and pediatric (12 years and older) patients with stage IIB, IIC, or III melanoma following complete resection.

Non-Small Cell Lung Cancer

KEYTRUDA, in combination with pemetrexed and platinum chemotherapy, is indicated for the first-line treatment of patients with metastatic nonsquamous non-small cell lung cancer (NSCLC), with no EGFR or ALK genomic tumor aberrations.

KEYTRUDA, in combination with carboplatin and either paclitaxel or paclitaxel protein-bound, is indicated for the first-line treatment of patients with metastatic squamous NSCLC.

KEYTRUDA, as a single agent, is indicated for the first-line treatment of patients with NSCLC expressing PD-L1 [tumor proportion score (TPS) 1%] as determined by an FDA-approved test, with no EGFR or ALK genomic tumor aberrations, and is:

KEYTRUDA, as a single agent, is indicated for the treatment of patients with metastatic NSCLC whose tumors express PD-L1 (TPS 1%) as determined by an FDA-approved test, with disease progression on or after platinum-containing chemotherapy. Patients with EGFR or ALK genomic tumor aberrations should have disease progression on FDA-approved therapy for these aberrations prior to receiving KEYTRUDA.

Head and Neck Squamous Cell Cancer

KEYTRUDA, in combination with platinum and fluorouracil (FU), is indicated for the first-line treatment of patients with metastatic or with unresectable, recurrent head and neck squamous cell carcinoma (HNSCC).

KEYTRUDA, as a single agent, is indicated for the first-line treatment of patients with metastatic or with unresectable, recurrent HNSCC whose tumors express PD-L1 [Combined Positive Score (CPS) 1] as determined by an FDA-approved test.

KEYTRUDA, as a single agent, is indicated for the treatment of patients with recurrent or metastatic HNSCC with disease progression on or after platinum-containing chemotherapy.

Classical Hodgkin Lymphoma

KEYTRUDA is indicated for the treatment of adult patients with relapsed or refractory classical Hodgkin lymphoma (cHL).

KEYTRUDA is indicated for the treatment of pediatric patients with refractory cHL, or cHL that has relapsed after 2 or more lines of therapy.

Primary Mediastinal Large B-Cell Lymphoma

KEYTRUDA is indicated for the treatment of adult and pediatric patients with refractory primary mediastinal large B-cell lymphoma (PMBCL), or who have relapsed after 2 or more prior lines of therapy.

KEYTRUDA is not recommended for treatment of patients with PMBCL who require urgent cytoreductive therapy.

Urothelial Carcinoma

KEYTRUDA is indicated for the treatment of patients with locally advanced or metastatic urothelial carcinoma (mUC):

Non-muscle Invasive Bladder Cancer

KEYTRUDA is indicated for the treatment of patients with Bacillus Calmette-Guerin-unresponsive, high-risk, non-muscle invasive bladder cancer (NMIBC) with carcinoma in situ with or without papillary tumors who are ineligible for or have elected not to undergo cystectomy.

Microsatellite Instability-High or Mismatch Repair Deficient Cancer

KEYTRUDA is indicated for the treatment of adult and pediatric patients with unresectable or metastatic microsatellite instability-high (MSI-H) or mismatch repair deficient (dMMR) solid tumors that have progressed following prior treatment and who have no satisfactory alternative treatment options.

This indication is approved under accelerated approval based on tumor response rate and durability of response. Continued approval for this indication may be contingent upon verification and description of clinical benefit in the confirmatory trials. The safety and effectiveness of KEYTRUDA in pediatric patients with MSI-H central nervous system cancers have not been established.

Microsatellite Instability-High or Mismatch Repair Deficient Colorectal Cancer

KEYTRUDA is indicated for the treatment of patients with unresectable or metastatic MSI-H or dMMR colorectal cancer (CRC).

Gastric Cancer

KEYTRUDA, in combination with trastuzumab, fluoropyrimidine- and platinum-containing chemotherapy, is indicated for the first-line treatment of patients with locally advanced unresectable or metastatic HER2-positive gastric or gastroesophageal junction (GEJ) adenocarcinoma.

This indication is approved under accelerated approval based on tumor response rate and durability of response. Continued approval for this indication may be contingent upon verification and description of clinical benefit in the confirmatory trials.

Esophageal Cancer

KEYTRUDA is indicated for the treatment of patients with locally advanced or metastatic esophageal or gastroesophageal junction (GEJ) (tumors with epicenter 1 to 5 centimeters above the GEJ) carcinoma that is not amenable to surgical resection or definitive chemoradiation either:

Cervical Cancer

KEYTRUDA, in combination with chemotherapy, with or without bevacizumab, is indicated for the treatment of patients with persistent, recurrent, or metastatic cervical cancer whose tumors express PD-L1 (CPS 1) as determined by an FDA-approved test.

KEYTRUDA, as a single agent, is indicated for the treatment of patients with recurrent or metastatic cervical cancer with disease progression on or after chemotherapy whose tumors express PD-L1 (CPS 1) as determined by an FDA-approved test.

Hepatocellular Carcinoma

KEYTRUDA is indicated for the treatment of patients with hepatocellular carcinoma (HCC) who have been previously treated with sorafenib. This indication is approved under accelerated approval based on tumor response rate and durability of response. Continued approval for this indication may be contingent upon verification and description of clinical benefit in the confirmatory trials.

Merkel Cell Carcinoma

KEYTRUDA is indicated for the treatment of adult and pediatric patients with recurrent locally advanced or metastatic Merkel cell carcinoma (MCC). This indication is approved under accelerated approval based on tumor response rate and durability of response. Continued approval for this indication may be contingent upon verification and description of clinical benefit in the confirmatory trials.

Renal Cell Carcinoma

KEYTRUDA, in combination with axitinib, is indicated for the first-line treatment of adult patients with advanced renal cell carcinoma (RCC).

KEYTRUDA is indicated for the adjuvant treatment of patients with RCC at intermediate-high or high risk of recurrence following nephrectomy, or following nephrectomy and resection of metastatic lesions.

Endometrial Carcinoma

KEYTRUDA, as a single agent, is indicated for the treatment of patients with advanced endometrial carcinoma that is MSI-H or dMMR, as determined by an FDA-approved test, who have disease progression following prior systemic therapy in any setting and are not candidates for curative surgery or radiation.

Tumor Mutational Burden-High Cancer

KEYTRUDA is indicated for the treatment of adult and pediatric patients with unresectable or metastatic tumor mutational burden-high (TMB-H) [10 mutations/megabase] solid tumors, as determined by an FDA-approved test, that have progressed following prior treatment and who have no satisfactory alternative treatment options. This indication is approved under accelerated approval based on tumor response rate and durability of response. Continued approval for this indication may be contingent upon verification and description of clinical benefit in the confirmatory trials. The safety and effectiveness of KEYTRUDA in pediatric patients with TMB-H central nervous system cancers have not been established.

Cutaneous Squamous Cell Carcinoma

KEYTRUDA is indicated for the treatment of patients with recurrent or metastatic cutaneous squamous cell carcinoma (cSCC) or locally advanced cSCC that is not curable by surgery or radiation.

Triple-Negative Breast Cancer

KEYTRUDA is indicated for the treatment of patients with high-risk early-stage triple-negative breast cancer (TNBC) in combination with chemotherapy as neoadjuvant treatment, and then continued as a single agent as adjuvant treatment after surgery.

KEYTRUDA, in combination with chemotherapy, is indicated for the treatment of patients with locally recurrent unresectable or metastatic TNBC whose tumors express PD-L1 (CPS 10) as determined by an FDA-approved test.

Mercks focus on cancer

Our goal is to translate breakthrough science into innovative oncology medicines to help people with cancer worldwide. At Merck, the potential to bring new hope to people with cancer drives our purpose and supporting accessibility to our cancer medicines is our commitment. As part of our focus on cancer, Merck is committed to exploring the potential of immuno-oncology with one of the largest development programs in the industry across more than 30 tumor types. We also continue to strengthen our portfolio through strategic acquisitions and are prioritizing the development of several promising oncology candidates with the potential to improve the treatment of advanced cancers. For more information about our oncology clinical trials, visit http://www.merck.com/clinicaltrials.

About Merck

At Merck, known as MSD outside of the United States and Canada, we are unified around our purpose: We use the power of leading-edge science to save and improve lives around the world. For more than 130 years, we have brought hope to humanity through the development of important medicines and vaccines. We aspire to be the premier research-intensive biopharmaceutical company in the world and today, we are at the forefront of research to deliver innovative health solutions that advance the prevention and treatment of diseases in people and animals. We foster a diverse and inclusive global workforce and operate responsibly every day to enable a safe, sustainable and healthy future for all people and communities. For more information, visit http://www.merck.com and connect with us on Twitter, Facebook, Instagram, YouTube and LinkedIn.

SOURCE: Merck

Original post:

European Commission Approves KEYTRUDA (pembrolizumab) Plus Chemotherapy as Neoadjuvant Treatment, Then Continued as Adjuvant Monotherapy After Surgery...

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The researchers also identified specific genes associated with resistance to most available drugs therapies, commonly referred to as refractory disease, which could provide the key to developing new, successful drugs to help these people.

While there has been much progress made over the past decades in treating arthritis, a significant number of patients (approximately 40%) do not respond to specific drug therapies, and 5-20% of people with the disease are resistant to all current forms of medication.

The researchers carried out a biopsy-based clinical trial, involving 164 arthritis patients, in which their responses to either rituximab or tocilizumab two drugs commonly used to treat RA were tested. The results of the original trial published in The Lancet in 2021 demonstrated that in those patients with a low synovial B-cell molecular signature only 12% responded to a medication that targets B cells (rituximab), whereas 50% responded to an alternative medication (tocilizumab). When patients had high levels of this genetic signature, the two drugs were similarly effective.

As part of the first-of-its-kind study, funded by the Efficacy and Mechanism Evaluation (EME) Programme, an MRC and NIHR partnership, the Queen Mary team also looked at the cases where patients did not respond to treatment via any of the drugs and found that there were 1,277 genes that were unique to them specifically.

Building on this, the researchers applied a data analyses technique called machine learning models to develop computer algorithms which could predict drug response in individual patients. The machine learning algorithms, which included gene profiling from biopsies, performed considerably better at predicting which treatment would work best compared to a model which used only tissue pathology or clinical factors.

The study strongly supports the case for performing gene profiling of biopsies from arthritic joints before prescribing expensive so-called biologic targeted therapies. This could save the NHS and society considerable time and money and help avoid potential unwanted side-effects, joint damage, and worse outcomes which are common amongst patients. As well as influencing treatment prescription, such testing could also shed light on which people may not respond to any of the current drugs on the market, emphasising the need for developing alternative medications.

Professor Costantino Pitzalis, Versus Arthritis Professor of Rheumatology at Queen Mary University of London, said: Incorporating molecular information prior to prescribing arthritis treatments to patients could forever change the way we treat the condition. Patients would benefit from a personalised approach that has a far greater chance of success, rather than the trial-and-error drug prescription that is currently the norm.

These results are incredibly exciting in demonstrating the potential at our fingertips, however, the field is still in its infancy and additional confirmatory studies will be required to fully realise the promise of precision medicine in RA.

The results are also important in finding solutions for those people who unfortunately dont have a treatment that helps them presently. Knowing which specific molecular profiles impact this, and which pathways continue to drive disease activity in these patients, can help in developing new drugs to bring better results and much-needed relief from pain and suffering.

The incorporation of these signatures in future diagnostic tests will be a necessary step to translate these findings into routine clinical care.

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New study shows genes can predict response to arthritis treatment and paves the way for future drug development - QMUL

Most people withCOVID-19will experience a mild illness, and they'll be able to take care of themselves at home. But someespecially those withunderlying health conditionscould benefit from one of several COVID-19 treatments. Some of these are available in pill form and others are given intravenously or by injectionand all of them must be prescribed by a health care provider.

It's important to remember that while new treatments are effective at reducing the severity of symptoms and helping prevent hospitalization and death in people who become infected with COVID-19, they are not a substitute forvaccination, which remains the single most effective strategy to prevent serious disease. Read on to find outYale Medicine's guide to COVID-19 treatmentsand to ensure your health and the health of others, don't miss these Sure Signs You've Already Had COVID.

What is it?Paxlovidis Pfizer's brand name for an antiviral oral medication (in pill form) that combines two generic drugs, nirmatrelvir and ritonavir. It was the first COVID-19 antiviral pill to receive Food and Drug Administration (FDA)emergency use authorization (EUA), and the National Institutes of Health (NIH) has prioritized its use over other treatments for eligible patients. It is meant for people who have a current COVID-19 infection.

When it was authorized:December 2021.

Who can get it:People ages 12 and up who weigh at least 88 pounds, who have a positive COVID-19 test result, have symptoms, and are at high risk for developing severe COVID-19.

How you take it:For most people, the dose is three pills twice daily for five days, and it must be started within five days of developing COVID-19 symptoms.

Side effects:They're usually mild, and may include altered or impaired sense of taste, diarrhea, increased blood pressure, or muscle aches. Because Paxlovid is still being studied, it's possible that all of the risksaren't yet known.

How it works:Paxlovid is an antiviral medication, a type of drug that stops viruses from replicating inside the body's cells. Two of the pills in the three-pill dose are nirmatrelvir, which prevents the SARS-CoV-2 virus from replicating. The other medication is ritonavir, which gives the first drug's levels a boost by essentially shutting down its metabolism in the liver, so that nirmatrelvir levels remain high and can work longer to fight the infection.

How well it works:89% efficacy against hospitalization and death in theclinical trialin which all participants were unvaccinated.Though the trial was conducted beforeOmicronbecame the predominant variant, Pfizer says that the treatment appears to work well against it. This is backed up bythree laboratory-based studies(all of which involved Pfizer) that have not yet been published in peer-reviewed medical journals.

What else you should know:Paxlovid interacts with many medications, including common ones that are sold over the counter like St. John's Wort, blood thinners, cholesterol medicines, and many more. In some cases, this can cause complications that are serious enough to justify not taking it. So, it's important for doctors to have an up-to-date medication list, including over-the-counter medications and supplements; they may consider other treatments for some patients.

There is no experience treating pregnant women or breastfeeding mothers with Paxlovid. Women who are pregnant should discuss their options with their health care provider. It is also recommended that patients use effective barrier contraception or do not have sexual activity while taking Paxlovid.

Paxlovid is also not recommended for patients with severe liver or kidney disease and those withHIVwho are not on treatment.

What is it?The antiviral treatment remdesivir, sold under the brand name Veklury, was the first COVID-19 therapy to get full FDA approval, and, so far, it's still the only one. Although originally used in COVID-19 patients only after they were hospitalized, new data suggests it can be helpful in outpatients who become infected and who are at high risk for severe disease.It is meant for people who have a current COVID-19 infection.

When it was authorized:Full approval was granted in October 2020. (It was first authorized in May 2020 for critically ill patients who were being treated with oxygen for COVID-19.) The authorization was later expanded to include other groups, and it was authorized to treat non-hospitalized patients in January 2022.

Who can get it:Fully approved for children and adultswho are at high risk for severe disease. Infants and children must be at least 28 days old, weigh over 6.5 pounds or more, and be either hospitalized or at high risk for severe illness.

How you take it:Via injection or IV and administered only in a health care setting by a health care professional. For outpatients, the treatment is a three-day course of infusions that must be initiated within seven days of symptom onset.

Side effects:Nausea is the most common side effect. Hypersensitivity, including infusion-related and anaphylactic reactions, has been observed following treatment. There is insufficient data on the safety of using remdesivir in pregnant women or women who are breastfeeding; patients should speak with their health care provider.

How it works:Administered intravenously to patients who are in the hospital or in an ambulatory setting, the drug inserts itself into new viral genes to block replication of the virus, shortening the time it takes seriously ill patients to recover. A number of experts believe that the drug may work best early in the course of an infection.

How well it works:87% reduction in risk of hospitalization in non-hospitalized patients given a three-day course, according to a study published inThe New England Journal of Medicinein December 2021.

What else you should know:For hospitalized patients, research in early 2020 showed that the therapy reduced length of stay (the number of days in the hospital) from 15 days to 12. However, questions have been raised about remdesivir's trial results for hospitalized patients. In late 2021, the World Health Organization (WHO) recommended against remdesivir after releasingdatathat showed disappointing results. Still, many U.S. hospitals continue to provide this medication.

This is one of two NIH-preferred therapies (after Paxlovid) for COVID-19.

What is it?Bebtelovimab is an FDA-authorized investigational monoclonal antibody treatment that was developed by Eli Lilly. Not all authorized monoclonal antibodies have worked against all of the SARS-CoV-2 variants. However, data showing bebtelovimab's efficacy againstOmicron and its BA.2 subvariantprompted the FDA to authorize the drug through an EUA.It is meant for people who have a current COVID-19 infection.

When it was authorized:February 2022.

Who can get it:Adults and children ages 12 and up who weigh at least 88 pounds. They must have a positive COVID-19 test result and be at high risk for developing severe COVID-19.

How you take it:An intravenous injection is given for at least 30 seconds. Patients are observed by a health care provider for at least an hour after injection. Bebtelovimab must be given within seven days of symptom onset.

Side effects:There is limited information known about the safety and effectiveness of bebtelovimab for the treatment of mild-to-moderate COVID-19, according to theFDA fact sheet.The sheetalso provides a list of potential side effects the FDArecommends reporting to a medical provider, and reports that allergic reactions can happen during and after injection. Because bebtelovimab is still being studied, it's possible that all of the risks aren't yet known.

How it works:It binds to the spike protein that causes COVID-19, similar to other monoclonal antibodies that have shown efficacy against hospitalization and death from the disease.

How well it works:The EUA for bebtelovimab was supported by clinical and nonclinical data that showed it has efficacy against Omicron and its BA.2 subvariant.The clinical data was based on a Phase 2 trial that treated non-hospitalized patients with bebtelovimab alone or together with another drug called etesevimab. That study is available in apreprint, whichhas not yet been peer-reviewed.

What else you should know:There is limited experience treating pregnant women or breastfeeding mothers. So, those patientsshould discuss their options and specific situation with their health care provider.

The NIH considers this to be an alternative treatment, whichshould be usedonly when neither of the NIH-preferred therapies (Paxlovid and remdesivir)are available, feasible to use, or clinically appropriate.

What is it?Molnupiravir, also known by the brand name Lagevrio, was developed by Merck and Ridgeback Biotherapeutics. It was heralded as a potential game-changer when the companies announced their initial clinical trial results in 2021. But when the data was finalized, it showed the drug to have lower efficacy than originally reported. Its FDA authorization came after a close vote that took into account the lowered efficacy and safety profile. The Centers for Disease Control & Prevention (CDC) now recommends that this drug should be used when the above-mentioned treatments aren't available.

When it was authorized:December 2021.

Who can get it:People ages 18 and up who are at high risk for hospitalization and death from COVID-19.

How you take it:Four capsules every 12 hours (for example, at 8 a.m. and 8 p.m.) for five days. It must be taken as soon as possible, within five days of symptom onset.

How it works:When the drug enters the bloodstream, it blocks the ability of the SARS-CoV-2 virus to replicate.

How well it works:30% efficacy against hospitalization and death. Merck initially reported the efficacy as 50%, but later adjusted that figure. Some laboratory studies from Merck have shown that molnupiravir is effective against the Omicron variant.

Side effects:Diarrhea, nausea, and dizziness are the most common side effects. You should stop taking the pills right away if you have an allergic reaction. Because molnupiravir is still being studied, it's possible that all of the risks aren't yet known.

What else you should know:Molnupiravir is not recommended during pregnancy, since it has not been studied in pregnant women and has shown potential harm inin vitrostudiestherefore, the true risk for harm to an unborn baby is unknown.

Individuals who are able to become pregnant should use reliable birth control during treatment and for four days after their last dose. It is also not known if molnupiravir could affect sperm, so individuals who are taking molnupiravir and who are sexually active with partners who are able to become pregnant should use reliable birth control during treatment and for three months after the last dose. (Studies to understand the risk to sperm beyond three months are ongoing.)

The NIH considers this to bean alternativetreatment, whichshould be usedonly when neither of the NIH-preferred therapies (Paxlovid and remdesivir)are available, feasible to use, or clinically appropriate.

What is it?Evusheld is a monoclonal antibody, but different than the other medications listed above. It combines two drugs, tixagevimab and cilgavimab. It is not designed to treat COVID-19; rather, its purpose is to keepimmunocompromised peoplewho do not respond to vaccination from getting sick. Developed by AstraZeneca, it is the first long-acting antibody to receive an EUA for pre-exposure prevention of COVID-19.6254a4d1642c605c54bf1cab17d50f1e

When it was authorized:December 2021.

Who can take it:Anyone 12 years or older who weighs at least 88 pounds and is at risk for severe illnessor those who cannot receive COVID-19 vaccines. Anyone taking the medication should have neither an active COVID-19 infection norbeen recently exposed to a close contact who is infected.

How you take it:A health care provider will give one dose of Evusheld in the buttocks in two separate injections (of tixagevimab and cilgavimab, respectively), one after the other, with repeat doses every six months, while SARS-CoV-2 remains in circulation.Patients will be monitored for an hour after each injection. In March, the dosage for Evusheld was doubled, so patients who received the two injections prior to the change in dosage recommendations should talk to their doctor about the need to repeat treatment.

Side effects:Any intramuscular injection can cause hypersensitivity, pain, bruising, soreness, swelling, possible bleeding, or infection at the injection site. Tell your health care provider if you experience any allergic reactions during and after an injection. Serious but uncommon cardiac adverse events have occurred in the clinical trial.

Contact your health care provider or get medical help right away if you have any symptoms of cardiac events, including pain, pressure, or discomfort in the chest, arms, neck, back, stomach, or jaw, as well as shortness of breath, feeling tired or weak (fatigue), feeling sick (nausea), or swelling in your ankles or lower legs. Because Evusheld is still being studied, it's possible that all of the risks aren't yet known.

How it works:It combines two antibodies with differentand complementaryactivities against the SARS-CoV-2 virus.

How well it works:According to a clinical trial, there was a 77% reduction in chances of getting COVID-19 initially; 83% six months after the treatment, according to theFDA news release. AstraZeneca says the drug should be effective for a year. It's important to note that the exact efficacy against the latest variants is still unclear. (Note: Because the trial did not include immunocompromised patients, it is also unclear If the 77% reduction would apply to those who are immunosuppressed.)

What else you should know:Evusheld is intended as an additional benefit for those who may not respond to vaccination or who cannot be vaccinated. People who get Evusheld may need to receive additional doses for ongoing protection if new variants emerge. The best timing for additional doses, if needed, is not yet known; it will depend on which SARS-CoV-2 variant is in circulation.

Note: If you are experiencingsymptoms of COVID-19and think you are eligible for a treatment, you can visit the governmentTest-to-Treat Locator. You can use the site to search for places near you where you can fill a COVID-19 prescription or identify sites that provide testing, medical care, and COVID-19 medications.

Follow the fundamentals and help end this pandemic, no matter where you liveget vaccinated ASAP; if you live in an area with low vaccination rates, wear an N95 face mask, don't travel, social distance, avoid large crowds, don't go indoors with people you're not sheltering with (especially in bars), practice good hand hygiene, and to protect your life and the lives of others, don't visit any of these 35 Places You're Most Likely to Catch COVID.

This article has been published in Yale's Medicine.

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These Medications are Best for New Variant Symptoms Eat This Not That - Eat This, Not That

Toronto, Ontario

Toronto Functional Medicine Centre in Toronto, ON, Canada, has recently published a blog post that discusses what people need to know about vitamin E for IV therapy in Toronto. The article points out that IV therapy patients may want to consider vitamin E for optimal health. Vitamin E, which is actually not just one vitamin but a cluster of compounds, may help in preventing cellular damage. These are fat-soluble compounds with significant amounts of antioxidants. Studies have noted that vitamin E may help the human body in promoting metabolism, immune function, cellular function, and gene regulation.

It should be noted that minimal intake of vitamin E or a vitamin E deficiency may occur in certain individuals because of genetics and certain health conditions. Ataxia with vitamin E deficiency and abetalipoproteinemia are two inherited conditions that pass on vitamin E deficiency genes. Meanwhile, celiac disease, Crohns disease, cystic fibrosis, liver disease, and pancreatitis (chronic) may cause patients to have problems with nutrient absorption, which may result in vitamin E deficiency.

Symptoms of vitamin E deficiency include: fragile muscles, vision issues, a weakened immune function, and damage to the nerves and muscles. And it has been observed that vitamin E treatments may have a number of beneficial effects, such as: reduction of oxidative stress; treatment or prevention of cataracts and age-related macular degeneration; and prevention or delaying of cardiovascular disease.

It has been observed that vitamin E is vital for maintaining optimal health. Thus, it is advisable to correct a deficiency in vitamin E. To find out if a patient has vitamin E deficiency, certain lab tests will need to be performed to confirm those key vitamins that are lacking. And if a patient has vitamin E deficiency, a functional medicine health care provider at the Toronto Functional Medicine Centre will discuss treatment options, such as oral supplementation, changes to daily diet, and IV therapy.

Those who have concerns or questions regarding vitamin E therapy are encouraged to contact the Toronto Functional Medicine Centre. Their health care team applies an integrative approach to patient care and functional medicine. They emphasize naturopathy, acupuncture, traditional Chinese medicine, and allopathic (western) medicine. Their integrative treatment strategies are all designed to help boost brain function and energy. Theyre suitable for various conditions, such as: chronic fatigue syndrome, thyroid conditions, infertility, skin rejuvenation, athletic recovery, DNA repair, adrenal function, blood pressure support, autoimmune disease, and mineral deficiencies such as IV therapy for iodine deficiency. Their vitamin drip treatments are made up of a broad mixture of vitamins, such as folic acid, additional B vitamins, ascorbic acid (high-dose vitamin C), a medley of amino acids, major minerals, and Myers Cocktail. Vitamin D intramuscular shots can also be provided at the clinic. However, it is important to note that before the patients first vitamin IV drip, an in-person or virtual consultation is required to avoid sensitivity reactions or medication interactions to the infusion solution. Functional medicine lab tests may also be required before IV therapy is administered.

The Toronto Functional Medicine Centre applies an integrative and functional medicine approach, which means that they combine functional medicine techniques with alternative medicine, such as herbal medicine, traditional Chinese medicine or Eastern medicine, bio-identical hormone replacement, and more. Furthermore, the restorative medicine centre applies functional medicine and alternative therapies for various types of health issues, such as: chronic disease, hormone imbalances, neuropathic pain, acute health issues, postmenopausal health, and more. The conditions that they may be able to help with include: chronic fatigue, tissue repair, cellular damage, DNA repair, athletic recovery, mineral deficiencies, thyroid conditions, infertility, immune function, skin rejuvenation, adrenal function, and others.

People who are interested in learning more about Vitamin E therapy in Toronto can visit the Toronto Functional Medicine Centre website, or contact them on the telephone at (416) 968-696 or through email at [emailprotected]. They are open from 9:00 am to 6:00 pm on Mondays, Wednesdays, and Fridays; 9:00 am to 5:00 pm on Tuesdays and Thursdays; and 9:00 am to 4:00 pm on Saturdays.

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For more information about Toronto Functional Medicine Centre, contact the company here:

Toronto Functional Medicine Centre(416) 968-6961[emailprotected]Toronto Functional Medicine Centre162 Cumberland St 222 AToronto, ON M5R 1A8

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Toronto Functional Medicine Centre Explains What People Need to Know About Vitamin E for IV Therapy in Toronto - Digital Journal

Guinness World Records just confirmed the world's oldest man! As of February 4, 2022, at 112 years and 253 days, Venezuela-native Juan Vicente Prez has been officially declared the oldest living male. However, his 113th birthday is quickly approaching, and he is ready to celebrate the title and another year around the sun on May 27th.

A major title to hold, we can't help but wonder how did Prez get to live to this milestone age. According to Guinness World Records, Perez's secret to a long life is drinking a glass of aguardiente every day.

"Work hard, rest on holidays, go to bed early, drink a glass of aguardiente every day, love God, and always carry him in your heart," Guinness shares.

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Aguardiente is an anise-flavored sugar cane distilled liquor. It translates to the English term, "firewater," and is referred to in Colombia as "guaro" (sugar water). Four ingredients make up aguardiente; alcohol, sugar, anise, and water.

Anise is an herb that has been used in medicine, as well as helped flavor foods and beverages. Although there has been little research, anise has been linked to helping with digestive issues. In a study posted by BMC Complementary and Alternative Medicine, a clinical trial showed that patients who took the herbal combination of drugs that contained anise were significantly more effective than placebo in increasing the number of bowel movements per day.

Anise has also been linked to stimulating appetite and being a natural remedy for asthma, diabetes, gas, insomnia, coughing, upset stomachs, and even neurological disorders.

Alcohol also seems to be common ground among some of the world's oldest people. Drinks like wine, even whiskey and beer, have been linked to longevity in some people.6254a4d1642c605c54bf1cab17d50f1e

According to the Mayo Clinic, drinking in moderation can have some stellar benefits, including reducing your risk of heart disease. There's also the possibility of reducing your risk of ischemic stroke and risk of diabetes.

Thanks to his favorite drink, his faith, and his loving family, Prez is in near-perfect health. Along with his drinking habit, he also makes sure to instill the habit of praying at least twice a day as part of his daily routine.

"My dad is in very good health, his daughter Nelyda Perez tells Guinness. "He does not suffer from any disease that requires medical treatment. "The next day after resting, he says he wakes up very well. The whole family is very grateful for my daddy's health."

To commemorate his birthday 113th birthday coming up, Perez will be celebrating with his family and close friends.

RELATED: The #1 Secret to Living Until 100, Says Science

Kayla Garritano

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The #1 Drink The Record Holding Oldest Man Has Every Day Eat This Not That - Eat This, Not That

CRESTONE, Colo. Philip Incao was about 6 years old when he asked his mother if it was true he would die. Yes, she replied. And what happens afterward? he asked.

Nothing, she said. You just die, thats all.

It was a profoundly unsatisfying answer, and one that Dr. Incao later identified as the starting point for a lifetime of study.

He pursued a path that wound through medical school, training in holistic healing and devotion to the early 20th-century esoteric Rudolf Steiner, a polymath who theorized that the spiritual world could be explored through scientific methods.

Decades of searching led him all the way to an unconventional decision about what would happen to his body after his death.

Before Dr. Incao died of prostate cancer on Feb. 28 at age 81, he arranged for a cremation in his adopted hometown, Crestone, Colo., at the countrys only public open-air funeral pyre.

All the old forms, all the old rituals, are being loosened up, he explained in interviews in the months before his death. And through this type of cremation, he planned to be a part of that shift.

He knew his body would be wrapped into a simple shroud, carried on a wooden stretcher into an enclosure, and placed on a platform a few feet from the ground. His sons and his wife would light the fire and watch his body burn for several hours. The next day, they would collect the ashes. He had attended several cremations at the pyre, and he was ready.

About 70 people have been cremated at the pyre in Crestone since it opened more than a decade ago. Its services are restricted to residents and landowners in Saguache County, with a population of less than 7,000 people spread across some 3,000 square miles.

Set inside a circular wooden fence a few miles out of town, with the Sangre de Cristo range of the Rocky Mountains looming in the background, the pyre itself is a utilitarian structure: two waist-high stuccoed concrete walls lined inside with firebrick, and spanned by a plain metal grate.

The simple design represents a defiant upending of American death rituals. Instead of a body being whisked away by a funeral home, it stays on view at home for several days. And rather than being chemically preserved and placed in a sealed coffin, it remains on ice, but otherwise in its natural state.

Burial as a practice in the U.S. is basically designed so that the American family doesnt have to deal with the dying, Dr. Incao reflected in December. By then, he was mostly confined to his bed, where he rested, met with friends, sorted through his belongings, and read books about reincarnation and near-death experiences.

More than half of Americans are cremated after death, a remarkable change from the 20th century, when it was completely against American sensibilities, said Gary Laderman, a professor in the department of religion at Emory University. But Crestones approach goes even further, defying one of traditional cremations core promises, to make the body disappear quickly and invisibly. A body on the pyre turns into ash and smoke while friends and family keep vigil for hours under the open sky.

Community cremation sites are commonplace in some parts of India, but they remain taboo in the United States. A Buddhist retreat center in northern Colorado maintains a private pyre, but efforts to open public sites like Crestones have faltered, running up against squeamish cultural sensibilities about death.

Folks who havent had direct experience of open-air cremation, whether its in Colorado or in Asia, can have some pretty strange associations, said Angela Lutzenberger, a hospice chaplain who bought 63 acres of land in Dresden, Maine, that she hopes to turn into a pyre site. They build up creepy ideas about what it could be.

It is not a coincidence that Crestone is the pyres home. About 200 miles south of Denver, the former gold mining town has attracted a population drawn to Eastern religious practices and wisdom traditions for decades. Its reputation solidified in the 1980s, when a Danish-born spiritual seeker and her oil magnate husband established a sprawling development just outside town that bills itself as the largest intentional, interreligious and sustainable living community in North America.

The winding roads around that development with street names like Serene Way and Jubilant Way lead to several towering Buddhist shrines, retreat centers and a spiral ziggurat commissioned in the 1970s by the father of Jordans Queen Noor. Some locals refer to a vortex of energy in the area.

Theres no other place quite like this in America, said Dr. Incaos son Sylvan, who visited his father there often over the years.

Sylvan had come to Crestone on a chilly week in March that would culminate in his fathers cremation. Fliers with information about the ceremony were posted at the health food store and the cafe next door, which function as the towns social center. Please carpool whenever possible, the flier read. Pyre lit at 8 AM.

Dr. Incao had moved to Crestone with his second wife, Jennifer, in 2006, after practicing anthroposophic medicine a Steiner-inspired holistic approach that many mainstream physicians characterize as pseudoscience in upstate New York and Denver.

Dr. Incao graduated from the Albert Einstein College of Medicine in New York City, but his career radically changed course when he was introduced to alternative medicine and Steiners work. Steiner lectured widely on topics including philosophy, Christianity, finance, architecture and art. His ideas about education led to the Waldorf school movement; his thinking on agriculture inspired biodynamic farming.

Steiners view of medicine was a revelation for Dr. Incao. He went on to spend his life exploring the teachings of Steiner, whose work guided not just his interest in philosophy and spirituality but his medical career.

He believed in reincarnation, which he felt gave a sense of purpose to life. And he was devoted to the idea of what he considered a natural approach to medicine.

For Dr. Incao, that meant choices that would seem extreme to many, even some members of his family. He strongly opposed vaccination, publishing articles and offering testimony against childhood vaccines and eventually opposing the Covid-19 shots. When he became sick, he declined traditional treatments for his cancer, including chemotherapy. He was at home in Crestone, where many residents are skeptical of traditional medicine.

Dr. Incao believed that the moment of death was just the beginning of the process of separation of the human identity, which he said took about three days.

And why be cremated outdoors? You do it because it makes a lot more sense than the alternative, which is giving the body over to the undertaker, he said. He decided on cremation after moving to Crestone, and officially signed up about four years ago.

Sylvan, 49, and his brother Sebastian, 47, supported their fathers plans, which they saw as in keeping with his spiritual sensibility and nonconformist streak. He loved nature, said Sebastian, an acupuncturist in New York. It seemed like a very powerful way to liberate his spirit.

Their older brother, Quentin, 51, was not so sure. He knew his father was a nonconformist, but he was still shocked when Dr. Incao told him about his intentions, on one of Quentins visits from his home in Montana. It just didnt make sense to me, I couldnt understand it, he recalled. He had agreed to be a pallbearer, but he was dreading the action of physically placing his fathers body on the pyre.

At a memorial service a few days before the cremation, the three brothers, their families and others gathered in Jennifers backyard art studio for a ceremony and eulogy delivered by a priest from the Christian Community, a small religious movement inspired by Steiner.

Dr. Incaos body lay in repose at the front of the room, with wreaths of fresh carnations and other flowers on his body. Into the calm of soul being walks the soul of our dear Philip, the priest said, reading from a hand-transcribed book of sacred texts. He is now on the other side of the threshold but his love has not stopped. At the small outdoor reception afterward, deer grazed in the yard.

Its one of the most beautiful volunteer activities, said Fane Burman, who has assisted at about a dozen cremations, helping stack the wood and tending to it as it burns. The nonprofit that operates the pyre, the Crestone End of Life Project, provides about a dozen local volunteers for each cremation. Although Mr. Burman does not always know the person who has died, once the fire gets burning it brings tears to my eyes.

On a cool Saturday, the family gathered at 7 a.m. to accompany Dr. Incaos body from his home to the pyre about four miles west. A volunteer had wrapped the body in a shroud of sheets the night before and covered it in roses. The stretcher was carefully loaded into the back of Sylvans black pickup truck, and Quentin and Sebastian rode in the back with their father our last moments with him, Quentin said. The truck slowly turned right at a small hand-painted sign reading Pyre.

By 7:30 a.m., about 70 people lined the path into the pyre site. A volunteer rang a bell to signify the start of the ceremony, and another played a tune on his handmade flute as the procession wound its way to the inside of the fence. The pallbearers laid the stretcher on the metal grate.

Dr. Incaos ceremony began with family members and friends laying juniper branches and flowers on the body. Incense burned in a terra cotta pot tended by a volunteer, while others added logs until they were piled above the rim of the pyre. Then Jennifer and Dr. Incaos sons lit large sticks in the incense pot and ignited the pyre together.

As the fire started to burn, Sylvan put his arm around Sebastian. A harpist played a tune as the flames crackled. Quentin wiped tears from his eyes, from smoke or emotion or both.

Smoke billowed thickly for about 10 minutes, and died down. By then, fire was putting off enough heat to warm the circle. Flaky ashes swirled in the air, which smelled of incense.

A threshold choir, which specializes in singing for the dying, performed some of the tunes they had sung for Dr. Incao in his last few months. Safe passage, pilgrim of the spirit, they sang. We are all just walking each other home.

Sylvan spoke about how he had always teased his father about wearing so many layers, always being cold. With the fire going, hes warm enough, he concluded with a smile. Another friend performed a hallelujah another Steiner concept in which she solemnly circled the pyre, lifting and lowering her arms, moving forward and backward.

Quentin, who had questioned his fathers plans from the start, watched the ceremony quietly and intently. It was almost like a weight lifted, to know hes moved on, he said later, as the crowd dispersed and the ashes smoldered.

He knew, in the end, it was what his father had wanted.

He was looking forward to being the smoke.

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One Mans Choice to Be Cremated Under the Open Sky - The New York Times

MAY 19 is celebrated across the globe as World Inflammatory Bowel Disease (IBD). The disease is chronic inflammatory condition of the intestine and is of two main types: Ulcerative Colitis and Crohns disease. IBD is increasing in India and this increase is largely driven by changes in the diet and westernization of lifestyle.

A recent editorial in Lancet Gastroenterology and Hepatology described South Asia (including India) as a new frontier of IBD. Some studies have shown that IBD is as common in North India as in the western world. Genetics, immune response, and changes in the dietary pattern also play a role in the causation of this disease. IBD can affect any age or gender. Usually, these patients have abdominal pain, diarrhoea, and bleeding in the stools. The diagnosis is often delayed because of the lack of awareness about the disease in the community, lack of access to colonoscopy, and confusion about other diseases like hemorrhoids, abdominal tuberculosis, and cancer.

The Department of Gastroenterology, PGI, celebrated the day to raise awareness about the condition and also to improve the care and treatment of patients living with IBD. Prof Usha Dutta, head, the Department of Gastroenterology, said that special lectures were organised where patients with IBD were educated about the disease, diagnostic tests, various treatment options, the role of diet, and health maintenance. Prof S K Sinha spoke about the nature and presentation of the disease, Dr Vishal Sharma spoke about the treatment options for the disease, and Prof Dutta spoke about the diet and lifestyle approaches for IBD.

The incidence of the disease is increasing steadily in India, and there are many factors that are responsible for the rise, like a Westernised diet, lack of fresh fruits and vegetables in our diet, pesticides, stress, lack of sun, adulterated food, contaminated water, highly refined oils, which affect our intestine lining and the balance of good bacteria in the body is affected. It is paramount that people do not ignore symptoms like loose motions, pain in the abdomen, and blood in the stool, which continue for more than two weeks. A specialist must be consulted and no painkillers, steroids, or over-the-counter drugs must be used, which can cause further complications. Only medicines prescribed by a specialist must be taken, and alternative medicine treatments must be avoided. Also, treatment must not be stopped and regular follow-ups are essential to pick up early cancer. Most patients respond well to treatment, and in our OPDs, we do a follow-up of more than 1500 patients, with new patients added every month, explains Prof Dutta.

As for the age group affected most by IBD, Prof Dutta adds, that it is seen across age groups, though the peak of IBD is seen in people between 20 and 40 years of age. Prof Dutta recommends early intervention by specialists, more awareness about the disease, changing our diets and adding more fresh and healthy food, use of natural probiotics like curd, lassi, and living an active and stress-free life.

On the occasion, an IBD card designed by the Department of Gastroenterology, in association with Colitis and Crohns Foundation, India was released. This card will provide a snapshot of the disease state and drug therapies with education material and will be helpful in improving various aspects of care including diet, preventive health, and medication. The card is designed with suggestions from other experts from AIIMS, Delhi, DMC, Ludhiana, and SGPGI, Lucknow. The card will be available to clinicians and gastroenterologists across the country for use and will be launched through a web meeting on World IBD Day.

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World Inflammatory Bowel Disease day: The incidence of IBD is increasing - The Indian Express

IV therapy is touted as an efficient way to deliver fluid and nutrients into the body, pumping them directly into the bloodstream. Oral therapies like vitamin pills, on the other hand, must first be absorbed and broken down by the stomach, which takes more time and can limit how much of the nutrients a person actually receives. Ali pointed out that IV therapies used in a nonhospital setting are not intended to treat anything, but rather act as a supplement.

But many health professionals are not fans of this relatively new wellness trend, citing a lack of federal regulation and sound clinical research, as well as potential health risks for some people, particularly those with certain medical conditions.

For Jenner, who has been open about her occasional use of IV vitamin therapy for several years now, it helps bring a sense of control over her health.

Literally since I can remember, Ive been a hypochondriac, and so I am obsessed with health right now, said Jenner, who has also been dealing with some weird post-COVID symptoms, too. Its been my number one priority, Id say. To the point where Im like eating myself alive thinking about my health.

Theres little proof that IV vitamin treatments work, said Dr. Joshua Septimus, associate professor of clinical medicine at the Houston Methodist Research Institute in Texas, who called the therapy nonsense.

It's the latest trend in functional or alternative medicine to kind of rip through the general community as a cure-all, Septimus told BuzzFeed News. It's just one more way to fleece people for money.

One of Septimuss biggest concerns is that IV vitamin therapies are not FDA regulated or approved, so what you get is going to depend on where you go and whos administering the snake oil, he said, adding that no mainstream physician would recommend the treatment for anyone unless medically necessary.

Companies that provide them sometimes make unsupported and deceptive health claims about their vitamin cocktails. In 2018, the Federal Trade Commission for the first time cracked down on a company making health claims about IV treatments without scientific evidence.

The company, called iV Bars, operated drip clinics in Texas and Colorado at the time and claimed its IV vitamin therapies could treat cancer, multiple sclerosis, diabetes, congestive heart failure, fibromyalgia, and neurodegenerative disorders. It also claimed its cocktails were more effective and better-tolerated than conventional medical therapies, the FTC said.

The research on these infusions is also scarce. A handful of studies show moderate benefits for asthma, inflammation, and fatigue, while a larger batch found the treatments have little to no impact, particularly for more serious health conditions like acute respiratory distress syndrome, cancer, sepsis, and stroke. However, in the studies, people were given a variety of different vitamin therapies in medical settings.

The majority of research on IV vitamin therapies show the treatments can be administered safely in certain groups (though keep in mind some studies have small sample sizes) but dont really have substantial benefits for specific conditions.

Ali of Beverly Hills said his clients typically feel better immediately after the vitamin infusion, which can last one to eight hours, depending on the chosen dosage.

While some people may certainly feel more refreshed after a treatment, Septimus is doubtful the vitamins are responsible.

Lying in a calm environment for a couple of hours while receiving the IV therapy will help anyone relax, he said, so there may be a placebo effect at play. (One 2009 study did conclude the placebo effect was likely a reason people with fibromyalgia felt relief after eight weeks of IV vitamin therapy.)

Not to mention if youre dehydrated, IV therapy may help you feel better by filling your blood vessels with the fluids they need.

However, just because a certain treatment seems biologically plausible, either theoretically or in a test tube, it doesnt mean the therapy actually works, Septimus said.

The first thing you learn in medical school is primum non nocere, which means first do no harm, Septimus said. But in order to first do no harm, you have to study something.

The risks of IV therapy treatments depend heavily on the mixture of nutrients you receive, some of which can be potentially hazardous for people with certain medical conditions. Because the vitamin cocktails are not FDA regulated, you may not really even know what youre getting.

For example, if your banana bag is brimming with calcium and you have an undiagnosed kidney insufficiency, you run the risk of developing blood clots in your arteries due to calcium deposits that can be life threatening, Septimus said.

Similarly, if you have any type of heart disease or condition, you should avoid IV vitamin treatments because the excess fluid may increase the risk of heart failure, a chronic condition where the heart struggles to pump enough blood.

If drip bags contain sugar solutions, people with diabetes should stay clear, Septimus added. Those with weakened immune systems should also never consider this kind of treatment (unless medically necessary) because in the event the needle isnt properly sanitized or inserted, you can develop a dangerous infection.

People with liver disease should avoid this therapy at all costs too, Septimus said.

The first question you should ask yourself before swiping your credit card at an IV drip clinic or lounge is, Do I really need these vitamins?

Generally, nutritional deficiencies in the US are rare outside of serious medical situations like gastric bypass surgery or extreme diets, so the fact is that most people dont need vitamins that theyre not already getting from their food, Septimus said.

For those who do have nutritional deficiencies, a multivitamin pill will usually suffice. And if you are so dehydrated that you need an IV drip, a nonmedical clinic may not be the best place to get treatment.

If you are volume depleted enough that you need IV fluids, you should be under the care of healthcare professionals, not that of a mobile IV clinic that's giving people sham treatments, Septimus said. You really should be seeing a physician to get a prescription for that fluid. And most of the time if someone is unwell enough that they need volume repletion, they can do it orally.

Even healthy people face some risks. Back in 2018, Jenner was hospitalized after experiencing a bad reaction to a vitamin IV drip, though the type of reaction or reason is unknown, People reported at the time.

Aside from possible infections from improper needle use (which can happen in both hospital and home settings), vitamin toxicity can occur. For example, if you take too much vitamin B6, which is associated with brain health and mood improvement, you can damage your nerves in a way that can lead to permanent numbness in your limbs.

Its also possible to overdo it. Ali said this hasnt happened to any of his clients, but that receiving IV vitamin therapy more than once a week would be too much, he said.

Your takeaway message, at least according to one physician: Don't waste your money. Get your nutrition from food. Get your hydration through your mouth, Septimus said. And if you're sick enough that you need an IV, you need to be evaluated by a healthcare professional.

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Whats Up With Those IV Therapy Treatments Kendall Jenner And Hailey Bieber Received? - BuzzFeed News