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Voice of Developing Communities, (VODEC) and Skyview Hospital is orgnainzing a free health screening at Domeabra and Windy Hill, two adjoining communities near Pokuase in the Ga West Municipality on 24th March, 2018.  

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Ghanaians eating too much fish – Fisheries Alliance convener

The excessively high intake of fish among Ghanaians is one of the reasons the country has to import over 60 percent of its fish, according to the Co-convener of the Fisheries Alliance, Richster Nii Amarfio.

Ghana, which consumes over 950,000 metric tons of fish annually, imported $135 million worth of fish in 2016 because of the reduction in the country’s fish stock.

There are fears Ghana may soon lose its fishing stock if nothing is done to overturn issues confronting the country’s fishing sector.

Speaking on the Citi Breakfast Show, Mr. Armafio attributed the state of affairs to failings in the post-harvest chain which contributes to Ghana’s 25 million population having a high fish consumption per capita.

“The fish we consume in Ghana per capital is way in excess of the world average. We consume between 25 and 27 kg per capita. The world average is around 11 to 13 kg per capita. So we are consuming about twice the world average consumption and only a few people consume that fish.”

But this lop-sided consumption can be corrected by investments into the post harvest sector of the fishing industry.

“We first need to look at the lopsided consumption in the fisheries sector and then develop a proper post-harvest sector that is able to attract investors into the country to now start the process of canning fish and if that happens, our consumption will go down and our earnings from the fisheries sector will grow.”

“ You can’t say that the 400,000 metric tonnes we are producing is not enough. It is the way we consume fish that is the problem because we have not developed the processes of storing fish,” Mr. Armafio added.

Impact of galamsey

Illegal mining activities have also contributed to this fish deficit as the inland contribution to fisheries “has completely been cut out.”

“People who were living in the North were depending on small streams and water bodies so they didn’t have to rely on imported fish. [But they] no longer have those fishes, so they now have to rely on imported fish because their fish and water bodies have all been destroyed by illegal mining activities.”

Aside from this, Ghana is also missing out on fish production from lagoons and mangrove swamps in Accra because “they have become industrial sinks.”

“Go to Accra, all the municipal drains are channeled into one water body or another and so the quality of water that we require in the lagoons to produce the brackish fish; we are losing them.”


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Is peanut butter healthy?

(CNN)Yes, peanut butter can be a nutritious diet staple, but some varieties are healthier than others.

Peanut butter is rich in heart-healthy fats and is a good source of protein, which can be helpful for vegetarians looking to include more protein in their diets. A 2-tablespoon serving of peanut butter contains up to 8 grams of protein and 2 to 3 grams of fiber. The nutty spread also offers vitamins and minerals including the B vitamin niacin, iron, potassium and vitamin E.
The healthiest peanut butter is made from just peanuts, while added salt, sugars and oils change its nutritional profile. For example, a peanut butter with salt added can have 100 to 150 milligrams of sodium, while an unsalted version is sodium-free. Sugars may be added too, especially in flavored varieties, and can contribute up to 7 grams, or 28 calories per serving.
Nuts, including peanuts (which are technically legumes), have been associated with lower risk of heart disease, cancer and premature death.
Consumption of nuts and peanut butter has also been associated with reduced risk of type 2 diabetes. However, one study that tracked more than 120,000 men and women from 1986 to 1996 found that while consumption of nuts and peanuts was associated with lower mortality rates among individuals, no protective effect was found for peanut butter.
"In the past, it has been shown that peanut butter contains trans fatty acids and therefore the composition of peanut butter is different from peanuts. The adverse health effects of salt and trans fatty acids could inhibit the protective effects of peanuts," researchers wrote in a news release on the study.
In fact, a 2001 USDA report found that peanut butter does not contain any detectable levels of trans fats in any of the 11 brands of peanut butters that researchers tested, which included both major store brands and "natural brands," even though small amounts of hydrogenated vegetable oils are added to commercial peanut butters to prevent the peanut oil from separating out.
Though it might seem that crunchy or chunky peanut butter might have an edge over the smooth kind, nutritionally speaking, they are pretty similar. Differences among peanut butters have more to do with a spread's ingredients, rather than its texture.
Linda V. Van Horn, professor of preventive medicine and a registered dietitian at Northwestern University, stated that commercial peanut butter formulations have been improved because the food industry is aware of the trans fat issues and has responded by reformulating those products. "Just remember to check the label for '0' trans fats and preferably '0' added sugars," she said. Fortunately, "there is no concern with ground-up peanuts ... otherwise known as 'natural' peanut butter."
eep in mind that most of the calories in peanut butter come from fat. While it's mostly the heart-healthy monounsaturated and polyunsaturated kind, it does make peanut butter a calorie-dense food. A 2-tablespoon serving has approximately 200 calories, so if you are carefully watching calories, you can cut that portion in half. And steer clear of flavored peanut butters with added sugars and cocoa butter, which morphs a healthy nut spread into dessert.
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New class of drugs targets aging to help keep you healthy

(CNN)Researchers have turned the spotlight on a new class of drugs that they say could "transform" the field of medicine -- and the drugs work by targeting aging.

The researchers, from the Mayo Clinic in Rochester, Minnesota, are calling for senolytic drugs to make the leap from animal research to human clinical trials. They outlined potential clinical trial scenarios in a paper published in the Journal of the American Geriatrics Society on Monday.
"This is one of the most exciting fields in all of medicine or science at the moment," said Dr. James Kirkland, director of the Kogod Center on Aging at the Mayo Clinic and lead author of the new paper.
As we age, we accumulate senescent cells, which are damaged cells that resist dying off but stay in our bodies. They can affect other cells in our various organs and tissues. Senolytic drugs are agents capable of killing problem-causing senescent cells in your body without harming your normal, healthy cells.
Senescent cells play a role in many age-related chronic diseases, such as diabetes, cardiovascular disease, most cancers, dementia, arthritis, osteoporosis and blindness, Kirkland said. Therefore, senolytic drugs are a possible treatment approach for such diseases.
As a practicing physician, Kirkland said that he has grown increasingly concerned for his patients who are sick with many of these age-related conditions.
"The same processes that cause aging seem to be the root causes of age-related diseases," he said. "Why not target the root cause of all of these things? That would have been a pipe dream until a few years back."
In 2015, scientists from The Scripps Research Institute and the Mayo Clinic, including Kirkland, identified this new class of drugs. In a study published in the journal Aging Cell, they described how senolytic drugs can alleviate symptoms of frailty in mice and extend the length of time the mice are healthy as they grow old.
Then, last year, the researchers demonstrated in a study in Aging Cell that clearing senescent cells in mice can improve their vascular health.
Fourteen senolytic drugs have been discovered and are being actively studied, 11 of which Kirkland's colleagues and their collaborators found, he said.

Are these age-modifying drugs ready for human trials?

Scientists have long known that certain processes influence your body's aging on the cellular level, according to the paper. Those processes include inflammation, changes in your DNA, cell damage or dysfunction and the accumulation of senescent cells.
It turns out that those processes are linked. For instance, DNA damage causes increased senescent cell accumulation, Kirkland said.
So an intervention that targets senescent cells could attenuate other aging processes as well, according to the new paper. That is, once such an intervention is tested for efficacy and safety.
"I think senolytic drugs have a great future. If it is proven that it can reduce senescent cells and rejuvenate tissues or organs, it may be one of our potential best treatments for age-related diseases," said Dr. Kang Zhang, founding director of the Institute for Genomic Medicine at the University of California, San Diego, who was not involved in the new paper.
Yet taking senolytic drugs from mouse studies to human ones is a "big leap," Zhang said.
"So we will have to wait for clinical trials to see whether this would work in humans," he said. "One possible clinical trial strategy is to test this class of drugs in an age-related disease, such as neurodegeneration, like Parkinson's disease, to see if it can reduce clinical severity of the disease and improve tissue functions."
In the new paper, the researchers wrote that potential clinical trial scenarios include testing whether senolytic drugs could alleviate multiple chronic diseases in a single patient or whether such drugs could treat conditions that involve senescent cell accumulation in one location in the body, such as osteoarthritis.
They also suggest testing whether the drugs could treat diseases for which there are no medicines proven to slow the progression of that disease, such as idiopathic pulmonary fibrosis, a cell senescence-associated disease that affects the lungs.
Other potential clinical trial scenarios include testing whether the drugs could alleviate frailty in older adults or could treat conditions associated with chemotherapy or radiotherapy, since radiation can produce cellular senescence, Kirkland said.
For instance, "in mice, if you treat one leg with enough radiation, after three months, the mouse has trouble walking. If you give a single dose of these drugs, they're able to walk quite well, and that persists for two years," he said. "These drugs could mitigate the effects of therapeutic radiation."
Certain experimental cancer drugs already undergoing clinical trials, such as navitoclax and obatoclax, have been shown to have some senolytic properties, Kirkland said. If senolytic drugs prove to be efficient in treating humans and end up available for use, he said, they could cost about the same as some cancer drugs.
"Some of the drugs at the moment are moderately expensive," he said.
Cancer drugs can range in cost from about $20 a month to thousands a month. Venclexta or venetoclax, which has been approved by the Food and Drug Administration and has been studied in combination with navitoclax, has a monthly price tag of about $8,000, according to the Memorial Sloan Kettering Cancer Center.
"If we're able to reduce hospitalizations ... the savings on the medical care and hospital side might more than offset the cost of these drugs by a longshot," Kirkland said, though it remains unclear what the dosage options would be for senolytic drugs for short- or long-term use.

What the future holds for senolytic drugs

As for how soon he thinks human clinical trials might commence, Kirkland said doctors could have an idea of how well senolytic drugs work for serious health conditions in about a year and a half or two years.
Once the drugs are tested in humans, researchers expect many companies to be lining up to develop or manufacture senolytic drugs. Some have already expressed interest.
One company, Unity Biotechnology, aims to be the first to demonstrate that removing senescent cells can cure human diseases, said its president, Nathaniel David.
"In the coming decades, I believe that health care will be transformed by this class of medicine and a whole set of diseases that your parents and grandparents have will be things you only see in movies or read in books, things like age-associated arthritis," said David, whose company was not involved in the new paper.
Yet he cautioned that, while many more studies may be on the horizon for senolytic drugs, some might not be successful.
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Angel Group president donates $30, 000 cardiac monitors to KATH

The President of the Angel Group of Companies, Dr. Kwaku Oteng has presented 6 pieces of Patient Cardiac Monitors to the Komfo Anokye Teaching Hospital.

The 6 machines are to be used at the Emergency Unit of the hospital to save lives of patients whose hearts need to be monitored and supported.

Presenting the items to the management of the KATH, Dr Oteng who was flanked by the CEO of Angel Broadcasting Network, Mr Samuel Kofi Acheampong, Deputy Operations Manager of Angel Group, Samuel Boateng , Morning Show Host of Angel FM Kwame Tanko, Programmes Manager of Angel Fm, Summer, News Editor of Angel Fm, Appau Aheng and a host of others, could not hold back his tears after considering the inadequacy of very important equipment at the hospital allowing people who could have been saved die.

He explained that the kind gesture extended to the hospital is a sign of his willingness to support the venerable and needy in society as he considers his riches to be a gift from God for the betterment of humanity.

He pledged he would continue to support the hospital and charged other wealthy individuals to follow his example.

Speaking on behalf of the hospital, the Director of Nursing Services at KATH, Madam Patience Yeboah-Ampong expressed the management’s profound gratitude to Dr. Kwaku Oteng for the love and care for the patients and called for more of such positive actions.


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Hunting a Killer: Sex, Drugs and the Return of Syphilis

OKLAHOMA CITY — For months, health officials in this socially conservative state capital have been staggered by a fast-spreading outbreak of a disease that, for nearly two decades, was considered all but extinguished.

Syphilis, the deadly sexually transmitted infection that can lead to blindness, paralysis and dementia, is returning here and around the country, another consequence of the heroin and methamphetamine epidemics, as users trade sex for drugs.

To locate possible patients and draw their blood for testing, Oklahoma’s syphilis detectives have been knocking on doors in dilapidated apartment complexes and dingy motels, driving down lonely rural roads and interviewing prison inmates. Syphilis has led them to members of 17 gangs; to drug dealers; to prostitutes, pimps and johns; and to their spouses and lovers, all caught in the disease’s undertow.

“Syphilis doesn’t sleep for anyone,” said Portia King, a veteran Oklahoma state health investigator. “We have 200 open cases of sex partners we’re looking for. And the spread is migrating out of the city.”

It took months for investigators to realize Oklahoma City had a syphilis outbreak. Last fall, the juvenile detention center reported three cases — a boy and two girls, the youngest, 14. The center had never had a syphilis case in seven years of testing for it.

Investigators were mystified: The teenagers did not know each other, live in the same neighborhood or attend the same school.

Then, in February, a prison inmate tested positive. In interviews, he listed 24 sex partners — some his own, others the so-called pass-around girls for gangs, usually in exchange for heroin or methamphetamine. Contact information from the Entertainment Manager, as he called himself, pointed the way to a syphilis spread that, by March, led health officials to declare an outbreak, one of the largest in the country.

Although syphilis still mostly afflicts gay and bisexual men who are African-American or Hispanic, in Oklahoma and nationwide, rates are rising among white women and their infants. Nearly five times as many babies across the country are born with syphilis as with H.I.V.

Syphilis is devilishly difficult to contain, but may be even more so now. Because most doctors haven’t seen a case since the late 1990s, they often misdiagnose it. The cumbersome two-step lab test is antiquated. Although syphilis can be cured with an injection, there has been a shortage of the antibiotic, made only by Pfizer, for over a year.

And funding for clinics dedicated to preventing sexually transmitted diseases is down. In 2012, half of state programs that address sexually transmitted infections experienced reductions; funding has largely stayed flat since then. The Trump administration has proposed a 17 percent cut to the federal prevention budget.

Nearly 24,000 cases of early-stage syphilis, when the disease is most contagious, were reported in the United States in 2015, the most recent data. That was a 19 percent rise over the previous year. The total for 2015, including those with later-stage disease, was nearly 75,000, according to the Centers for Disease Control and Prevention.

The way to shut down an outbreak is to locate all the sex partners of people who are infected and persuade them to get tested, treated and disclose other partners. That task has fallen on a handful of the health department’s disease intervention specialists.

This most recent wave of infections, spread through gang networks and prostitution rings, has made their jobs not only difficult but also dangerous.

Danger and Determination

Erinn Williams, the lead field investigator for the Oklahoma City outbreak, drove slowly down a one-lane gravel road curtained by overgrowth and bristling with barbed wire and “No Trespassing” signs.

Ms. Williams, 39, life-seasoned by an Alaska upbringing, Air Force training and two small daughters, usually makes these visits alone. She keeps her baby’s car seat in the back, to allay suspicions that she may be an undercover police officer.

“What you do is your business,” she tells the wary. “I’m here because I care about your health.”

She is accustomed to stopping by houses with locks punched out; to being warned off by drug dealers; to wearing comfortable shoes, the better to run away in.

She pulled up to a clearing. Across a ragged lawn, she could see a battered blue trailer surrounded by pickup trucks and a stand of trees. Access was blocked by an iron fence, monitored by video cameras.

Ms. Williams pushed a call button. “Hi, I’m here from the health department. Can I talk to you? I have some news.”

A young woman hesitantly crossed the grass. For months she had avoided health workers. Once, an investigator spotted her slipping in through a side entrance to her mother’s house; at the front door, the mother denied that her daughter was there.

Fresh-faced, her blonde hair in a ponytail, the woman looked healthier than most people Ms. Williams visits, with their grayish skin, abscesses and mottled veins.

Ms. Williams was gentle but direct: “Your blood test results came back. It’s positive for syphilis.”

The woman buried her face in her hands. “I’m so embarrassed,” she sobbed. (Bound by confidentiality rules, Ms. Williams did not disclose her name.)

“Is that why my baby died?” she asked.

Ms. Williams nodded affirmatively.

“Can my kid get it? We sometimes share the same glass.”

No, Ms. Williams said. Just your sexual partners.

The woman insisted she had slept with only two men that year — her boyfriend and her ex, the father of the baby who had died.

Ms. Williams, who knew the woman’s Facebook page revealed many friends in a gang central to the outbreak, asked her to think carefully about whether there were more. We never reveal your name, she said, just as we cannot tell you who gave us yours.

The woman shook her head.

It was time to coax the woman into treatment. Just an injection and you will almost certainly be cured, Ms. Williams said, offering to drive her to the clinic. Her boyfriend too, Ms. Williams added.

He wasn’t around, the woman said, but she promised they would be there in the morning.

Are you sure you don’t want to go now? Ms. Williams asked.

Again, the woman shook her head.

Reluctantly, Ms. Williams got in her car and drove away.

An Elusive Killer

Syphilis, caused by bacteria, has been well known for centuries, chronicled as a scourge since at least the 1400s.

In 1932, the United States government began the ignominious “Tuskegee Study of Untreated Syphilis in the Negro Male” to observe the progress of the disease in black Alabama sharecroppers. Although penicillin had become accepted as the cure by 1945, Tuskegee researchers left the men untreated until 1972, when the study was shut down.

By then, largely because of treatment and public education, syphilis was disappearing. A generation of physicians rarely learned to recognize it firsthand.

But with the AIDS epidemic, syphilis surged, peaking around 1990. It was most common — and still is — among men who had sex with men, often those whose H.I.V. status made them vulnerable to other sexually transmitted infections.

Once again, public health campaigns sent syphilis into retreat. By 2000, only 5,970 cases were reported in the United States, the lowest since 1941, when reporting became mandatory.

But in the last few years, it has crept back.

Here in Oklahoma City, 199 cases have been connected so far this year. More than half the patients are white and female. The youngest girl is 14; the oldest man, 61. Three stillbirths have been attributed to syphilis and 13 of the infected were pregnant women.

Rare permutations are now more common. Ocular syphilis, which can strike at any stage of infection, often appears as blurred vision and reddened eyes. Congenital syphilis can cause deformed bones in newborns.

Many people never suspect they have the disease. Early symptoms, including genital lesions and, later, rashes on palms and soles, have led patients and health care providers to mistake it for herpes or allergic reactions. The disease can lie dormant for decades and then affect the liver, joints, blood vessels.

Once people are treated, though cured, they will almost always test positive. It is difficult to know whether a positive result indicates a new infection. After transmission, the bacteria may take three months to register. Those who test negative may have the disease.

This spring the Centers for Disease Control called for educating doctors and nurses about symptoms, testing pregnant women considered at risk and developing a better diagnostic test.

The cure for syphilis — usually two injections of Bicillin L-A, a type of penicillin — is relatively simple. But supplies have dwindled. Recently in Oklahoma, there were only seven doses statewide. Pfizer announced that stockpiles would be replenished by the end of 2017.

Dr. Vivian L. Wilson is medical director for eight community health clinics. In 37 years of practice, she has seen perhaps two cases of syphilis. But as a black Alabamian, she knows well the Tuskegee legacy. Though she appreciated a recent refresher course the state provided for staff members, the standard education materials, she noted, are severely outmoded.

“All the photographs still show patients who are Afro-American men,” Dr. Wilson said. “What message does that send?”

Watching the Detectives

After several months, dispirited Oklahoma investigators acknowledged that old-school tactics for locating contacts, like knocking on doors and cold-calling, were not very effective. Many people they sought are transient and use disposable phones.

“But they want to stay connected to their friends and their drugs,” said Ms. King, a supervising investigator. “So they’re all on Facebook. That’s where we’re finding them.”

Through Facebook, investigators memorize faces and gang tattoos, and follow the flare-ups and flameouts of relationships. As gang members and dealers post partying plans, the sleuths determine where to point their investigation. They send potential patients messages through Facebook.

Ms. Williams’s team realized they were tracking a spread that reached back to last summer, involved members and associates of 17 gangs, and had infected young people from stable backgrounds who had used prescription opioids, then heroin. Patients often had symptoms that were a signature of this outbreak: weeping genital warts, called condylomata lata; patchy hair loss; and mucosal oozes inside the mouth.

The office created a chart of the outbreak, coded with symbols. Diamond: drug user. Blue heart: pregnant. Strawberry: prostitute.

They have come to understand why more than half of this outbreak’s victims are women: “The men give up the women’s names,” Ms. King said. “But the women are too loyal or afraid to give up the men. ”

But recently investigators persuaded a gang leader to text members, ordering them to contact Ms. Williams.

Every day, the team checks arrest reports for people they are seeking. Chloe Hickman interviews inmates. Wearing glasses and no makeup, inclined toward modest cardigans, she doesn’t come across as someone who chats up gang members about their sex lives.

“I don’t cuss in my real life,” she said. “But in the jail, I flirt. I wear tight pants, a low-cut top and I use the F-word.

“Most of them don’t know what syphilis is. When I say it’s curable, they relax. And they’ll give me names.”

Usually such efforts lead to sagas of unrelenting grimness: mothers who prostitute daughters, and men who forcibly inject runaways with drugs to hook them, a practice known as guerrilla pimping.

Acquaintances of the investigators often dismiss their work as disgusting. For support, the women call each other daily, to laugh and vent.

Ms. Williams, on the job for eight years, said it gets to her, but she cannot let it go. “I remind myself that I’m not trying to fix all their problems,” she said. “Just one.”


Erinn Williams often drives isolated roads during her investigations. Credit Nick Oxford for The New York Times

Maybe Next Time

By 10 o’clock the next morning, Ms. Williams had arranged to pick up one person for treatment, been stood up by another and was texting with a man who refused her offer of a blood draw, claiming that needles made him anxious. She had driven a woman to the clinic, after waiting outside her house as, apparently, the woman was getting high on meth.

Now at the clinic, the woman seemed to have fled. Ms. Williams and nurses ran through hallways, looking for her.

One victory: The woman from the trailer was in the waiting room. But she was alone. In the parking lot, her boyfriend sat out the appointment in his pickup truck, motor idling. He would not come inside for treatment.

He would almost certainly reinfect his girlfriend. And Ms. Williams would have to persuade her to be tested and treated, yet again.

Source:NY Times

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Ten tasty snacks under 200 calories, and four disappointing ones

(CNN)Nearly all Americans snack at least once a day, most often to satisfy cravings, according to a recent snacking report. For some, frequent snacking may replace a typical meal or two.

Regardless of your health goals, what you choose to snack on matters, especially if you snack often. A healthy nutrient-rich snack can fill in nutritional gaps and boost energy. But sugary junk foods can leave you feeling tired and craving more food fixes.
Pairing protein or small amounts of heart-healthy fat with carbohydrates promotes satiety and gives you sustained energy while keeping calories down. Below is our list of tasty, low added-sugar snacks under 200 calories (according to the counts at the USDA nutrient database unless otherwise linked to), which will keep your stomach full and your waistline slim.
Avocado on whole-wheat toast
This heart-healthy avocado spread on toast makes for a tasty, super-satisfying snack.
  • 1 slice whole-wheat bread, toasted = 76 calories, 4g protein, 1g fat, 2g fiber, 1.4g sugar
  • ¼ avocado, mashed = 80 calories, 1g protein, 7.37g fat, 3.4g fiber, 0.33g sugar
  • Salt and pepper to taste = 0 calories
  • Total: 156 calories, 5g protein, 8.4g fat, 5.4g fiber, 1.7g sugar
Banana peanut butter graham sandwich, open-faced
This delicious combo comes in handy as an after-school snack and is a favorite among (my) kids.
  • ½ small banana = 45 calories, 0.55g protein, 0.2g fat, 1.3g fiber, 6g sugar
  • 2 teaspoons peanut butter = 64 calories, 2.4g protein, 5.5g fat, 0.5g fiber, 1.1g sugar
  • 1 graham cracker sheet = 65 calories, 1g protein, 1.5g fat, 0.5g fiber, 4g sugar
  • Total: 174 calories, 4g protein, 7.2g fat, 2.3g fiber, 11g sugar.
Popcorn with almonds and chocolate chips
Air-popped popcorn adds volume and texture to this indulgent snack, for few added calories.
  • 2 cups air-popped popcorn = 62 calories, 2.07g protein, 0.73g fat, 2.3g fiber, 0.1g sugars
  • 2 tablespoons almonds (0.6 oz), dry-roasted with salt = 102 calories, 3.6g protein, 9g fat, 2g fiber, 0.8g sugar
  • 0.5 ounce semi-sweet chocolate chips (approx 2 tsp) = 35 calories, 0g protein, 2g fat, 0g fiber, 4g sugar
  • Total: 199 calories, 5.7g protein, 11.7g fat, 4.3g fiber, 4.9g sugar
Apple slices with sun butter
A savory spread made from sunflower seeds that is appropriate for those with peanut or tree nut allergies.
  • 1 medium apple (Gala), sliced = 98 calories, 0.43g protein, 0.21g fat, 4g fiber, 18g sugar
  • 1 tablespoon sunflower seed butter = 99 calories, 2.8g protein, 8.8g fat, 1g fiber, 1.7g sugar
  • Total: 197 calories, 3.2g protein, 9g fat, 5g fiber, 19.7g sugar
Greek yogurt with strawberries, sprinkled with flaxseed
Greek yogurt packs protein, strawberries boast vitamin C and antioxidants, and flaxseed boosts fiber and omega-3s.
  • 1 container plain low-fat Greek yogurt (7 oz; 200g) = 150 calories, 20g protein, 4g fat, 0g fiber, 8g sugar
  • ½ cup strawberries, sliced = 27 calories, 0.6g protein, 0.25g fat, 1.7g fiber, 4g sugar
  • 2 teaspoon flaxseed = 20 calories, 1g protein, 1g fat, 1.3g fiber, 0g sugar
  • Total: 197 calories, 21.6g protein, 5.25g fat, 3g fiber, 12g sugar
Shrimp cocktail
This filling low-calorie snack offers omega-3 fats and can double as an appetizer or mini-meal.
  • Jumbo cooked shrimp (5) = 100 calories, 19g protein, 1.5g fat, 0g fiber, 0g sugar
  • Cocktail sauce (2 tablespoons) = 40 calories, 0.5g protein, 0g fat, 0.5g fiber, 8g sugar
  • Total: 140 calories, 19.5g protein, 1.5g fat, 0.5g fiber, 8g sugar
A simple, fun-to-eat snack that is rich in soy protein, edamame can be bought frozen and quickly defrosted whenever hunger strikes.
  • ¾ cup edamame in pods (salted) = 165 calories, 13.5g protein, 5.25g fat, 6g fiber, 3g sugar
  • Total: 165 calories, 13.5g protein, 5.3g fat, 6g fiber, 3g sugar
Whipped cottage cheese with dried apricots on Wasa bread
Whipped cottage cheese works well as a protein-rich spread, while the dried apricots offer a hint of sweetness.
  • 4 tablespoons (¼ cup) low-fat whipped cottage cheese = 45 calories, 7.5g protein, 0.5g fat, 0g fiber, 2g sugar
  • 2 multigrain Wasa crackers = 90 calories, 4g protein, 0g fat, 4g fiber, 0g sugar
  • 6 dried apricot halves = 51 calories, 0.7g protein, 0.1g fat, 1.5g fiber, 11.2g sugar
  • Total: 186 calories, 12.2g protein, 0.6g fat, 5.5 g fiber, 13.2g sugar
Hummus with sugar snap peas
Any veggie pairs well with hummus, but sugar snap peas are a crunchy treat when they're in season.
  • 4 tablespoons hummus = 140 calories, 4g protein, 10g fat, 4g fiber, 0g sugar
  • 1 cup sugar snap peas = 35 calories, 2g protein, 0g fat, 2g fiber, 3g sugar
  • Total: 175 calories, 6g protein, 10g fat, 6g fiber, 3g sugar
Spinach and blueberry smoothie
Blend these ingredients for a delicious protein- and fiber-rich smoothie.
  • ¼ cup plain non-fat Greek yogurt = 36 calories, 6g protein, 0g fat, 0g fiber, 2g sugar
  • ½ cup non-fat milk = 42 calories, 4g protein, 0g fat, 0g fiber, 6g sugar
  • ½ medium banana = 53 calories, 0.6g protein, 0.2g fat, 1.5g fiber, 7g sugar
  • ½ cup blueberries = 42 calories, 0.6g protein, 0.2g fat, 2g fiber, 7g sugar
  • 1 cup fresh spinach = 7 calories, 0.86g protein, 0.1g fat, 0.7g fiber, 0.1g sugar
  • Total: 180 calories, 12.6g protein, 0.5g fat, 4.2g fiber, 22g sugar
And there are also snacks under 200 calories that may sound good but are actually disappointing. Try to avoid these snack fails.
Half of a double chocolate cupcake
Just half of a chocolate cupcake delivers over 4 teaspoons of sugar.
A third of a bagel with cream cheese
A bagel with cream cheese has close to 450 calories. Share it with two friends to stay within your snack calorie budget.
  • One large bagel = 337 calories, 2g fat, 7g of sugar
  • 2 tablespoon of cream cheese = 102 calories, 10g fat, 1g sugar
  • Total for a third: 146 calories, 4g fat, 3g sugar
Four tablespoons (¼ cup) of Ben and Jerry's Out of this Swirled Ice Cream
Eat only four spoons of this ice cream to stay under 200 calories. That small scoop will also deliver a quarter of your daily saturated fat limit and over 3 teaspoons of sugar.
  • ¼ cup (four tablespoons) of this Out of this Swirled = 155 calories, 5g saturated fat, 14g sugar
One ounce of frozen hot chocolate
A few long sips of this drinkable chocolate delivers 8 teaspoons of sugar -- your daily limit.



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Is wine healthy?

(CNN)Yes, wine may protect our hearts when consumed in moderation -- defined as up to one drink per day for women, and up to two drinks per day for men, according to US dietary guidelines. Five ounces of wine is considered one drink.

Benefits of moderate alcohol consumption such as wine include a 30% reduction in the risk of heart attack compared to non-drinkers, a finding that has been repeated over 30 years and in various countries, according to Eric Rimm, a professor of epidemiology and nutrition who has been researching the effects of alcohol and chronic disease for decades at the Harvard T.H. Chan School of Public Health.
Additionally, alcohol consumption has been associated with a 30% to 40% reduction in the risk of Type 2 diabetes, compared to those who don't drink.
But more is not better. Excessive drinking can increase the risk of diseases, including heart disease, liver disease and certain cancers.
The pattern of drinking matters too, so saving up for a bottle of wine during a Saturday night dinner isn't quite the same as following a 'one-a-day' rule. "The maximum benefit appears to be when alcohol consumption is spread out over the course of a week, or at least every other day," said Rimm.

Isn't red wine better?

Red wine has been praised for its resveratrol content. Resveratrol is a polyphenol (plant chemical) found in the skin of red and purple grapes (less so in green). It has antioxidant properties and it also helps to make arteries more flexible, which lowers blood pressure. The amount of resveratrol in red wine is greater than in white and rosé wines, since grape skins are removed early during the production of white and rosé wines.
According to Rimm, a few studies suggest that consuming red wine may be more beneficial than drinking other alcoholic beverages. But, he adds, the amount of polyphenols in red wine is simply not enough to explain the benefits on health.
"If you are a woman, and you're drinking a glass of red wine each day, the amount of polyphenols is small compared to other sources of polyphenols in your diet, like blueberries, tea, apples and dark chocolate," he said.
For example, if you are consuming a glass of red wine daily and also consuming a healthy, Mediterranean-style diet, the polyphenols from red wine represent less than 5% of the total amount of polyphenols in your diet, according to Rimm.
By comparison, the amount of resveratrol given to mice in studies is equivalent to the amount that you would find in 8 to 10 bottles of red wine -- an amount considered unhealthy for humans.
What's more, research that has looked at resveratrol in humans isn't that promising. One recent study involving close to 800 men and women 65 years or older concluded that resveratrol consumed from dietary sources was not associated with longevity; nor did it decrease the incidence of heart disease or cancer.
"When you consume wine in moderation, most or all of the benefit is coming from the ethanol (alcohol) in wine," said Rimm. "Having a shot of spirits or a can of beer will give you equal benefit as wine."
Specifically, ethanol increases HDL, or "good" cholesterol, improves insulin sensitivity, and slows down the ability of blood to clot. It also helps to decrease inflammation inside of your arteries, according to Rimm.
"That being said, if you enjoy red wine, by all means, go for it," he said.

Calorie cutting?

Compared to other alcoholic beverages, wine is a good choice for those watching their weight, as it has fewer carbs than beer. Unlike beer, most of the calories in wine come from alcohol. (An exception is a sweet wine like a dessert wine, where sugar contributes to the total calorie count). Wine also lacks the sugar calories from mixers used for cocktails and other drinks.
For example, though they are all considered one standard "drink" with equivalent amounts of alcohol, 12 ounces of regular beer (5% alcohol) may have about 150 calories, 5 ounces of wine (12% alcohol) may have about 120 calories, and 7 ounces of a rum (40% alcohol) plus cola may have about 155 calories according to US Dietary Guidelines.
But the higher the alcohol content, the more calories in wine. For example, a red Zinfandel with 15% alcohol is going to have more calories than a Riesling with 8% alcohol. Wines from warm climates often have 14% to 15% alcohol, according to Stephen Mutkoski, professor emeritus of wine education and management at the school of hotel administration at Cornell University.
According to Dwayne Bershaw, who teaches wine making classes in the department of food science at Cornell, most whites and rosés are lower in alcohol than most reds, so they have fewer calories compared to red wines.
And though many whites and rosés do contain a small amount of residual sugar, left over when not all of the sugar in grapes is used up to produce alcohol, the amount is not significant enough to outweigh the greater calorie difference from variations in alcohol content among reds, whites and rosés. "A half a percent of residual sugar will add 4 or 5 calories ... it's not that much," said Bershaw.
Bershaw said low calorie wine seems to be a trending item in some circles; this is simply wine with no residual sugar and a lower percent alcohol by volume (%ABV).

A note of caution

Alcohol consumption increases the risk of cancer. For men, drinking a couple glasses of alcohol a day was associated with 26% increased risk of cancers such as liver, colon and esophagus. Women with a high risk of breast cancer (PDF) should be cautious when consuming wine.
"For someone who is at high risk for breast cancer, due to a strong family history or other risk factors, I wouldn't necessarily tell that woman to stop drinking," said Rimm, "but I would say if you are at high risk, drink a little less."
Rimm said while it's true that women who drink a drink per day have a 10% increased risk of breast cancer, it is nowhere near the 30% reduction in risk of heart disease achieved by consuming alcohol in moderation.
But if you are pregnant, nursing or have other health or medical issues where alcohol consumption is not advised, you should avoid alcohol completely. And drinking wine isn't more important than eating a nutritious diet, engaging in regular exercise, and avoiding smoking.
"Wine should be enjoyed along with other aspects of a healthy lifestyle," said Rimm.
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The new secret to losing weight? Water

(CNN)Suddenly starving? Try drinking some water.

That recommendation isn't new -- but it suddenly got some serious evidence to back it up. A study of nearly 10,000 adults ages 18 to 64 shows that staying hydrated by drinking water and eating more water-loaded fruits and vegetables could help with weight management, especially if you're overweight or obese.
"Staying hydrated is good for you no matter what, and our study suggests it may also be linked to maintaining a healthy weight," said lead author Dr. Tammy Chang, an assistant professor in the department of family medicine at the University of Michigan Medical School. "Our findings suggest that hydration may deserve more attention when thinking about addressing obesity on a population level."
Being dehydrated can mess with your mental, physical and emotional health. Numerous studies show attention, memory and mood can be damaged, and physical distress such as headaches, constipation and kidney problems can result.
But when it came to weight loss and gain, the science on the role of water has been murky. Some studies found drinking water helped control weight gain, yet other studies showed the opposite. Part of the problem, said Chang, was the way hydration has been measured.
"Water consumption is not an ideal measure of hydration," explained Chang. "The amount of water it takes to stay hydrated depends on your body size and many other factors like your activity level and the climate you live in. Imagine if you were a landscaper in Arizona versus a receptionist in Michigan. The amount of water it takes to stay hydrated will be drastically different."

Some need more water to stay hydrated

Chang and her fellow researchers at the University of Michigan looked at the topic in a new way -- not how much water you drink, but how well hydrated you are when you do so. To do that, they measured the concentration of water in urine.
They found that staying hydrated -- which helps your heart pump blood more efficiently to your muscles, which then makes them work more efficiently -- was especially important for anyone with a body mass index (BMI) over 25, which is technically overweight and unfortunately applies to all too many of us. In fact, two out of every three Americans are overweight or obese.
"We found hydration and BMI/obesity are associated," said Chang. "A bigger person needs more water than a smaller person to stay hydrated."
"It could be that those people with higher BMI are more likely to be inadequately hydrated or that those that stay well hydrated are less likely to be obese."

Signs you need more fluids

More research is needed, said Chang. But in the meantime, here are ways you can find out if your body has enough fluids.
"Feeling thirsty is the most straight forward way to know if your body needs more water," said Chang. "Your mouth may feel dry. You may feel run down or less alert. However, I have found that my patients often confuse these symptoms with other urges like hunger or general fatigue."
The color of your urine is another good way to tell. If your urine is light yellow, almost the color of water, you're in good shape. If your urine is dark yellow, it's time to drink up.
And yes, water is best. "Other beverages come with other substances like sugar in soda, or caffeine in coffee that are not recommended in large amounts," said Chang. "Soft drinks typically contain sugar or chemical sugar substitutes that I do not recommend to my patients. Water is the best for hydration for most people."
Here's another easy way: Increase your intake of water-laden foods, such as cucumbers, celery, watermelon, raw broccoli and carrots, plums, apples and peaches.
"Eating fruits and vegetables with high water content is good for you not just because of the nutrients they deliver to your body, but also because they can improve your hydration."
And they don't come with a ton of calories. It's a win all around.
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Rare case of 9-year-old in HIV remission for years -- without drugs

Paris (CNN)A 9-year-old South African child diagnosed with HIV when he was 1 month old has been in HIV remission for 8½ years -- without regular treatment.

This is the first reported case of a child controlling their HIV infection without drugs in Africa and the third known case globally.
Soon after diagnosis, the child was placed on antiretroviral treatment, or ART, for 40 weeks, at which point treatment was stopped and the child's health was monitored.

Blood tests in late 2015 revealed the child is in HIV remission, meaning levels of the virus in the blood are undetectable using standard tests. Subsequent testing of samples dating back to the child's infancy confirm remission was achieved soon after treatment was stopped.

Treatment was paused as part of a larger research trial investigating the potential for early ART to decrease infant mortality and reduce the need for lifelong treatment among newborns infected with HIV.
"This is really very rare," said Dr. Avy Violari, head of pediatric clinical trials at the Perinatal HIV Research Unit at the University of Witwatersrand in South Africa. Violari is the child's doctor and presented the findings at the 9th International AIDS conference on HIV Science in Paris on Monday.
"By studying these cases, we hope we will understand how one can stop (treatment)," Violari told CNN.
There is no cure or vaccine against HIV, and lifelong treatment for children comes with the risk of potential toxicity, side effects and the need for daily adherence, which becomes harder during the teen years.

The benefits of early treatment

The child, who was not identified, was part of a study known as the Children with HIV Early Antiretroviral Therapy, or CHER, trial, which ran from 2005 to 2011. More than 370 infants infected with HIV were randomly assigned to immediately receive ART for either 40 weeks or 96 weeks. A third group were not placed on immediate treatment, but instead received treatment according to standard guidelines at the time.
When the trial began, standard treatment was based on the level of immune cells damaged by the virus, known as CD4 cells, within the body. Current guidelines recommend immediate treatment, irrespective of CD4 cell count.
In infants infected with HIV close to birth, progression of the disease occurs very rapidly within the first few months of life and can often lead to death, according to the World Health Organization. An estimated 110,000 children died of AIDS-related illnesses in 2015, according to UNAIDS.
Pediatricians also worry about the side-effects and health impacts of lifelong treatment with antiretroviral drugs for those who survive.
More than 1.8 million children were living with HIV in 2015, according to UNAIDS, and 150,000 children became newly infected, the majority of which were in Africa.
The CHER trial set out to investigate whether mortality rates could be reduced, but also whether earlier treatment could keep children healthy enough to enable them to come off treatment for certain periods.
"We were hoping to make it a slower-progressing disease," said Violari.
The study found mortality decreased by 76% and HIV disease progression reduced by 75% among the infants who received treatment immediately, for 40 or 96 weeks. The group receiving standard treatment saw an increase in mortality based on interim results, so that arm of the trial was stopped early.
Children receiving early treatment in the trial needed to go back onto it, on average, after two years, Violari said, with cases ranging from needing it immediately to needing it after four years. An estimated 10 children have not had to go back on treatment, she said, as their viral loads are fairly low -- between 1,000 to 3,000 per milliliter of blood -- meaning they are healthy, in clinical terms.
But virus levels in the 9-year-old case are undetectable. "The child is the only child showing remission," said Violari.
"We cannot see virus in the blood using standard techniques ... we can see fragments of the virus in the cells," she said, adding that these fragments appear not to be able to replicate, for now, giving hope the child may stay this way. "This child is unique."

Only three cases

The South African child is the third reported case of long-term HIV remission in a child after early, limited treatment with antiretroviral drugs.
The first case was a Mississippi baby, a girl born in 2010, who received ART just 30 hours after birth until she was 18 months old, at which point HIV remission was achieved. The baby sustained remission for 27 months, until 2015, when she rebounded and the virus was found in her blood, crushing hopes that this approach could be the route to a "functional cure" for HIV.
Next came the 2015 case of a French teenager, now 20, whose mother was HIV positive. The French child was given antiretroviral treatment soon after birth, stopped treatment at age 6 and has maintained undetectable levels of the virus in her blood since.
Asier Saez Cirion from the Institut Pasteur in France, who presented the findings on the teenager in 2015, confirmed to CNN this week that the teen is still in remission and maintaining good health, meaning she has been controlling her virus for more than 13 years.
Now comes the case of the 9-year-old in South Africa, in remission for more than eight years, but after just 40 weeks of treatment. Violari stressed, however, these cases are extremely rare and that people infected with HIV should by no means come off their treatment.
"Not everyone can achieve remission," she said.
Three adults have also been reported to achieve remission to date, known as the Boston patients and Berlin patient, but all received bone marrow transplants for this result, not early treatment with antiretroviral drugs. The two Boston patients rebounded, leaving Timothy Ray Brown, the Berlin patient, as the only person to be clinically cured of HIV.
"This (case in South Africa) tells you this is possible in some babies, to see long-term remission," said Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, part of the National Institutes of Health, which funded the CHER trial and ongoing followup on these infants.
"The real question will be what percentage of babies treated early will achieve this result? We don't know," he said.
Fauci believes this kind of outcome only becomes important if you have a considerable proportion of babies protected, making it applicable as a potential therapy approach.
"You always get an outlier," he said. In this case, the outlier being the 9-year old. "Further study is needed to learn how to induce long-term HIV remission in infected babies," Fauci said.

How is it possible?

Violari agrees that this new remission case is not applicable to all infants with HIV, but instead that something unique about his biology and immune system helped him protect himself from the virus, aided by starting treatment early.
He developed an effective immune response to the virus early on, she said, and treatment then protected the child. "I think the early treatment aided it," she said.
Her team now hopes to investigate the child, and others from the original CHER trial along with HIV-negative children to try to elucidate just what is unique about the biology enabling a child who has been treated to then suppress the virus indefinitely -- and independently -- known as a post-treatment controller.
"We need to see where the differences lie," she said, adding that this insight could be used to inform vaccine design or new treatment approaches, such as the use of neutralizing antibodies to help people suppress the virus.
We could develop a product given to people in combination with ART so people can eventually stop ART, said Violari. This would not be because they are cured, but because virus levels are low enough, or undetectable, to help them stay healthy without the need for drugs.
"It's a long shot," Violari said. "But we can look at what's different."
Fauci agreed that extensive evaluation of immune regions of these cases could help scientists find something special to guide inducing this in others. "That's being intensively studied now," said Fauci. "We have the outcome, we just need to get there."

Hope for future HIV control

"We are delighted and excited by what happened with this child ... we need to extrapolate (from this) to the benefit of other children on antiretroviral drugs," said Dr. Mark Cotton, professor of pediatrics at Stellenbosch University in South Africa, who co-led the study. "Africa is still the epicenter of the epidemic and more babies are acquiring HIV than anywhere else."
Cotton hopes his team presenting these results will boost morale, both among cure researchers and those managing treatment programs for children across the continent.
Dr. Deborah Persaud, professor pediatrics at Johns Hopkins University School of Medicine in the United States, agreed this discovery will become useful in terms of treating HIV-infected infants.
"This offers hope for the field," she said. "Every case like this keeps optimism around perinatal infection."
Persaud is part of team that reported the case of the Mississippi baby in 2013 and continues to care for the child and track progress.
She agreed with Violari's team that there is something unique about the South African child's biology, because their viral levels began coming down even before the child received treatment. "This suggests there was an immune mechanism at play here," she said. "Somehow, there was early control of the virus."
The three cases to date all form part of this era in which rare examples of remission are coming to light and providing valuable insight for HIV cure researchers. They serve as proof of concept that this can occur, she said, stressing that this is far from the norm.
"Many kids around the world have been treated early and are not off treatment," she said.
A current trial, known as IMPAACT P1115 and funded by the US NIH, is providing treatment to HIV-infected infants within 48 hours of birth, further exploring options to eventually enable children to come off ART, even if just for a few months at a time, and investigate the potential for remission.
Almost 400 infants have been enrolled across nine countries. The first cases might be eligible to stop ART later this year, according to the NIH.
While Persaud said remission cases are likely to be the exception to the rule, she added that the long-term hope is to go from the need for daily ART, which involves potential toxicity and the need for adherence, to children being able to come off treatment for extended periods.
Even not taking drugs for three months of life, some adults say is a big step for them, she said. "This can make living with HIV less burdensome ... and just make life a lot more livable."
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'Astounding' second-chance cancer drug heading for FDA approval

(CNN)A new gene therapy drug, the first in its class, was recommended for approval to the US Food and Drug Administration by an advisory committee on Wednesday. If approved by the FDA, the agency would consider it the first gene therapy to hit the market.

The drug may provide a second chance to some leukemia patients whose first-line drugs have failed.
A panel of experts voted to endorse the immunotherapy drug, known as tisagenlecleucel, which treats a type of leukemia that is more common among children. Ten committee members voted in favor, and one left early without voting. None voted against.
The drug enables patients' own immune cells to recognize and kill the source of the cancer: a different immune cell gone awry.
"Which one wins is really the question of life or death," said Dr. Catherine Diefenbach, clinical director of lymphoma at the NYU Perlmutter Cancer Center. Diefenbach, who was not involved in researching the drug and has no ties to its manufacturer, Novartis, described its results as "astounding."
The research presented to the committee studied the drug as a treatment for the relapse of a blood cancer known as B-cell acute lymphoblastic leukemia, or ALL. This is the most common type of cancer among children, according to the National Cancer Institute.
Nearly 5,000 people were diagnosed with acute lymphoblastic leukemia in 2014, the most recent year on record, according to the US Centers for Disease Control and Prevention. Although more than half of those with this diagnosis were children and teens, they represented only 14% of those who died that year.
The vast majority of people with ALL recover through other treatments, including chemo, radiation and stem-cell transplantation. But if the cancer comes back, the prognosis can be dire.
"The patients who are left behind when chemotherapy doesn't work are left in really tough shape," Dr. Stephan Grupp, director of the Cancer Immunotherapy Program at Children's Hospital of Pennsylvania, said Wednesday at the FDA advisory committee's meeting. His hospital is one of 26 clinical centers that participated in the study, and he served as the lead investigator there. As such, he has studied and treated patients with tisagenlecleucel for over five years and receives research support from Novartis.
But the drug has side effects that can be fatal, such as cytokine release syndrome or CRS, which "looks like sepsis" and causes blood pressure to drop dangerously low, said Diefenbach. This could limit the drug's availability to those hospitals that are specially equipped to deal with this complication, she added.
In this pivotal study informing the committee's decision, roughly half of 68 patients receiving the drug experienced high-grade CRS, though none died from it.
Slightly fewer patients experienced neurological side effects, such as seizures and hallucinations, according to the committee's briefing document.
And because the treatment kills one type of immune cell, patients are more likely to come down with certain infections. At least three patients died with various infections -- including viral, bacterial and fungal -- more than a month after the drug's one-time infusion, according to the brief.
But the overall effectiveness of the drug and the lack of other options seem to have won the committee over: Based on the available data, patients had an 89% chance of surviving at least six months and a 79% chance of surviving one year or more, with the majority being relapse-free at that point.
"They're taking some people that had uncurable diseases and potentially turning them into curable diseases," said Dr. Joshua Brody, director of the Lymphoma Immunotherapy Program at Mount Sinai's Icahn School of Medicine. Brody has helped design trials for similar drugs but not for Novartis.
Tisagenlecleucel is a type of immunotherapy called chimeric antigen receptor T-cell therapy, or CAR-T.
CAR-T drugs like tisagenlecleucel are made by removing immune cells from a patient, genetically modifying them using a virus and putting them back into the patient. The virus creates a new cell receptor -- which is, in Novartis' case, part mouse -- that targets another receptor on the cancer cells: CD19. This modification of the cells causes them to attack the cancer cells.
By modifying immune cell DNA, this method could, in theory, lead to other cancers -- a longtime concern for gene therapy. But researchers have found no cases of this happening with the CAR-T treatment so far. Brody said it could take decades to conclusively say this does not happen.
"We've never seen this theoretical thing," Brody said, arguing that the chance of any adverse event happening is certainly smaller than the certain death of relapsed cancer. "It's not an opinion. This is straightforward numbers."
Brody said personalized immunotherapy treatments like this one require that patients use their own immune cells because they would "almost never (find) a match" in an off-the-shelf product.
"You can put someone else's red blood cells into you," he said. "You can almost never put someone's (immune) cells into you."
"This therapy will no doubt save the lives of many children and young adults who have had no other effective therapy," said Dr. John Maris, a pediatric oncologist at The Children's Hospital of Philadelphia and leader of the SU2C-St. Baldrick's Pediatric Cancer Dream Team. "This is truly a turning point in the management of this disease."
Kite Pharmaceuticals has another CAR-T drug up for FDA priority review for the treatment of lymphoma.
The Novartis drug would not be the only FDA-approved drug to target CD19; Amgen's blinatumomab treats ALL using this target, but "it's overall not quite as good" as the data coming out of the Novartis trials, Brody said.
The FDA previously approved Amgen's T-VEC, which injects a modified herpesvirus into melanoma cells, causing them to rupture. The same goes for personalized immunotherapy: Dendreon's Provenge was FDA-approved to treat prostate cancer in 2010, for example.
Novartis refers to the drug as immunotherapy, not gene therapy. The FDA, however, would classify it as gene therapy.
The FDA does not have to follow the recommendation of their advisory committees, although it often does. The agency declined to comment on when it would issue a final decision on the committee's recommendation. Novartis expects the FDA to make a final decision by October but declined to comment on
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How to make fast food healthier for vegetarians and vegans

(CNN)Ordering fast food can be tricky for people who are trying to eat healthfully, but it can be particularly challenging for vegetarians. Menus are often limited in vegetarian staples such as beans, lentils, whole grains and vegetables.

The good news is that more and more restaurants are catering to meatless customers, which now number approximately 8 million adults in the United States, with many more trying to eat less meat in general for health reasons.
"I am seeing more options out there for plant-based eaters who want to grab fast food," said Sharon Palmer, a vegetarian, nutritionist and author of "Plant-Powered for Life."
Vegetarian dining requires some careful planning, however. Here are some tips and strategies for eating well at fast food restaurants if you are a vegetarian or vegan:
Check out menus in advance. Since some chains have more vegetarian options than others, you should go online or try calling a restaurant to see whether there's something you will eat. If the menu seems limited, it may be worth traveling a bit farther if it means you'll get healthier, more appealing meatless options.
Seek out newer fast food chains. Traditional chains offering burgers and fried chicken are sometimes less vegetarian-friendly than newer chains. "Look for plant-based fast food restaurants, such as Veggie Grill, which are on the rise," Palmer said. "Also, look for ethnic fast casual restaurants -- Indian, Vietnamese, Chinese, Ethiopian -- as they have many traditional vegetarian and vegan dishes on the menu that offer delicious options just as quickly as a drive-through."
A website (or app) such as Happy Cow can help you identify vegetarian-friendly restaurants if you are traveling in a city you're not familiar with.
Veggie up. "I like to look for plenty of veggie-rich options -- salads, sandwiches with a side salad, a wrap filled with veggies -- so I am gaining all of those health benefits and the satiety value and lower calorie load of eating more vegetables at a meal," Palmer said.
A good old veggie burger is often an option. "Savvy vegan and vegetarian travelers know that veggie burgers are cropping up in the most unlikely places, like the new veggie sliders at White Castle," said Virginia Messina, a registered dietitian who blogs at The Vegan RD.
Ask about "off-menu" items. Don't assume that if a vegetarian option is out of sight, it's not available. "You'd be surprised how many fast casual restaurants I've been to that offer a veggie burger, but it's not listed on the menu," Palmer said. Additionally, you can try custom-ordering your meal. For example, vegans can ask for burritos, pizza or tacos without cheese and sour cream.
Breakfast, for lunch. Some chains serve breakfast all day long, which means an egg and cheese sandwich from the breakfast menu can be a healthful option, especially if it's paired with a side salad for some veggies.
Pack foods that can balance out the meal. "If you're traveling, you can use fast food restaurants to round out your own picnic fare. I always take whole-grain crackers, peanut butter and mixed nuts on the road with me and then grab a side salad at a fast food restaurant when nothing else is available," Messina said.
Palmer agrees. "Sometimes, your options are limited to a piece of whole fruit and a green salad, leaving you hungry and improperly nourished. Look for ways to make a balanced meal no matter where you go; if you really are stuck, you can combine that salad and piece of fruit with a bag of peanuts and some whole-grain crackers for a more balanced option."
Check ingredients. "Bread used for burgers and sandwiches is sometimes not vegan," Messina said. The breads might have milk products or honey added to them, for example. Veggie patties may also contain milk or egg ingredients. "People may often assume that veggie burgers are vegan; they often are not. So it's important to ask or to check ingredient lists online."
Find tofu. The soy bean-based curd is a helpful source of vegetarian protein. "I get extra excited if I find tofu or tempeh on a fast food menu," said Kristine Duncan, a registered dietitian and nutrition blogger at Veg Girl RD. If you are watching your salt intake, you may wish to share, however, as meals with tofu can be high in sodium.
Beans in general are protein-rich. "Beans are getting more common in fast food restaurants, making it an excellent go-to option," Palmer said.
Palmer agrees. "Sometimes, your options are limited to a piece of whole fruit and a green salad, leaving you hungry and improperly nourished. Look for ways to make a balanced meal no matter where you go; if you really are stuck, you can combine that salad and piece of fruit with a bag of peanuts and some whole-grain crackers for a more balanced option."
Check ingredients. "Bread used for burgers and sandwiches is sometimes not vegan," Messina said. The breads might have milk products or honey added to them, for example. Veggie patties may also contain milk or egg ingredients. "People may often assume that veggie burgers are vegan; they often are not. So it's important to ask or to check ingredient lists online."
Find tofu. The soy bean-based curd is a helpful source of vegetarian protein. "I get extra excited if I find tofu or tempeh on a fast food menu," said Kristine Duncan, a registered dietitian and nutrition blogger at Veg Girl RD. If you are watching your salt intake, you may wish to share, however, as meals with tofu can be high in sodium.
Beans in general are protein-rich. "Beans are getting more common in fast food restaurants, making it an excellent go-to option," Palmer said.
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Can poor sleep lead to Alzheimer's?

(CNN)One in three Americans doesn't get enough sleep, and 45% of the world's population doesn't, either. The US Centers for Disease Control and Prevention calls that a "public health problem," because disrupted sleep is associated with a higher risk of conditions including diabetes, stroke and cardiovascular disease.

It may not be long before we can add Alzheimer's and other types of dementia to that list.
It's well known that people with Alzheimer's suffer sleep issues. Insomnia, nighttime wandering and daytime sleepiness are common for them, as well as other cognitive disorders such as Lewy body dementia and frontal lobe dementia.
But could poor sleep earlier in life actually cause dementia?

Sleep and dementia

A growing body of research in both mice and humans shows that disturbed sleep leads to higher levels of soluble beta amyloid, the protein that folds and forms the sticky plaques that kill brain cells and bog down information processing. Depositing amyloid in brain tissue is the first known preclinical stage of Alzheimer's and happens well before any obvious symptoms of dementia begin.
A few studies in cognitively normal people and one in mice have shown a connection between chronic sleep disruption and the development of amyloid plaques. The research in mice was particularly interesting because it showed that mice who slept well reduced their levels of beta amyloid, effectively clearing the toxin from their brains.
A new study in Neurology, the journal for the American Academy of Neurology, is adding to that research by looking at the relationship between sleep quality and levels of various proteins and inflammatory markers in the cerebrospinal fluid of 101 cognitively healthy adults with an average age of 63.
All participants had known risk factors for Alzheimer's, such as family history or evidence of the APOE gene, which is associated with a greater chance of developing the disease. Their sleep quality was rated on a standard scale that measured amount, quality and trouble sleeping, along with daytime drowsiness and naps.
"Participants in our study were willing to undergo a lumbar puncture to move research on Alzheimer's disease forward," said co-author Barbara Bendlin of the Wisconsin Alzheimer's Disease Research Center. "Analyzing this fluid allowed us to look at markers related to Alzheimer's disease such as plaques and tangles, as well as markers of inflammation and nerve cell damage."

Tangles and cell damage

Tangles are created by damaged tau, a protein responsible for cell stability and structure. Recent research points to tau-tangle accumulation as a possible step beyond amyloid plaques in the development of actual signs of Alzheimer's disease.
By comparing the spinal fluid against self-reported sleep problems, Bendlin and her colleagues found that the subjects who had sleep issues were more likely to show evidence of tau pathology, brain cell damage and inflammation, even when other factors like depression, body mass, cardiovascular disease and sleep medications were taken into account.
"Our findings align with the idea that worse sleep may contribute to the accumulation of Alzheimer's-related proteins in the brain," Bendlin said. "The fact that we can find these effects in people who are cognitively healthy and close to middle age suggest that these relationships appear early, perhaps providing a window of opportunity for intervention."
That's important, Bendlin added, because delaying the onset of Alzheimer's in those at risk by a mere five years "could reduce the number of cases we see in the next 30 years by 5.7 million and save $367 billion in health care spending."
"Another new finding in this study is that daytime sleepiness, and not just disrupted nighttime sleep, is associated with early changes of Alzheimer's disease," said Dr. Yo-El Ju, an assistant professor of neurology at Washington University's Sleep Medicine Center. Ju also studies the association between sleep and dementia, and she co-wrote an accompanying editorial for the new study.
"Overall, this study confirms the relationship between early Alzheimer's disease and sleep disturbance," Ju said, "and (it) expands -- in terms of both time and symptoms -- the window in which sleep-wake problems can be assessed for and treated, with the hope of reducing the risk of dementia due to Alzheimer's disease."
One of the limitations of the study was that the sleep problems were self-reported. Bendlin and her colleagues are recruiting people at risk for Alzheimer's to be studied in a sleep lab, where objective measurements can be taken.
"If it turns out to be the case that an intervention which improves sleep also results in less amyloid being deposited in the brain, that would provide strong support for implementing interventions before people start to show cognitive decline associated with Alzheimer's disease," she said.
Dr. Rudolph Tanzi, who directs the genetics and aging research unit at Massachusetts General Hospital, agreed.
"Increasing amounts of evidence indicate that getting at least seven to eight hours of sleep is essential for brain health and function," Tanzi said. "In the deepest stage of sleep, the brain cleans itself out of plaque and other toxic materials that trigger Alzheimer's disease. This reduces brain inflammation and is entirely consistent with this exciting new study."

Which problem came first?

Not everyone with sleep problems in the study had abnormalities in their spinal fluid. For example, those with obstructive sleep apnea showed no association. Bendlin stresses that much remains to be discovered about the link between sleep and dementia.
"Not everyone who experiences sleep problems should now worry about developing dementia due to Alzheimer's disease," she said, adding that there is not yet a clear cause and effect relationship.
"Animal studies suggest sleep affects development of brain changes, but brain changes in turn also affect sleep," Bendlin said. "In terms of figuring out which comes first, brain changes or sleep problems, that will be difficult to tease apart, because the effects really do appear to be going in both directions."
"In experimental studies, there does seems to be evidence of both chicken and egg," said neuroscientist Jeffrey Iliff of Oregon Health and Sciences University. "You can drive it either direction. So there may be a bio-directional interaction."
That's good news if true, he said, because it means we have may have some control over whether we develop dementia.
"No, the public can't remove amyloid plaque," Iliff said. "But if sleep disruption is promoting this process, then improving sleep is half of the solution to slowing the process of dementia as it develops over one's life."

Keith Fargo, director of scientific programs and outreach for the Alzheimer's Association, agreed: "This new study suggests there may be an opportunity to improve cognition and possibly reduce dementia risk through early diagnosis and effective treatment of sleep disorders."


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One-month sugar detox: A nutritionist explains how and why

(CNN)If you've read about the latest wellness trends, you may have entertained the idea of a diet detox.

But whether you've considered juicing, fasting or cleansing in an effort to lose weight or improve your well-being, you're probably aware that drastically cutting out foods is not effective as a long-term lifestyle approach to healthy eating.
In fact, strict detoxing can cause issues including fatigue, dizziness and low blood sugar.
But there is one kind of sustainable detox that is worthwhile, according to some experts. Reducing sugar in your diet can help you drop pounds, improve your health and even give you more radiant skin.
"Sugar makes you fat, ugly and old," said Brooke Alpert, a registered dietitian and co-author of "The Sugar Detox: Lose the Sugar, Lose the Weight -- Look and Feel Great." "What we've discovered in the last couple of years is that sugar is keeping us overweight. It's also a leading cause of heart disease; it negatively affects skin, and it leads to premature aging."

Sugar addiction

Here's more bad news: We can't stop consuming sugar. "People have a real dependency -- a real addiction to sugar," Alpert said. "We have sugar, we feel good from it, we get (the feeling of) an upper, and then we crash and need to reach for more."
About 10% of the US population are true sugar addicts, according to Robert Lustig, professor of pediatrics and member of the Institute for Health Policy Studies at the University of California, San Francisco. What's more, research suggests that sugar induces rewards and cravings that are similar in magnitude to those induced by addictive drugs.
One of the biggest concerns is the amount of added sugars in our diets, which are often hidden in foods. Although ice cream cake is an obvious source of sugar, other foods that may not even taste sweet -- such as salad dressings, tomato sauces and breads -- can be loaded with the white stuff.
"People don't realize that seemingly healthy foods are loaded with sugar -- and so we're basically eating sugar all day long, from morning till night," Alpert said.

How to sugar detox: Going cold turkey for three days

The good news is that even if you're not a true sugar "addict," by eliminating sugar from your diet, you can quickly lose unwanted pounds, feel better and have a more radiant appearance.
"There is no one person who wouldn't benefit by eliminating added sugars from their diets," Lustig said.
Children can benefit, too. Lustig's research revealed that when obese children eliminated added sugars from their diets for just nine days, every aspect of their metabolic health improved -- despite no changes in body weight or total calories consumed.
But going cold turkey is what works best, at least in the beginning.
"Early on in my practice, when I would notice that people had real addiction to sugar, we'd start trying to wean them of sugar or limit their intake or eat in moderation ... but the word 'moderation' is so clichéd and not effective," Alpert said. "It was just ineffective to ask people to eat less of something when they're struggling with this bad habit. You wouldn't ask an alcoholic to just drink two beers.
"What was so successful in getting my clients to kick their sugar habit was to go cold turkey. When they would go cold turkey, I wasn't their favorite person -- but the number one positive effect was that it recalibrated their palate," she said. "They could now taste natural sugars in fruits, vegetables and dairy that they used to be so dulled to."
So for the first three days on a sugar detox, Alpert recommends no added sugars -- but also no fruits, no starchy vegetables (such as corn, peas, sweet potatoes and butternut squash), no dairy, no grains and no alcohol. "You're basically eating protein, vegetables and healthy fats."
For example, breakfast can include three eggs, any style; lunch can include up to 6 ounces of poultry, fish or tofu and a green salad, and dinner is basically a larger version of lunch, though steamed vegetables such as broccoli, kale and spinach can be eaten in place of salad. Snacks include an ounce of nuts and sliced peppers with hummus. Beverages include water, unsweetened tea and black coffee.
Though they don't contribute calories, artificial sweeteners are not allowed on the plan, either. "These little pretty colored packets pack such a punch of sweetness, and that's how our palates get dulled and immune and less reactive to what sweetness really is," Alpert said.
Consuming artificial sweeteners causes "you not only (to) store more fat," Lustig explained, "you also end up overeating later on to compensate for the increased energy storage."

How to sugar detox: When an apple tastes like candy

Once the first three days of the sugar detox are completed, you can add an apple.
"By the fourth day, an apple tastes like candy," Alpert said. "The onions are sweet! Almonds are sweet! Once you take sugar away from your diet cold turkey, your palate recalibrates, and you start tasting natural sugars again."
Starting with day four, you can add one apple and one dairy food each day. Dairy, such as yogurt or cheese, should be full-fat and unsweetened. "Fat, fiber and protein slow the absorption of sugar, so taking out fat from dairy will make you absorb sugar faster," Alpert said.
You can also add some higher-sugar vegetables such as carrots and snow peas, as well as a daily serving of high-fiber crackers. Three glasses of red wine in that first week can be added, too.
During week two, you can add a serving of antioxidant-rich berries and an extra serving of dairy. You can also add back starchy vegetables such as yams and winter squash.
For week three, you can add grains such as barley, quinoa and oatmeal, and even some more fruit including grapes and clementines. You can also have another glass of red wine during the week and an ounce of dark chocolate each day.
"Week three should be quite livable," Alpert said.
Week four is the home stretch, when you can enjoy two starches per day, including bread and rice, in addition to high-fiber crackers. Wine goes up to five glasses per week.
"You can have a sandwich in week four, which just makes things easier," Alpert said. "I want people living. Week four is the way to do it."
Week four defines the maintenance part of the plan -- though intentional indulgences are allowed, such as ice cream or a piece of cake at a birthday party. "Because the addictive behavior is gone, having ice cream once or twice will not send you back to square one," Alpert said. Additionally, no fruit is off-limits once you've completed the 31 days.
"The whole purpose is to give people control and ownership and a place for these foods in our life," Alpert said.

Benefits and cautions with slashing sugar

Detoxing from sugar can help you lose weight quickly. "We had over 80 testers from all over the country, and they lost anywhere between 5 to 20 pounds during the 31 days, depending on their weight or sugar addiction," Alpert said. "Many also noticed that a lot of the weight was lost from their midsection. Belts got looser!"
Participants also reported brighter eyes, clearer skin and fewer dark circles. They also had more energy and fewer mood swings.
"I have lost approximately 40 pounds following the sugar detox," said Diane, who preferred not to share her last name. She has been on the plan for approximately two years.
"I thought I was educated on weight loss, but like many, I was miseducated, and by reducing fat, I was really just adding sugar. With the elimination of sugar, including artificial sweeteners, it is incredible how sweet foods tastes."
Diane added back some healthy fats into her diet, which keeps her feeling satisfied. And her sugar cravings disappeared. "This is probably the longest I have remained on a plan, and I don't feel like this will change. It just feels natural and normal."
There are challenges and medical considerations before starting, though. Since the first few days of a sugar detox can be challenging, it's important to pick three days during which your schedule will be supportive.
"Depending on how intense your addiction is, you can experience withdrawal symptoms, such as brain fog, crankiness and fatigue," Alpert said. Lustig found that the children in his study experienced anxiety and irritability during the first five days of eliminating sugar and caffeine, though it eventually subsided.
"If you feel bad, stop and have a piece of fruit. But if you can push through and stay well-hydrated, you can really break your cycle of sugar addiction," Alpert said.
It's important to note that the plan may not be appropriate for diabetics, extreme athletes or anyone taking medication to control blood sugar. It is also not recommended for pregnant women.
Finally, before starting a sugar detox, enlist the help of friends and/or family members for support. "You need people around you to help you be successful," Lustig said. "The whole family has to do it together."
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Apple cider vinegar: What the experts say

(CNN)Apple cider vinegar is one of the most popular natural health products around, with claims for everything from sanitizing toothbrushes to whittling waistlines.

But how much of its popularity is based on hype? Could you be wasting your time or -- even worse -- harming your health?
Here are 10 of the top ways people are using apple cider vinegar and what the science says.


What's the most popular use for apple cider vinegar? If a simple internet search is any measure, it involves diabetes.
Dietitian Carol Johnston has been studying the effects of the main component of any vinegar, acetic acid, on diabetic blood glucose levels since 2004. She's conducted 10 small randomly controlled studies and published six papers on the subject.
Her studies indicate vinegar can help lower blood sugar in people with type 2 diabetes; in those who are prediabetic, also called insulin-resistant; and even in healthy control subjects. The improvement was slight for all but those at risk for diabetes, she says.
"In pre-diabetics, it was too good to be true," says Johnston, who is also associate director of the Arizona State University's School of Nutrition and Health. "It fell a good bit and stayed that way. It may be this is the group that could benefit the most."
But this antiglycemic response can be induced by any sort of vinegar, she says: red and white wine vinegars, pomegranate vinegar or even white distilled vinegar. She suggests adding it to salads, as in the Mediterranean diet, or diluting it in water and drinking it before a meal.
"Basically, what acetic acid is doing is blocking the absorption of starch," Johnston says. "If my study subjects eat a starch and add vinegar, glucose will go down. But if they drink sugar water and add vinegar, nothing happens. So if you're having bacon and eggs, don't bother. It only helps if you are consuming a starch."
If you choose to use apple cider vinegar, be sure to tell your doctor, says nutritionist Lisa Drayer.
"If you're taking a diabetes drug, the vinegar could amplify the effects of your meds," she warns, "and your doctor might want to adjust your dosage."
Most important, if you're expecting vinegar to significantly alter or prevent diabetes, science suggests you reconsider.
Johnston notes that there is no evidence, in her studies or others, to establish that connection.
"I simply determine if your glucose level goes up and down," she says. "If I was to show that vinegar slows progression to diabetes, then I would need hundreds of people and millions of dollars to do the studies, because diabetes has a lot of causes, including genetics."

Weight loss

Weight loss, or dieting, is another popular use for apple cider vinegar and there is some evidence that it can help.
The most cited study was done with 175 heavy but otherwise healthy Japanese subjects. The 12-week treatment produced lower body weight, body mass index, visceral fat, waist measurements and triglyceride levels. Sounds great, right?
"People didn't really lose that much weight," Drayer says. "Only 2 to 4 pounds in three months over a placebo. That's only a third of a pound a week."
Johnston agrees the study showed "a very, very modest weight loss.'
"In fact, I would say most people who are on a diet for 12 weeks and only lose a couple of pounds aren't going to be very happy," she adds.
If you are using apple cider or other vinegars as one part of an overall plan, combining it with a healthy diet, portion control and exercise, it might help, Drayer says. She suggested using balsamic vinegar on salads, in a 4:1 ratio with oil, or adding it to sauces for poultry and fish.
The best way to consume apple cider vinegar is on your salad, experts say.
"If you were doing all the other things to lose weight, it might give you a slight edge," Drayer says. "Also, if you're drinking it in water, that's good, as water makes you feel full."
"Sometimes, people get really excited to try something new, and then their other behaviors change, too," she adds. "So if this helps people be more careful overall, that's a good thing."

Teeth cleaning and whitening

"Some people like to use it to remove stains and whiten their teeth," according to one of many online articles touting apple cider vinegar for this purpose: "To try this, rub a small amount of apple cider vinegar onto your teeth with a cotton swab."
"I let out an audible gasp when I read about this!" says Chicago dentist and American Dental Association spokeswoman Alice Boghosian. "It made me cringe, to be honest with you. What are people doing?"
"You're putting acid on your teeth," Boghosian continues, "the last thing you'd want to do to promote oral health. What would be a healthier option is to brush your teeth twice a day for two minutes, with a whitening toothpaste with the ADA seal. That shows it's been tested to do what it's supposed to do."
Other articles promote rinsing your mouth with apple cider vinegar, soaking dentures with a diluted mixture or using it to clean a toothbrush.
"You just have to rinse off your toothbrush, get all the toothpaste out, and let it air out. That's all you have to do," Boghosian says. "Cleaning dentures or rinsing with vinegar is not a good idea. It too could put your teeth at risk. And just think how it might affect the metal on partial dentures."
A pH of 7 is neutral, explains Boghosian; anything less is acid. She said many of today's popular apple cider vinegars are in the 2 to 3 range -- about the same as stomach acid.
"Anything acidic which contacts your teeth will wear out the enamel, the protective coating, and that will cause cavities," Boghosian adds. "So, this is totally, completely wrong, unless you want to be paying more visits to your dentist."

Skin, hair and nails

Commonly suggested uses for apple cider vinegar across the internet include it's use as a treatment for skin infections and acne, fighting lice and dandruff, as a natural wart remover and as an anti-aging treatment.
"It will dry out a pimple, but it's not an anti-aging method," says dermatologist Dr. Marie Jhin, a spokeswoman for the American Academy of Dermatology. "It might fade dark spots, or maybe you could use it as a skin toner, if you dilute it a great deal. But I wouldn't recommend it. We have much more effective and safe methods today than this."
One use she can agree with: "I do love it for bites, especially mosquito bites. It's a very underutilized home remedy. If you have a lot of bites, put two cups in a full tub of water and soak. It will help with itching," she says.
"It can also help with sunburn, although there are so many other good remedies," Jhin adds. "We don't usually suggest that to patients."
Apple cider vinegar might help with dandruff, says Jihn, because the acidity could increase the sloughing of the skin on the scalp, and it does have some antifungal properties.
But don't turn to it to get rid of head lice. One study found the use of vinegar to be the least effective method among several natural solutions; only petroleum jelly killed adult louse, but it did next to nothing to fight the eggs.
Another use Jhin recommends: "I love vinegar for paronychia, an infection under the cuticle that a lot of people get," Jhin says. She suggests mixing one-fourth cup of vinegar with three-fourths cup of water and soaking nails.
But what about warts and other home uses?
"Warts are caused by a virus, so there's no cure," Jihn explains. "You can dab a diluted version of apple cider vinegar on a wart with a Q-tip, and it's going to help remove dead skin, which is what we do in the office by paring it down, cutting it out or burning it with liquid nitrogen. But it's not going to be as fast or effective as what we do in the office."
American Academy of Dermatology spokesman Dr. Michael Lin, director of the Advanced Dermatology and Skin Cancer Institute in Beverly Hills, has a more negative perspective on home use.
"I've had quite a few patients harmed by apple cider vinegar," Lin explains. "One terrible example was a man trying to treat genital warts. When he came into the office, the entire area was raw, burned by the vinegar.
"I don't know if he was using it full-strength, but whatever he was doing it was too strong," he continues. "He probably has permanent scarring from that natural home treatment."
Lin says he feels more comfortable recommending distilled white vinegar, as it is created to a standardized formulation of 5% acidity.
"With apple cider vinegar, you don't know what strength you're getting," Lin says. "It's depends on the brand, and even among batches within a brand, you could get different concentrations of acidity."
"If you do choose to use apple cider vinegar, try to buy a name brand that clearly labels the acidity level. And whatever you do, don't use it full-strength."
He suggests a 1:10 ratio.

All-purpose cleaner

Because of apple cider vinegar's antimicrobial properties, it is often suggested as a natural cleanser for the home.
The acid is effective against mold, but according to the Pesticide Research Institute, an environmental consulting firm, so are salt, lemon juice, hydrogen peroxide, tea tree oil and baking soda.
Many of those also smell better.
Apple cider vinegar is biodegradable, and because of its low pH, it's great against alkaline grime such as hard water and mineral deposits, as well as soap scum.
But it won't cut grease. Why not? Just think of a simple oil and vinegar salad dressing. After mixing, the oil and vinegar quickly separate because oil is nonpolar, while vinegar and water are polar, meaning they are not attracted to each other.
Will apple cider or other vinegars sanitize or disinfect your home? Probably not enough to make you feel germ-free.
This 1997 study showed that undiluted vinegar had some effect on E. coli and salmonella, but a study conducted in 2000 showed no real impact against E. coli or S. aureus, the common staphylococcus bacteria responsible for most skin and soft tissue infections.
That 2000 study also showed vinegars to be quite effective against the waterborne bacteria Pseudomonas aeruginosa, mostly found in hospitals and untreated hot tubs. It was also effective against Salmonella choleraesuis, a rare pig-borne version of salmonella.
If you do choose to use a vinegar to clean your home, never mix it with bleach or ammonia, because it will create toxic chlorine or chloramine gases.

Food preservatives

Used for centuries to preserve everything from pickles to pig's feet, vinegar is now becoming popular as a natural preservative in processed meat and poultry items as well.
Most home pickling uses 5% distilled white vinegar because it doesn't affect the color of the vegetables or fruits, but apple cider vinegar is a popular choice due to its mellow, fruity flavor. Do know, however, that it will turn most fruits and veggies dark.
Another popular use for apple cider, and other vinegars, is as a food wash to reduce bacteria or viruses on the surface of fruits and vegetables. Studies have had varying results, often depending on the type of fruit or vegetable and the amount of time spent in the vinegar solution.
Apple cider and other vinegars is used by some as a food wash to reduce the number of bacteria or virus on fruits or vegetables.
After listing a number of studies and results, the US Food and Drug Administration sums it up: "Vinegar and lemon juice have potential as inexpensive, simple household sanitizers; however, possible negative sensory effects [color, odor] when used on produce would be a disadvantage."

Cough and sore throat

The use of vinegar medicinally starts with the father of modern medicine, Hippocrates. He would mix it with honey and use it for chronic coughs and sore throats, and the suggestion continues today across the internet.
Many parents might think this is a natural and safe option for their children. The American Academy of Pediatrics doesn't have an official stance on the use of apple cider or other vinegars as a health aid, but spokeswoman Dr. Jennifer Shu urges caution.
"I would just think that the vinegar would irritate the throat even more," says Shu, an Atlanta pediatrician and author of "Food Fights". "But diluting it and mixing it with other ingredients such as salt or honey might decrease any pain that the vinegar might cause."
The University of Arizona's Johnston cautions against trying any vinegar straight, due to the risk of inhaling the liquid and damaging the lungs.
"Vinegar has that strong smell and puckering taste, so if you take a breath, you could inhale it into your lungs as you swallow," she says. "It can burn the lungs a little, because it is an acid."
"It can also burn your esophagus," says Dr. Andrew Freeman, director of cardiovascular prevention at National Jewish Health in Denver, Colorado. "And if you're predisposed to reflux, ulcers or stomach problems, it could certainly make those worse."

Heart disease and cancer

If you're a rat worried about heart disease, put apple cider and other vinegars on your shopping list.
Studies show the vinegar can reduce blood pressure, triglycerides and total cholesterol in rodents fed a high-fat, cholesterol-rich diet. But similar studies have not been conducted in humans.
Freeman, who serves on the American College of Cardiology's prevention board, says there could be some benefit due to its antioxidant properties, like other heart-healthy fruits and vegetables, such as broccoli and blueberries.
"The data is not particularly strong or overwhelming, but vascular health may be enhanced," Freeman says. "What's best to avoid heart disease is to exercise and eat a low-fat, plant-based diet."
Freeman further recommends using apple cider or other vinegars on salads, to maximize the benefits and reduce any reactions to the acidity.
What about cancer? Japanese scientists have inhibited the growth of human leukemia and other cancer cells in Petri dishes by exposing them to sugar cane vinegar and Japanese rice vinegar. Other studies showed a reduction in tumors and a prolonged life by adding rice vinegars to drinking water and food in rats and mice respectively.
Studies in humans are nonexistent.
So, does apple cider vinegar measure up to its positive internet reputation? If you consider that almost any other vinegar will produce the same benefits, not so much.
There are also some serious downsides, if used full strength and inappropriately. As the experts suggest, make sure you check with your doctor before giving it a try.
"When do you a search for apple cider vinegar you see so many claims, and people will try it, searching for that natural cure-all," says Drayer.

"Whether any of those claims are based on science is another matter".

Source CNN

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10 ways to make fast food healthier for your kids

(CNN)If you're a busy parent, chances are you've been in the company of hungry children, desperate to find the nearest place to eat and refuel.

Although fast food can make for a quick and appealing pit stop, meals can be high in calories, sugars and sodium.
But that doesn't mean fast food can't have its place in a child's diet.
"When we look at fast food, it's one meal in the course of a child's day or week. Families need to find that place in the middle where they can fit fast food in reasonable and healthful ways so their children can learn how to fit it into their own lives down the road," said Jill Castle, a registered dietitian and childhood nutrition expert.
Here are tips, tricks and strategies for dining at fast food restaurants with your kids:
Never leave home without snacks. "If possible, stop at a grocery store or stock up on healthy snacks in advance, such as cut-up fruit, cheese sticks and yogurt, which will cost less than anything on a fast food menu and fill everyone up while they're waiting for their food to be served," said Victoria Stein Feltman, a registered dietitian and co-founder of Apple to Zucchini, a healthy eating resource for parents and families.
Choose age-appropriate sizes for meals. A kids meal is often a good choice, especially because portions are typically smaller. "Beyond opting out for any super-size options, the regular-sized portions at fast food restaurants tend to be large and too big for kids," said Nicole Silber, a New York-based registered dietitian and pediatric nutritionist.
Encourage fruit over fries. "Adding fruits, vegetables and dairy foods help to round out the meal and make it balanced," said Castle, who is also the author of "Fearless Feeding: How to Raise Healthy Eaters from High Chair to High School."
In the United States, for example, McDonald's Happy Meals now include either seasonal fruit (such as apple slices or an orange) or a low-fat dairy option. The Happy Meal still comes with a kid size fries, but you can opt for a fruit or yogurt in its place. Other healthy side options found in fast food restaurants include side salads, and carrot and celery sticks.
Share a meal with your child. This not only downsizes portions, it helps introduce fast foods to your child, such as a grilled chicken sandwich. Indulgences can be shared, too. "Parents might also consider sharing less-healthy sides (such as French fries or onion rings) and desserts (such as milkshakes and ice cream sundaes), and supplementing with fresh fruit and vegetables," Feltman said.
Pass on the soda. Nutritionists agree that the healthiest beverage options include unflavored milk or water. Juice can be an option, though the amount should be limite,d according to new juice guidelines for children: no more than 4 ounces per day for toddlers age 1 to 3 years, and 4 to 6 ounces day for children age 4 through 6. For children 7 to 18 years of age, juice intake should be limited to 8 ounces per day.
Establish your expectations beforehand. If you don't want your child ordering fries or you want them to have fruit or vegetables, let them know ahead of time. "A simple thing that parents can do to help their kids make healthy choices is to have a dialogue and ordering plan before going in. This can be done on the drive over to the restaurant. Managing a child's expectations can be half of the battle and can reduce a child's frustration and possible tantrum at the time of ordering," Silber said.
It's also important for parents to think though what can come up in terms of a request. If parents have a problem with some of the options available, they may want to steer clear of the chain in the first place. "If you're taking your child to a fast food restaurant that serves hamburgers, it's likely your child will be excited to have a hamburger," Castle said. "You need to understand that you are entering into this zone -- and if you are not comfortable with the options, you may need to reconsider going."
Decide on dessert -- in advance. "Have that decision (about dessert) made before you go so you're not trying to make it on the fly," Castle said. And if dessert is an option, don't police it. "If dessert is going to be part of the meal, let it be part of the meal -- but don't place eating performance criteria on it ... like 'you have to eat the whole hamburger before you can eat the ice cream.' " Doing this makes the ice cream a much more valuable part of the meal, according to Castle.
Insist that they sit. "I encourage all families to have their children sit down and eat their meal together," Castle said. "Some of the fast food restaurants have jungle gyms, and kids may choose to run around instead of eating. ... They may grab a fry and go back and forth, but it's important that the parents carve out a rule to have children sit down to eat at a table, with the people who are there with them. They can sit before playing or play first, but at a certain point, they should sit down to eat."
Teach teens healthy habits. It's true that a teenager can afford more calories than an adult, especially if they are in a growth spurt. Still, encouraging healthy choices among teens can be tricky, since they are often making food decisions on their own.
Choose age-appropriate sizes for meals. A kids meal is often a good choice, especially because portions are typically smaller. "Beyond opting out for any super-size options, the regular-sized portions at fast food restaurants tend to be large and too big for kids," said Nicole Silber, a New York-based registered dietitian and pediatric nutritionist.
Encourage fruit over fries. "Adding fruits, vegetables and dairy foods help to round out the meal and make it balanced," said Castle, who is also the author of "Fearless Feeding: How to Raise Healthy Eaters from High Chair to High School."
In the United States, for example, McDonald's Happy Meals now include either seasonal fruit (such as apple slices or an orange) or a low-fat dairy option. The Happy Meal still comes with a kid size fries, but you can opt for a fruit or yogurt in its place. Other healthy side options found in fast food restaurants include side salads, and carrot and celery sticks.
Share a meal with your child. This not only downsizes portions, it helps introduce fast foods to your child, such as a grilled chicken sandwich. Indulgences can be shared, too. "Parents might also consider sharing less-healthy sides (such as French fries or onion rings) and desserts (such as milkshakes and ice cream sundaes), and supplementing with fresh fruit and vegetables," Feltman said.
Pass on the soda. Nutritionists agree that the healthiest beverage options include unflavored milk or water. Juice can be an option, though the amount should be limite,d according to new juice guidelines for children: no more than 4 ounces per day for toddlers age 1 to 3 years, and 4 to 6 ounces day for children age 4 through 6. For children 7 to 18 years of age, juice intake should be limited to 8 ounces per day.
Establish your expectations beforehand. If you don't want your child ordering fries or you want them to have fruit or vegetables, let them know ahead of time. "A simple thing that parents can do to help their kids make healthy choices is to have a dialogue and ordering plan before going in. This can be done on the drive over to the restaurant. Managing a child's expectations can be half of the battle and can reduce a child's frustration and possible tantrum at the time of ordering," Silber said.
It's also important for parents to think though what can come up in terms of a request. If parents have a problem with some of the options available, they may want to steer clear of the chain in the first place. "If you're taking your child to a fast food restaurant that serves hamburgers, it's likely your child will be excited to have a hamburger," Castle said. "You need to understand that you are entering into this zone -- and if you are not comfortable with the options, you may need to reconsider going."
Decide on dessert -- in advance. "Have that decision (about dessert) made before you go so you're not trying to make it on the fly," Castle said. And if dessert is an option, don't police it. "If dessert is going to be part of the meal, let it be part of the meal -- but don't place eating performance criteria on it ... like 'you have to eat the whole hamburger before you can eat the ice cream.' " Doing this makes the ice cream a much more valuable part of the meal, according to Castle.
Insist that they sit. "I encourage all families to have their children sit down and eat their meal together," Castle said. "Some of the fast food restaurants have jungle gyms, and kids may choose to run around instead of eating. ... They may grab a fry and go back and forth, but it's important that the parents carve out a rule to have children sit down to eat at a table, with the people who are there with them. They can sit before playing or play first, but at a certain point, they should sit down to eat."
Teach teens healthy habits. It's true that a teenager can afford more calories than an adult, especially if they are in a growth spurt. Still, encouraging healthy choices among teens can be tricky, since they are often making food decisions on their own.
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Military diet: 3-day diet or dud?

(CNN)Looking for an easy diet to lose a quick few pounds? If you're searching on the Internet, chances are you've stumbled on something called the "military diet."

It's also known as the Navy diet, the Army diet and sometimes the ice cream diet, because in addition to hot dogs and tuna fish, you get to eat ice cream on all three days of the program.
Smells fishy, right? Well, hold your nose. It's about to get really stinky.

What is the military diet?

The military diet is a variation of the ever-popular three-day diet, a crash plan of "fill-in-the-blank" foods to eat if you want to lose weight fast. These diets typically claim that you can lose about 10 pounds in three days to a week if you follow their blueprint to the letter. The meal plans are usually extremely basic and calorie-restrictive, because let's face it, that's how you lose weight.
But are these diets healthy? Will the weight stay off?
"With this type of low-calorie, lower-carbohydrate diet, you are losing mostly water and potentially some muscle," said registered dietitian Elaine Magee, author of "Tell Me What to Eat If I Have Diabetes." "Water weight drops quickly as the body's glycogen stores decline, which happens when you restrict carbs and calories. Weight will come back when you begin to eat normally again."
Could it be that the military diet is different? Here's a breakdown of what's prescribed on days one to three of the military diet, with calories calculated via the US Department of Agriculture's calorie-calculating tool, Supertracker.
Breakfast is a cup of caffeinated coffee or tea, one slice of toast with 2 tablespoons of peanut butter and half a grapefruit. That's 308 calories.
Lunch is another cup of coffee or tea, a bare-bones slice of toast (whole-wheat is best, they rightly say) and a half-cup of tuna. This meal is tiny, only 139 calories.
Dinner is 3 ounces of any meat (that's about the size of a playing card), a cup of green beans, half of a banana and a small apple (not a large apple, even though the calorie difference is minuscule), but wait: You get a whole cup of vanilla ice cream! If you choose steak instead of a lean chicken breast as your entree, this meal equals 619 calories.
But even with the steak and the cup of full-fat ice cream, the day adds up to a mere 1,066 calories. No snacks allowed.
"If you're used to eating 2,000 to 2,500 calories a day, such a drastic drop will be hard to do," said registered dietitian Lisa Drayer, who writes about nutrition for CNN. "You're going to be tired and irritable, with difficulty concentrating. It will be hard to exercise, and I would think you'll be quite hungry as well."
Here's day two's repast. It adds up to only 1,193 calories, even if you pick some higher-fat options.
Breakfast is another dry piece of toast, one egg cooked however you like and half of a banana. Let's say you fry your egg in oil. That's 223 calories.
Lunch is a hard-boiled egg, five saltine crackers and a cup of cottage cheese. If you choose full-fat cottage cheese, the total is 340 calories.
Dinner is half of a banana, a half-cup of carrots, a full cup of broccoli, two hot dogs (that's right!) and another treat: a half-cup of vanilla ice cream. The meal totals 630 calories (if you eat a full-fat pork or beef dog).
How does this fare fair?
"I never recommend hot dogs or any processed meats," Drayer said, "because they are associated with a higher risk for cancer."
"Ice cream is not a good use of the meager calories," she added. "You could have 3 cups of salad and only eat 100 calories, or other nutritious foods that will be satisfying and hold back the hunger."
Day three is the most restrictive, only 762 calories.
Breakfast is a slice of cheddar cheese with five saltines and a small apple. That's 232 calories.
Lunch is grim: one dry slice of toast and an egg. Even if you fry the egg in oil again, that's a total of 170 calories.
Dinner is 460 calories and a stomach-turning combination of half a banana, a full cup of tuna and another cup of ice cream. Maybe they think that by now, you're so hungry, you'll be willing to eat those foods together.
The websites promoting the military diet say that eating certain food combinations will boost your metabolism.
"There is no truth behind claims that the food combinations in the first few days will increase your metabolism and burn fat," Magee said.
"There's no research I know of behind those claims," Drayer agreed.
And what about the rest of the week?
You round out your week by eating what you like, so long as it's less than 1,500 calories a day. Then you can start on the three-day restrictions again.
Best of all, no exercise -- zero, zip, nada -- is said to be needed on this diet.
"Yet another fad diet that won't lead to healthy or sustainable weight loss!" Magee said with passion, adding that exercise is "key to lasting weight loss."
She also feels there are potential physical and emotional ramifications to diets that restrict and deprive you to this extent.
"It can lead to weight cycling, a quick loss and regain of weight, that can weaken your immune system, mess with your metabolic rate and increase the risk of other health problems, such as gallstones and heart trouble," Magee said.

Why is it called the military diet?

Why would such a fad diet be associated with the military? According to various articles, bloggers, YouTubers and message board posts, it was designed by nutritionists in the US military to drop pounds off recruits who otherwise wouldn't measure up.
"What? In my 30 years working with the military, I've never heard of it," said certified nutrition specialist Patricia Deuster, professor at the Uniformed Services University and author of the first US Navy SEAL Nutrition guide.
"We did not develop this. We do not use it. It has absolutely no resemblance to the real military diet. Even our rations are healthier and more nutritionally sound," Deuster said. "It looks like they just took the name 'military' and added it to the diet and capitalized on it."
An Internet search shows that this very diet -- down to the hot dogs and ice cream -- is also known as the American Heart Association diet, the Cleveland Clinic diet, the Mayo Clinic diet, the Kaiser diet and the Birmingham Hospital diet. What do they have to say?
"The Birmingham Hospital Diet did not originate with the University of Alabama at Birmingham, and we do not support or recommend it," university public relations manager Bob Shepard said. "This diet has absolutely no connection to UAB Hospital other than the often repeated but false Internet rumors."
"It is unfortunate our name has been associated with this diet," the Cleveland Clinic said in a statement. "We have never endorsed this meal plan, and it does not meet the standards for what we would consider a healthy diet for heart health or overall well-being."
"The American Heart Association is not -- and never has been -- associated with this diet."
"This didn't come from us, despite the use of the word Kaiser. Kaiser Permanente supports a balanced diet, rich in fruits, vegetables and whole grains."
"None of these diets, including the three-day diet, was developed at or ever associated with Mayo Clinic," said Dr. Donald Hensrud, director of the Mayo Clinic Healthy Living Program and medical editor of the real Mayo Clinic Diet. "It is likely the originators tried to capitalize on Mayo Clinic's brand recognition as a way of promoting these diets."

Where did this diet come from?

If you search the Internet for the military diet, you'll probably end up on the top result: themilitarydiet.com. There, you'll find the detailed diet, with pictures and tips on how to make it work for you. There are substitutions, frequently asked questions, a blog, a calorie count, a link to like them on Facebook and a review that fights back against nutritionists who debunk the diet.
Oh, and there are lots of ads.
But nowhere on the page is there an author, an expert, a nutritional guru. No one takes ownership of this information or gives you any credentials to prove their expertise.
"That's a red flag," Drayer said. "Any helpful diet plan should be created or supported by a credible person or resource or organization. If something is out there without any author or inventor, anyone can say anything and not know how the body works."
Trying to track down the owners of three of the most popular military diet sites proved to be a dead end. Emails and calls to listed numbers got no responses.

How diet misinformation spreads

"Due to our democratic process, we have a wide-open information environment in the US," said Brian Southwell, editor of a new book on fake news called "Misinformation and Mass Audiences." "There's no careful censoring of false information."
Add to that the fact that science still doesn't have the "perfect" solution for weight loss and maintenance, he said, and you've got an area that is ripe for exploitation.
"These dieting sites have a catchy name, the promise of lineage to established institutions, and that is what tends to spread across the Internet, instead of a peer-reviewed study," said Southwell, who directs the Science in the Public Sphere program at the nonprofit research group RTI International. "And just like direct mail, if you get 5% of people to click through, you can make a huge profit. It doesn't cost much to unleash stuff online."
Drayer agreed. "I think a lot of people just want to know the next dieting magic bullet, quick fix, and they just go for these fad things."
But why are so many of us fooled in the first place?
The failure of some people's "BS detectors" when they encounter fake information can be explained, Southwell said, by what science now knows about how the brain processes data. Instead of sorting the good from bad as the information arrives, the brain accepts it all, "and then in another part of the brain, it's tagged as true or false."
"It leaves open this window of opportunity," he explained, "so people believe just long enough and then get tired, distracted, and what happens? They get sucked in. They might be skeptical at first but fail to do the research and think, 'well, maybe this will work. This might be my solution.' "
The fact that so many of us share our discoveries with friends and loved ones on social accounts fuels the misinformation fire. Southwell calls it "social contagion."
"It's like the dynamics of infectious disease. You've spread the disease before you've even come down with it, " he explained. "You find it, you share, you read more and find out that it's not effective, or you try it out and you're disappointed. But the genie is out of the bottle already."
According to Southwell, that's exactly what many of these sites are counting on.
"It doesn't matter if it ultimately gets debunked, because it's going to take a while for it to reach the same numbers of people as the original rumor or fake diet," he explained. "And the debunking is not as sexy as the original diet lure.
"In the meantime, you might see the spread of unhealthy dieting behavior, and for some people with certain diseases or conditions, that can cause real harm," Southwell said, such as heart disease or diabetes. "But it can't be traced back. Who is culpable for that?"

Healthy ways to lose fast?

Let's face it. We still want a quick way to lose 5 or 10 pounds fast, just in time for that special occasion. Is it possible to do so in a healthy way?
"I will prescribe a modified three-day diet just to jump-start weight loss," Drayer said. "I typically recommend increasing your water intake and eliminating all starchy carbs like breads, pasta, cereal and rice, as well as sweets and treats for one week. Doing this not only cuts calories, but you also shed some extra water too, which can be motivating as the numbers on the scale go down."
For those who drink their calories, Drayer recommends slashing sugary beverages such as sodas, flavored lattes, fruit juices and smoothies, "as the calories from these beverages can really add up."
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Magee prefers to trick the body into losing weight, to avoid what she calls a starvation backlash.
"When you decrease your calories so severely as they do in the three-day military diet, your body tends to go into conservation mode and actually burns fewer calories," she said, "because it thinks you are entering a potato famine or similar, and it wants to survive.
"I think it's better to trick your body into burning calories by decreasing the calories you eat a little, increasing exercise to burn more calories, to create a daily deficit of about 250 calories a day," she explains. "It's slower but more sustained weight loss, and you are more likely to lose body fat rather than muscle tissue and water."
Regardless of what method you try, said Drayer, remember that any diet should be cleared by your nutritionist or doctor before you begin. And when it comes to the three-day military diet, she concluded: "I can't imagine any doctor or expert endorsing the military diet as healthy or beneficial in any way."
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Eat Mediterranean diet for a healthier and younger brain, studies say

(CNN)As we age, our brains naturally shrink and our risk of having a stroke, dementia or Alzheimer's rise, and almost everyone experiences some kind of memory loss.

Scientists know that people who exercise regularly, eat a healthy diet, avoid smoking and keep mentally stimulated generally have healthier brains than people who aren't as careful about diet and exercise.
Now, a new study seems to confirm that eating an easy-to-follow Mediterranean diet can have lasting benefits for brain health. The study was published Wednesday in the journal Neurology.
For the study, researchers analyzed the diets of about 400 adults, 73 to 76 years old, in Scotland over a three-year period. During this same time, the researchers took MRI scans of the participants to analyze their overall brain volume and thickness of the brain's cortex.
The researchers found that those who closely followed a Mediterranean-like diet were less likely to lose brain volume as they aged, compared with those who didn't follow such a diet.
However, more research is needed to determine an association between a Mediterranean diet and a specific effect on risk for degenerative brain diseases, such as dementia.
A 2015 study from the journal Neurology also suggests that a Mediterranean diet (which includes wine!) may help make your brain about five years younger.
Researchers figured this out by looking at the brains of 674 people with an average age of 80. They asked these elderly people to fill out food surveys about what they ate in the past year, and researchers scanned their brains. The group that ate a Mediterranean diet had heavier brains with more gray and white matter.
"The previous study only measured brain volume at a single time point, whereas we had longitudinal measurements: two measurements three years apart," said Michelle Luciano, a lecturer of psychology at the University of Edinburgh in Scotland and lead author of the latest study.
"The previous study was therefore not looking at brain volume change over time but differences in brain volumes at a single time point," she said. "We also looked at two components of the diet, meat consumption and fish consumption, and neither of these had an individual effect on brain volume loss. It might be that the diet as a whole is beneficial, and it is the combination of the foods and nutrients that protects against, for example, vascular disease and inflammation, which can cause brain atrophy," or volume loss.
The Mediterranean diet is relatively simple to follow. It involves eating meals made up mostly of plants: vegetables, fruit, beans and cereals. You can eat fish and poultry at least twice a week. You don't have to keep away from carbs; in fact, you should have three servings of those a day, particularly of the whole grain variety.
A glass of wine a day is perfectly fine, too. What you do typically have to limit is the amount of meat, dairy and saturated fat you eat. Cook more with olive oil, as opposed to butter.
In the 2015 study, a higher consumption of fish was associated with keeping your brain young. But if you don't really like fish, scientists at Harvard and Rush University in Chicago created the MIND diet, a combination of the Mediterranean and DASH diets that may be a little bit easier to follow, as it requires you to eat less fish and fruit.
People who ate a diet close to the MIND diet saw a 53% lower risk of developing Alzheimer's. Even people who ate the MIND diet "most" (as opposed to "all") of the time saw a 35% reduced chance of developing the disease. This is considered a significant result.
This latest Mediterranean diet research builds on other evidence that the diet is likely the way to go. It has also been shown as a key to helping you live longer. It helps you manage your weight better and can lower your risk for cancer, and cardiovascular diseases.
Bottom line: you'll likely be physically and mentally healthier long into old age if you stick with this diet.
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Jogging the Brain

The holiday season is a good time for a reminder that alcohol can do bad things to the brain. Studies on animals suggest that it reduces the number of neurons in the hippocampus, the brain’s memory center, and weakens mitochondria there. Because mitochondria help produce energy within cells, their impairment can damage or kill brain cells. But two new animal studies offer some succor: Aerobic exercise, it turns out, may meliorate some of the impacts of heavy drinking on the brain.

Both studies were presented earlier this month at the annual Society for Neuroscience meeting in San Diego. The first, conducted by physiologists at the University of Louisville, involved adult male mice. Every day for 12 weeks — the equivalent of several human years — groups of mice received either injections of alcohol or salt water. Half the animals in each group were then put through daily treadmill workouts. These exercise sessions were short but intense: roughly two-tenths of a mile run at a strenuous pace.

The second study focused on binge drinking. Researchers from the University of Houston inserted tubes into the stomachs of female rats to provide consistent doses of either alcohol or nonalcoholic liquid every Monday night for 11 weeks. Half the rats in each of these two groups were then kept idle in their cages for the rest of the week, while the other half ran on wheels for up to two hours, three days a week.

In each study, the brains of the rodents that exercised after receiving alcohol were substantially different from those of their sedentary counterparts. The inactive mice had weakened mitochondria in many neurons; the runners had hardy mitochondria. The sedentary rats given alcohol had almost 20 percent fewer neurons in their hippocampi than the control animals. The rats who were made to work out, though, had as many neurons as the controls, even if they were given alcohol.

“It’s well known that running increases neurogenesis” — that is, the creation of new brain cells — according to J.L. Leasure, the associate professor of psychology at the University of Houston who oversaw the rat study. So it seems likely that running stabilized the total number of brain cells in the bingeing rats, she says, even if some neurons died as a side effect of alcohol consumption. Exercise is also known to improve mitochondrial health in the brain.

This does not mean working out is a license to be a lush, Leasure says, adding that alcohol probably has other undesirable effects within the brain that are not countered by exercise. Nor has research shown how much or what types of exercise provide the best protection — or even whether animal studies like these translate to people. There is also your liver to consider, along with other bodily consequences. Still, if you overdo it this holiday season, Leasure says, going for a run is “probably wise.”

Source:NY Times

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Harnessing the Immune System to Fight Cancer

Steve Cara expected to sail through the routine medical tests required to increase his life insurance in October 2014. But the results were devastating. He had lung cancer, at age 53. It had begun to spread, and doctors told him it was inoperable.

A few years ago, they would have suggested chemotherapy. Instead, his oncologist, Dr. Matthew D. Hellmann of Memorial Sloan Kettering Cancer Center in New York, recommended an experimental treatment: immunotherapy. Rather than attacking the cancer directly, as chemo does, immunotherapy tries to rally the patient’s own immune system to fight the disease.

Uncertain, Mr. Cara sought a second opinion. A doctor at another major hospital read his scans and pathology report, then asked what Dr. Hellmann had advised. When the doctor heard the answer, Mr. Cara recalled, “he closed up the folder, handed it back to me and said, ‘Run back there as fast as you can.’”

Many others are racing down the same path. Harnessing the immune system to fight cancer, long a medical dream, is becoming a reality. Remarkable stories of tumors melting away and terminal illnesses going into remissions that last years — backed by solid data — have led to an explosion of interest and billions of dollars of investments in the rapidly growing field of immunotherapy. Pharmaceutical companies, philanthropists and the federal government’s “cancer moonshot” program are pouring money into developing treatments. Medical conferences on the topic are packed.

All this has brought new optimism to cancer doctors — a sense that they have begun tapping into a force of nature, the medical equivalent of splitting the atom.

“This is a fundamental change in the way that we think about cancer therapy,” said Dr. Jedd Wolchok, chief of melanoma and immunotherapeutics services at Memorial Sloan Kettering.

Hundreds of clinical trials involving immunotherapy, alone or combined with other treatments, are underway for nearly every type of cancer. “People are asking, waiting, pleading to get into these trials,” said Dr. Arlene Siefker-Radtke, an oncologist at the University of Texas M.D. Anderson Cancer Center in Houston, who specializes in bladder cancer.

The immune system — a network of cells, tissues and biochemicals that they secrete — defends the body against viruses, bacteria and other invaders. But cancer often finds ways to hide from the immune system or block its ability to fight. Immunotherapy tries to help the immune system recognize cancer as a threat, and attack it.

Doctors tried a primitive version of immunotherapy against cancer more than 100 years ago. It sometimes worked remarkably well, but often did not, and they did not understand why. Eventually, radiation and chemotherapy eclipsed it.

Researchers are now focused on two promising types of immunotherapy. One creates a new, individualized treatment for each patient by removing some of the person’s immune cells, altering them genetically to kill cancer and then infusing them back into the bloodstream. This treatment has produced long remissions in a few hundred children and adults with deadly forms of leukemia or lymphoma for whom standard treatments had failed.

The second approach, far more widely used and the one Mr. Cara tried, involves mass-produced drugs that do not have to be tailored to each patient. The drugs free immune cells to fight cancer by blocking a mechanism — called a checkpoint — that cancer uses to shut down the immune system.

These drugs, called checkpoint inhibitors, have been approved by the Food and Drug Administration to treat advanced melanoma, Hodgkin’s lymphoma and cancers of the lung, kidney and bladder. More drugs in this class are in the pipeline. Patients are clamoring for checkpoint drugs, including one, Keytruda, known to many as “that Jimmy Carter drug” which, combined with surgery and radiation, has left the former president with no sign of recurrence even though melanoma had spread to his liver and brain.

Checkpoint inhibitors have become an important option for people like Mr. Cara, with advanced lung cancer.

“We can say in all honesty to patients, that while we can’t tell them we can cure metastatic lung cancer right now, we can tell them there’s real hope that they can live for years, and for a lot of patients many years, which really is a complete game-changer,” said Dr. John V. Heymach, a lung cancer specialist and chairman of thoracic/head and neck medical oncology at M.D. Anderson.

Yet for all the promise and excitement, the fact is that so far, immunotherapy has worked in only a minority of patients, and researchers are struggling to find out why. They know they have their hands on an extraordinarily powerful tool, but they cannot fully understand or control it yet.

One Patient’s Story

Mr. Cara, an apparel industry executive from Bridgewater, N.J., had non-small-cell lung cancer, the most common form of the disease. The diagnosis shattered what had been an idyllic life: a happy marriage, sons in college, a successful career, a beautiful home, regular vacations, plenty of golf.

In December 2014, he began treatment with two checkpoint inhibitors. They cost about $150,000 a year, but as a study subject he did not have to pay.

These medicines work on killer T-cells, white blood cells that are often described as the soldiers of the immune system. T-cells are so fierce that they have built-in brakes — the so-called checkpoints — to shut them down and keep them from attacking normal tissue, which could result in autoimmune disorders like Crohn’s disease, lupus or rheumatoid arthritis. One checkpoint stops T-cells from multiplying; another weakens them and shortens their life span.

As the name suggests, checkpoint inhibitors block the checkpoints, so cancer cannot use them to turn off the immune system.

Mr. Cara took drugs to inhibit both types of checkpoints. Every two weeks, he had intravenous infusions of Yervoy and Opdivo, both made by Bristol-Myers Squibb. He had no problems at first, just a bit of fatigue the day after the infusion. He rarely missed work.

But turning the wrath of the immune system against cancer can be a risky endeavor: Sometimes the patient’s own body gets caught in the crossfire. About two months into the treatment, Mr. Cara broke out in a rash all over his arms, back and chest. It became so severe that he had to go off the drugs. A steroid cream cleared it up and he was able to resume treatment — but with only one drug, Opdivo. Doctors stopped the other in hopes of minimizing the side effects.

heckpoint inhibitors can take months to begin working, and sometimes cause inflammation that, on scans early in treatment, can make it look like the tumor is growing. But Mr. Cara’s first scans, in March 2015, were stunning.

His tumor had shrunk by a third.

By August, more than half of the tumor had vanished. The rash came back, however, and worsened. Steroids worked again, but in October a far more alarming side effect set in: breathing trouble.

Doctors diagnosed pneumonitis, a lung inflammation caused by an attack from the immune system — a known risk of checkpoint drugs. Continuing the treatment posed too great a danger.

Mr. Cara stopped the infusions, but the months of treatment seemed to have transformed his cancer to stage 2 from stage 4, meaning that it was now operable. This spring surgeons removed about a third of his right lung, and discovered that the cancer was actually gone.

“No cancer was seen in any of the tissue they took out,” Dr. Hellmann said. “‘One hundred percent treatment effect,’” he read from the pathology report. “It was pretty cool.”

Immunotherapy had apparently wiped out the disease. “It’s amazing. Unbelievable,” Mr. Cara said.

As of now, he needs no further treatment, but he will be monitored regularly. He is back to work, and golf.

“He’s had the best possible response,” Dr. Hellmann said. “I hope that remains permanent. Only time will tell, and I think he’s conscious of that.”

Mr. Cara acknowledged, “Is there something in the back of me that says this thing never goes away, it could come back any time? Sure. But it’s not the main thing I think. I’m young, I’m strong, I’m healthy, my pathology report came back clean.”

He considered framing that pathology report.

But, he said, “I don’t want to jinx myself.”

Drugs Help Some, but Not Others

When checkpoint inhibitors work, they can really work, producing long remissions that start to look like cures and that persist even after treatment stops. Twenty percent to 40 percent of patients, sometimes more, have good responses. But for many patients, the drugs do not work at all. For others, they work for a while and then stop.

The vexing question, and the focus of research, is, why?

One theory is that additional checkpoints, not yet discovered, may play a role. The hunt is on to find them, and then make new drugs to act on them.

Despite the gaps in knowledge, checkpoint inhibitors are coming into widespread use and are being tried in advanced types of cancer for which standard chemotherapy offers little hope.

One example is anal cancer, a painful disease that carries a stigma because it is often linked to the sexually transmitted human papillomavirus or HPV, which also causes cervical cancer.

Lee, 59, who asked that her last name be withheld to protect her privacy, found out in 2014 that she had the disease, and that it had spread to her liver.

“I was told I’d be dead in 12 to 18 months with treatment, six months with no treatment,” she said.

Chemotherapy and radiation at a hospital near Dallas brought a remission that lasted only a few months. The cancer spread to her lungs.

Bedridden and in severe pain, she entered an immunotherapy trial at M.D. Anderson. In May 2015 she began receiving Opdivo every two weeks. The tumors in her liver and lungs have shrunk by about 70 percent. She is back at work.

While the drugs initially were given only to people with advanced disease, especially those who had little to lose because chemotherapy had stopped working, Dr. Heymach of M.D. Anderson predicted that soon some patients — including some with earlier stages of lung cancer — will receive checkpoint inhibitors as their first treatment.

Immunotherapy is also enabling doctors to help patients in unexpected ways.

Until recently, surgeons were reluctant to operate on people with advanced cancer because they knew from experience that it would not lengthen the patient’s life. But checkpoint inhibitors are changing that. For instance, some patients have taken checkpoint inhibitors for an advanced cancer that had spread around the body, and wound up with only one stubborn tumor left. They then have had it surgically removed and have gone years without a relapse.

“Time has slowed down to the point where you can pay attention to individual tumors, since you’re not running to put out the fire of wholesale systemic progression,” Dr. Wolchok said.

If there is a potential downside to the advances, Dr. Hellmann said, it is that the buzz about immunotherapy has led some patients to think chemotherapy is passé.

“Immunotherapy represents a hugely important new tool, but chemotherapy can work too and has been the backbone of the way we’ve treated patients with lung cancer,” he said. “Immunotherapy is not a replacement for that. It’s a new weapon.”

One of his patients, a 60-year-old man with lung cancer that had spread to his brain, was eager to try immunotherapy instead of chemotherapy. After having radiation treatment for one brain tumor, he began treatment with two checkpoint inhibitors.

But they did not work. So his doctors switched to chemotherapy. “He’s had a tremendous response,” Dr. Hellmann said.

He said it was impossible to tell whether the immunotherapy could have had some delayed effect and worked synergistically with the chemotherapy. Clinical trials are now trying to resolve that question.

But the potential for dangerous side effects cannot be overemphasized, doctors say. A 2010 article in a medical journal reported that a few melanoma patients had died from adverse effects of Yervoy.

In addition to causing lung inflammation, checkpoint inhibitors can lead to rheumatoid arthritis and colitis, a severe inflammation of the intestine — the result of an attack by the revved-up immune system that over-the-counter remedies cannot treat. Patients need steroids like prednisone to quell these attacks. Fortunately — and mysteriously, Dr. Wolchok said — the steroids can halt the gut trouble without stopping the immune fight against the cancer. But if patients delay telling doctors about diarrhea, Dr. Wolchok warned, “they could die” from colitis.

Checkpoint inhibitors can also slow down vital glands — pituitary, adrenal or thyroid — creating a permanent need for hormone treatment. Mr. Cara, for instance, now needs thyroid medication, almost certainly as a result of his treatment. Doctors have reported that a patient with a kidney transplant rejected it after taking a checkpoint inhibitor to treat cancer, apparently because the drug spurred his immune system to attack the organ.

Another of Dr. Hellmann’s lung-cancer patients, Joanne Sabol, 65, had to quit a checkpoint inhibitor because of severe colitis. But she had taken it for about two years, and it shrank a large abdominal tumor by 78 percent. Patients like her are in uncharted territory, and doctors are trying to decide whether to operate to remove what is left of her tumor.

“I have aggressive cancer, but I’m not giving in to it,” Ms. Sabol said. “It’s going to be a big battle with me.”

Coley’s Toxins

Dr. William B. Coley, an American surgeon born in 1862, is widely considered the father of cancer immunotherapy. But he practiced a crude form of it, without understanding how it worked.

Distressed by the painful death of a young woman he had treated for a sarcoma, a bone cancer, in 1891, Dr. Coley began to study the records of other sarcoma patients in New York, according to Dr. David. B. Levine, a medical historian and orthopedic surgeon.

One case leapt out at him: a patient who had several unsuccessful operations to remove a huge sarcoma from his face, and wound up with a severe infection, then called erysipelas, caused by Streptococcal bacteria. The patient was not expected to survive, but he did — and the cancer disappeared.

Dr. Coley found other cases in which cancer went away after erysipelas. Not much was known about the immune system, and he suspected, mistakenly, that the bacteria were somehow destroying the tumors. Researchers today think the infection set off an intense immune response that killed both the germs and the cancer.

Dr. Coley was not alone in believing that bacteria could fight cancer. In a letter to a colleague in 1890, the Russian physician and playwright Anton Chekhov wrote of erysipelas: “It has long been noted that the growth of malignant tumors halts for a time when this disease is present.”

Dr. Coley began to inject terminally ill cancer patients with Streptococcal bacteria in the 1890s. His first patient, a drug addict with an advanced sarcoma, was expected to die within weeks, but the disease went into remission and he lived eight years.

Dr. Coley treated other patients, with mixed results. Some tumors regressed, but sometimes the bacteria caused infections that went out of control. Dr. Coley developed an extract of heat-killed bacteria that came to be called Coley’s mixed toxins, and he treated hundreds of patients over several decades. Many became quite ill, with shaking chills and raging fevers. But some were cured.

Parke-Davis and Company began producing Coley’s toxins in 1899, and continued for 30 years. Various hospitals in Europe and the United States, including the Mayo Clinic, used the toxins, but the results were not consistent.

Early in the 20th century, radiation treatment came into use. Its results were more predictable, and the cancer establishment began turning away from Coley’s toxins. Dr. Coley’s own institution, Memorial Hospital (now Memorial Sloan Kettering Cancer Center) instituted a policy in 1915 stating that inpatients had to be given radiation, not the toxins. Some other hospitals continued using them, but interest gradually waned. Dr. Coley died in 1936.

Chemotherapy, developed after World War II, was another blow to his methods. And in 1965, the American Cancer Society added Coley’s toxins to its list of “unproven” treatments. (The toxins were later taken off the list.)

After Dr. Coley’s death, his daughter, Helen Coley Nauts, studied some 800 case records that he had left behind, and became convinced that he was onto something important. She tried to rekindle interest in his work, but she was thwarted by doctors who opposed it, including some with high rank at Sloan Kettering. However, in 1953 she founded the Cancer Research Institute in New York, a nonprofit that has become a significant supporter of research on the interplay between cancer and the immune system. The group awarded more than $29.4 million in scientific grants in 2015, and its advisory board includes Dr. Wolchok and the scientist credited with developing the first checkpoint inhibitor, James P. Allison.

Source:NY Times

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Turning Points: Together in sickness, married in health

(CNN)Leeanne Hester was seeing a patient when she suddenly felt like she was going to pass out and had to excuse herself from the room. The 23-year-old was working a part-time job at a primary care physician's office while close to finishing earning her master's degree in public health at George Washington University in the early summer of 2013.

For months, she had dealt with an unbearable level of fatigue that shadowed her every day, until she was exhausted all of time. Then there was a sick feeling in her stomach that wouldn't go away and unexplained weight loss. But this light-headed episode was enough to finally make her see a doctor.
Everything had been falling into place. Soon, she would finish school. Her boyfriend, Jimmy Mako, would be joining her in Virginia in the fall. They had met while she was an undergraduate student trainer at Wittenberg University in Ohio and he was on a physical therapy rotation in the athletic department. Now, they were talking more and more about their future together.
After a colonoscopy, Hester was diagnosed with Crohn's disease. But what she wouldn't know for several months is that she had been misdiagnosed. Her situation was much more dire.

A rare case

Between the summer and fall of 2013, she followed up with her doctors and learned that her blood counts weren't recovering, which meant the illness wasn't Crohn's. She credits her education, especially in public health, for helping her to advocate for herself.
"I cannot emphasize how important it is to advocate for yourself in our health care system," she said. "I didn't shy away from asking questions and pushing for answers, because I knew something wasn't right with my body. I even had to call and remind one of my specialists that I needed to schedule a followup appointment. Had I waited even a month or two, it may have been too late."
Following her instincts, Hester scheduled a bone marrow biopsy for early December. After so many specialists, she didn't expect it to reveal anything.
But on December 3, she was diagnosed with acute myeloid leukemia, a rare and aggressive blood cancer, and told to start chemotherapy immediately. The cancer can kill within four to six weeks without treatment, Hester said.
"It was extremely overwhelming and shocking to be told that I had cancer," Hester said. "It was the last thing I expected. But I knew all along that something was going on. You know your body."
Three days later, Hester was admitted to the Ohio State University Comprehensive Cancer Center in her hometown of Columbus. For a week straight, she received a constant drip of chemotherapy. She was hospitalized for treatment for a month, and she would go back in the following months for two more rounds.
Meanwhile, after finishing his physical therapy contract in the Washington, D.C., area, Mako packed up her things and moved to Columbus to be closer to her. He never missed a day visiting her in the hospital.
"You know a man really loves you when he shaves your head for you when your hair is falling out, and he still tells you you're beautiful, kisses you and holds your hands through it all," Hester said.
At the James, Hester was finally able to receive some answers about her misdiagnosis.
"Her case was unusual but not challenging," said Dr. Rebecca Klisovic, her lead doctor at the James. "She faced a few months of confusion because she was a little bit anemic when she was diagnosed with Crohn's. But when her anemia got worse, then we looked closer at that."
Acute myeloid leukemia is an uncommon cancer, especially for people Hester's age, with three to five cases per 100,000 people in the United States and Europe per year, Klisovic said. But Hester's case was even more rare: She had two mutations associated with her leukemia. One was low-risk, but the other, FLT3, was high-risk. One-third of acute myeloid leukemia patients have this mutation, which increases the chances of a relapse.
Klisovic recommended that Hester be placed on the waiting list for a bone marrow transplant. Given the fact that she was young and healthy outside of having the cancer, she would be able to handle the rigors of the procedure.
Without a transplant, Hester might have lived for five more years at best. But because a bone marrow transplant is essentially like transplanting an immune system, it would help stave off a relapse.
Family members are ideal bone marrow donors, but Hester's younger sister, Lindsay, wasn't a match. In March 2014, her doctors narrowed the list to four candidates through the National Marrow Donor Program. Three responded, and one, a 22-year-old man in Israel named Evgeny Galinsky, was a perfect match.
In May, Hester received the transplant, which is comparable to a blood transfusion. She was placed in isolation because the pre-transplant process had involved essentially killing off the T cells of her own immune system so her body would accept the new marrow. When he came to visit, Mako had to wear a mask.
She struggled with graft versus host disease, in which the new immune system attacks organs. Not unlike an allergic reaction, she had skin and joint issues in response. Hester also suffered from gastrointestinal infections, some of the worst Klisovic had seen. But she was able to overcome it all.
Her doctors will continue to keep an eye on her, as the risk of a relapse is greatest in the first two years after treatment, but they don't anticipate any further problems.
In December 2014, Mako took her on a long weekend trip to Chicago. That Sunday, they went out for a nice dinner before taking an evening walk past the sculpture known as the "Bean" and on to a fountain. There, he bent down on one knee and proposed.
"The emotional and physical rigors of cancer definitely made us a lot closer and strengthened our bond," Hester said. "It forced us, as it would most people, to really address those tough issues in life at a young age; it made us more vulnerable and honest with each other. It took away all the frills of love and made us really look at our commitment to one another and especially, in my opinion, his commitment to me. It truly revealed the depth of our love for each other. I think we've got that whole 'in sickness and in health' thing down."

A 'life-saving donation'

Per the rules of the transplant center, Hester had to wait a year before learning the identity of her donor. She wrote him a letter and sent it to his address in Israel. It turned out that he was part of a helicopter squadron with the Israel Defense Forces.
When Israeli soldiers are enlisted, they can provide a cheek swab to become part of the bone marrow registry partnership through the transplant center Ezer Mizion.
"I thanked him for his life-saving donation, which gave me a chance to experience all life's events, including marriage to Jimmy and the privilege of growing old," Hester said.
Two months later, she received an email from Galinsky. He was happy to learn that she was recovering and that she had even reached out. Before her letter, he had no way of knowing whom his donation had helped, but he said he believed that all lives were worth saving.
They exchanged more correspondence, and she began to develop a portrait of Galinsky: a humble and kind young man who used emojis when he was joking and liked to ride motorcycles with his friends. They talked about their hobbies and shared stories and photos of their families.
In April, Galinsky came to the wedding, a small ceremony in a historical church in Ohio. Hester said it was surreal to meet him in person, after only ever exchanging emails, but she wouldn't have had it any other way.
"We were both very grateful to have Evgeny be a part of our wedding celebration, which probably wouldn't have been possible without his donation," Hester said. "Having him there really felt like it gave a wholeness to the day, because the wedding not only marked a new chapter for me and Jimmy as being husband and wife, but also that we could move forward with me being healthy and hope for the future."
She is continuing to do well more than a year after the transplant and returned to work six months ago. Now, the happy couple is enjoying married life, and Hester (now Mako) hopes she can use her experience to help others.
"Cancer is really ugly and hard," she said, "but the love and resilience that people show through the suffering is really beautiful."
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Will This Common Spice Help You Lose Weight?

Amomon means “fragrant spice plant” in Arabic and Hebraic and in Italian, canella means “little tube”. These are a few of the many terms given to the popular spice known as cinnamon. Dating back as far as 2800 B.C., Chinese writings describe cinnamon as an important part of the culture, so much so that over the years this spice was traded right up there with silver. Nowadays we find it in sweetened cereals, baked goods and sprinkled on various foods such as yogurt. Yet, many do not consider it’s wealth of healing capabilities including the potential as a weight loss remedy.

In the Mix

Cinnamon is derived from the inner bark of the cinnamon tree grown and harvested mostly in Sri Lanka but also found in Brazil, Indonesia, Vietnam, China and Burma. After a cinnamon tree grows for about six to eight years it is cut down leaving a stump to allow it to grow again making it a very sustainable practice. It is then stripped from the bark, dried and packaged as sticks for export.

Fighting Fat

Several studies have been published regarding the weight loss properties of cinnamon. This includes it’s unique ability to be used for Type 2 diabetes which is a disease often resulting from obesity. When ingested, the spice seems to slow down glucose absorption within the intestines while stimulating insulin production. This normalizes blood glucose levels which in turn can indirectly decrease weight gain.

The Studies

The Department of Human Nutrition, NWFP Agricultural University, Peshawar, Pakistan conducted a study titled, ‘Cinnamon improves glucose and lipids of people with type 2 diabetes’ and concluded that, “The results of this study demonstrate that intake of 1, 3, or 6 g of cinnamon per day reduces serum glucose, triglyceride, LDL cholesterol, and total cholesterol in people with type 2 diabetes and suggest that the inclusion of cinnamon in the diet of people with type 2 diabetes will reduce risk factors associated with diabetes and cardiovascular diseases.”

The Journal of the Academy of Nutrition and Dietetics published a study from the Department of Family and Consumer Sciences, Ball State University, Muncie, IN called, “Effect of ground cinnamon on postprandial blood glucose concentration in normal-weight and obese adults.” finding that, “These results suggest cinnamon may be effective in moderating postprandial glucose response in normal weight and obese adults.”

A Pro Comments

Columbia University and New York Giants team nutritionist Tara Ostrowe comments to Reader’s Digest on the benefits of this spice, “Cinnamon really is the new skinny food…Scientists already credit cinnamon in helping lower blood sugar concentration and improve insulin sensitivity.  When less sugar is stored as fat, this translates to more help for your body when it comes to weight loss.”

Talk to your doctor about incorporating daily cinnamon into your healthy diet and exercise program. Add it to your tea, oatmeal, fruit, toast or anything else you can think of as a small amount will go a long way and potentially assist in your weight loss mission.


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When Do You REALLY Need a Check-Up?

When you get into the swing of everyday life it can seem like a real pain to have to head to the doctor or the dentist when you’re not sick just for a check up. So how often do you actually need to go? It varies based on what part of the body we’re talking about.

Breast Exam

For checking the breasts for lumps this can be done at home and should be done once a month. You should be checking for any weird lumps or changes to the breasts, and the best time to check is a few days after your period ends.


To keep up on checking your skin for any changes with things like moles, you should be checking your own skin about once a month as well. If you notice anything that has appeared suddenly or changed it might be worth it to get checked out. Anything with an irregular border, large, uneven color pattern, or asymmetrical should be treated with caution as well.


You should be heading to the dentist for a cleaning about every six months. They will also check for anything more important going on and suggest treatment if necessary. In between your cleanings you should of course call the dentist if you notice anything out of the ordinary.

Physical Exam

A general physical from your primary doctor should be scheduled once a year. This will usully check your weight, blood pressure, and breast exam for women. They can also add on tests that check things like your hormone levels and blood count to make sure everything is running smoothly in the body.


You only need to head to the gynecologist for a general pap smear every three years…but only if you have had three in a row that show up normal and are in a monogamous relationship that has no risk factors as far as your sexual health goes. If you are sexually active with multiple people you should still get to gynecologist at least once a year or more if you engage in risky behavior. When you get a general pap smear the doctor will scrape the cervix to test the cells and check for any abnormalities. This can help catch things like HPV and cervical cancer in the off chance that they occur. Even if you don’t go to get a pap smear, you might want to get a general pelvic exam every year. During that procedure the doctor will feel around to check for things like cysts or infection.


You should be getting your eyes checked every two years if you do not currently wear glasses to check for changes in the eyes. If you do you should be heading to the doctor each yera to make sure that your current corrective prescription is still accurate if you wear glasses or contacts.


People over the age of 35 should begin getting their thyroid checked about every five years.


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Is There A Solution For Constant Fatigue?

PALM SPRINGS, CA (HH) -- According to patients at the Center for Restorative Medicine, a new discovery has completely transformed their lives.

Founder and Director Dr. Steven Gundry is a world-renowned heart surgeon, a best-selling author, and the personal physician to celebrities such as Tony Robbins. But his latest medical breakthrough could be the most important accomplishment of his career.

In a dramatic press conference yesterday, Dr. Gundry unveiled a simple — yet highly effective — solution to symptoms that plague millions of Americans over 40: low energy, low metabolism and constant fatigue.

He went on to say that persistent fatigue can be a warning sign for much more serious health problems…including diabetes, obesity, hypertension and heart disease.

“When you’re feeling low energy, that’s your body screaming HELP!” He told the crowd of reporters and medical professionals.

Dr. Gundry’s radical solution was inspired by a breakthrough with a “hopeless” patient who had been massively overweight, chronically fatigued and suffering from severely clogged arteries.

The secret to his breakthrough? “There are key ‘micronutrients’ missing from your diet,” Dr. Gundry told the room. “If you can replenish them in very high dosages, the health results are astonishing.”

This unorthodox philosophy is what led Dr. Gundry to create the world’s first at-home treatment for fatigue — which has since become remarkably successful with his patients.

“They’re reporting natural, long-lasting energy without a ‘crash’ and they’re feeling slim, fit and active,” he revealed yesterday.


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Immunotherapy Offers Hope to a Cancer Patient, but No Certainty Drawing on his immune system to fight Hodgkin’s lymphoma, my friend saw a stunning improvement. Then came the relapses.

DENVER — A cancer patient nicknamed the Steel Bull got his death sentence on a gloomy March Wednesday in 2015.

He was 47, his given name Jason Greenstein, but he had earned the moniker from his oncologist for his stubborn will during more than four years of brutal chemotherapy and radiation treatment — all of which had failed.

That Wednesday, March 4, his left side bulged with 15 pounds of tumor, doubling in size every few weeks. Lumps of Hodgkin’s lymphoma cells swelled in his lungs, making it hard to breathe, impinging a nerve and nearly paralyzing his left hand. Yet Mr. Greenstein, ever the optimist, was not prepared for his doctor’s frank words when he displayed his latest symptom: tumors along his right jawline, the first spread of cancer to that side.

The oncologist, Dr. Mark Brunvand, said he excused himself to the hallway to gather his emotions. When he returned a moment later, he looked Mr. Greenstein in the eye.

“You are going to die,” he remembers saying. “And because you’re my friend, it’s my job to make you as comfortable as possible.” Behind the doctor stood Mr. Greenstein’s case manager, Poppy Beethe, crying.

DENVER — A cancer patient nicknamed the Steel Bull got his death sentence on a gloomy March Wednesday in 2015.

He was 47, his given name Jason Greenstein, but he had earned the moniker from his oncologist for his stubborn will during more than four years of brutal chemotherapy and radiation treatment — all of which had failed.

That Wednesday, March 4, his left side bulged with 15 pounds of tumor, doubling in size every few weeks. Lumps of Hodgkin’s lymphoma cells swelled in his lungs, making it hard to breathe, impinging a nerve and nearly paralyzing his left hand. Yet Mr. Greenstein, ever the optimist, was not prepared for his doctor’s frank words when he displayed his latest symptom: tumors along his right jawline, the first spread of cancer to that side.

The oncologist, Dr. Mark Brunvand, said he excused himself to the hallway to gather his emotions. When he returned a moment later, he looked Mr. Greenstein in the eye.

“You are going to die,” he remembers saying. “And because you’re my friend, it’s my job to make you as comfortable as possible.” Behind the doctor stood Mr. Greenstein’s case manager, Poppy Beethe, crying.

What happened next qualified as well beyond “dramatic response.” A few days later, Mr. Greenstein agreed to try a last-ditch drug called nivolumab that was being tested for Hodgkin’s. It dripped into his veins, just like those body-racking chemotherapy treatments. But this time, there were no harsh side effects. And this time, the outcome was very different.

Three mornings later, Mr. Greenstein woke up to shock from his girlfriend.

“Jason, you’ve got to see this!” she said. She looked at his back, where the cancer had so bulged that she affectionately called him Quasimodo. “Your tumors have shrunk!”

In an eye blink, after years of agonizing and futile treatment, Mr. Greenstein’s cancer would disappear. Within weeks after that first treatment, his doctors declared him in remission.

It was a result that put him at the vanguard of a new generation of cancer treatment called immunotherapy that casts into sharp relief the harshness of how we have long treated cancer and the less grueling way we might. Immunotherapy’s aim is to prompt the immune system, which is often stymied by cancer, to attack tumors with the zeal and sophistication that it attacks other diseases. The concept, at least in a primitive form, stretches back more than a century, but only in recent years have therapies been developed that show its true promise — and, for now, its limitations.

In that astonishing span of six weeks, few of immunotherapy’s successes seemed as dramatic as Mr. Greenstein’s. “His story is not just one in a million,” Dr. Brunvand marveled, but “one in 20 million.”

On a personal level, this stunning medical reversal was not entirely surprising to Mr. Greenstein’s family and friends. Jason and I were in a tight circle of high school buddies in Boulder, Colo. To us, he has always been a fierce competitor who attacked the world with passion, humor and unbridled optimism — along with, at times, inattention to detail and procrastination. Life was always an adventure, including Jason’s death match against cancer, which he allowed me to chronicle.

Then again, cancer is not easily beaten. And for all its promise, immunotherapy for now brings more disappointment than marvel for the majority of patients. The end of this story, sadly, allows no easy ebullience. Not for medicine. Not for Jason.

In the Shadow of Cancer

When the symptoms hit in 2010, Jason was living in Las Vegas, where he had started a company called Green Man Group. It sold trinket boxes to casinos for use as gifts.

Jason went to both law and business school and was obsessively entrepreneurial. He loved selling and schmoozing with customers on a noon-to-midnight instead of 9-to-5 clock. Visiting casinos, he crisscrossed the country in an aging Chrysler Concorde, often with Skoal tobacco packed in his lip. He had come from tobacco users; his dad had smoked cigars, his mom cigarettes since age 14.

It was unseasonably warm on May 10 when Jason, driving back to Las Vegas from Arizona, felt his throat tickle and his head hurt. His legs had felt heavy for several months. Several days later, he attacked the symptoms with a homegrown remedy: He downed most of a 12-pack of Bud Light Chelada.

“It didn’t work out too well,” he said with a laugh, looking back. He felt worse in the morning.

My first memories of Jason come from the dugout. We were teammates for years in Little League. I was a two-bit player and Jason a perennial All-Star — center fielder and shortstop, leadoff hitter. He had the same gifts in football and basketball. Not just that — he was funny, self-effacing, a good student and a good guy. His junior high nickname was Golden.

But all was not golden for Jason. One morning in eighth grade, our friend Tom Meier found him in the locker room, sobbing. Jason had learned the day before that his dad, Joel, at 46, had been told he had colon cancer.

“Here was the strongest person I knew, and he was absolutely shattered,” Tom said.

Over the years, Jason’s friends and family would debate the extent to which his father’s cancer and eventual death, in the summer before our senior year of high school, unmoored Jason. He had been Jason’s first coach and chief advocate, attending every game, often chomping a stogie, stoic and hunch-shouldered. In the weeks before he died, he watched Jason, a 5-foot-9 point guard, help lead Boulder High School to a state basketball championship game.

After his father’s death, Jason’s senior-year grades tanked such that he had to explain them to Occidental College, where he was to play basketball and baseball. A manic side of Jason became more prominent. He never settled down with a family, and his businesses came and went. His inimitable passion remained, while his follow-through sometimes faltered.

“Dad was his guru; I don’t know how to describe it,” Guy Greenstein, Jason’s older brother, and one of five siblings, told me. “When my dad was gone, he was left to flounder a bit.”

After Jason first felt sick, one doctor diagnosed mononucleosis, but two courses of antibiotics did not work. Each week, he felt more rundown, until one day in August, he could not get off the couch. “It reminded me of my dad,” Jason reflected. “He had never done that before, and then he started lying on the couch.”

At summer’s end, a family doctor told him he had Hodgkin’s. It was the best case of a bad-case scenario — Hodgkin’s has a 95 percent cure rate.

No problem, Jason thought, I’ll get it cured and move on.

Beaten Down by Treatment

In 1990, Dr. Brunvand, was climbing Mount McKinley when he and his group got a distress call from 19,600 feet. Seven Japanese climbers needed rescue in 100-mile-an-hour winds. Dr. Brunvand, then huddled at 17,000 feet, helped bring six of the climbers back alive. His tenacity made him a perfect match for Jason, and he knew what he would be putting Jason through.

Dr. Brunvand, 60, a bow-tie-wearing veteran in his field, likens traditional chemotherapy to napalm. It kills not just cancer but other rapidly dividing cells, like the ones in the gut, hair follicles and mouth. “When you have cancer, you spread napalm on it and burn everything to the ground.”

Jason received his first treatment in September 2010 in Denver. A thin nurse with a kind smile hooked him to an IV. He tried to read, and felt like he did not belong with the line of sick people in chemo chairs. Into his veins dripped a four-drug cocktail called A.B.V.D. that has been in wide use since the 1980s.

After chemo, he described feeling “the sickest you’ve ever felt but multiplied by 10.”

In spring 2011, after a brief remission, Jason became one of the unlucky few with Hodgkin’s; his cancer recurred in his chest wall. He moved to the next level of treatment, “salvage” chemotherapy with the acronym ICE. Side effects: diarrhea, bruising, bleeding, hair loss, sore mouth.

That winter, he got a round of high-dose chemotherapy followed by a stem-cell transplant. Before the transplant, he met a psychologist at the Colorado Blood Cancer Institute, and, to prove his zest for life, Jason played air guitar and sang to her, wearing sunglasses.

But when the psychologist, Andrea Maikovich-Fong, went to see him in the hospital after his transplant, he was slumped in a hoodie. “He looked like this shadow sitting there. He looked up with his eyes, and not his chin, and said: ‘This is terrible,’” she recalled.

This was what I, and others, began to see. Cancer had not beaten Jason yet; treatment was starting to. When we talked by phone, he sometimes wept about his pain, exhaustion, pill regimen — 15 medications or more daily, an alphabet soup of drugs, from acyclovir to fight infection to Zofran for nausea.

Once, he showed up at the hospital after an all-night drive from Las Vegas with his red blood cell count so depleted (20 percent of normal) it could have killed him en route. He crawled to the elevator, where he was discovered, and then, while being wheeled away, joked with Dr. Brunvand that he had been in Las Vegas spending money on “hookers and blow.”

“It’s hard not to love a guy who sees God with one eye and the seedy side with the other,” Dr. Brunvand said.

In fall 2013, Jason was in remission again, finally, he said, feeling like himself. Then, the morning after his beloved Denver Broncos were crushed in the 2014 Super Bowl by the Seattle Seahawks, Jason’s phone rang. It was Ms. Beethe, his case manager. “Jason, I have some bad news.” Another relapse, tests showed.

“I didn’t know what was worse,” Jason grimly joked later, “getting cancer again, or the Broncos losing. Any true Bronco fan would say it’s a tie.”

Jason came up with an analogy to describe being a patient in a fight with cancer; in his analogy, healthy people live in a village on a beautiful Tahitian island while cancer patients float around it in canoes.

“The doctors pull on the rope and pull me back to the pier. I can still visit the people in the village. But I’m drifting further and further,” Jason said. “All around me are coffins — the people who died from cancer. I’m waiting for my canoe to turn into a coffin.”

A few weeks after the Super Bowl, his friends planned a weekend for him in Boulder to, without putting so fine a point on it, say goodbye. Tom came from Minnesota and I from San Francisco. Jason, true to form, showed up to his own party two hours later than everyone else, having made a marathon drive from Las Vegas. At the end, we all said goodbye in the parking lot. I assumed I’d never see Jason again.

Crossing a Threshold

Jason battled for another year, until March 2015, when he received his death sentence and his family met with Dr. Brunvand to plan hospice care. Without much hope, they agreed to take a flier on a drug called nivolumab, part of the new frontier of immunotherapy.

Nivolumab had been approved for advanced melanoma in 2014. An article published that year in The New England Journal of Medicine reported the drug’s remarkable effect on relapsed Hodgkin’s patients, albeit in just 23 people. Dr. Brunvand’s team managed to get a dose, though it was not yet on the market for Hodgkin’s, through a program called “compassionate use.”

Dr. Brunvand expected little. The evidence was scant, Jason so far gone.

“When I start to pray, I know it’s time to let go,” Dr. Brunvand said. “I’d started to pray for Jason.”

Immunotherapy is based on the fact that once the immune system recognizes cancer and gears up to fight it, something remarkable happens: The immune system is rendered helpless.

Scientists believe that the cancer sends signals to put the brakes on our T-cells, which are the ones that fight disease. A crucial way the tumor tricks T-cells is by displaying on its surface a protein that is recognized by the T-cell through a receptor called PD-1. It stands for “programmed death.” It tells the T-cell to, in effect, self-destruct.

This might seem like a serious design flaw. After all, why would immune cells commit suicide? It turns out that the PD system is essential to survival: It is fail-safe against the immune system attacking our own bodies (see: lupus, Crohn’s disease, rheumatoid arthritis). Sometimes we want our bodies to halt the system; cancer takes advantage of this survival mechanism.

As Jason slogged through chemo, researchers around the country were experimenting with developing a so-called PD-1 inhibitor for cancer so as to unleash the immune system. This concept was at the heart of the nivolumab treatment that Jason was about to receive.

On March 13, Jason’s girlfriend, Beth Schwartz, drove him to his first treatment. On the ride, he was not thinking about surviving, but about having his pain managed well enough to see his nephew Jack play that night in the state high school basketball tournament.

Midafternoon, Jason sat in a recliner in the bleak, boxy room. A nurse in a blue gown cleaned his central line, an intravenous port in Jason’s chest. She gave him steroids. Jason couldn’t move his left arm or close his hand, the nerve so squeezed by Hodgkin’s.

She hung a translucent bag from an IV pole. It held saline and 200 milligrams of nivolumab. The treatment lasted an hour. At least there were no side effects; this was not scorched earth but immune-system tinkering. Then Jason went to his nephew’s game and sat with a former high school teammate, Dan Gallagher, who thought: “He looks so bad, I wonder if he’ll make it through the night. It was like looking at his dad again.”

Three mornings later, when Beth exclaimed that Jason’s tumor had shrunk, she wondered if she might be imagining things. So she decided to take pictures each day of his back.


Crossing a Threshold

Jason battled for another year, until March 2015, when he received his death sentence and his family met with Dr. Brunvand to plan hospice care. Without much hope, they agreed to take a flier on a drug called nivolumab, part of the new frontier of immunotherapy.

Nivolumab had been approved for advanced melanoma in 2014. An article published that year in The New England Journal of Medicine reported the drug’s remarkable effect on relapsed Hodgkin’s patients, albeit in just 23 people. Dr. Brunvand’s team managed to get a dose, though it was not yet on the market for Hodgkin’s, through a program called “compassionate use.”

Dr. Brunvand expected little. The evidence was scant, Jason so far gone.

“When I start to pray, I know it’s time to let go,” Dr. Brunvand said. “I’d started to pray for Jason.”

Immunotherapy is based on the fact that once the immune system recognizes cancer and gears up to fight it, something remarkable happens: The immune system is rendered helpless.

Scientists believe that the cancer sends signals to put the brakes on our T-cells, which are the ones that fight disease. A crucial way the tumor tricks T-cells is by displaying on its surface a protein that is recognized by the T-cell through a receptor called PD-1. It stands for “programmed death.” It tells the T-cell to, in effect, self-destruct.

This might seem like a serious design flaw. After all, why would immune cells commit suicide? It turns out that the PD system is essential to survival: It is fail-safe against the immune system attacking our own bodies (see: lupus, Crohn’s disease, rheumatoid arthritis). Sometimes we want our bodies to halt the system; cancer takes advantage of this survival mechanism.

As Jason slogged through chemo, researchers around the country were experimenting with developing a so-called PD-1 inhibitor for cancer so as to unleash the immune system. This concept was at the heart of the nivolumab treatment that Jason was about to receive.

On March 13, Jason’s girlfriend, Beth Schwartz, drove him to his first treatment. On the ride, he was not thinking about surviving, but about having his pain managed well enough to see his nephew Jack play that night in the state high school basketball tournament.

Midafternoon, Jason sat in a recliner in the bleak, boxy room. A nurse in a blue gown cleaned his central line, an intravenous port in Jason’s chest. She gave him steroids. Jason couldn’t move his left arm or close his hand, the nerve so squeezed by Hodgkin’s.

She hung a translucent bag from an IV pole. It held saline and 200 milligrams of nivolumab. The treatment lasted an hour. At least there were no side effects; this was not scorched earth but immune-system tinkering. Then Jason went to his nephew’s game and sat with a former high school teammate, Dan Gallagher, who thought: “He looks so bad, I wonder if he’ll make it through the night. It was like looking at his dad again.”

Three mornings later, when Beth exclaimed that Jason’s tumor had shrunk, she wondered if she might be imagining things. So she decided to take pictures each day of his back.

The evidence startles. On Day 1, his left half still looks like the Incredible Hulk, a veritable watermelon protruding. If you squint, you can see it shrinking by Day 3. Then, at two weeks, he looks slender, normal definition having returned. He had more nivolumab. Then he went for a follow-up appointment.

What happened to my cancer, he asked Dr. Brunvand, using an expletive.

“I watched the moon landing in 1969, and it was a similar sense of awe,” Dr. Brunvand said. “It was that same sense we’d crossed a threshold,” he said, adding, “I’d just seen the power of the immune system.”

This is when I started taking notes. How could this be possible? Was this, indeed, a miracle?

I spoke to Dr. John Timmerman, an oncologist at the University of California, Los Angeles, who was among the researchers on the paper in The New England Journal of Medicine. I told him Jason’s story, and he said, “Wow.”

But he also said, “I have seen some pretty remarkable cases similar to this.”

In 2013, Dr. Timmerman treated a 27-year-old woman “near death’s door,” in such pain she could hardly move or sit down. She took the drug. The results: “A miracle,” he said. “The next time she came in, two weeks later, she popped up on the exam table on her butt and my jaw dropped.”

In almost the same breath, Dr. Timmerman offered a warning. “We’re in the honeymoon period,” he said, and for one crucial reason: “Patients are responding. They are also relapsing.”

Sometimes, tumors return in a few months or a year, sometimes not.

“I stay awake at night trying to get us beyond the honeymoon,” Dr. Timmerman said. “How do we leverage this into a cure?”

Dr. Brunvand, who had worked in his first AIDS clinic in 1986, hopes immunotherapy leads to fruitful, pain-free lives for cancer sufferers just as antiretroviral drugs have for people with H.I.V. In summing up his hopes for immunotherapy in cancer, he says, simply, “Think Magic Johnson.”

If Dr. Brunvand is right, some future Jason might not only survive but also not be driven to the edge by the treatment itself. For now, though, life on medicine’s cutting edge is no bowl of cherries, not with your survival at stake. Jason relapsed in August 2015.

Independence Day

On Aug. 13, a resplendent Colorado day, Jason pulled up to my in-laws’ house in Denver, where I was visiting. He was a broken man. He moved slowly, hunched at his shoulders, wore Ray-Bans and looked to me like a character in “Dallas Buyer’s Club.”

We sat in the backyard. Jason sobbed.

“No matter how many times they tell you you’ve got cancer, you don’t get used to it,” he said.

He mourned the toll it had taken on his family, especially on his mother, who supported him emotionally and financially.

“I think it would be easier for everyone if I was dead.”

He asked for ice for his dry lips.

But would you believe it? Jason wasn’t done.

He went in for radiation treatment, and soon appeared to have beaten the cancer back again.

“It’s awesome. I’m so psyched, dude,” he told me on Oct. 5. He was thinking of new business ventures, including working with a cancer doctor and researcher to develop an immunotherapy company. “I’m living proof!”

In early April this year, I called him to check in. Jason did not pick up or call back. After several days, I called Dr. Brunvand.

“Jason’s relapsed,” he said. “Ten days ago.”

He had been shoveling snow at his mother’s house when he felt his back go out. In excruciating pain, he went for an M.R.I. and other tests. They found evidence of Hodgkin’s in a vertebrae in the middle of his back and in the lining of his spinal column. Soon, his seventh vertebrae fully collapsed, an agonizing compression fracture, due in part to years of bone-density-depleting therapies.

“The treatment is killing him,” his mother, Catherine, told me when I arrived to visit on April 19. Jason sat in a recliner in the living room, in such agony he could hardly move. Heavy pain medications made him delirious.

The next day, it took three nurses to gently lower him into a wheelchair outside the hospital, where he got a course of immunotherapy to treat Hodgkin’s in his spinal column.

On May 17, the Food and Drug Administration approved nivolumab for patients with Hodgkin’s lymphoma in cases like Jason’s, where the patient has relapsed or the cancer has progressed after a transplant.

Jason got his last dose of the drug in late May. On June 1, he got the results of his latest scan. The tests showed no trace of cancer. But he was still in the hospital, virtually immobile, recuperating from surgery to stabilize his back with rods, and facing complications from coming off pain medications and steroids.

On June 21, I woke to a text from Dr. Brunvand. “Jason has taken a dramatic turn for the worse.”

Jason, who had been in the hospital for more than 70 days rehabilitating from the surgery, had suddenly stopped talking, his eyes closed most of the time, glassy and not home when open. Flummoxed, Dr. Brunvand could not find anything on brain or blood scans, ultimately deciding it was encephalopathy, meaning his brain had temporarily shut down to flush out toxins.

Too many drugs for too many years. Specifically, Dr. Brunvand reasoned, the awakening of his immune system had led to inflammation in the nervous system.

Jason was moved to intensive care, where he had a feeding tube, catheter, intubation. Dr. Brunvand ordered a spinal tap to give him steroids to combat the inflammation. But frankly, we all braced ourselves.

“I think he’s lost the fight in him — and why wouldn’t he?” his mom told me.

I sent a text for his sister to read to him: “Richtels send their love.”

Over the next few days, Jason remained enveloped, struggling not to be pulled under by toxins, as he had been doing for years against cancer. On July 4, his girlfriend was sitting by his side in the intensive care unit when his eyes popped open.

Source:NY times

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How To Get Ripped Abs... After 40

We all want great abs. In fact, “abs” consistently rank as the number one body part people are most attracted to AND want to improve most about themselves. So, why is it so darn hard to trim down and tone up your mid-section? I’m going to set the record straight right now and give you the TRUTH about losing that spare tire so you can reveal those lean, defined abs hiding underneath that stubborn layer of belly fat.

First, let me ask you a question: have you been doing countless sit-ups, crunches and side bends hoping to flatten your stomach, but you haven’t noticed a bit of difference whatsoever? 

Heck, maybe you’ve even resorted to trying out those “As Seen on TV” ab gadgets you saw on late night informercials, just to see if anything would make a difference. 

No need to be ashamed… I’ve made this mistake myself. 

In fact, I struggled for years before I finally figured out the truth about getting lean, defined abs.  (I sure wish someone had let me in the info I’m about to share with you before I wasted so much money on useless gadgets and dedicated so many hours to doing “ab-targeted” exercises.)

Here’s the thing about ab exercises that’s so misleading:  When you do ab-targeted exercises like sit-ups, your muscles get sore, which makes you think you’re strengthening your abs.  There you are, crunching away thinking it’s only a matter of time before you’ll be looking beach ready with your rock-solid core, right?

…Yet weeks after you’ve religiously been doing your ab routine, your belly looks just as bloated and squishy as it did before.  All that time and pain for nothing!

Here’s the TRUTH…

Most people think that abs are made to crunch, twist, and bend, but in reality it’s the complete opposite.  The role of your abdominal muscles is to prevent your mid-section from crunching, twisting, and bending.  Yep… you heard it right, your abs are a stabilizing force designed to resist movement in order to protect your spine.

So even though you “feel the burn” when you do crunches and other traditional ab moves, you’re actually putting unnecessary pressure on your back, causing much more harm than good.  These isolated ab exercises can cause lower back injuries by forcing your spine to flex too much, and they do very little to actually strengthen your abs!!

The bottom line: Ab-targeted exercises will NOT burn off belly flab OR strengthen your abs.  Instead, they will make your back weaker and more prone to injuries.

So then how the heck do you get ripped abs?

It’s a lot easier than you might think, once you know what (and what not) to do. 

Here are my top three simple, insanely effective strategies (#3 is my top fat-fighting secret weapon!).  If you actually take my advice, I think you’ll be flat-out amazed at how quickly your belly fat will seem to melt away, finally revealing those washboard abs that have been hiding underneath for all these years.

Alright, let’s get to it…

#1 - Do “Core” Exercises

If you want to get rid of that muffin-top and shrink wrap your waistline, you need to do exercises that hit your entire mid-section, not just your abs!  Your abs are only one part of your “core” and in order to go from having flabby abs to being tight and defined all the way around your middle, you must strengthen your abs AND all of the muscles surrounding them.

Here’s an example of one of my favorite core exercise you can do (I’ve got many more of these to show you later on, so stay with me).

The best plank exercise for ripped abs

To do this exercise, you’re going to start in a “plank” position (keep your body straight, don’t let your butt sag to low or stick up too high). 

Next, raise your left arm out straight in front of you and raise your right leg straight out behind you.  Hold this position for 5 seconds.  Now switch sides.  Repeat 5 times.

The reason this exercise is so effective is because you are not only working your abs, you are strengthening your entire core, toning things up while helping to actually protect your spine!

This brings me to my next tip, which has absolutely nothing to do with exercise, but if you don’t take my advice on this one, you will NEVER get flat abs — no matter how many core exercises you do…

#2 - Cut Out The #1 Belly Fat Causing Food

Sugar makes you FAT!

Sugar is the #1 reason that you carry fat on your belly. That’s right…it’s not fat that makes you fat, it’s SUGAR

That’s because sugar stimulates a fat-storing hormone called insulin, which is secreted by your pancreas.  The more sugar you eat, the more insulin your body secretes… and that means you gain more and more FAT. 

But here’s the worst part…

Of all your body parts, guess where your insulin hormone loves to store fat the most?  Yep, you guessed it — your stomach!

If you ever want to shed belly fat and reveal those lean abs, you MUST eat less sugar.

That is a fact.  But for the times when you DO eat sugar, remember this:

“Don’t drink your sugar, EAT your sugar!”

Memorize it, tattoo it to your forehead…whatever.

Here’s why: when you eat sugar from natural, whole foods (an apple for example), you are consuming the sugar along with fiber from the fruit.  Fiber slows down the uptake of sugar into your bloodstream, preventing your insulin from spiking so that you don’t store gobs of fat.

On the other hand, when you have sugary drinks (yes, even fruit juice!), there is NO fiber.  With every sip, you are essentially telling your body, “Hey, let’s pack on lots of fat!”

Here’s something else you need to understand:  all carbohydrates break down into sugar once they’re in your body.  That’s why foods like bread, pasta, and rice make you pack on the pounds and cause you to feel bloated all the time. 

Now, even though you should cut back on these high-carb foods, I’m not saying you can’t eat carbs at all.  In fact, let me fill you in on a little trick that let’s you “cheat” and eat more carbs — without expanding your waistline…

If you’re going to eat carbs, the best time is AFTER you workout.

You see, after you finish a workout, your glycogen (glucose stored in your muscles) gets depleted.  So when you eat carbs, your body uses the sugar to replenish your muscles first, instead of sending it straight to your gut!

Okay, let’s move on to my #1 best gut-busting secret of all…

#3 - Wake Up Your Metabolism!

Wake up your metabolism!

Your metabolism works around the clock 24/7 to keep your body functioning optimally and it requires fuel to keep running. 

Guess where that fuel comes from? 

Your body fat!  That’s right, your metabolism is fueled by fat.  So by increasing your metabolism, you’re telling your body to burn off MORE fat.

I know, I know.  That sounds easier said than done, but stick with me and you’ll discover how increasing your metabolism is MUCH easier than you think (no matter your age or genetics)…

But first, if you’ve been doing cardio workouts to try and slim down, I have some bad news for you…

Steady-state cardio (like jogging or doing the elliptical) increases the production of a stress hormone called cortisol.  Cortisol causes weight gain and makes it more difficult to burn off stubborn belly fat.  That’s why no matter how much cardio you do, you always hit a plateau eventually.

Even worse, too much cardio accelerates aging!  When you put your body under prolonged stress, you start producing free-radicals, which damages your cells and causes inflammation…and inflammation is what makes you OLD.  Yikes!

Now here’s the good news: science has proven that the most effective way to increase your metabolism is by doing short bursts of high-intensity exercises.  This type of exercise triggers a potent fat-burning effect, known as the “afterburn”, which skyrockets your metabolism and boosts your fat-burn for up to 48 hours after your workout is over

I call this scientifically-proven method metabolic training

Don’t worry, it’s not as technical as it sounds.  Let me explain…

Metabolic training involves specific exercises that activate more of your muscle fibers, which creates a bigger metabolic boost, demanding more fat to be burned for fuel—so you can burn off the flab that’s covering up your abs and KEEP it off.

There’s even more good news.

…Metabolic training stimulates your youth-enhancing hormones so you can slough away old, dead cells — making you look and feel younger.  Yes, it’s the Holy Grail of all workouts!

Look, getting lean, defined abs is easy once you know HOW to trigger the right hormones in your body (and stop the production of the bad hormones that are making you fat and old). 

On the next page, I’ll show you the specifics behind this fast and easy method.  Soon you’ll be able to turn on your youth-enhancing, fat-burning, and lean-muscle building hormones so you can finally uncover your abs without exercising to death or starving yourself …and you’ll even defy the aging process so you can look and feel 10 years younger…

Source: MensHealth.com

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Divorced, deceased parents linked to kids' smoking and drinking

(CNN)We know that parents have a profound influence on their child's life, and increasingly, scientific research is connecting the dots between attention or neglect and behavior.

Children who experience the loss of a father or mother early in life are more likely to smoke and drink before they hit their teens, a new study of English families found. This association between parental absence and risky behavior in childhood occurred no matter whether the cause was death, separation or divorce.
In fact, preteens with an absent parent were more than twice as likely to smoke and drink, the researchers discovered. They defined parental absence as the loss of a biological parent before a child reached age 7.
"We know from previous research that people may take up risky health behaviors as a coping strategy or as a form of self-medication, to help them cope with stressful situations," noted Rebecca Lacey, an author of the study and a senior research associate at University College London.
Possible evidence of the link between parental absence and behavior comes from an unlikely source from across the pond: President Obama.
In a new MTV documentary, "Prescription for Change: Ending America's Opioid Crisis," Obama reveals his past drug use: "When I was a teenager, I used drugs, I drank, I pretty much tried whatever was out there, but I was in Hawaii, and it was a pretty relaxed place. I was lucky that I did not get addicted except to cigarettes, which took me a long time to kick."
Notably, Obama's parents divorced around his 3rd birthday, within the parental absence time frame defined by Lacey and her colleagues.
Based on her findings, Lacey says, early life assistance provided to children with an absent parent may help prevent substance use, which might set a pattern and lead to poor fitness later in life.
"Health behaviors established earlier in life are known to track into adulthood," Lacey and her co-authors wrote in their study, published Monday in the journal Archives of Disease in Childhood.

Thousands of children studied over time

The research team examined data from the UK Millennium Cohort Study, which records health data for thousands of children born between 2000 and 2002. Among the goals of the study is to collect information on fathers' involvement in children's care and development. After a first survey of the children at 9 months old, surveys collected information for each child at ages 3, 5, 7 and 11 years old.
Overall, the researchers examined the records of nearly 11,000 children. Of these thousands of children, more than a quarter had experienced the absence of a biological parent by age 7.
During their age-11 survey, the children were asked whether they had ever smoked cigarettes or drunk alcohol. Those who had tried booze also answered whether they'd had enough to feel drunk.
The results to the smoking question would soothe the nerves of most parents: The overwhelming majority of preteens said they had not smoked. However, 11-year-old boys were more likely than girls to have tried cigarettes: 3.6% versus 1.9%.
Drinking was much more common among the 11-year-olds. Here again, the boys outnumbered the girls, with one in seven boys reporting that they'd tried alcohol, compared with one in 10 of the girls. Of the preteens who tried drinking, nearly twice as many boys (12%) said they'd had enough to feel drunk, compared with slightly less than 7% of the girls.
Lacey and her colleagues calculated that preteens who had experienced parental absence before the age of 7 were more than twice as likely to have taken up smoking and 46% more likely to have started drinking.
Although the boys were more likely to have reported smoking or drinking, they weren't any more likely than girls to have reported smoking or drinking as a consequence of parental absence, explained Lacey.

Is death more significant than divorce?

One interesting datapoint in the study showed that kids whose parent had died were less likely to have tried alcohol by the age of 11; however, those who had tried it were more than 12 times as likely to get drunk than kids with absent parents due to separation or divorce.
"We need to be a little bit cautious about overinterpreting this result," Lacey said, since the sample population contained very few children who had experienced parental death.
Overall, Lacey and her colleagues believe that a range of factors -- including less parental supervision and unhealthy coping mechanisms on the part of the kids -- may contribute to the association between parental absence and risk behaviors.
Mitch Prinstein, a professor and the director of clinical psychology at the University of North Carolina-Chapel Hill, believes the study covers "an extraordinarily important topic."
"The rate of health risk behaviors like smoking and consumption of alcohol is a serious concern, not just in the UK but in many nations, especially here in the US," said Prinstein, who was not an author of the study. Prinstein added that anything to help us understand which kids are at risk at the earliest age "deserves our attention."

Other adults can make a difference

Though it's "exciting," Prinstein noted that the study had one weakness in that the researchers could not control for factors such as parental depression or physical illness. As a result, no one can say whether a parent's absence was the cause of a child's risky behavior or whether other factors, such as a parent's depression, might have played a more direct role.
"All studies have limitations, of course, so this is not to suggest this (research) is not an important contribution," he said, adding that previous research suggests parental neglect can be a factor leading to risky behavior in children. Though the study focuses on children in the UK, Prinstein also believes the results "might not be culturally bound" and so probably apply to American families.
Still, Prinstein cautions against misinterpreting the results since past studies revealed that "aunts, uncles, grandparents, coaches, members of the neighborhood community can serve a very important role for kids."
Someone who is not in the "formal role of a parent" can still have a "dramatic" and positive influence in the life of a child, he said, and they may even help a child resist peers who have begun to experiment with substances.
Prinstein concluded, "I would hate for anyone to feel stigmatized that what they're providing for a child is not OK if they are offering that child access to other adults, like grandparents and aunts and uncles -- because we know that is very helpful."
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5 Foods That Are Healthier Than You Think

Sometimes foods we love land in the nutritional “dog house” because of a negative news story. And then it doesn’t matter what health experts say, or what new research comes to light. In our minds we come to think of these foods as unhealthy choices.

Take these five much-maligned foods. Experts now agree: eating these former food vices might actually make you a healthier, happier fiftysomething.

Perceived as a vice because:
Eggs, or specifically the yolks, are rich sources of cholesterol. And since the plaque that clogs arteries and damages hearts is made up mostly of cholesterol, “people sort of connected those dots,” explains Walter Willett, Fredrick John Stare Professor of Epidemiology and Nutrition at Harvard. But “there was never any data that showed that people who ate more eggs had higher risk of heart attacks.”

Good for you because:
An extensive body of research confirms that cholesterol in the diet has very little impact on blood cholesterol levels. (Foods high in saturated and trans fats are what raise blood cholesterol.) So the 2015 U.S. Dietary Guidelines now recommend that it’s OK for healthy people to eat up to seven eggs per week. Rich in protein and a good source of everything from Vitamin D to phosphorous, eggs illustrate the “good things come in small packages” rule of thumb.

Perceived as a vice because:
Plenty of people still see coffee drinking “as an unhealthy habit, along the lines of smoking and excessive drinking, and they may make a lot of effort to reduce their coffee consumption or quit drinking it altogether, even if they really enjoy it,” says Harvard scientist and professor Rob van Dam.

Good for you because:
When Harvard researchers looked at the coffee drinking habits of 130,000 volunteers (healthy men and women in their 40s and 50s) and then followed these volunteers for 18-24 years, they saw no evidence that drinking up to six cups of coffee a day increased risk of death from any cause.

“Our findings suggest that if you want to improve your health, it’s better to focus on other lifestyle factors, such as increasing your physical activity, quitting smoking, or eating more whole grains,” says van Dam.

Of course, he’s talking about black coffee here. All bets are off when you start adding copious amounts of sugar and cream and whip them up into a slushy frozen confection.

One exception to the rule: People who have a hard time controlling their blood pressure or blood sugar might want to avoid coffee or switch to decaf. Caffeine is a stimulant and going overboard might increase heart rate and raise blood pressure.

Perceived as a vice because:
Drinking too much red wine can raise blood pressure and it may increase risk for several types of cancer. And when a 2014 Italian study found that the antioxidant resveratrol, often credited for conferring some of the health benefits in red wine, didn’t reduce cardiovascular disease, cancer, or deaths, it again raised the question: Is red wine good for health?

Good for you because:
While they didn’t find benefits to reservatrol in the Italian study, lead researcher Dr. Richard D. Semba of Johns Hopkins University says other studies have shown that red wine, dark chocolate and berries can reduce inflammation and still appear to protect the heart. “It’s just that the benefits, if they are there, must come from other polyphenols or substances found in those foodstuffs,” he says.

Perceived as a vice because:
Pinned by dieters with a scarlet “F” for fattening, the 21 grams of fat in a small avocado do sound a bit rich. If you focus on total fat it’s easy to lump the fruit with other guilty indulgences like quarter pound burgers (20 grams of fat), scoops of rich, premium ice creams (17 grams of fat) and buttery croissants (18 grams.) Yet, unlike these favorite fatty splurges, the bulk of fat in avocados is the “healthy-for-the-heart” monounsaturated variety.

Good for you because:
A 2015 study from the American Heart Association finds that eating one avocado per day as part of a moderate fat diet can drop LDL, or “bad” cholesterol, nearly 14 points.

“We need to focus on getting people to eat a heart-healthy diet that includes avocados and other nutrient-rich food sources of better fats,” says Penny M. Kris-Etherton, senior study author and chair of the American Heart Association’s Nutrition Committee.

And if you eat that avocado at lunch all the better. Loma Linda University researchers find that eating half an avocado at lunch helps squash food cravings for three to four hours after the meal, which could prevent a diet-busting case of the afternoon munchies.

Peanut Butter (Peanuts)
Perceived as a vice because:
It’s fine for the grandkids, but this quintessential sandwich spread has “too much fat” for many fiftysomethings. So they skip it all together. Same goes for peanuts. Many people believe pretzels are a better snack than peanuts or peanut butter.

But a 2010 study shows that refined carbs (like pretzels) might be worse for the heart than saturated fats. “The obesity epidemic and growing intake of refined carbohydrates have created a ‘perfect storm’ for the development of cardiometabolic disorders,” says Harvard researcher Frank Hu.

One good strategy, he suggests, is “replacing carbohydrates (especially refined grains and sugar) with unsaturated fats and/or healthy sources of protein.” Peanuts (and peanut butter) are rich in heart-healthy unsaturated fats and contain generous amounts of protein.

Good for you because:
Researchers at Penn State, who had volunteers eat peanuts as part of a high-fat meal, might have figured out why peanuts are good for the heart.

“Previous studies have shown that individuals who consume peanuts more than two times a week have a lower risk of coronary heart disease,” lead researcher on the new study, Xiaoran Liu, said. “Our new study indicates that the protective effect of peanut consumption could be due, in part, to its beneficial effect on artery health.”


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What is the polio-like illness paralyzing US children?

(CNN)Polio is a highly infectious disease that can lead to paralysis -- even death. Thankfully, most children today are unfamiliar with the virus, as it was eliminated from the United States in 1979.

But this week, the US Centers for Disease Control and Prevention reported a spike in a mysterious polio-like illness, confirmed this year in nearly half of the states in the country. From January 1 to August 31, 50 people in 24 states were diagnosed with acute flaccid myelitis. Most of the cases are in children.
Like polio, AFM affects the body's nervous system -- specifically, the spinal cord -- and can cause paralysis. Unlike polio, there is no vaccine for AFM.
What we know: AFM first spiked in August 2014. By the end of that year, 120 people had been diagnosed in 34 states. The year 2015 saw just 21 people diagnosed in 16 states. Cases diagnosed in September of this year will be reported at the end of October.
What we do not know: the exact cause of the illness, though scientists think it is most likely the result of a viral infection. Other potential culprits include environmental toxins, genetic disorders and Guillain-Barré syndrome, according to the CDC.
"This is a very rare condition, but I think it's important that we take it seriously because it does have long-term and potentially disabling consequences," said Dr. Kevin Messacar, a pediatric infectious disease physician and researcher at Children's Hospital Colorado.

What is acute flaccid myelitis?

"The key with AFM is that it's sudden onset," said Dr. Manisha Patel, AFM team lead at CDC and a practicing pediatrician. "Symptoms include limb weakness, facial drooping and difficulty swallowing and talking.
"AFM is an illness that can be seen with a variety of different causes. The most famous one is polio, but there are also enteroviruses, which are circulating very broadly in the US and other countries."
"What we saw ... is that the majority of children had a fever and a respiratory illness," said Messacar. "Five days later, they would develop pain in the arms and legs, and weakness followed."
Messacar and his colleagues have followed their hospital's 12 AFM patients since 2014. He said most of them are doing better than when they first came into the emergency room, but the majority continue to have some level of disability.
"It's important to understand that there's a wide spectrum of severity of this disease," said Messacar. On one end, you see mild weakness in one extremity, he said. On the other, you've got children who have lost the ability to breathe on their own, and exhibit complete paralysis in their arms and legs.
Patel and Messacar agree: There are no known proven, effective therapies. Both doctors stress the importance of recognizing the early signs of AFM and seeking care as soon as possible.
"A doctor can tell the difference between AFM and other diseases with a careful examination of the nervous system, looking at the location of the weakness, muscle tone and reflexes," according to the CDC's website. "Magnetic resonance imaging (MRI) can be very helpful in diagnosing cases of AFM."
"Finally, by testing the cerebrospinal fluid (CSF, the fluid bathing the brain and spinal cord), clinicians can look for findings suggestive of AFM," according to the CDC.
There is no cure for AFM. Treatment only focuses on alleviating symptoms.

How worried should you be?

"CDC is always concerned when there is a serious illness that is affecting the public, especially when it's affecting children," said Patel. "We're looking closely at what might be causing this, and what might put someone at risk for AFM."
In the meantime, Patel encourages practicing what she calls "general prevention strategies" -- washing your hands with soap and water, getting vaccinated and preventing mosquito bites.
Why is this important? AFM has also been liked to West Nile virus and other viruses in that family, according to the CDC; in particular, Japanese encephalitis and Saint Louis encephalitis. No link has been established between AFM and the Zika virus.
There is some good news here. "Enteroviruses tend to appear in the late summer and early fall, and go away in the winter," said Messacar. "So we expect to see [AFM cases] decrease based on the epidemiology of enteroviruses."
"We understand this condition better than we did in 2014, but there's still a lot to learn," said Messacar. "The process is slow, but progress is being made."
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Could your fitness tracker sabotage your diet?

(CNN)Wearable technologies can monitor your physical activity or your allergies. Increasingly, they are part of our everyday lives. But a new analysis comparing two sets of dieters discovered that those wearing activity trackers lost less, not more, weight than the tech-free dieters.

"We went in with the hypothesis that adding the technology would be more effective than not having the technology, and we found just the opposite," said John Jakicic, author of the study, published in the Journal of the American Medical Association.
"One of the things we didn't study here was, maybe these things are really effective for people gaining weight, but maybe that's different from helping people lose weight," said Jakicic, a professor and director of the Physical Activity and Weight Management Research Center at the University of Pittsburgh. "We need to do a lot more digging in the data to understand that."

How do I lose weight and keep the pounds off?

It's not only dieters who ask this question; it's researchers, too.
"We've been doing this weight-management stuff for a very long time and realized that we have really good approaches to help people lose weight in the first three to six months," Jakicic said. He wondered whether the increasingly popular wearable devices might help.
"Activity monitors started coming onto the market in a commercial sense in the early 2000s, but they've really picked up steam in the last couple of years," observed Jakicic. The idea behind the new study, funded by the National Heart, Lung, and Blood Institute, was to compare two sets of dieters: those with wearable activity monitors and those without.
Jakicic acknowledges having received past funding from Jawbone, a wearable device company, and both he and two other researchers have received past honorariums from Weight Watchers International.
For the new study, the researchers enlisted the help of 470 adults between the ages of 18 and 35. Each participant's body-mass index fell within the range of 25 to 39; commonly, 25 to 29 is considered "overweight," and 30 to 39 is considered "obese." Slightly more than three-quarters of the participants were women, and not quite a third were non-white.
The researchers randomly divided participants into two groups for a 24-month weight loss study.
Both groups participated in a group-based, face-to-face weight loss intervention. "We find those to be the most effective way to deliver these programs and cost-effective way to deliver these programs," Jakicic said. All the participants received counseling around nutrition and physical activity: the basics of healthy eating and activity.
"But beyond that, more importantly, it's not just 'here's what you eat, and you need to exercise more,' " Jakicic said. Instead, the program was grounded in behavioral theory that helps patients understand why they are struggling and what's getting in the way.
"How do I make it work today when yesterday it didn't work?" Jakicic suggested.

Calls and texts

Group sessions were scheduled weekly for the initial six months and monthly between months seven and 24. During those later months, participants also received brief (just 10 minutes at the longest) telephone calls once each month and weekly text messages.
Half the participants were provided with and encouraged to use a commercially available wearable technology (with a Web-based interface), while the other half simply recorded their activity on a website.
What happened? The change in weight at 24 months differed "significantly" by intervention group: The group wearing activity monitors lost, on average, 7.7 pounds compared with an average loss of 13 pounds for those walking "naked." However, the researchers reported that both groups showed improvements in body composition, fitness, physical activity and diet.
Dr. Barbara Berkeley, a board-certified physician in both internal and obesity medicine, points to a simple statement in the study that indicates there were no "significant" differences between diet intake and physical activity for the two groups.
"That means that something is amiss," said Berkeley, who was not involved in the new study. She explained that if there was "absolutely no difference" between what the two groups ate and how much they exercised, the average weight losses "should be the same whether the study subjects wore a device or not."
Berkeley observed that studies on dieting are "notoriously hard to do," so adding exercise into the mix makes accurate research doubly difficult. The main issue is that any long-term study must rely on the participants self-reporting what they ate and how much they exercised, so accuracy is naturally a problem.

Wearable but in the drawer

Jakicic is eager to look more closely at the data, but he and his colleagues have come up with a few hypothetical explanations for the unexpected result.
"Anecdotally, these devices tend to work or people tend to engage with them for about three months or so, and after that, a lot of people start throwing them in the drawer. They get bored with them," Jakicic said.
Another possibility: Not everyone likes wearables. Instead, many people feel " 'I got this device, and I just hate it,' " he said.
Berkeley, the author of "Refuse to Regain: 12 Tough Rules to Maintain the Body You've Earned," noted that "weight loss is much more dependent on scrupulously following a weight-reducing diet than on exercise." Generally, she said, diet is more important than exercise during the active weight loss phase, but exercise becomes much more important during weight maintenance.
"It's entirely possible that those who were paying more attention to the exercise part of their regimen [because of the wearable device] were less scrupulous about their intake," Berkeley said. She added that exercising can often cause dieters to "feel that they've 'earned' the chance to eat more."
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In America's drug death capital: How heroin is scarring the next generation

Huntington, West Virginia (CNN)Sara Murray tends to two dozen babies in the neonatal therapeutic unit at Cabell Huntington Hospital. They shake. They vomit. Their inconsolable, high-pitched screams pierce the air. The symptoms can last for hours, days or months.

Graceful and soft-spoken, Murray is a seasoned nurse tirelessly defending the innocent. But even she gets worn down. On difficult days, she seeks a moment of refuge behind her desk and wonders: How did we get here?
These babies -- her babies -- are the youngest, most vulnerable victims of a raging epidemic.
They are heroin babies, born addicted.
Her third-floor unit, a calm and quiet space with dim lighting, is meant to accommodate 12 babies, but it's been two years since the numbers were that low. One in 10 born at the hospital endures withdrawal from some type of drug -- heroin, opiates, cocaine, alcohol or a combination of many.
That's about 15 times the national average.
The figures reflect a startling reality about this Appalachian town of 49,000 on the banks of the Ohio River: One in four residents here is hooked on heroin or some other opioid, local health officials say. That's a staggering 12,000 people dealing with opioid addiction, in a state with the highest rate of drug overdose deaths in the nation.
The truth is nearly everyone in Huntington is a victim of this epidemic: parents whose children lie about their habits and steal from their homes, fathers and mothers who outlive their daughters and sons.
Most devastating is the impact on the youngest generation growing up in this toxicity: children who witness their parents' descent into a living hell, or are abandoned, or born addicted.
"It's frustrating, it's sad and it's heart-wrenching," says Murray, a nurse for the last 26 years. "My personal passion is for the baby and that they have a voice."
On this day, August 15, Murray and her staff of eight nurses are particularly concerned about one baby boy. The mother won't reveal the name of the dope she's on, which makes it unnerving for the nurses trying to treat him.
Most of the infants' parents are absent, and the possibility that they are somewhere shooting up lingers like the babies' screams.

The first overdose

It's about 3:30 p.m., the heat nearing triple digits, when Lt. David McClure pulls his blue-striped ambulance SUV to a crash near the West Huntington Bridge. First on the scene, the senior paramedic with Cabell County EMS finds a compact car stuck on a curb in the median.
The hum of the engine grows louder as he walks toward the vehicle. Through a rolled-down window, McClure sees a 21-year-old woman hunched toward the steering wheel. Her chin touches her chest. Drool dribbles out of her mouth. Her breaths are few and far between.
"Can you hear me?" he yells near her face. "Can you hear me?"
After shifting the car into park, McClure lifts her eyelids and shines a penlight into her pupils. Both are the size of pinpoints -- a sure sign of an opioid overdose. When he looks down, he spots a syringe in her lap.
McClure has grown accustomed to drug overdoses -- his crew responds daily to such calls. You name it, he's seen it: Moms passed out with their kids still seat-belted. Dads sprawled on floors, their toddlers within an arm's reach of heroin. Never once has a heroin user thanked McClure for saving his or her life. Sometimes they complain about the interruption of their high.
With minutes left to save the woman on the bridge, another paramedic sets up a bag-valve mask to squeeze air into her lungs. Together he and McClure place her on a stretcher and roll her toward an ambulance. They search her left arm for a decent vein and, after finding an unscarred one, pierce her skin with a needle containing an opioid blocker called naloxone. The drug, known for reversing overdoses, can save heroin users on the brink of death.
Within two minutes, she blinks her eyes, wincing with discomfort from the stark lights in the back of the ambulance. Outside the window, a Cabell Huntington Hospital billboard towers over the crash scene with a foreboding offer: "No appointment necessary."
By the time she's transported there for treatment, the next message from dispatch reverberates across town.
"They're just showing up and dying."

'All hell broke loose'

Tragedy has defined this town before. In November 1970, a plane carrying members of Huntington's beloved Marshall University football team smashed into a mountainside, killing 75 players, coaches and supporters.
Huntington lost more than 25,000 residents in the last several decades as factories tied to coal mines closed.
The terms "before the crash" and "after the crash" became part of the town's legacy. The movie "We Are Marshall" captured Huntington's spirit in the crash's aftermath as the community came together and healed. Today Huntington must rally against a very different and relentless foe. Heroin use has grown so prevalent that a new catch phrase has emerged: "Narcanned," the brand-name for the opioid blocker that reverses overdoses. As in, "How many times have you been narcanned?"
It's not uncommon to hear an addict say 3, 4, 5 times.
A new number will emerge from this day: 28 overdoses in a five-hour span. The ordeal will stretch every resource in Huntington, clogging the emergency rooms in the town's two hospitals, testing the resolve of the most hardened medics and prompting a manhunt for the peddler of a batch of heroin laced with an unknown substance.
The victims' ages will range from 19 to 59. They'll turn up in homes and alleys, a Marathon convenience store bathroom and a Burger King parking lot. They'll include a father and son shooting up together. A husband and wife. A recovering addict who relapses.
It's the moment "all hell broke loose," Huntington Mayor Steve Williams will say later.
The moment everyone knew was coming. The moment no one knew how to stop.

Nine overdoses within minutes

Capt. Derrick Ray with Cabell County EMS gets out of his ambulance at the "showing up and dying" scene. Authorities treat it like a "mass casualty" event. Ambulances, police cars and fire trucks line Sycamore Street. Local TV crews set up too, cameras rolling. It's shortly after 3:30 p.m.
Ray knows the neighborhood well. He's responded to calls there many times. Residents here tend to cuss him, then ask for his help when their lives need saving.
Today is one of those days.
A police officer enters a small ranch house and injects naloxone into the thighs of two users who appear dead. Both revive. Two others are groggy, but not so far gone they need to be narcanned. Ray heads next door to a tiny low-income apartment complex.
In a shady narrow courtyard, he finds three women, ages 23, 27 and 32. Two lay unconscious in the grass. The third crawls on the ground with her arms raised like a zombie from "The Walking Dead."
Acting fast, paramedics pump oxygen into the victims' lungs and administer naloxone to all three.
A supervisor with two decades of experience and dough-boy looks, Ray catches a breath when his phone rings. It's McClure, who has finished treating the woman who crashed her car on the bridge. He wants guidance: Where should he go next?
By 2013, the year Williams became mayor, opioid abuse had spiraled so far out of control that Cabell County's fatal heroin overdose rate rose to nearly 13 times the national average.
Officials have responded with a series of progressive policy initiatives, from a needle exchange program to help curb hepatitis outbreaks to landing a donation of 2,200 naloxone auto-injectors (worth $1.5 million) to be given away to residents. Williams also took the unprecedented step for such a small town of appointing a drug czar, responsible for getting everyone -- paramedics and pastors, judges and jailers, cops and community leaders -- on the same page to combat the opioid epidemic.
Unlike other drugs that came to West Virginia, Williams says, heroin doesn't discriminate, affecting both men and women, white and black, homeless and lawyers, grandchildren as young as 12 and grandparents approaching 80. The mayor never knows who might overdose, so he carries a naloxone injector everywhere he goes.
On days like today, the priorities shift from running heroin out of town to saving lives. The mayor hopes residents can be spared the coffin.

'God's star in heaven'

It's been nearly a decade since Teddy Johnson buried his 22-year-old son. News of the overdose outbreak hits hard, but he's not surprised given heroin's takeover.
Teddy Johnson polishes the grave of his son, Adam, who died of a heroin overdose in 2007.
Why has the problem only worsened?
The 65-year-old father has warned of the scourge the last nine years, long before heroin reached historic levels in Huntington. He's stared down his son's dealer in court and an undocumented immigrant connected to a Mexican cartel responsible for distributing black-tar heroin in the region. Neither dared return his glare.
Every week Johnson visits his son's gravestone in Spring Hill Cemetery. He trims the grass with a hedge clipper and weed whacker. He polishes the stone with a rag and granite cleaner. He outlines the engraved letters of his son's name with a black Sharpie.
Then he steps backs and takes a look at the inscription: "Adam Tyler Johnson: Our star on earth, God's star in heaven."
The father runs a plumbing shop founded by his grandfather 78 years ago. He's expanded the business to make showcase bathrooms, designer kitchens and dynamic outdoor patios. Adam, who was a history major at Marshall University, was in line to become the fourth generation to carry on the family business.
Instead, visitors to the showroom are greeted by memorials to Adam.

Police chief: Find the heroin

Shortly before 4 p.m., Capt. Rocky Johnson, commander of the Huntington Police Department's special investigations unit, prepares to lead a drug raid at Marcum Terrace, a cluster of two-story, red-brick public housing units that dot a hill on the city's east side. The neighborhood is home to the town's poorest folks, a place where fistfights get posted on YouTube and scores are settled with knives. A preacher says baby's shoes hanging from telephone wires indicate drop-off sites for drug dealers.
The complex is within a stone's throw of where first responders earlier treated seven overdoses.
Johnson's phone rings. It's the chief, Joe Ciccarelli.
"Are you monitoring the radio traffic?" Ciccarelli asks. "We're having all these overdoses."
Patrolman Jacob Felix prepares to go out on a call. More than 50% of his job, he says, is responding to heroin overdoses.
When Ciccarelli joined the force in 1978, Huntington only had about a dozen known heroin addicts. Officers chased after those few users and monitored parking lots for people smoking weed. Now, the addicts have multiplied. Though the drug has origins south of the border, the chief says the dealers here are "so far down the chain, they can't spell Mexico."
He orders Johnson to abandon the raid. There's a new assignment: Find the source of today's heroin.
Dressed in jeans and T-shirts, Johnson and his nine undercover officers break cover and shift gears. If the spread of this particular batch isn't reined in quickly, dead bodies will be found all over Huntington.
Johnson and his officers begin conducting interviews. They're told an out-of-towner, a man about 6 feet 4 inches and built like a middle linebacker, cruised through the neighborhood about an hour before the first overdose occurred. His nickname was Benz, though he drove a white Chevy Cruze.
Some residents say he handed out free samples; others say he sold a new product.
When he stopped and took a stroll, witnesses tell police, scores of people followed.
It was like he was the pied piper.

A mother needs her fix

Andrea has followed the lure of the high for a decade now. She shoots up twice a day regardless of costs. Addiction has robbed her of her job, friends and family.
She agrees to be interviewed and photographed on the condition that her last name be withheld. She says paramedics saved her life twice. She sought refuge in rehab once -- attending a 30-day treatment center. She stayed clean for more than eight months -- 264 days to be exact. She shook her habit but kept her friends, staying in a circle that led to relapse.
Andrea trades dirty needles for clean ones at the health department's exchange program.
The 36-year-old former nurse says her three children -- ages 18, 14 and 11 -- live with her grandmother. Her own mother and father refuse to speak to her. Her oldest son, she says, hates her. Her daughter, the youngest of the bunch, found her on the bathroom floor two years ago.
The girl cries and prays for her mother.
In spite of today's overdoses, Andrea chases her fix and chooses to shoot up anyway. Prayers be damned.

Never again

"The devil has come to Huntington," Sara Murray says. It's as simple and complicated as that.
Newborns in the nurse's hospital ward weren't just exposed to heroin; the pregnant addicts have often downed alcohol, taken prescription painkillers or dabbled with the latest fad, the anti-seizure drug Neurontin.
Most babies in the unit will likely suffer long-term neurological problems. Nearly 1 in 10 can expect to suffer from Hepatitis C in their lifetime.
When babies are born with drugs in their systems, state child protection workers are notified. Murray recalls one shattering case where doctors and nurses believed a fussy baby boy would be in danger if sent home with his parents. She says they shared notes with child protection services about the family's behavior and pleaded on the child's behalf.
Murray rarely knows the outcome when a child leaves her care, but this time the case made headlines in the local paper. The father was arrested, accused of killing the boy.
She and her fellow nurse, Rhonda Edmunds, made a pledge: "That will never happen on our watch again."
They lobbied the hospital to open a neonatal therapeutic unit. As heroin use climbed, so did the number of babies suffering from withdrawal. Their fussiness disturbed the care of others in the neonatal intensive care unit. The therapeutic unit opened a year later.
Sara Murray is a registered nurse and co-founder of Lily's Place, a facility for addicted babies.
The two continued their dedication by opening a separate facility, called Lily's Place, to provide a homier environment for babies exposed to drug use before birth. Each newborn has a separate room, and young mothers are taught skills for dealing with their babies. Most of the moms want to learn; some do not.
Nearly all the children get sent home with a parent. Most of the time it's their birth mom or dad. Once in awhile, they go to foster care or are put up for adoption, but that's a rarity.
One mother confided to Murray that she finally got help when her child was 4 months old and she couldn't recall if she'd fed her baby at all one day. The mother asked a relative to care for the child while she went into treatment.
Murray worries about the addicts who don't feed their babies and don't call someone for help. She empathizes with their chemical dependency but says it's difficult to hear parents prioritize their fix over their family with a simple justification: "I like being high."
"We have generational addiction and that's their normal. It was their mother's normal. It was their grandmother's normal," Murray says. "And now, it's their normal."
A normalcy that is completely abnormal.

Overdoses everywhere

Lt. McClure marches up a footpath that cuts through brush behind Marcum Terrace. The next victim is splayed out beneath a hollowed out area of bushes, amid needles and a heap of sticks and water bottles piled up like a campfire.
Time for naloxone.
Less than 20 feet away, on the other side of the path, Capt. Ray comes across an overdosed man lying on a bed of brush. Another life saved.
Sweat drips from beneath the bill of Ray's brown EMS baseball cap. The oppressive heat won't let up. Neither will the overdoses.
Capt. Derrick Ray takes naloxone out of a first-responder's kit. Many residents carry the opiate blocker in case they encounter an overdose.
A commotion erupts outside an apartment. People scream for a medic. As Ray makes his way down the narrow sidewalk, distrustful bystanders pull out cell phones and record his every move.
He can't let the cameras faze him. Another man is down, clutching groceries in one hand, a bag of needles in the other.
The overdose count nears 20.

'They can't unring the bell'

It's nearly 5 p.m., closing time at the Cabell County Courthouse, as Family Court Judge Patricia A. Keller wraps up another day of child support cases. Within the hour, the 58-year-old West Virginia native is home and flipping on the news in her living room. She stands there in shock, unable to focus on preparing dinner.
How many overdose victims are parents, she wonders. Will those families fracture?
Keller never thought drugs would consume her court. Fifteen years ago, she was mostly setting visitation schedules for alcoholic dads. Now at least a third of the cases she sees involve protecting children from the havoc wreaked by opioid addiction.
Every week Keller decides whether moms and dads who have lost custody, like the ones at Lily's Place, can see their children again. Whenever possible, she prefers to create avenues for heroin users, including mothers like Andrea, to regain visitation rights. First, they must typically meet with a counselor and submit to random drug tests.
Far too often, addicts aren't willing participants. In some cases, parents show up high to her chambers, if they show up at all. Sadly, some parents lose their children for good.
"When people have been in the madness of their addiction, being a good parent is the last thing on their minds," Keller says. "When they start to become clean, they can't unring the bell."
Diapers with parents' notes hang on the wall at Lily's Place, which cares for newborns suffering from withdrawal.
Likewise, Keller never thought her job would also mean being a counselor. But she can't ignore the fact that about three of every four parents in her court are so poor they can't afford a lawyer. She's encouraged dads struggling with heroin addiction to get clean needles at the exchange. Other times, she's offered moms literature about recovery programs.
Keller also presides over a local drug court that's one of West Virginia's largest. Founded in 2008, it gives nonviolent criminals with a high risk of reoffending or relapsing a chance at treatment instead of incarceration. Half of the participants drop out, leading them back to prison. For the other half who graduate, 9 out of 10 don't commit another crime, Keller says.
But the drug court has limitations: Addicts can only get help once they're in the criminal justice system, a point where families have already suffered the consequences. For those who want assistance before that point, it can be hard to find.
"A lot of people want to get help," Keller says. "But we don't have enough treatment beds. It's so frustrating. You've got to get it for them as soon as they're ready."

Resurrected in recovery

While the 6 o'clock news airs, Will Lockwood sits in a crowd of about 70 at the Expression Church of Huntington, a refuge for recovering addicts sandwiched between Cabell Huntington Hospital's emergency room and Spring Hill Cemetery.
Tim Hazelett, an administrator with the county's health department, takes the stage and acknowledges the string of overdoses that have occurred this afternoon. Then he uses the pulpit as a teachable moment.
The people who are overdosing, he says, are in need of help. Put out the word, he tells the crowd. There's a batch of heroin laced with something that can kill you -- so stay away from it.
He dives into a PowerPoint presentation, 37 slides in total, that describe how to recognize the signs and symptoms of an overdose, how to administer an intranasal form of naloxone and what to do if a child overdoses.
Lockwood, who helped organize this session, relates to every word. The 25-year-old overdosed four times in a three-year period. He's stayed clean for nearly two.
Two summers ago, he embarked on a mission to end his life by means of a lethal fix.
He holed up in room No. 216 of the Coach's Inn, a dingy pink motel where passersby can see walking skeletons stumble from room to room. Lockwood overdosed for what he hoped would be the last time. When he awoke, his drug dealer pounded his chest in a bathtub, cold water running down his face.
He stood and, as he came to his senses, glimpsed at his reflection in the mirror. His body-builder frame had withered by more than 60 pounds.
"You are worth more than this," he told himself. "You have a son. You have a family. You know exactly what you need to do."
Now Lockwood works as a peer coach for The Lifehouse, a faith-based recovery center that helped him get sober. As part of his job, he mentors men who are desperately trying to quit.
"I empathize with the people of this community," he says. "A lot of them don't want to be in this situation. Truly, what it boils down to is fear."
Fear of rejection. Fear of judgment.
Tonight, everyone learns the value of life-saving intervention. When the naloxone course ends, worship begins. Lockwood and the rest of the congregation proclaim their commitment to God, to one another and to themselves. Many of his fellow worshippers have skirted death -- in biblical terms, resurrected.

The fallout

Just blocks away, as the church service continues, a man stiffens in the bathroom at the Marathon convenience store. His legs, contorted, stick up straight in the air. His pupils are dilated.
A woman lies sprawled on the floor, beneath the sink.
This is one of Lt. McClure's final stops -- almost exactly 12 hours into a shift that began at 7 a.m. His clothes are drenched in sweat and the stench of a hard day's work.
Two more get narcanned.
A man and woman overdosed in this Marathon gas station bathroom.
Almost two hours later, as darkness falls, Mayor Williams' phone buzzes once again. He swipes his screen. It's an update from Huntington Fire Chief Carl Eastham. The victim of the final overdose -- a 19-year-old woman just outside the city limits -- has made it alive to Cabell Huntington Hospital.
"There have been no OD deaths that we can find at either hospital," Eastham texts a few minutes before 9 p.m.
"Thank heaven for that," the mayor replies, before firing off another text: "Obviously carfentanil has arrived."
"Appears that way," Eastham writes.
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Poured or Peeled, Why You Need Fruits and Veggies

Despite the best of intentions, consuming the ideal amount of healthful foods is easier said than done. Take the produce department: U.S. Department of Agriculture research finds Americans waste 15 to 20 percent of fresh fruits and vegetables they purchase each year. One option is purchasing canned items—especially if you have kids.

“Nine out of 10 American children are not eating enough vegetables, and 6 out of 10 kids do not eat enough fruit,” says Rich Tavoletti, Executive Director, Canned Food Alliance. “A recent NHANES study showed that kids who ate canned fruits and vegetables increased their overall consumption of fruits and vegetables, enjoyed a better diet quality overall and increased intakes of certain nutrients. We recommend keeping all forms of fruits, vegetables and beans on hand, whether they are canned, fresh, frozen, dried or 100 percent juice.”

Food for thought

According to the Journal of Nutrition and Food Sciences, canned foods often provide needed nutrients at a lower cost. Canned foods also require no refrigeration and little preparation.

“Unfortunately,” Tavoletti explains, “there is a misperception that ‘fresh is always best,’ leaving consumers confused about what they should feed their families.” Canned foods, in some cases, are actually more nutritious, because of the canning process. According to the USDA National Nutrient Database for Standard Reference, one-half cup of canned tomatoes provides 11.8 milligrams of lycopene, compared with 3.7 milligrams found in one medium fresh, uncooked tomato.

Getting creative

School Nutrition Association President Becky Domokos-Bays says fruits and veggies, overall, are playing a bigger role.

“School cafeterias are using a variety of methods to promote healthier choices to students. Often, the first hurdle is getting students to take that first bite. Through taste tests, free samples and produce-of-the-month promotions, schools are gradually introducing students to unfamiliar produce.”

For breakfast, choosemyplate.gov suggests decorating your child's cereal bowl with a smiley face using sliced bananas, raisins and an orange slice. Tavoletti adds, “Adding fiber-rich foods, and vegetables like spinach or a can of vitamin A-packed pumpkin, can spice things up and provide essential vitamins kids need to grow.”


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Fewer teens pregnant, but it's not because they're having less sex

Teen pregnancy is way down. And a study suggests that the reason is increased, and increasingly effective, use of contraceptives.

From 2007 to 2013, births to teens age 15 to 19 dropped by 36 percent; pregnancies fell by 25 percent from 2007 to 2011, according to federal data (PDF).
But that wasn't because teens were shunning sex. The amount of sex being had by teenagers during that time period was largely unchanged, says the study (PDF), which was published online in the Journal of Adolescent Health. And it wasn't because they were having more abortions. Abortion has been declining among all age groups, and particularly among teenagers.
Rather, the researchers from the Guttmacher Institute and Columbia University found that "improvement in contraceptive use" accounted for the entire reduced risk of pregnancy over the five-year period.
"By definition, if teens are having the same amount of sex but getting pregnant less often, it's because of contraception," said Laura Lindberg, the study's lead author and a Guttmacher researcher.
No single contraceptive method stood out as singularly effective, said the researchers. Instead, they found that teens were using contraceptives more often, combining methods more often, and using more effective methods, such as the birth control pill, IUDs and implants.
Also, the use of any contraceptive at all makes a big difference, said Lindberg. "If a teen uses no method they have an 85 percent chance of getting pregnant [within a year]. Using anything is way more effective than that 85 percent risk."
The downturn in teen births actually dates back to the early 1990s, the authors say, with the rate dropping by 57 percent between 1991 and 2013. The increase in contraceptive use dates to the mid-1990s, with the use of any contraceptive at the most recent sexual encounter rising from 66 to 86 percent from 1995 to 2012.
Valerie Huber, who advocates for programs that urge teens to wait to have sex rather than provide information about contraception, says the study is biased toward birth control.
"As public health experts and policymakers, we must normalize sexual delay more than we normalize teen sex, even with contraception," said a statement from Huber, president and CEO of Ascend, a group that promotes abstinence education. "We believe youth deserve the best opportunity for a healthy future."
More recent policy changes could help drop the teen pregnancy rate even more. One is the Affordable Care Act requirement that boosted insurance coverage for contraception, starting in 2012. The other is the 2014 recommendation from the American Academy of Pediatrics that sexually active teenagers be offered "long-acting reversible contraception" methods such as implants and intrauterine devices, which are highly effective and do not require any additional action, such as remembering to take a daily pill.
But Lindberg noted that just as for older women, teens should be offered a full choice of contraceptives. "In the end, the best method for anyone is one that they are willing and able to use."
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Hepatitis A outbreak sickens 89 people in 7 states, CDC says

(CNN)A continuing outbreak of foodborne hepatitis A linked to frozen strawberries has sickened 89 people in seven states, the Centers for Disease Control and Prevention said Thursday. No deaths have been reported, though 39 patients have been hospitalized.

Health officials confirmed 70 people are ill in Virginia, where the outbreak first appeared, along with additional infections in Maryland (10), New York (1), North Carolina (1), Oregon (1), West Virginia (5) and Wisconsin (1).
Hepatitis A is a viral liver infection that is highly contagious but does not result in chronic infection. Symptoms include yellow eyes or skin, abdominal pain, or pale stools. Exposure to the virus can occur by consuming tainted food or through direct contact with another person who has the infection.
Nearly all of the ill people reported drinking smoothies containing strawberries at Tropical Smoothie Cafés in Maryland, North Carolina, Virginia and West Virginia prior to August 8. Some of the victims traveled to these locations on vacation. The strawberries were imported from Egypt.
Generally, Hepatitis A infections have an incubation period of 15 to 50 days before symptoms appear. Because of this long lag time, new cases have developed many days after August 8, when all contaminated food products were removed from the restaurants and more cases are to be expected.
Anyone who consumed a smoothie after August 8 is not thought to be at risk for hepatitis A and available data does not indicate a continued risk at these restaurants, the CDC stated. Tropical Smoothie Café reported switching to another supplier for all restaurants nationwide.
According to the CDC, there are between 1,700 and 2,800 cases of the highly contagious virus each year in the United States. The majority of children who become infected with hepatitis A show no signs of illness, though more than 80% of adults will experience symptoms. Once recovered from their illnesses, patients are protected against reinfection for life.
Along with several states and the Food and Drug Administration, the CDC continues to investigate cases of hepatitis A related to this outbreak.
A hepatitis A vaccine became available in 1995, resulting in a 95% decline in infections, according to the CDC. Taken shortly after exposure, the vaccine or medicine can be helpful to anyone fearing they've come in contact with the virus.
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Exercise can cancel out the booze, says study

(CNN)You might want to chase that next beer with a little exercise. Exercising the recommended amount "cancels out" the higher risk of cancer death brought about by drinking, a new study revealed. Similarly, physical activity lessened any greater risk of death resulting from any cause due to alcohol.

With its "very high standing" in Western culture, "alcohol will continue to be abused despite the damage it causes to the health of individuals and society in general," said Dr. Emmanuel Stamatakis, senior author of the study, which appeared today in the British Journal of Sports Medicine, and an associate professor at the University of Sydney's medical school. Yet, policies to regulate consumption have never worked well, explained Stamatakis. Since people continue to drink, this realistic researcher and his colleagues decided to see whether the harms of drinking might be offset by the benefits of exercising.

Observation over time

Stamatakis and his colleagues gathered data from health surveys conducted in England and Scotland. Then the researchers grouped the study participants -- 36,370 people, all 40 years of age or older -- into three categories: people who are not very active, those who do a moderate amount of exercising, and those who do the most. Next, the research team looked at alcohol use among the participants.
Calculating 5,735 total deaths over an average follow-up period of nearly 10 years per person, and crunching the numbers, the researchers discovered that compared with lifelong abstinence from alcohol, drinking at hazardous levels was linked to a heightened risk of death from all causes. Hazardous drinking is 8 to 20 US standard drinks for women and 21 to 49 for men, as defined by the researchers.
And, the more alcohol units drunk each week, the greater the risk of death from cancer -- even when a person drank less than the recommended maximum per week. The recommended weekly maximum, as defined, is 8 standard drinks for women and 12 for men.
However, all the numbers changed when Stamatakis and his colleagues factored exercise into their equations.
Specifically, they looked at the impact of the recommended amount of weekly exercise for adults, which is 150 minutes of moderate aerobic activity. That includes brisk walking, swimming and mowing the lawn, according to the US Department of Health and Human Services. HHS also advises strength training for all major muscle groups at least twice a week.
Exercising the recommended amount "appeared to wipe off completely" the inflated risk of cancer death resulting from alcohol, said Stamatakis. Similar physical activity also offset the increased risk of all-cause mortality linked to drinking. Exercising more provided slightly better results.
One thing exercise did not moderate, though, was death risk among those who drank at harmful levels --- "over 20 US standard drinks per week for women and over 28 US standard drinks for men," said Stamatakis.
The results also showed that occasional drinking -- drinking alcohol sometimes but not every week -- was associated with a reduced risk of death from cardiovascular disease among physically active people.
"I would have expected that the moderating effect of physical activity would be more pronounced for cardiovascular disease than for cancer mortality risk," noted Stamatakis.
Because it is an observational study, the results only "suggest a relationship" between exercise, drinking and health benefits, said Michael Hyek, senior director of OhioHealth's McConnell Heart Health Center. The researchers relied on self-reported accounts of lifestyle factors, which may or may not be reliable, and they didn't study eating habits or medication use or other factors that might play a role in how exercise plays into health when drinking is involved, noted Hyek, who was not involved in the research.
Still, Stamatakis believes his study gives "yet another reason" to promote physical activity and make the environment more conducive to physical activity and generally empower people to sit less. "How many more reasons do we need for physical activity to be taken seriously?" he asked.
With this, Hyek has no argument. The benefits of moderate intensity exercise include stress reduction, the prevention, control and reversal of diabetes, and a positive impact on blood pressure, body weight and depression, he explained.
"I know very few chronic medical conditions that exercise will not have a positive impact on," said Hyek. "It's a good thing regardless of what your circumstances are."
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F.D.A. Bans Sale of Many Antibacterial Soaps, Saying Risks Outweigh Benefits

WASHINGTON — The Food and Drug Administration banned the sale of soaps containing certain antibacterial chemicals on Friday, saying industry had failed to prove they were safe to use over the long term or more effective than using ordinary soap and water.

In all the F.D.A. took action against 19 different chemicals and has given industry a year to take them out of their products. About 40 percent of soaps — including liquid hand soap and bar soap – contain the chemicals. Triclosan, mostly used in liquid soap, and triclocarban, in bar soaps, are by far the most common.

The rule applies only to consumer hand washes and soaps. Other products may still contain the chemicals. At least one toothpaste, Colgate Total, still does, but the F.D.A. says its maker proved that the benefits of using it — reducing plaque and gum disease — outweigh the risks.

The agency is also studying the safety and efficacy of hand sanitizers and wipes, and has asked companies for data on three active ingredients — alcohol (ethanol or ethyl alcohol), isopropyl alcohol and benzalkonium chloride — before issuing a final rule on them.

Public health experts applauded the rule, which came after years of mounting concerns that the antibacterial chemicals that go into everyday products are doing more harm than good. Experts have pushed the agency to regulate antimicrobial chemicals, warning that they risk scrambling hormones in children and promoting drug-resistant infections.

“It has boggled my mind why we were clinging to these compounds, and now that they are gone I feel liberated,” said Rolf Halden, a scientist at the Biodesign Institute at Arizona State University, who has been tracking the issue for years. “They had absolutely no benefit but we kept them buzzing around us everywhere. They are in breast milk, in urine, in blood, in babies just born, in dust, in water.”

The agency first proposed the rule in 2013, when it told companies that unless they could prove that chemicals like triclosan and triclocarban did more good than harm, they would have to remove the products that contained them from the market. On Friday, the agency said that it was not convinced.

The F.D.A. has given industry more time to prove that an additional three chemicals are safe and effective — benzalkonium chloride, benzethonium chloride and chloroxylenol. Products with those chemicals can stay on the market for now.

The American Cleaning Institute, a trade group, opposed the rule, saying the agency “has in its hands data that shows the safety and effectiveness of antibacterial soaps.” The group said manufacturers were continuing to work to provide even more science and research “to fill data gaps identified by the F.D.A.”

But some of the largest companies have already started removing the chemicals, in part a reaction to rising consumer concerns. Both Johnson & Johnson and Procter & Gamble announced their intention to phase out the chemicals in their products before the rule was made final, said Dr. Theresa Michele, the director of the division of nonprescription drug products at the F.D.A.’s Center for Drug Evaluation and Research.

Studies in animals have shown that triclosan and triclocarban can disrupt the normal development of the reproductive system and metabolism, and health experts warn that their effects could be the same in humans. The chemicals were originally used by surgeons to wash their hands before operations, and their use exploded in recent years as manufacturers added them to a variety of products, including mouthwash, laundry detergent, fabrics and baby pacifiers. The Centers for Disease Control and Prevention found the chemicals in the urine of three-quarters of Americans.

Dr. Halden began publishing findings on what appeared to be risks of triclocarban in 2004. He said it is an older chemical, part of the family of organochlorines, like DDT and hexachlorophene, some of which were eventually banned. Newer chemicals are much lighter on the environment, he said, but triclocarban takes a very long time to disappear. In one study in New York City, for example, his team found traces of it that dated back to the 1960s.

“It was still sitting there in Jamaica Bay near J.F.K. Airport,” he said. “This stuff makes no sense.”


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A Lobbyist Wrote the Bill. Will the Tobacco Industry Win Its E-Cigarette Fight?

WASHINGTON — The e-cigarette and cigar industries have enlisted high-profile lobbyists and influential congressional allies in an attempt to stop the Food and Drug Administration from retroactively examining their products for public health risks or banning them from the market.

The campaign targets a broad new rule that extends F.D.A. jurisdiction to include cigars, e-cigarettes and pipe and hookah tobacco.

The bipartisan effort has featured a former senator who did not register as a lobbyist before going to work for the cigar companies and a former Obama administration official, now a private consultant, who is trying to undo his earlier work reviewing the rule. In addition, one member of Congress introduced industry-written legislation without changing a word of it.

The battle shows how, nearly two decades after the $200 billion settlement between tobacco companies and state attorneys general to compensate the public for health consequences of smoking, the industry still wields extraordinary clout in Washington.

With its army of more than 75 lobbyists, tobacco-aligned companies have argued that the F.D.A.’s so-called Deeming Rule could hurt public health by forcing a large share of e-cigarette companies out of business.



Keith Glenna, left, and Trevor Heidenreich worked on the production line at Johnson Creek Enterprises in Hartland, Wis., last month. The company makes fluid used in e-cigarettes. Credit Lauren Justice for The New York Times

“The F.D.A. has blatantly ignored evidence that our products improve people’s lives,” said Christian Berkey, chief executive of Johnson Creek Enterprises, one of the first companies to sell the e-liquid ingredient used in e-cigarettes and vaping products.

F.D.A. officials acknowledge that e-cigarettes, made out of tobacco-derived nicotine, are potentially less harmful than cigarettes. But they insist they must examine whether the electronic cigarettes or the liquid nicotine juices might contain toxic chemicals like diethylene glycol, an ingredient also used in antifreeze, or candy-like flavors contributing to the surge in the numbers of teenagers using e-cigarettes. They also want to examine the safety of the e-cig devices themselves after reports of battery-related burns.

“In the absence of science-based regulation of all tobacco products, the marketplace has been the wild, wild West,” said Mitch Zeller, the director of the F.D.A.’s Center for Tobacco Products, which is in charge of enforcing the new rule. “Companies were free to introduce any product they wanted, make any claim they wanted, and that is how we wound up with a 900 percent increase in high schoolers using e-cigarettes and as well as all these reports of exploding e-cigarette batteries and products that have caused burns and fires and disfigurement.”

The lobbying effort has been led by the Altria Group, the nation’s largest tobacco company, which has a growing e-cigarette unit.

Documents obtained by The New York Times show that Altria last year distributed draft legislation on Capitol Hill that would eliminate the new requirement that most e-cigarettes already on sale in the United States be evaluated retroactively to determine if they are “appropriate for the protection of public health.”

The proposal was endorsed by the R.J. Reynolds Tobacco Company, which has its own e-cigarette unit, as well as the National Tobacco Company, a major seller of loose tobacco, and trade associations representing the cigar industry and convenience stores, the documents show.

Altria delivered its proposal, entitled “F.D.A. Deeming Clarification Act of 2015,” to Representative Tom Cole of Oklahoma in April 2015, the documents show, even before the F.D.A. rule became final.

Just two weeks later, Mr. Cole, a Republican, introduced the bill — with the title and 245-word text pulled verbatim from the industry’s draft.

“Yes, we have shared our views with many policy makers, including Congressman Cole’s office,” David Sutton, a spokesman for Altria, said in a written statement, after being presented with a copy of its “legislative language” draft and Mr. Cole’s resulting bill, which has 71 co-sponsors and is still pending in the House.

Separately, former Senator Mary Landrieu, Democrat of Louisiana, spent part of her first year after losing re-election pressing officials from the White House, State Department and F.D.A. on behalf of the cigar industry — even though records show she had not registered as a lobbyist as required by federal law, which Ms. Landrieu said was an oversight.

“This is my fault,” she said. “I’m calling my lawyer now to get it corrected.”

The electronic vapor industry — representing smaller companies that sell e-cigarettes that can be refilled with vapor juice — also has a lobbying contingent, buttressed by a highly motivated community of consumers and vape shops.

Mr. Cole, and Representative Sanford D. Bishop Jr., Democrat of Georgia, who co-sponsored one of the tobacco-related measures originally drafted by Altria, said that the rule would bankrupt small businesses and curb the availability of e-cigarette options, which some use as a way to quit smoking.

“I don’t like regulating in the rearview mirror,” Mr. Cole said in an interview.

Mr. Bishop and Mr. Cole are also two of the top House recipients of tobacco industry campaign donations, with Mr. Bishop receiving $13,000 from Altria this election cycle and a total of at least $60,000 from the industry since 2004.

Continue reading the main story

Representative Nita M. Lowey of New York, the ranking Democrat on the House Appropriations Committee, said it was embarrassing that more than 70 lawmakers had signed on as co-sponsors of legislation that lobbyists from Altria and other industry groups originally wrote.

“For Congress to consider going backward in how we regulate the public health hazard is simply mind-boggling,” she said. “It wasn’t that long ago that tobacco companies were telling the public that cigarettes were not addictive and denying clear evidence that they caused cancer.”



Mr. Cole speaking with reporters last year. Credit Tom Williams/CQ Roll Call, via Associated Press

Matthew L. Myers, president of the Campaign for Tobacco Free Kids, who helped negotiate the 1998 tobacco settlement, said: “It is worse than spoiled kids who don’t get their way. It is bullies that don’t get their way and who are holding public health hostage.”

Industry executives and their allies on Capitol Hill dismiss such criticism, noting that they support provisions intended to prevent youths from buying and using e-cigarettes or cigars.

“The argument that it would make it more accessible to children is fallacious,” Mr. Bishop said.

The cigar industry lobbying pitch has gained the most traction in Congress.

Arguing that premium cigars are more of a recreational product with fewer health risks than cigarettes, the industry has been separately pushing members of Congress to enact legislation that would broadly exempt “premium cigars” from the new F.D.A. oversight. A bill to do so — also written in part by industry lobbyists — was introduced by Senator Bill Nelson, Democrat of Florida. It has 20 co-sponsors, while an identical bill in the House has another 165 co-sponsors.

The industry lobbyists, in addition to Ms. Landrieu, include Paul DiNino, a former finance director of the Democratic National Committee and onetime senior aide to Senator Harry Reid of Nevada, the Democratic leader. Mr. DiNino is assigned to enlist prominent Senate Democrats.

Mr. Reid, records show, contacted the White House on the industry’s behalf, with his spokeswoman explaining that cigar-oriented events are important to Las Vegas.

To target the House, the cigar industry hired former Representative James T. Walsh, Republican of New York, a former House Appropriations Committee member, who has implored lawmakers and their staffs to back the exemption for cigars.

Mr. Walsh and his lobbying partners from the firm K & L Gates drafted language that was inserted into a House Appropriations bill approved by the full committee in April that defines an exemption for a premium cigar and that would prohibit the F.D.A. from spending money in the 2017 fiscal year on enforcement provisions.

“My fingers are crossed,” Mr. Walsh said, about the prospects for getting the exemption.

Another critical assist came from Andrew Perraut, who until 2014 served as a desk officer at the Office of Management and Budget division that reviews major federal regulations, including the F.D.A.’s tobacco rule.

White House records show that he helped represent the Obama administration at more than a dozen meetings with outside parties, mostly pressing the government to ease the rule, before he was hired by a cigar-industry trade organization and by NJoy, a manufacturer of e-cigarettes.



Former Senator Mary Landrieu, Democrat of Louisiana, before she left office in December 2014. She spent her first year out of office pressing government officials on behalf of the cigar industry. Credit J. Scott Applewhite/Associated Press

Within less than a year, records show, Mr. Perraut was back at the Office of Management and Budget on the other side of the table.

Because Mr. Perraut was not a senior official and the regulation affects numerous industry players, federal revolving door rules did not apply, an agency spokeswoman said. Mr. Perraut said he was simply trying to help stop a “train wreck” that will be caused by the F.D.A. overreach.

Richard W. Painter, who served as the White House chief ethics lawyer during the George W. Bush administration, said Mr. Perraut’s quick turnabout violated the spirit of President Obama’s ethics pledge, intended to prevent former aides from lobbying the executive branch.

“Even if it is not prohibited, it is just not appropriate,” he said.

Interest groups attempting to shape the debate also have financial patrons with a clear stake in the outcome.

Americans for Tax Reform, a conservative group, and National Center for Public Policy Research, a pro-free market think tank, have come out against the F.D.A. rules, even as they receive funding from the e-cigarette and tobacco industry, including Altria and R.J. Reynolds, records show.

Jeff Stier, a scholar at the National Center for Public Policy Research, and Grover Norquist, from Americans for Tax Reform, both said they opposed the F.D.A. rule as bad policy.

The American Lung Association, which has spoken out in defense of the rule, accepts contributions from pharmaceutical companies like Pfizer and GlaxoSmithKline, which sell smoking-cessation products that could lose sales if e-cigarettes continue to gain market share, Mr. Stier added.

Erika Sward, an association lobbyist, while acknowledging the money her nonprofit group has received from companies that sell smoking-cessation treatments, said the criticism of her group is a diversionary tactic.

“For so many years the focus in fighting tobacco wars has been on the cigarette industry,” she said. “With historic declines in cigarette use, which is wonderful, what we are seeing is a surge in use in other tobacco products. And their push on Capitol Hill reflects this new clout.”

Source:NY Times.com

Source:NY Times.com

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10 Secrets to Brighter, Whiter Teeth

Want Brighter, Whiter Teeth?

Have your pearly whites lost their luster because of dingy gray or yellow stains? Stained teeth can occur as we age, but some common foods, drinks, and even mouthwashes can stain teeth. Do-it-yourself remedies can help whiten teeth, and avoiding substances that stain teeth can stop further discoloration. Use these secrets to whiter teeth to restore your bright smile.

Do-It-Yourself Teeth Whitening

You may be able to get rid of superficial stains by yourself. A number of at-home tooth-whitening products -- kits, strips, toothpastes, and rinses-- may lighten stains. There are even some old-fashioned remedies you can try. Tooth-whitening products available on drugstore shelves use mild bleach to brighten yellow teeth. Toothpastes use abrasives and chemicals to remove surface stains. For deep stains, you may need a dentist's help.

Tooth-Whitening Kits

A home tooth-whitening kit contains carbamide peroxide, a bleach that can remove both deep and surface stains and actually changes your natural tooth color. If you have coffee-stained teeth, a tooth-bleaching kit can help. With some kits, you apply a peroxide-based gel (with a small brush) to the surface of your teeth. In other kits, the gel is in a tray that molds to the teeth. The tray must be worn daily (for 30 to 45 minutes) for a week or more.

Home Whitening Strips

Tooth-whitening strips will help get rid of tooth stains. These strips are very thin, virtually invisible, and are coated with a peroxide-based whitening gel. You wear them a few minutes daily for a week or more. Results are visible in just a few days, and last at least a year. The results with strips are not as dramatic as with whitening kits, but the strips are easy to use and pretty much foolproof.

Home Whitening Strips

Tooth-whitening strips will help get rid of tooth stains. These strips are very thin, virtually invisible, and are coated with a peroxide-based whitening gel. You wear them a few minutes daily for a week or more. Results are visible in just a few days, and last at least a year. The results with strips are not as dramatic as with whitening kits, but the strips are easy to use and pretty much foolproof.

Home Remedies for Whiter Teeth

Some people still prefer the age-old home remedy of baking soda and a toothbrush to gently whiten teeth at home. Also, some foods such as celery, apples, pears, and carrots trigger lots of saliva, which helps wash away food debris on your teeth. Chewing sugarless gum is a tooth-cleansing action and also triggers saliva. A bonus from all that saliva: It neutralizes the acid that causes tooth decay. With teeth, more saliva is better all around.

Tooth Whitening and Dental Work

Approach tooth whitening with caution if you have lots of dental veneers, bonding, fillings, crowns, and bridges. Bleach will not lighten these manufactured teeth -- meaning they will stand out among your newly whitened natural teeth. In order to match your whiter teeth, you may need to investigate new dental work, including veneers or bonding.

Preventing Teeth Stains

As we age, the outer layer of tooth enamel wears away. The underlying layer, called dentin, is yellower. That's why it's important to try to avoid staining teeth in the first place, especially after whitening. If you take care with foods and drinks that discolor teeth, the results of whitening may last up to one year. Whitening teeth too often could make them look translucent and blue, so you'll want to maintain your new smile.

To Keep Teeth White, Don't Light Up

Not only is it bad for your health, smoking is one of the worst offenders when it comes to staining teeth. Tobacco causes brown stains that penetrate the grooves and pits of tooth enamel. Tobacco stains can be hard to remove by brushing alone. The longer you smoke, the more entrenched the stains become. Smoking also causes bad breath and gingivitis (gum disease), and increases the risk of most types of cancer.



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How to pay less for your prescription drugs, legally

(CNN)Even a not-so-pricey drug can add up to a nightmare expense when it needs to be refilled every month.

The $600 price tag on EpiPens, $1,000-per-pill hepatitis C drug Sovaldi and the $750-per-pill price increase on the AIDS drug Daraprim have spurred outrage over pharmaceutical drug costs. To get prescription medicines for less, many people try these six tricks.

Free samples

Some patients request free samples from their doctors to help reduce drug costs, according to the Food and Drug Administration website. From the physician's perspective, this is an easy way to ease a patient's concerns. After all, pharmaceutical companies give free samples of brand-name drugs -- usually the new, expensive ones -- to doctors as a promotional tool, so those doctors usually have no problem passing them on to their patients.
However, free samples are intended to allow patients to evaluate the side effects of a new drug for a couple of weeks before actually buying it, according to the FDA. So samples, by definition, provide only a temporary fix.

Generic drugs

Many people ask either their doctors or their pharmacists to swap out a brand prescription for a cheaper generic alternative. Generics are variations on the expensive name-brand drugs that have lost patent protection.
"Whereas the average cost of a name-brand prescription was $268 in 2011, it was only about $33 for a generic drug," noted the National Center for Policy Analysis (PDF), a nonprofit, nonpartisan public policy research organization.
Naturally, many people make good use of these lower prices. According Holly Campbell, a spokeswoman for PhRMA, an industry representative for drug makers, "generic utilization rates are nearly 90%."
Getting the best price on a drug may require an extra step beyond simply asking. Often, pharmacies offer discounts on generics for those who buy in bulk, such as when you purchase a three-month supply of your medication all at once. You may also need to explain any special circumstances, such as being a student or a senior, and it helps to simply request the lowest price possible.
The major chain pharmacies also offer discount generic-drug programs, which you usually pay a small fee to join. You also need to provide them with personal information (that may be sold to marketing companies). If you have a chronic illness and know that many refills are down the road, the fee and divulged data may be worth it to you.
Though generic drugs may appear to be more cost-efficient, they may not be as low-cost as consumers anticipate. For instance, the National Center for Policy Analysis found that half of all generic drugs increased in price over a one-year period ending in July 2014, with some rising in price dramatically: Eighteen percent of generic drugs rose in price by 25% or more, while some increased by more than 100%.
Another potential downside with generics is a slight difference in formulation, which may equal a big difference in side effects. Though the brand name is easy to tolerate, you might get a headache, say, when taking the generic. However, in some cases, the reverse is true, and some patients tolerate the generic better than the brand-name.

Prescription drug coupons

These coupons market discounts and rebates on out-of-pocket expenses or co-pays directly to the consumer. They are available from various sources, including doctors' offices, marketing pamphlets and online. Typically, consumers sign up online for virtual drug discount cards and then do a web search and print out an eCoupon to be used at a pharmacy.
Non-manufacturer websites actively promote eCoupons and drug discount card services using Facebook promotional pages, Twitter and even YouTube videos.
The free app and website GoodRx allows consumers to search, shop for and download coupons from their own cell phone or computer. Basically, you print out a card or coupon, go to the pharmacy and present it for either a reduced cost or reimbursement.
What may be misleading about coupons is that you may end up paying more or being reimbursed less than you expected, said Timothy K. Mackey, director of the Global Health Policy Institute at the University of California, San Diego School of Medicine.
As Mackey explained, zero-pay coupons may seem generous on the part of pharmaceutical companies, but ultimately, insurers end up paying what you do not. To offset costs, insurers eventually change their coverage limits or raise the co-pay on certain drugs in order to pass the costs back to consumers.
Even more, whenever you apply online for a discount card or coupon, what is written into the terms and conditions is data collection: The pharmaceutical company is gathering marketing data on what you think and your demographics, which can be used or sold.
While most of us perceive these subsidized consumer copays as a discount, they're really a whole ecosystem of brand recognition, brand loyalty and data generation for marketing, said Mackey. Consumers need to be careful when using coupons, keeping abreast of any changes in terms and prices. Though at first a coupon supplies a discount, a generic may come on market some time later, so you may continue buying the discounted brand when a much cheaper generic is available.
A recent behind-the-curtain program was launched by Physicians Interactive: eCoupon automatically searches for and delivers any applicable prescription drug coupons for you directly to your pharmacy. That may sound wonderful, but according to Mackey, it's just another direct-to-consumer advertising scheme.
Essentially, the system checks coupon availability for any medication prescribed by your doctor, checks your personal eligibility and then automatically sends a coupon for you directly to your pharmacy. Leveraging and linking your electronic health records to prescribing systems, this smart system "target markets" you at the point of sale.

Patient assistance programs

Commonly referred to as PAPs, these pharmaceutical drug company programs offer free or reduced-cost medications to low-income, underinsured or uninsured individuals.
Because each medication may have its own PAP and eligibility requirements, signing up for these programs is "onerous," according to Mackey.
"Every company has its own eligibility criteria for PAPs, and, in most cases, US citizenship and some proof of income, such as tax records or a record of social security benefits, are required," according to the FDA. PAP forms also require a doctor's signature.
PatientAssistance.com, a nonprofit organization founded in 2008, provides consumers with a searchable database of thousands of PAPs, allowing you to browse by brand name, generic drug name or pharmaceutical company name. There's also the Partnership for Prescription Assistance, a website that provides access to more than 275 public and private PAPs, including more than 150 programs offered by drug companies. It also shows people how to contact Medicare and other government programs.
"We in the research community don't see them as terribly effective, but we don't have data on this," Mackey added. "We don't know the impact they have."

Comparison shopping

Prescription drug prices are not set in stone and can vary greatly among pharmacies and retail stores. The indie drugstore may offer a better price than the big chain. Prices can even vary between locations of the same chain.
To help you find the best price, there are a variety of websites and apps. One website, BlinkHealth, offers online prices with the security of brick-and-mortar oversight; with this site, you can search for drugs and pay cut-rate prices online and then pick up your prescription at a nearby pharmacy.
LowestMed, a freebie, helps you compare prescription drug prices at local stores. Type in the name of your drug, and this app, which claims it will find discounts as high as 85%, will compare prices in your area. Prescription Saver, another free app, performs nearly the same service, with the added benefit of giving directions to the nearest cost-saving pharmacy.
The OTC Plus, designed by board-certified doctors, is essentially a matchmaking app joining an over-the-counter medication to a list of your particular symptoms. This free app also shows you how to read medicine labels and sends coupons to your cell phone.
Finally, the big-time players such as Walgreens, CVS and Rite Aid each have free apps for customers. These help customers fill and refill prescriptions and show weekly discounts on pharmaceutical prices.

Online pharmacies

"In January 1999, Soma.com became the first pharmacy to operate via the Internet and sell medicines directly to the consumer," Mackey noted in a paper published this year. Today, an estimated 35,000 online pharmacies operate globally.
Digital drugstores may work to your benefit ... or deliver death directly to your door via UPS.
"If you go to online pharmacies, there's a host of drugs they sell," said Mackey, who noted among the plethora of available options are "products you shouldn't be able to get," such as drugs in critical shortage, vaccines and controlled substances.
Make no mistake that excellent online pharmacies exist, selling FDA-approved medications to people with prescriptions. To verify a website, the FDA recommends looking for the National Association of Boards of Pharmacy's Verified Internet Pharmacy Practice Sites Seal and then visiting the website to confirm.
Mackey suggests Legitscript, an internet security company that uses computational methods to determine whether a particular site is complying with laws and regulations.
In the virtual world, you cannot trust that an online pharmacy with an address in Saskatchewan, Canada, is real. You need to check a pharmacy's legitimacy; otherwise, you may unknowingly purchase counterfeit drugs or real drugs that have expired.
"You're taking a risk," said Mackey, "Expired or counterfeit, the drug's not going to be effective when you use it." For a drug intended to be life-saving -- such as an EpiPen -- unless it's the real deal, you could die.
"The reason online pharmacies exist is because there's a demand," Mackey said.
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Sleep apnea's CPAP machine doesn't cut heart risks, study says

(CNN)A new study might tempt some sleep apnea patients to unplug their machines. Continuous positive airway pressure, or CPAP, does not reduce the risk of heart attacks or other cardiovascular emergencies in sleep apnea patients with heart disease, the researchers say.

Obstructive sleep apnea causes breathing pauses, sometimes 30 times or more each hour, during sleep. Men are twice as likely to have it, according to the Mayo Clinic. "Since it reduces the brief awakenings caused by the sleep-disordered breathing, individuals have less fragmented sleep and consequently feel more refreshed upon awaking and more alert throughout the day," explained Dr. Clete Kushida, a professor of psychiatry and behavioral sciences at Stanford School of Medicine who did not contribute to the current study.
A common treatment for sleep apnea, CPAP therapy includes a small machine that supplies a sleeper with constant and steady air pressure through a mask or nose piece.
Despite the disappointing study results, CPAP is still "worthwhile," said Dr. Doug McEvoy, the principal investigator. He explained in a news release that patients using CPAP "are much less sleepy and depressed, and their productivity and quality of life is enhanced." The New England Journal of Medicine published the study results on Sunday.

Head-to-head comparison

Up to 60% of patients with cardiovascular disease also suffer from obstructive sleep apnea. Previous small-scale studies have showed that some CPAP patients are less likely to suffer a cardiovascular complication, and other studies have showed that nightly CPAP use lowers blood pressure and improves blood flow in patients.
One 2005 study including hundreds of men found three times as many fatal heart attacks and strokes over a 10-year period among those who did not use CPAP compared with those who did. Notably, only some of the participants had existing heart problems going into the study.
To test how effective CPAP was in reducing cardiovascular events among patients with cardiovascular disease, McEvoy and his colleagues designed the Sleep Apnea Cardiovascular Endpoints (SAVE) study.
An "event," as defined by the researchers, would include a heart attack, stroke, mini-stroke, hospitalization for heart failure or death from any cardiovascular cause.
The team recruited 2,717 patients with moderate to severe obstructive sleep apnea from 89 medical centers in seven countries. Most of the participants were older (about 61 years old), overweight, snorers and male; all had coronary artery or cerebrovascular disease. McEvoy, a professor at Flinders University in Adelaide, Australia, and his team randomly divided patients into two groups: One group received usual care alone, and the other received usual care plus CPAP.
"Usual care" consisted of advice on healthy sleep habits and lifestyle changes along with cardiovascular risk management.
The researchers discovered that 42% of the patients assigned to CPAP used the machines for an average of four or more hours each night, though the overall average duration was 3.3 hours per night. Importantly, their sleep apnea severity decreased from 29 breath pauses per hour to four.
However, in terms of cardiovascular emergencies, the patients using CPAP in addition to following a usual care plan showed no differences from the usual care-only patients after more than three years, on average. Specifically, 17% of patients in the CPAP group and 15.4% in the usual-care group had some kind of serious heart event.
"It's not clear why CPAP treatment did not improve cardiovascular outcomes," McEvoy said.

Some wins

An editorial accompanying the study suggested that since McEvoy and his colleagues recruited participants from a variety of geographic locations, limited resources in some places may have reduced some patients' ability to stick with the CPAP program.
Still, there were clear wins: CPAP significantly reduced snoring and daytime sleepiness and improved quality of life and mood. In fact, work attendance improved among patients using CPAP.
Past studies have shown that obstructive sleep apnea can negatively impact attention, memory, learning and overall intellectual function. A new, unrelated review of recent research found that CPAP improved verbal memory after just two to three months of use, while using CPAP for six hours a night offered even more intellectual function benefits. Those included included improvements in attention and visual memory, as well.
"The evidence is strong," said Dr. Charles Davies, lead author of the review and a neurologist at Carle Neuroscience Institute who specializes in sleep medicine. Davies looked at scientific studies performed over the past few years, which used the latest and most validated tests. In one of the studies, the researchers compared CPAP with sham CPAP, in which participants used a machine that did not provide enough pressure to be effective, and found improvements in intellectual abilities after just two months of CPAP use for about four hours a night. In particular, participants sharpened their abilities to quickly shift their focus and concentrate.
Though the current study showed CPAP as ineffective with heart health risks, it still provides many benefits, including an uptick in mood and, some patients would say, a little white noise that can be helpful for many sleepers. Check with your doctor before unplugging.
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Simple Rules for Healthy Eating

Over the past few months, I’ve written a number of times on how nutrition recommendations are seldom supported by science. I’ve argued that what many people are telling you may be inaccurate. In response, many of you have asked me what nutrition recommendations should say.

It’s much easier, unfortunately, to tell you what not to do. But here at The Upshot, we don’t avoid the hard questions. So I’m going to put myself on the line. Below are the general rules I live by. They’re the ones I share with patients, with friends and with family. They’re the ones I support as a pediatrician and a health services researcher. But I acknowledge up front that they may apply only to healthy people without metabolic disorders (me, for instance, as far as I know).

These suggestions are also not supported by the scientific weight of rigorous randomized controlled trials, because little in nutrition is. I’ve inserted links to back them up with the available evidence. They are not “laws” and should not be treated as such. No specific nutrients will be demonized, and none will be held up as miracles. But these recommendations make sense to me, and they’ve helped me immensely.

Full disclosure: I did not invent most of these. I’ve developed them from reading the work of others, including what may be the most impressive “official” nutritional guidelines, those of Brazil, as well as from earlier suggestions from readers, as in this great NYT interactive graphic. It captures readers’ responses to food rules by Michael Pollan. He is, of course, the promulgator of the well-known advice: “Eat food. Not too much. Mostly plants.”

1. Get as much of your nutrition as possible from a variety of completely unprocessed foods. These include fruits and vegetables. But they also include meat, fish, poultry and eggs that haven’t been processed. In other words, when buying food at the market, focus on things that have not been been cooked, prepared or altered in any way. Brown rice over white rice. Whole grains over refined grains. You’re far better off eating two apples than drinking the same 27 grams of sugar in an eight-ounce glass of apple juice.

1b. Eat lightly processed foods less often. You’re not going to make everything yourself. Pasta, for instance, is going to be bought already prepared. You’re not going to grind your own flour or extract your own oil. These are meant to be eaten along with unprocessed foods, but try to eat less of them.

1c. Eat heavily processed foods even less often. There’s little high-quality evidence that even the most processed foods are dangerous. But keep your consumption of them to a minimum, because they can make it too easy to stuff in calories. Such foods include bread, chips, cookies and cereals. In epidemiologic studies, heavily processed meats are often associated with worse health outcomes, but that evidence should be taken with a grain of salt (not literally), as I’ve written about before.


2. Eat as much home-cooked food as possible, which should be prepared according to Rule 1. Eating at home allows you to avoid processed ingredients more easily. It allows you full control over what you eat, and allows you to choose the flavors you prefer. You’re much less likely to stuff yourself silly if you eat home-cooked food. I’m not saying this is easy. Behavioral change takes repetition and practice. It also, unfortunately, takes time.

3. Use salt and fats, including butter and oil, as needed in food preparation. Things like salt and fat aren’t the enemy. They are often necessary in the preparation of tasty, satisfying food. The key here is moderation. Use what you need. Seasoning is often what makes vegetables taste good. Don’t be afraid of them, but don’t go crazy with them either.

4. When you do eat out, try to eat at restaurants that follow the same rules. Ideally, you should eat at restaurants that are creating all of their items from completely unprocessed foods. Lots and lots of restaurants do. Follow Rule 1 even while out to dinner. Some processing is going to be fine, but try to keep it to a minimum.

5. Drink mostly water, but some alcohol, coffee and other beverages are fine. As I’ve pointed out before, you can find a study to show that everything either prevents or causes cancer — alcohol and coffee included. But my take is that the preponderance of evidence supports the inclusion of a moderate consumption of most beverages.

6. Treat all beverages with calories in them as you would alcohol. This includes every drink with calories, including milk. They’re fine in moderation, but keep them to a minimum. You can have them because you like them, but you shouldn’t consume them as if you need them.

7. Eat with other people, especially people you care about, as often as possible. This has benefits even outside those of nutrition. It will make you more likely to cook. It will most likely make you eat more slowly. It will also make you happy.

I’ve avoided treating any food like the devil. Many nutrition experts do, and it may turn out they’re right, but at this point I think the jury is still out. I’ve therefore tried not to tell you to avoid anything completely. My experience tells me that total abstinence rarely works, although anecdotes exist to support that practice. I think you’ll find that many other diets and recommendations work under these rules. These are much more flexible and, I hope, reasonable than what some might prescribe.

All of these rules are subtly trying to get you to be more conscious of what you’re eating. It’s far too easy these days to consume more than you think you are, or more than you really need, especially when eating out. I’ve found that it’s impossible to tell any one person how much they should be eating. People have varying requirements, and it’s important for all of them to listen to their bodies to know when they should eat, and when they should stop.

One other thing: Don’t judge what others eat. One of my closest friends has been avoiding carbohydrates for months, and has seen remarkable results. Another was a pescatarian — a person whose only meat dishes are fish — for a year and was very happy with that. I, on the other hand, avoid no food groups in particular.

People are very different. Some may have real problems consuming even the smallest amount of carbohydrates. Others may be intolerant of certain foods because of allergies or sensitivities. It will most likely take a bit of experimentation, on an individual level, to find the actual diet within these recommendations that works for you. But the above rules should allow for a wide variety of foods and for remaining healthy. At least, I hope so.

Source:NY times.com


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Gene Tests Identify Breast Cancer Patients Who Can Skip Chemotherapy, Study Says

When is it safe for a woman with breast cancer to skip chemotherapy?

A new study helps answer that question, based on a test of gene activity in tumors. It found that nearly half of women with early-stage breast cancer who would traditionally receive chemo can avoid it, with little risk of the cancer coming back or spreading in the next five years.

The so-called genomic test measures the activity of genes that control the growth and spread of cancer, and can identify women with a low risk of recurrence and therefore little to gain from chemo.

“More and more evidence is mounting that there is a substantial number of women with breast cancer who will not need chemotherapy to do well,” said Dr. Rachel A. Freedman, a breast cancer oncologist at the Dana-Farber Cancer Institute in Boston. She was not involved in the study.

The researchers estimated that their findings, published Wednesday in The New England Journal of Medicine, would apply to 35,000 to 40,000 women a year in the United States, and 60,000 to 70,000 in Europe. They are patients with early disease who because of tumor size, cancerous lymph nodes and other factors would normally be prescribed chemo.

Genomic tests, which doctors have been using for about 10 years in some breast cancer patients, are part of a growing effort to spare women from chemo and its harsh side effects whenever it is safe to do so. But the decision to forgo a potentially lifesaving treatment is never taken lightly, and doctors have been eager for more data to make sure they are on the right path.

The new study is one of the largest and most rigorous trials of genomic testing, and offers reassurance to doctors and patients that the technology can be trusted to help identify patients who do not need chemo. But an editorial accompanying the report said the study was not the final word, and additional research now underway would provide more clarity. Although women who skipped chemo had low recurrence rates, their rates were slightly higher than those of women who had chemo.

The results of the study will be of most use for cases that have fallen into a gray zone, when the disease is in an early stage but has some anatomical features that suggest it may be aggressive. But the genomic test says it is low risk.

“We all see these patients in our practice all the time,” Dr. Freedman said. “What do you do with that person?”

The study involved women with early cases of the most common type of breast cancer: hormone-sensitive tumors that test negative for a receptor called her2. In the United States, about three quarters of breast cancers are that type.

Early stage in the study referred to Stage 1 or 2, meaning the tumors were generally no bigger than five centimeters and had spread to no more than three lymph nodes. The study was done in Europe, where “early stage” includes somewhat larger tumors than would be included in the United States.

More than half of the breast cancers in the United States are diagnosed at early stages.

The research involved 6,693 women with early-stage breast cancer at 112 hospitals in nine European countries. The study was paid for by grants from governments, drug companies and charitable groups. Agendia, the company that markets MammaPrint, did the testing at no cost.

The women had the usual initial treatments — surgery, hormonal therapy and radiation. Then, researchers determined whether each woman had a high or low risk of recurrence based on genomic testing and on clinical features like tumor size and number of positive lymph nodes. Sometimes, the clinical and genomic risks did not match.

MammaPrint looks at the activity of 70 genes. In a low-risk tumor, 50 genes are turned off and 20 are active, according to Laura J. van ’t Veer, a molecular biologist at the University of California, San Francisco who was an author of the study and a developer of the test. In high-risk cases, 50 genes are on and 20 off.

The researchers were especially interested in the women — about a quarter of those in the study — who seemed to have a high clinical risk but a low genomic risk.

Dr. Fatima Cardoso, an author of the study and a breast oncologist at Champalimaud Clinical Center in Lisbon, said that traditionally, women with early cancer but a high clinical risk were usually given chemotherapy. She said that doctors knew that not all would benefit from it, but gave it to all anyway to err on the side of caution, because they could not identify which women did not really need it.

The main goal of the study was to find out whether women with a high clinical risk but a low genomic risk could safely forgo chemo.

There were 1,550 women with high clinical risk and low genomic risk. They were assigned at random to be treated according to their genomic risk or their clinical risk. So some received chemotherapy, and others did not. Then the researchers watched to see if any had distant spread of the cancer to other organs, which is often fatal.

After five years, among those who did not receive chemotherapy, 94.4 percent had no distant spread. Those who received chemo fared slightly better: 95.9 percent had no distant spread.

“We have to continue to follow these patients and see what happens at 10 years,” Dr. Cardoso said.

But given the small difference so far, the researchers said that it was safe for women with early disease and high clinical risk, but low genomic risk, to skip chemotherapy. The findings, they said, mean that 46 percent of women with early-stage disease who are thought to be at high clinical risk may be able to skip chemo.

An editorial accompanying the article praised the research but sounded a note of caution. The authors, Dr. Clifford A. Hudis and Dr. Maura N. Dickler, from Memorial Sloan Kettering Cancer Center in New York, said that the study was not large enough to be sure that the 1.5-percentage-point difference would hold up statistically.

The editorial also noted that other studies of genomic tests had identified groups of women in whom the five-year recurrence risk was only 1 percent, and asked what level of risk was acceptable. Patients’ attitudes also differ.

Dr. Freedman said some women wanted no part of chemo, even if it offered a significant benefit. But, she added, “others line up at the door for almost no benefit, just so they can have peace of mind.”

Source:NY Times.com

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'The system is broken' and EpiPens are just the tip of the iceberg

Think the EpiPen price hike is scary? That's just the tip of the iceberg

Everyone is mad at Mylan for passing off massive price hikes for its EpiPen allergy treatment, but it’s far from the worst bad guy in the field. Eleven other drugmakers have off-the-charts prices, well beyond what we're seeing with Mylan (which, by the way, just offered some discounts after the firestorm of feedback to the price increase). Each of these drug companies prices are so high they were able to keep 25 cents of every dollar in revenue after paying operating costs. Cha-ching! Remember when Martin Shkreli, as CEO of Turing Pharmaceuticals, orchestrated a 5,000% price hike on the medication used to treat a parasitic disease that affects AIDS patients and pregnant women? He weighed in, too

Souce:USA Today.com

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5 Ways to Cook Cauliflower

Rice it, mash it, roast it, blend it… the opportunities are endless! Learn how to cook cauliflower with these five kitchen techniques. 

how to cook cauliflower-steaks-HelloFresh

Cauliflower is the unsung hero of the vegetable world, often overshadowed by its colorful and more commonly known counterpart: broccoli. However, over the past year or so, this humble vegetable has made a triumphant comeback and asserted its rightful spot in the cabbage family. (And not to brag or anything, but we totally called it back in 2014 when predicting it would become the next kale.)

With a sweet and slightly bitter flavor, cauliflower (aka “cabbage flower”) boasts impressive anticancer, antioxidant, antibiotic, and antiviral characteristics. But its real claim to fame? Versatility.

We put this creamy white vegetable to the test by blending, chopping, mashing, roasting, baking, and grilling it. The results may just surprise you.

How to cook cauliflower:

1. Cauliflower Rice

how to cook cauliflower-rice-HelloFresh

You know those healthy takes on traditional dishes that end up tasting like cardboard and leaving you begging for the original? Well, cauliflower rice is not one of those.

It’s a surprisingly delicious and easy way to sneak more veggies into your diet without sacrificing rice’s beloved texture and consistency.

All you have to do is place cauliflower chunks in a food processor and pulse until broken down into rice-sized grains. Drizzle some oil or butter in a large skillet, stir in the “rice,” and season with salt and pepper. Cover and let cook for six to eight minutes before fluffing with a fork. We love to toss in fresh herbs for a pop of color, but feel free to dress it up however you want – or leave it as is, that works too!

2. Cauliflower Soup

how to cook cauliflower-soup-HelloFresh

Cauliflower combines well with other ingredients, which means it’s the perfect addition to chilled or warm soups.

Although we may be getting ahead of ourselves here with fall flavors, the combination of nutty roasted cauliflower, creamy coconut milk, a touch of coriander, and a kick of cilantro is too good to ignore. And it’s easy, too! Get the recipe for our deliciously earthy soup.

3. Cauliflower Steak

how to cook cauliflower-steak-HelloFresh

Let cauliflower take center stage at your next dinner by whipping up this veggie-centric dish. With a hearty texture, golden sear, and guiltless bite, it gives meat a run for its money.

Cut a whole cauliflower vertically into four steaks. Drizzle with olive oil, season with salt and pepper, and place on a baking sheet. Roast in a preheated oven for 35-40 minutes, flipping once, until tender and golden brown on the edges.

For a burst of flavor, serve the “steak” on a bed of herbed bulgur, top it with creamy Tzatziki, and sprinkle on some crunchy pepitas.

4. Cauliflower Mac and Cheese

how to cook cauliflower-mac-and-cheese-HelloFresh

We know what you’re thinking… comfort food with veggies? Is that even possible?

It absolutely is. Cut cauliflower into bite-sized florets and bake 20-25 minutes until golden brown and tender. Then, toss into a baking dish with pasta, creamy cheese sauce, scallions, and even a bit of pancetta if you’re feeling fancy. The vegetable lends a great flavor to this American classic while contributing a mighty nutritional boost.

5. Cauliflower Mash

how to cook cauliflower-mash-HelloFresh

Cauliflower mash has the same comforting and creamy (read: dreamy) allure as starchy mashed potatoes. The only difference? It won’t sabotage your waistline. In fact, cauliflower is three times less carb-heavy and caloric as potatoes.

To create this winning side dish, bring a large pot of water to a boil with a pinch of salt. Cut the cauliflower into bite-sized florets before adding them to the water. Cook until tender (about 8-10 minutes), drain, and return to the pot. Using a potato masher or a fork, mash the cauliflower in the pot until it’s as smooth as possible. Place over low heat and add butter, milk, and herbs.

We’ve got a feeling you’re going to love pairing cauliflower mash with pork sausage and onion gravy.

You know what cauliflower pairs well with no matter how it’s prepared? Turmeric. Get all the details about this super spice and start cooking! 


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Scallops recalled after hundreds of people contract hepatitis A

(CNN)Sea Port Products Corp is voluntarily recalling a batch of its scallops after at least 206 people became sick with hepatitis A, prompting an investigation by the US Food and Drug Administration and Centers for Disease control and Prevention.

The federal agencies are assisting the Hawaii Department of Health, which reported the cases on August 17.
The cases are linked to raw scallops. Of those who contracted hepatitis A, 51 were hospitalized. All the cases involve adults.
Hepatitis A is a liver disease that can cause severe stomach pains, dark jaundice and fatigue. If someone has a weak immune system it can also cause liver failure and death.
People typically get hepatitis A after eating food that has been contaminated with fecal matter from a person who has the infection. Symptoms can show up in 15 to 50 days.
The scallops were not for sale in stores. They were supplied to restaurants and other commercial groups by Sea Port Products Corp. The company voluntarily recalled the scallops that were distributed to Hawaii, Nevada and California. The FDA is working with the company to make sure the products are pulled off shelves, according to the FDA website.
The scallops were produced on November 23 and 24, 2015.
On August 17 the federal agencies and the Hawaiian Department of Health told Sea Port Products that tests confirmed their product was positive for hepatitis A and that they were the likely source of the outbreak.
The FDA suggests customers who would like to eat scallops in the states where the recall is in effect should ask the restaurant where the scallops come from.
As with any question about food safety, the FDA has an information line: 1-888-SAFEFOOD. It's open Monday through Friday between 10 a.m. and 4 p.m. ET.
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Doctors face medical marijuana knowledge gap

Medical marijuana has been legal in Maine for almost 20 years. But Farmington physician Jean Antonucci says she continues to feel unprepared when counseling sick patients about whether the drug could benefit them.

Will it help my glaucoma? Or my chronic pain? My chemotherapy's making me nauseous, and nothing's helped. Is cannabis the solution? Patients hope Antonucci, 62, can answer those questions. But she said she is still "completely in the dark."
Antonucci doesn't know whether marijuana is the right way to treat an ailment, what amount is an appropriate dose, or whether a patient should smoke it, eat it, rub it through an oil or vaporize it. Like most doctors, she was never trained to have these discussions. And, because the topic still is not usually covered in medical school, seasoned doctors, as well as younger ones, often consider themselves ill-equipped.
Even though she tries to keep up with the scientific literature, Antonucci said, "it's very difficult to support patients but not know what you're saying."
As the number of states allowing medical marijuana grows -- the total has reached 25 plus the District of Columbia -- some are working to address this knowledge gap with physician training programs. States are beginning to require doctors to take continuing medical education courses that detail how marijuana interacts with the nervous system and other medications, as well as its side effects.
Though laws vary, they have common themes. They usually set up a process by which states establish marijuana dispensaries, where patients with qualifying medical conditions can obtain the drug. The conditions are specified on a state-approved list. And the role of doctors is often to certify that patients have one of those ailments. But many say that, without knowing cannabis' health effects, even writing a certification makes them uncomfortable.
"We just don't know what we don't know. And that's a concern," said Wanda Filer, president of the American Academy of Family Physicians and a practicing doctor in Pennsylvania.
This medical uncertainty is complicated by confusion over how to navigate often contradictory laws. While states generally involve physicians in the process by which patients obtain marijuana, national drug policies have traditionally had a chilling effect on these conversations.
The Federation of State Medical Boards has tried to add clarity. In an Aug. 9 JAMA editorial, leaders noted that federal law technically prohibits prescribing marijuana, and tasks states that allow it for medical use to "implement strong and effective ... enforcement systems to address any threat those laws could pose to public safety, public health, and other interests." If state regulation is deemed insufficient, the federal government can step in.
That's why many doctors say they feel caught in the middle, not completely sure of where the line is now drawn between legal medical practice and what could get them in trouble.
In New York (PDF), which legalized marijuana for medicinal purposes in 2014, the state health department rolled out a certification program last October. (The state's medical marijuana program itself launched in January 2016.) The course, which lasts about four hours and costs $249, is part of a larger physician registration process. So far, the state estimates 656 physicians have completed the required steps. Other states have contacted New York's Department of Health to learn how the training works.
Pennsylvania and Ohio are also developing similar programs. Meanwhile in Massachusetts, doctors who wish to participate in the state medical marijuana program are required to take courses approved by the American Medical Association. Maryland doesn't require training but encourages it through its Medical Cannabis Commission website, a policy also followed in some other states.
Physicians appear to welcome such direction. A 2013 study in Colorado (PDF), for instance, found more than 80 percent of family doctors thought physicians needed medical training before recommending marijuana.
But some advocates worry that doctors may find these requirements onerous and opt out, which would in turn thwart patients' access to the now-legal therapy, said Ellen Smith, a board member of the U.S. Pain Foundation, which favors expanded access to medical cannabis.
Education is essential, given the complexity of how marijuana interacts with the body and how little physicians know, said Stephen Corn, an associate professor of anesthesiology, perioperative and pain medicine at Harvard Medical School. Corn also co-founded The Answer Page, a medical information website that provides educational content to the New York program, as well as a similar Florida initiative. The company, one of a few groups to offer teachings on medical marijuana, is also bidding to supply information for the Pennsylvania program, Corn said.
"You need a multi-hour course to learn where the medical cannabis works within the body," Corn said. "As a patient, would you want a doctor blindly recommending something without knowing how it's going to interact with your other medications? What to expect from it? What not to expect?"
But many say the science is too weak to answer these questions.
One reason: the federal Drug Enforcement Agency classifies marijuana as a schedule I drug, the same level as heroin. This classification makes it more difficult for researchers to gain access to the drug and to gain approval for human subjects to participate in studies. The White House rejected a petition this past week to reclassify the drug in a less strict category, though federal authorities say they will start letting more facilities grow marijuana for the purpose of research. (Currently, only the University of Mississippi can produce it, which advocates say limits study.)
From a medical standpoint, the lack of information is troubling, Filer said.
"Typically, when we're going to prescribe something, you've got data that shows safety and efficacy," she said. With marijuana, the body of research doesn't match what many doctors are used to for prescription drugs.
Still, Corn said, doctors appear pleased with the state training sessions. More than 80 percent of New York doctors who have taken his course said they changed their practice in response to what they learned.
But even now, whenever Corn speaks with doctors about medical marijuana, people ask him how they can learn more about the drug's medical properties and about legal risks. Those two concerns, he said, likely reduce the number of doctors comfortable with and willing to discuss marijuana's place in medicine, even if it's allowed in their states.
Though others say this circumstance is starting to ease, doctors like Jean Antonucci in Maine continue to struggle to figure out how marijuana can fit into safe and compassionate medicine. "You just try and be careful — and learn as much as you can about a patient, and try to do no harm," she said.
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Getting Rid Of Spider Veins Without Surgery?

BEVERLY HILLS (HH) - A recent discovery is leaving beauty insiders speechless—while giving women new hope in the fight against an all-too-common sign of aging.

Earlier this month, renowned plastic surgeons, Drs. John Layke and Payman Danielpour, announced they would soon be revealing a breakthrough, that would allow people to remove the look of embarrassing dark veins—without surgery or lasers.

Traditionally, spider veins (the red, blue, or purple lines that show up on our legs, face, and other areas, as we get older) could only be treated with assistance from a cosmetic surgeon or dermatologist.

But Dr. Layke stated that their new technique would produce the same results, without the pain of surgery or high cost of laser treatments—yet was so simple, people could use it in the privacy of their own home.

At first, the announcement was understandably met with skepticism from industry experts. Drs. Layke and Danielpour have been leaders in anti-aging innovation for years, but a breakthrough of this magnitude had never been achieved before.

Not to mention, visible veins are one of the biggest concerns for women over 35, so it seemed unusual for plastic surgeons to invest in a solution that would potentially cause them to lose a large portion of their in-office clients.

But disbelief quickly turned into astonishment, after Dr. Layke finally revealed their breakthrough ‘do-it-yourself’ solution to the public late last week. The vein-banishing technique is detailed in a free online video (which went viral within 24 hours of its release).

In the report, Dr. Layke presents the science behind this game-changing discovery. And more importantly, he actually shows viewers how they can use it to quickly achieve a vein-free appearance on their own.

With the evidence laid out, even former skeptics now find it hard to question Dr. Layke’s unusual new approach, or the results it delivers.

Monica Brennan, a beauty consultant based in Hollywood, CA, not only watched the video—she tried using the technique herself.

“I saw a difference almost immediately. I used to have very prominent spider veins on my cheeks, and even darker ones on my legs,” Brennan recalls.

“But (Dr. Layke’s method) worked better than anything I’ve ever tried. I couldn’t believe it at first, but now I’m recommending it to all of my clients.”

The question of why Drs. Layke and Danielpour decided to let the world in on something most plastic surgeons would want to remain a secret, has been answered as well. When we reached out to Dr. Layke for comment, he explained that doctors should never keep important findings from the public.

“When I know there is an effective solution to a problem that affects so many people, I feel compelled to report it. I don’t worry about the bottom line.” Dr. Layke said.

The video has been up for less than a week, so despite its initial success, some skincare experts, like Michael Ortega, still urge viewers to maintain reasonable expectations.

“We don’t know if these results will be permanent or if they’ll require routine maintenance. It’s a simple technique, but may need to be used on a regular basis. We also don’t know if it’s going to work for 100% of people who try it,” says Ortega.

“But if does, it’s going to save a lot of people from the embarrassment of dark veins— which is what really matters. It’ll also save people a whole lot of money…and that doesn’t hurt either.”

If you’ve ever struggled with the appearance of ‘unsightly’ dark veins, you can watch Dr. Layke’s presentation below, to determine if his unusual at-home technique will work for you.


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Uncertain future for baby born in US with Zika-related complications

(CNN)Throughout her pregnancy, Maria Mendoza, who currently lives in Miami, anguished about her baby's health.

Would little Micaela be OK even though Maria had contracted the Zika virus when she was three months pregnant?
Her ultrasounds looked fine and Maria and her husband, Omar, were relieved when Micaela appeared healthy at birth, just like their three older children.
But then the day before she was to be discharged, doctors told the Mendozas that Micaela would have to stay in the hospital because an MRI had found calcifications in her brain.
They were stunned.
"I cried a lot," Maria said. "It was terrible."
The calcifications were the scarring left when Zika had infected Micaela's brain and destroyed tissue while she was still in the womb.
"Doctors wouldn't say a lot because they were doing a bunch of tests," Maria said. "It was terrible, and the fear is still there."

The sinister nature of Zika

Micaela is among the first babies to be born in the United States with Zika-related complications.
Doctors are learning that some problems, such as having microcephaly, or a very small head, are relatively easy to spot during pregnancy or shortly after birth. But other, more subtle problems such as brain calcifications can be more difficult to catch.
And it's hard to know what these more subtle complications will mean for a child later in life.
"There's a lot we don't know about Zika," said Dr. Marcelo Laufer, a pediatric infectious disease expert at Nicklaus Children's Hospital in Miami who has evaluated Micaela. "We have more questions than answers."
When Zika attacks a fetus' brain, it can cause intellectual disabilities as well as vision and hearing problems, he said.
Micaela has abnormalities in her retinas because of the virus, but her mother says doctors told her it shouldn't cause any vision problems.
There's more uncertainty about what the brain calcifications will mean for her future.
While other viruses, such as herpes and cytomegalovirus, can also affect a fetus' brain, it's hard to draw parallels to Zika, according to Dr. Gary Clark, chief of neurology at Texas Children's Hospital.
"Different viruses have different patterns of brain calcification -- it's a response of the brain to that particular pathogen," Clark said.
"This is a whole new ballgame, and we're going to have to see what happens with Zika," he added. "But you do have to be worried."

Micaela's story

When Maria developed a fever and rash in December in her native Venezuela, Zika wasn't the first thing doctors thought of, considering the virus had appeared just months before in Latin America.
Maria Mendoza pregnant in Miami.
When they determined later that it was Zika, they told the Mendozas not to worry, as it wouldn't affect her unborn child.
But then the Mendozas saw a story on CNN about the link between Zika and microcephaly, and she urged her physicians to monitor her baby.
They did, and everything looked fine, but her doctors told her she could choose to terminate the pregnancy given the uncertainties about Zika.
"It was my decision to have her or not," she said. "It was a matter of waiting and asking God and the Virgin (Mary) that everything would be OK. And that's what we did."
But it wasn't easy.
"It was a very stressful situation, a lot of anguish, weeks of waiting without knowing if she was going to develop as a baby the way she was supposed to normally," she added.
Maria said she often travels with her husband for his business, and joined him in Miami while seven months pregnant.
Ultrasounds there showed the baby was fine.
She said that made it all the more difficult to learn of the brain calcifications when Micaela was a few days old.
Maria Mendoza massages her daughter Micaela's hands during a session of occupational therapy.
Micaela is now starting physical and occupational therapy several times a week, and Maria does therapy for her at home, doing exercises to encourage her baby to develop good head control and relaxed muscles.
She said she felt relieved when doctors told her that with the therapy and constant monitoring, they expect Micaela will be okay.
"The future is uncertain," she said. "But we stay positive."
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How to Avoid Your Migraine Triggers While Dining Out A smart order at your favorite restaurant could help you avoid a migraine.

As sufferers know, migraines can strike anywhere. And unfortunately, that includes during nice dinners out, as certain foods can serve as dietary triggers for some. Here are some ways to help navigate the menu and avoid foods that could trigger a migraine.

At the Small Plates Spot: Skip the brie, try the mozzarella.

If you’re going to start or end with a cheese plate, know that aged cheeses such as cheddar, blue, brie, Swiss, parmesan and Roquefort contain a natural compound called tyramine, which may trigger a migraine in some. The National Headache Foundation suggests limiting intake to four ounces for aged cheeses, but if you’d rather not take any chances, go for fresh cheese like mozzarella and ricotta.

At the Burger Joint: Skip the pickles, try raw cucumber.

A few favorite burger toppings can be migraine triggers for some, all thanks to tyramine, so the next time you hit up your fave joint, be wary of a few items like raw onion, cheddar or blue cheese and sauerkraut (for you non-traditionalists). Pickled food can be high in tyramine, too, so you might consider laying off that pile of pickles. It might sound weird, but raw cucumber can give you that same satisfying crunch, so you might ask your server for a swap-out.


At the Pizza Cart: Skip the pepperoni, try a classic.

Aged, dried, fermented or smoked meats are (you guessed it) high in tyramine, so that pepperoni-lover’s pizza could cause a migraine for some. Stick to a classic margarita version (mozzarella cheese is a-ok), or load up your slice with veggies.


At the Salad Bar: Skip snow peas, try …anything else.

You’re all good when sticking to raw, fresh veggies at the salad bar, except for snow peas, which contain tyramine. Broad beans such as favas also contain tyramine, so consider passing them by, as well. And about the dressing: Citrus such as orange, lemon and lime can contain tyramine. But the National Headache Foundation’s low-tyramine diet suggests limiting citrus to half a cup serving per day, so a spritz of lemon on your salad hopefully won’t be an issue.


At the Sushi Spot: Skip the teriyaki, try steamed.

This one might hurt, but it’s true: Fermented soy products, such as miso, soy sauce, and teriyaki sauce are foods that can trigger migraines thanks to their high tyramine levels. So if this compound is a trigger for you, the sushi or teriyaki place around the corner might not be your idea of a nice lunch out. Never fear: Ask for a steamed or grilled entree instead, and learn to love your sushi without dousing it in sauce. The National Headache Foundation suggests limiting these sauces to one ounce per day.

Not sure if tyramine is a trigger for you?  Keeping track of what you do and don’t eat in a migraine diary can help you determine which foods are migraine triggers. And once you have an idea of your triggers, restaurants can become less of a headache landmine — and more of the enjoyable destination they’re meant to be.


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First Aid for Epilepsy Caregivers

If your loved one suffers from epilepsy, you know how helpless you can feel watching him or her experience a seizure. Or perhaps you haven’t been present for one, but are nervous about how you might handle it. No matter how many seizures you may have witnessed, they can be unpredictable. It’s hard to tell how long they will last or what might happen. But knowing how to respond safely and when to get help is the best way to prepare.

Protect, Care and Comfort

Some people remain fully aware and alert during a seizure; others may seem alert, but really aren’t aware of what’s going on. The main goal during any seizure is to protect the person from harm until his full awareness returns.

For most seizures, these basic first aid steps will help you protect and care for your loved one during the episode, and keep him comfortable once it’s over.

  • Remain calm. Most seizures only last a few seconds or minutes and can be handled with basic care and comfort. Speak calmly and reassure the person that she is safe and you are there to help. If you remain calm, so will others around you.

  • Stay with your loved one. Though most seizures are brief, some may last longer. Seizures can also start with minor symptoms but lead to a loss of consciousness, which could result in a fall. Always stay with the epileptic until you are sure the seizure is over or until a medical professional arrives. Make sure the person is fully aware of what is going on before leaving him alone.

  • Check your watch. It’s important to time the seizure so you know how long it lasts. If it goes on for more than five minutes, call for emergency help.

  • Clear the area. Sometimes someone may walk around during a seizure but won’t be in control of what they are doing or where they are going. Be sure to remove any sharp objects or other dangerous obstacles, and don’t let the person wander away.

  • Ease her onto the floor. If you can, try to get her into a comfortable reclining position on the floor or on a flat surface to prevent any falls.

  • Place something soft and flat under her head. And make sure there is nothing tight around her neck that could interfere with breathing.

  • Turn him to one side. Gently position him on one side to keep his airway clear to prevent choking. If he’s seated, try to turn his head to one side so any fluids can drain away from his mouth.

  • Don’t put anything into his mouth. Don't try to open the person’s mouth or give him any fluids or medicine until the seizure is completely over and he is fully alert again. And rest assured, contrary to popular belief, seizures do not cause people to swallow their tongues.

  • Don’t restrain him. It’s important to protect a person from injury during a seizure, but you also don’t want to hold him down or stop any jerking movements. Muscles contract with force during seizures, and restraining him could cause tears in his muscles or even break a bone. As the jerking begins to slow, make sure he’s breathing normally.

  • Comfort. Some people are confused or cranky after a seizure while others may be exhausted. Reassure your loved one with kind, comforting words, and encourage her to take slow, deep breaths or do something relaxing.

When to Get Help

Most seizures end without incident or the need for any medical treatment. But in rare cases, you may need to get emergency help. Be sure to call 911 if any of the following occur:

  • It’s the person’s first seizure.

  • The seizure goes on longer than five minutes.

  • Another seizure starts right after the first one.

  • He has trouble breathing or is choking.

  • He seems hurt or in pain during or after the seizure.

  • The seizure occurs in water.

  • He asks for medical help.

  • He seems confused more than an hour after the seizure or isn’t returning to her normal self.

Seizures can be frightening, but with a little preparation, you can feel confident in your abilities to keep your loved one safe.


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Aleppo's angel: A nurse's devotion to Syria's children

(CNN)Malaika, a 29-year-old head nurse, holds Ali, a 2-day-old infant, as he struggles to take his final breaths. Born in eastern Aleppo, one of the hardest-hit cities in Syria's five-year civil war, Ali was born with chest issues that forced him to rely on an oxygen pump and an incubator in the neonatal unit at Aleppo Children's Hospital.

At 1:20 p.m.on July 23, a government airstrike scored a direct hit to the hospital. Dust and debris filled the room where 11 babies lay in incubators.
Several hours later, early July 24, a second airstrike hit. Staff members scrambled to save the infants and rushed them to a safer location in the basement, but Ali -- already weak -- lost his oxygen supply. Malaika and a doctor tried to perform manual CPR on Ali's fragile body but knew there was nothing they could do. Malaika held him as he died, struggling to breathe.

'It was intentional. It was a war crime.'

Three more babies died from dust inhalation during the attacks. "I was crying. It was very painful," Malaika said through an interpreter.
"It was intentional. It was a war crime."
Malaika no longer has a home to return to at the end of the day.
These were just two horrific days in a life now full of them. Malaika no longer goes home at the end of her workday. Her house was destroyed in one of countless airstrikes, so she sleeps at the hospital. Her entire extended family has fled to Turkey, and she is the only one left.
Her husband divorced her and took their two daughters to Marea, a town north of Aleppo that is inaccessible to those still in the city. He's a supporter of the regime of President Bashar al-Assad. He was angry that, as a nurse, she treated an injured rebel fighter.
Malaika is one of only a handful of health care workers still in the besieged city of Aleppo. The eastern part of the city was taken over by rebel groups in 2012.
Only 35 doctors are left to care for the 300,000 residents who remain.

Doctors on the brink

This week, 15 of the country's doctors sent a letter to the White House, pleading for help: "We do not need tears or sympathy or even prayers, we need your action. Prove that you are the friend of Syrians.
"Last month, there were 42 attacks on medical facilities in Syria, 15 of which were hospitals in which we work," they added. "Right now there is an attack on a medical facility every 17 hours. At this rate, our medical services in Aleppo could be completely destroyed in a month, leaving 300,000 people to die."
A senior White House official acknowledged receipt of the letter.
"The US has repeatedly condemned indiscriminate bombing of medical facilities by the Assad regime in Aleppo and elsewhere in Syria," the official said.
"These attacks are appalling and must cease," the official continued. "We commend the bravery of medical professionals across Syria who are working every day in perilous circumstances with minimal supplies to save lives."
The official said the US government is working with the United Nations and engaging with Russia to find a diplomatic approach to reducing the violence and allowing humanitarian assistance into the city.

Some reprieve

Saturday, rebels finally broke through Aleppo's siege, beating back regime forces on the ground and breaking through the main blockade.
Rebels broke through a key government line in Aleppo
Malaika joined dozens of people who flooded the streets to celebrate. Then came another airstrike. She was hit by shrapnel as surrounding structures exploded and was taken to the hospital with two others, one of whom was a 6-year-old girl.
Ten people were injured, and two more were killed.
Malaika underwent an operation to remove the shrapnel and returned to work at Aleppo Children's Hospital the next day. The operation was unsuccessful, so two days later, she tried it again. All the while, she continued to work.
Malaika refuses to leave Aleppo despite the constant danger. "The children. I love those children. It's impossible," she said. "I love my country, and I love the children very much."
In Arabic, "Malaika" means "angel."
"I know there is a lot of danger," she said. "And we want to die here. I love my country, and I'm not leaving."
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8 Foods You Should Never Give Your Kids

8 Foods You Should Never Give Your Kids

Every parent knows that getting kids to eat healthy wholesome foods is an uphill struggle.

Adults understand that healthy, satisfying meals usually comprise of ingredients like plain grilled chicken, fish, salads, vegetables, and fresh fruit for dessert. Kids, when confronted with these foods, find them boring, bland, unappealing, or simply disgusting!

Food battles with kids are terribly frustrating, but it’s important to keep issues like fussy eating and the avoidance of fruit and vegetables in balance. Encouraging healthy eating behavior is essential. In later life your kids will be grateful for your persistent focus on good nutrition.

Many foods seem nourishing and delicious. In reality, they actually have very little nutritional value and contain large quantities of hidden fats and sugars.

But, how can you know for certain which foods to avoid?

To help you to decide, we’ve listed eight of the worst foods that you can feed your children for breakfast, lunches, dinners or snacks.

1. Kids’ Breakfast Cereal

Kids’ eating Cereal

Many breakfast cereals specifically target the kids market. Images on the boxes are colorful and exciting, and the blurb has buzzwords, like delicious, healthy and nutritious.
The amount of sugar and processed ingredients per serving completely outweighs the miniscule amount of nutritional value. Search for brands that contain at least 3-grams of fiber per serving and less than 10 grams of sugar. The best morning cereal is whole grain oatmeal; it’s high in fiber, vitamins, and minerals, and you can always sprinkle on some berries or mix it with yogurt.

2. Granola Bars

Granola Bars

Granola bars marketed to kids lack nutritional value even more than the adult brands. They’re full of sugar and added ingredients like chocolate chips, marshmallows, candy, high fructose syrup, and artificial dyes, Make your own energy bars at home with natural ingredients like almond or peanut butter, raisins, coconut, whole grain cereal, honey, and dried fruit and nuts.

3. Luncheon Meats

Luncheon Meats

Processed meats can be both dangerous and toxic as they frequently contain nitrates. These are preservatives used in food processing that drastically increase the risk of heart disease and cancer. Check out the label to see if the meat contain nitrates; search for products that that are labeled as organic or not containing preservatives.

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4. Snack Cakes

Snack Cakes

Kids love snack cakes like Ho-Hos, Twinkies, or Wagon Wheels. But these snack cakes are full of trans fats, the most unhealthy processed fat possible. For something sweet, try using some mixed berries and grapes, or bake cookies or squares using natural ingredients.

5. French Fries

French Fries

There’s no way to keep French Fries totally out of your kid’s weekly menu.
The problem is giving French Fries at every meal. French fries provide almost no nutritional value—they’re super high in fat and sodium. If you decide you have no choice, restrict them to a few meals per week. Substitute oven-baked chips, or make baked potato wedges instead.

6. Pizza


After a stressful day, the easy option is to order pizza. But shop-bought pizzas are not like you bake in your oven at home. Don’t phone! Just put together a homemade pie with natural, low-fat cheese, shredded chicken, and tons of vegetables..

7. Crackers


Most crackers are made from processed, white flour, preservatives, and unhealthy oils. Exchange them for a brand made with fibrous whole grains. Anyway, they satisfy hunger for longer,

8. Fruit Snacks


Most fruit snacks are actually like candy. Just give real fruit and fiber to your kids in the form of dried whole fruit, like raisins or apricots, or fresh grapes, berries, and sliced apples and pears.

If you follow our suggestions you can be sure your kids will feel all the better for it. You just might have to wait for them to grow up before they tell you!


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Heel spurs and stammers: What kept people from military service?

(CNN)On the heels of Donald Trump facing scrutiny over his multiple US military deferments during the Vietnam War, many Americans are questioning what exactly qualifies as a draft exemption -- especially from a medical perspective.

The New York Times reported Monday that the Republican presidential nominee dodged the draft due to four student deferments and a medical deferment after he was diagnosed with heel spurs, calcium deposits that cause bony protrusions on the bottom of the heel.
Classification records shared with CNN by the federal government's Selective Service System confirm that Trump received a student deferment and was later found "disqualified for military service" in 1968 after he underwent a physical exam.

No 'habitual drunkenness' or 'masturbation' allowed

Regulations determining which diseases and ailments disqualify a registered man from being drafted for military service can be traced to the Civil War, according to a digital copy of an 1863 regulation manual in the National Library of Medicine that spans 100 pages.
Consider just a few of the many medical conditions that could have disqualified someone from military service, if found to be severe or detrimental, in 1863:
  • Insanity or mania
  • Scrofula or constitutional syphilis
  • Cancer
  • Habitual drunkenness
  • Acne rosacea
  • Masturbation may result in rejection or discharge of service
  • Minimum stature of 5-foot-3, and possibly maximum height of 6-foot-3
  • A greater weight than 220 pounds, unless accompanied by corresponding height and muscular sufficiency
  • Deafness
  • Hernia and stomach ulcers
  • Contagious skin diseases
  • Club feet, splay feet, flat feet
However, "a national bureaucracy for managing conscription did not emerge until after the passage of the Selective Service Act of 1917 -- although even this relied on the contributions of approximately 4,000 local draft boards, which retained the prerogative of granting exemptions," said John Hall, professor of military history at the University of Wisconsin-Madison.
"In 1940, as European and Asian war clouds darkened America's skies, the United States implemented 'peacetime' conscription for the first time -- but the world was already at war," he said. "The real break from American tradition came in 1948 when the United States for the first time employed the draft as a routine element of defense manpower policy, whether or not the United States was at war."
Around that same time, physical and mental standards for Selective Service registrants were developed.
In 1942, the list of medical conditions that could have disqualified someone from military service, if found to be severe or detrimental, looked a little different. Among dozens of other conditions, it included:
  • Brain tumors
  • Epilepsy
  • Sexual perversions
  • Stammering to such a degree that the registrant is unable to express himself clearly or repeat commands
  • Psychopathic personalities
  • Chronic alcoholism and drug addiction
  • Multiple sclerosis
  • Cerebrospinal syphilis
"When Richard Nixon took office in 1969, he realized that the draft was undermining rather than sustaining the war effort in Vietnam, so he initiated a transition to an exclusive reliance on volunteers, which culminated in 1973," Hall said. "Partly because of the scarring experience of Vietnam, the United States is very unlikely to resort ever again to the draft."

Modern standards of health

Currently, each branch of the military -- from the Navy to the Air Force -- has its own medical or fitness assessment for applicants.
"They do have guidelines on what is disqualifying and what is qualifying and, in some cases, what can be waived and what cannot be waived," said Jim Dower, who formerly worked in both Selective Service and the military. He retired in 1994 and now resides in Sarasota, Florida.
"You're psychologically screened, you're physically screened in the normal things you would take a physical for, and your history is taken," Dower said. "If there's any questions, they go out and get consultations for whatever is required."
For instance, the standards of medical fitness for the United States Army were last updated in 2011 (PDF), when the "don't ask, don't tell" policy was repealed.
By then, some of the dozens of medical conditions that could disqualify someone from serving in the US Army, if found to be severe or detrimental, included:
  • Cleft lip defects
  • Stomach ulcers and stomach bleeding
  • Heel spur syndrome and hammertoe result in referral to a medical evaluation board
  • Current or history of coronary heart disease
  • Current absence of one or both testicles
  • Plantar flexion of the foot must meet 30 degrees
  • Women below 58 inches or over 80 inches tall do not meet standards
  • Men below 60 inches or over 80 inches tall do not meet standards
"Although there has not been a draft in over 40 years, men 18 [years old] are still required to register with the Selective Service System. It's a law and civic duty," said Matthew Tittmann, a spokesman for the agency.
"At 26, they become too old to register, but failure to register can carry lifelong consequences, and non-registrants risk being disqualified from access to federal college loans and grants, job training programs, all federal jobs and many state and municipal jobs," he added. "All documented and undocumented immigrants must register, as well. Otherwise they risk losing the aforementioned benefits and could delay their citizenship process."
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How 'Pokemon Go' is helping kids with autism and Asperger's

"He's willingly starting to go out and going to Pokestops, get Pokeballs and catch creatures, whereas he didn't have the interest to go outside before," Barnhill said. "He's not a go-outside-and-play kind of kid. But this game has enabled him to want to reach out to people and strike up conversations about creatures that they've caught."
The game's augmented-reality feature and method of rewarding players who go to Pokestops located at popular landmarks in their communities have led people to be more interactive than normal while playing video games.
Lenore Koppelman is the mother of 6-year-old Ralphie, who has autism and hyperlexia, which is associated with verbal language difficulties. She has also found "Pokemon Go" useful in helping her son socialize with other kids.
"They want to play 'Pokemon Go,' and so does he, so it gives them something in common to do. The kids are so fixated on catching Pokemon that they are concentrating on finding them more than they are concentrating on his behaviors like they usually do," Koppelman said. "As a result, he is finally finding himself in the middle of groups of kids he doesn't even know, being welcome to play with them."
Though no quantifiable research has been done on the effects of "Pokemon Go," Dr. James McPartland, director of Yale's Developmental Disabilities Clinic in the Child Study Center, says the game is appealing among kids with autism or Asperger's because of its consistency and structure.
"('Pokemon Go') involves a finite set of interesting characters that is consistent, stable. Kids with autism often like things that are like this that are list-based or concrete or fact-based," said McPartland, who doesn't treat Ian or Ralphie. "They're very good at learning about things and memorizing things, so not only is this a shared area of interest, it's an area in which the kinds of strengths with autism can shine."
According to Dr. Peter Faustino, a school psychologist in New York who doesn't work with Ian or Ralphie, it's the common interest that's helped spark changes in children with autism or Asperger's.
Faustino describes how he guides children with Asperger's or autism to adapt a "social hook," which he defines as "something that will sort of share an experience or a connection." Normally, he advises them to take an interest in sports or pop music. However, Pokemon's popularity proves to be an exception.
" 'Pokemon Go' seems to be making Pokemon mainstream and cool. So it's almost this reverse social hook that's really kind of exciting for some kids," Faustino said. "The other thing that seems to be going on is this opportunity to get outside, to be more interactive outside of the house. This seems to be offering that hook."
While "Pokemon Go" has had some positive effects on Ian and Ralphie, Dr. Fred Volkmar, a professor in Yale's Child Study Center, who does not treat either boy, also warns of possible pitfalls for kids on the autism spectrum.
"The problem with Pokemon is that kids can do it to a point where it interferes with learning about the world," Volkmar said. "If you can make it somewhat functional, it's fine. It's detrimental if it's the only thing they're interested in. If it helps the kid become more isolated, it's not good."
But McPartland, who has worked with Volkmar, advises that with careful monitoring, these detrimental effects could be avoided.
"I don't think there's anything intrinsically detrimental about 'Pokemon Go,' " McPartland said. "Any activity any child does should be monitored by a parent. And parents should say how much is appropriate and when is appropriate and with whom it's appropriate. Like anything else, if those things aren't monitored, issues could arise."
Ralphie's mom says the new interactions are priceless, and she's proud of the positive changes in her son.
"He seems happier. He's laughing more. He seems more confident," Koppelman said. "He fist-pumps and says 'Yes!' when he catches one and then gives people high-fives and shouts 'I did it!' His father and I are both proud of him and how far he has come in only a week's time."
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Are Rio's hospitals ready for the Olympics?

Rio de Janeiro (CNN)Sirens blaring, an ambulance peels out of the parking bay of a firehouse in southern Rio de Janeiro -- our car in hot pursuit.

We've been given access to Rio's First Emergency Response Battalion for the day, to see how prepared they are for medical emergencies during the upcoming Olympic Games.
We speed through crowded streets for some time, but then traffic strikes. We're stalled.
I check my watch. It's been 18 minutes since we left -- response time in most major cities in America is about nine minutes.
A couple of minutes later we arrive. But no, actually, we're lost. We've stopped because paramedics aren't completely sure where the patient is. Better directions are called in from dispatch and finally, success. It took 25 minutes from start to finish.
The victim, one of Rio's many homeless, is passed out on the street. "Did he fall?" the medics ask a woman standing nearby. "No, he just laid down and passed out," she replies.
Quickly, his head is padded and he's strapped onto a stretcher and wheeled over to the ambulance. There, medics attempt to revive him, doing all they can to avoid a trip to the hospital. This is one of the many ways Rio tries to ease the burden on overcrowded medical centers.
I soon see why.
"So these pictures show pretty much the five hospitals that they have dedicated for the Olympics. They have patients in the hallways. They have patients lying on the floor sometimes. It's a completely crazy situation," says Nelson Nahon, a doctor for Rio's regional Council for Medicine, a medical watchdog association called CREMERJ.
The pictures Nahon is showing me are startling. They remind me of makeshift medical shelters put in place after natural disasters. Patients on gurneys are shoved into every spare corner, lined up like dominoes.
"This is a picture of the red room -- the emergency patients," he says, gesturing to images CREMERJ has captured to illustrate the problem. "You can see the beds crammed next to each other, in row after row. So when the doctors walk in to see a patient, they have to put a bed aside, then put another bed aside, so that they can actually reach the patient."
Most disturbing is the site of a body bag lying in a bed next to other patients, waiting to be removed.
"This is a completely absurd situation, where a patient died and they put him inside this black bag next to others," says Nahon. "Normal procedure would be to take the deceased patient outside and then put him in the black bag and then forward him to wherever he should go."
Nahon tells me this type of overcrowding is common among Rio's public hospitals.
"Every day in Rio, we lack about 150 beds for emergency care," he says. "Intensive care is the same. They might even die in that period because they need intensive treatment and in the semi-intensive rooms they have, people who are supposed to stay there for 24 hours -- they stay for 15 days."
Nahon tells me this type of overcrowding is common among Rio's public hospitals.
"Every day in Rio, we lack about 150 beds for emergency care," he says. "Intensive care is the same. They might even die in that period because they need intensive treatment and in the semi-intensive rooms they have, people who are supposed to stay there for 24 hours -- they stay for 15 days."

A startling contrast

When I step into the Americas Medical City Hospital, it's hard to imagine that I'm in the same country. The chaos of people desperate for care has been replaced with the busy, but quiet, hum of a hospital that I'm used to. It feels like a big city academic hospital back in the United States.
For the next few weeks, this hospital will be under the watch of Dr. Antonio Marttos, a trauma surgeon from the University of Miami.
A Brazilian native, Dr. Marttos has spent most of the past three years commuting back and forth from his home in Miami to ready the facility for the 2016 Olympic Games. He has been tasked with overseeing all trauma and emergency services during the Games. This includes the Olympic Village Polyclinic -- a mini hospital in the Olympic Village that provides everything from emergency services to dental care -- as well as the Americas Medical City facility, which is composed of two hospitals, one that will cater to athletes and the other to Olympic dignitaries and VIPs.
If someone needs to be rushed from the Olympic Village or the Polyclinic to the hospital, it should take approximately 12 minutes.
It's full-service healthcare that will be run by a staff of 5,000 doctors, nurses, and other medical personnel -- many of whom will volunteer to do these jobs.
While many of the larger countries taking part in the Games come with their own medical teams, many smaller countries use this as an opportunity to get basic check-ups and preventative care.
Dr. Marttos tells me that in the event of an injury, a doctor needs to be on hand right away. "My role is to be sure my hospital has everything in place. We have protocols and guidelines," he said. "It looks like an American hospital, they have everything ready, like my hospital in Miami."
As a reporter, I've been talking a lot about Zika, Rio's notoriously dirty water and even threats of terrorism. When I ask him how much of a concern this is for him, he says his priority is the athletes. "How to take care of the injuries. Everything else, terrorism, is not under our control. Brazil got ready. They did a lot of training."
He adds, "I can say that for all the athletes, for all the people inside the venues, if they need us, we're going to be ready to take care of them."
Waiting times in public hospitals won't improve during Olympics.
As we tour the nearly 500-bed hospital, I can't help but think of just how starkly different this facility is compared to the pictures of the public hospitals that Dr. Nahon showed me: rooms filled to capacity, patients waiting for days for emergency services -- sometimes dying before being treated -- and the body bag next to a patient.
I ask Dr. Marttos what he thinks of the public hospital situation. He's very diplomatic and says that sometimes the physical infrastructure isn't the same as here. The walls may not be as nice, the equipment not quite as new, but that the quality of the doctors is the same.
He's optimistic that perhaps the work that he has put into the facility here will be a legacy for the care for future Brazilians.

More people turning to public hospitals

I'm back in the command center for Rio's Emergency Response Battalion, feeling the pulse of activity. More than a thousand people help keep the ambulances running and responding to emergencies 24 hours a day. The control board fills an entire wall, tracking minor to major injuries with color codes of blue, yellow and red.
Doctors, both military and civilian, triage the calls, making sure that everyone who gets an ambulance truly needs one. They cannot afford to waste efforts, especially with the extra stress of the Olympics.
Lt. Col. Carlos Sima shows me around his command center with pride, and puts a good face on their lackluster response time and the well-known overcrowding of the hospitals they deliver to.
"The economic crisis has made it very difficult," he tells me. "Even people who used to afford private hospitals are now going to public ones to save money."
I ask him what his biggest concern is during the upcoming Olympics, and hear a familiar refrain.
"A terrorist attack," he says quickly. "We don't have history with that. We are used to big accidents and the like, but because we don't have a history with terror, that would be of real concern."
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Zika mosquito: thrives in hot water, hard to wipe out

Behind the spread of the Zika virus is a tiny menace that just won't go away.

It's called the Aedes aegypti (AYE'-dees uh-GYP'-tie), a species of mosquito that has played a villainous role in public health history and defeated attempts to wipe it out.

The mosquito is behind the large outbreaks of Zika virus in Latin America and the Caribbean. On Friday, Florida said four Zika infections in the Miami area are likely the first caused by mosquito bites in the continental U.S. All previous U.S. cases have been linked to outbreak countries.

Five things to know about the bug:


Aedes aegypti is a small, dark, hot weather mosquito with white markings and banded legs. Scientists believe the species originated in Africa, but came to the Americas on slave ships. It's continued to spread through shipping and airplanes. Now it's found through much of the world, including cities across the southern United States.


Early in the 20th century, it was the engine behind devastating yellow fever outbreaks and became known as the yellow fever mosquito. Since then, it's also been identified as a carrier for other tropical illnesses such as dengue fever, chikungunya and Zika. Scientists say other types of mosquitoes might also spread Zika but Aedes aegypti is the main culprit. The vast majority of the mosquitoes tested recently in South Florida have been that kind.

Aedes aegypti has an unusually cozy relationship with people. While other species thrive in more rural areas, or at least in parks and gardens, this is a domesticated species - sort of a housecat mosquito - accustomed to living in apartment buildings and city centers. It prefers biting people to animals and likes to feed indoors, during daylight hours. It doesn't venture far. Researchers say it doesn't travel more than a few hundred yards during its lifetime - usually two to four weeks


The mosquito is a hardy bug that can be particularly challenging to get rid of. In the early 20th century, many countries tried to wipe out the mosquito with chemicals and other measures. By 1970, it was eradicated from much of South America - including Brazil. But many mosquito-control programs lapsed due to budget problems, concerns about insecticides and the success of the yellow fever vaccine. The species roared back. More recently, scientists have been exploring novel ways of curbing the pest with genetic engineering, radiation or bacterial infections.


Female mosquitoes drink human blood for nutrients used in making eggs. After a female bites an infected person, it can spread the virus through its saliva to its next human victim. While the virus is mostly spread to people through mosquito bites, scientists have established that it's been spread through sex - mostly by men to their partners - in some cases. Zika can also be spread through blood; the virus usually stays in the blood for about a week, though it's been seen longer in the blood of pregnant women. A U.S. lab worker was accidentally infected through blood.

Source:USA Today.com

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7 Foods to Avoid with Asthma

Avoiding certain foods might help you avoid an asthma attack.

You can’t magically cure yourself of your asthma symptoms by eating special foods. But the food you eat can have an influence. Some may even make your asthma symptoms worse. Not everyone will react the same way to the same foods, of course, but it may be worth closely monitoring your reaction to certain foods and avoiding them if necessary. 

1. Dried fruit

Many kinds of dried fruit include sulfites, which are preservatives designed to stretch out the shelf life of the food—and one of the most problematic additives in foods for many people with asthma. Read the package for words like “potassium bisulfite” and “sodium sulfite” to determine if those dried cherries or apricots may trigger an asthma flare. 

2. Wine or beer

Many kinds of wine and beer also contain those pesky sulfites. You may have to forsake that glass of cabernet if you find yourself coughing or wheezing after indulging. Some research also suggests that histamines in wine can cause symptoms like watery eyes, sneezing and wheezing. 

3. Shrimp

Frozen or prepared shrimp could be risky for you. If you suspect that sulfites are once again the culprit, you’re right! Frozen shrimp—and other seafood—often contain sulfites because they discourage the growth of unappetizing black spots. If you’re eating out, be sure you don’t accidentally eat something that’s been cooked in a broth made with shrimp or other shellfish.

4. Pickles

You may need to toss the pickle included with your deli sandwich. Pickled foods tend to contain sulfites as preservatives, as do fermented foods like sauerkraut. Watch out for relishes, horseradish sauce, and even salad dressing mixes for the same reason.

5. Packaged or prepared potatoes

The next time you’re tempted to make mashed potatoes from a mix, think again. Take a look at the ingredients list on the package. Sure, that package contains potatoes, maybe some vegetable oil, some salt, perhaps some whey powder or dried nonfat milk, but further on down the list, you’ll probably spot a preservative like sodium bisulfite. The sulfites strike again! Opt for a whole potato that you can toss in the oven instead. Don’t forget to pierce it with a fork a few times first. 

6. Maraschino cherries

They look so beautiful, like brightly-colored jewels in a glass jar, but anyone with asthma who’s sensitive to sulfites should just admire maraschino cherries from afar. Canned fruits and bottled fruit juices—such as lemon and lime juice—may also contain preservatives that could trigger bronchospasms or other symptoms of asthma. 

7. Any foods to which you’re allergic

You’re probably already on high alert for foods that you know you’re allergic to. Keep on keepin’ on, since those foods may also play a role in triggering asthma attacks. The American Academy of Allergy, Asthma & Immunology reports the foods that cause the majority of allergic reactions include tree nuts, wheat, soy, peanuts, eggs, fish, shellfish and cow’s milk. If you’re allergic to any of those foods, definitely avoid eating them—or anything that’s cross-contaminated by them.


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Deadly heat wave scorches central and eastern U.S.

(CNN)Dangerously high temperatures will keep scorching the Northeast in the wake of a deadly wave of heat and humidity that has plagued the Midwest.

Heat indexes well over 100 degrees are expected across dozens of states in the nation's central and eastern portions, the National Weather Service forecasts. A heat index combines the effects of temperature and humidity on the human body.
Temperatures also could reach the century mark Monday afternoon in New York, Philadelphia and Washington.
Nearly 114 million people are under excessive heat watches, warnings and advisories in effect across 27 states on Sunday, CNN meteorologist Sean Morris said.
The sweltering Midwest weather claimed the lives of a handful of people in the Detroit area over the course of three days, Roseville Police Chief James Berlin told CNN.
Five elderly residents who had underlying health issues died as a result of the soaring temperatures, Berlin said. Residents were encouraged to stay hydrated and find an air-conditioned place to avoid heat exhaustion or heat stroke.

Deadly heat wave scorches central and eastern U.S.

Story highlights

  • Temperatures close to 100 degrees are expected across dozens of states
  • Five elderly Michigan residents died due to record heat and humidity

(CNN)Dangerously high temperatures will keep scorching the Northeast in the wake of a deadly wave of heat and humidity that has plagued the Midwest.

Heat indexes well over 100 degrees are expected across dozens of states in the nation's central and eastern portions, the National Weather Service forecasts. A heat index combines the effects of temperature and humidity on the human body.
Temperatures also could reach the century mark Monday afternoon in New York, Philadelphia and Washington.
Nearly 114 million people are under excessive heat watches, warnings and advisories in effect across 27 states on Sunday, CNN meteorologist Sean Morris said.
The sweltering Midwest weather claimed the lives of a handful of people in the Detroit area over the course of three days, Roseville Police Chief James Berlin told CNN.
Five elderly residents who had underlying health issues died as a result of the soaring temperatures, Berlin said. Residents were encouraged to stay hydrated and find an air-conditioned place to avoid heat exhaustion or heat stroke.
Police and firefighters in the Detroit suburb of Roseville are doing their part to help residents beat the summer heat. They are offering rides to cooling centers set up at the city's recreation center and public library and distributing water to residents.
Heat is one of the country's leading weather-related killers, and each year dozens of Americans die from overexposure to high temperatures, according to The National Weather Service.
Heat stroke can happen very quickly after heat exhaustion settles in.
Hot, dry and breezy conditions across the West Coast have also hampered efforts to contain the rapidly expanding Sand Fire. The fast-growing wildfire, which was only 18% contained Sunday, has consumed more than 22,000 acres.

Warmest half-year on record

Scientists note the record temperatures across the country could be part of a long-term global warming phenomenon. Last week NASA announced that every month in 2016 has been the hottest ever recorded.
Global temperatures were on average 1.3 degrees Celsius (2.4 degrees Fahrenheit) higher than average between January and June this year when compared to the late 19th century, NOAA said.
Source: CNN.com
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7 Ways Diabetes Affects The Body

Uncontrolled diabetes can lead to a multitude of complications because the disease affects the body in many ways. With this condition, your body either doesn’t make enough insulin or can’t use its own insulin as well as it should. This causes a buildup of sugars in your blood which can wreak havoc on your body. Here what diabetes can do to your body.

Having diabetes increases your risk of developing a multitude of heart disease problems, such as chest pain, high cholesterol, narrowing of the arteries and high blood pressure. Many of these problems may be subtle or be "silent" until a major event, such as a heart attack or stroke.

Diabetes remains the leading cause of vision loss in the U.S. It can lead to various eye problems, including glaucoma, cataracts, and diabetic retinopathy.

Diabetes can cause wounds or sores in the skin to heal more slowly, which can result in people with diabetes being more susceptible to infections.

Gum disease risk also can increase with diabetes. Gum disease can lead to inflamed gums and eventually to tooth loss.

Kidney disease is one more potential complication of poorly controlled diabetes, and, unfortunately, it can develop over a number of years before symptoms show. Symptoms include swelling of the legs and feet. Diabetes is the leading cause of kidney failure among adults in the U.S

Nearly 70 percent of people with diabetes will suffer from nerve damage. High blood sugar levels can harm nerves, and can develop to either peripheral diabetic neuropathy (usually starting in the toes or feet) or autonomic neuropathy (damage to the nerves that control internal organs).

With the nerve damage that may be caused by poorly controlled diabetes, can come nausea, constipation, or diarrhea.

Well-controlled diabetes can keep all these effects at bay and even stop them. To better control your diabetes, make sure to control your blood glucose levels with medication or through a lifestyle change. Eating healthy, losing weight, and engaging in regular physical activity all can help keep your diabetes under control and your health on track.


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The Best Foods On Your Journey To Flat Abs!

I’ve said this many times before girls, but unfortunately you will not achieve flat abs simply doing crunches alone. Just like you can’t choose where you gain fat, you also can’t choose where you lose fat, so it’s important to include exercises that help target your whole body.  

The other single most important thing when wanting to achieve flat abs is your diet. What you eat has a massive affect on your abs and how they look. These ten foods are the perfect flat ab snacks because they help to banish bloating with their fibre content and protein to help keep your metabolism regular. 

Apples are a great source of fibre and also help to keep you feeling full. Replace snacking on chips and crackers with one apple.

Dark Leafy Greens
Dark leafy greens such as spinach, kale and broccoli are a some of the healthiest foods you can eat. They contain fibre which will help to keep you full and regular, and are full of nutrients. Add your greens to salads, stir frys, sandwiches and smoothies.

Greek Yoghurt
Greek yogurt is a great source of probiotics, which help to keep the good bacteria in your tummy happy. This will also help to banish the bacteria that promote bloating. Make sure to buy the variety that still has ‘live cultures’ to reap all the benefits.

Almonds are high in monounsaturated fat, as well as fibre, protein and magnesium which can help to stabilise your body’s blood sugar levels. They are the perfect snack, helping to keep you full and blood sugar spikes at bay.

Grapefruit is packed with Vitamin C and it may work to lower cholesterol. Snacking on grapefruit can help you to feel fuller and satisfied for longer, due to it’s acidity which may slow down your digestion when eating it.

Quinoa is a great little grain that can help combat belly fat. Anytime you choose whole grains over white, processed flours you are helping to keep your belly flatter. Quinoa is an amazing source of fibre and protein, which helps to keep you full and can be eaten in so many different ways! I love mine in salads and alongside lean meats.

Fatty fish such as salmon are a great source of Omega-3 fatty acids which are essential for your health. Salmon may promote fat burning by helping to boost your metabolism. Try grilling it to add to salads!

Berries are full of fibre and antioxidants which are optimal for keeping your abs flat. Add a handful to your diet daily as a healthy snack.

Green Tea
Green Tea is full of powerful antioxidants which can help to boost your metabolism. It is the perfect fat burning drink!

Legumes such as lentils and beans are high in protein, B Vitamins, iron, potassium and other minerals. They are an awesome source of fibre which helps to keep you feeling full for longer and helps to stabilise your blood sugar levels.


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New HIV vaccine to be trialled in South Africa

Durban (CNN)A vaccine against HIV will be trialed in South Africa later this year after meeting the criteria needed to prove it could help fight the epidemic in Africa.

In 2015, 2.1 million new infections were reported -- two-thirds of which occurred in sub-Saharan Africa.
A small trial, known as HVTN100, took place in South Africa in 2015 to test the safety and strength of immunity the vaccine could provide, ahead of any larger-scale testing in affected populations.
Two-hundred and fifty-two healthy volunteers were enrolled to receive either the vaccine, known as ALVAC-HIV/gp120, or a placebo to compare the extent of immune response generated. The results were presented Tuesday at the 21st International AIDS Conference in Durban, South Africa.
"This was precautionary to see if the vaccine looks promising," said Linda Gail Bekker, deputy director of the Desmond Tutu HIV Centre in Cape Town, South Africa, and president-elect of the International AIDS Society, who is leading the vaccine trials.
The vaccine stems from a landmark trial in Thailand in 2009 that was the first to show any protection against HIV, with 31% protection against the virus. This was enough to get experts in the field excited after years with no success.
"The obvious question is: Can we now replicate those results and can we improve upon them with greater breadth, depth and potency?" said Anthony Fauci, director of the National Institutes of Allergy and Infectious Disease, whose organization sponsors the study.
The vaccine was improved for use in the higher-risk populations of sub-Saharan Africa, where a different subtype of the virus also exists.
"We've inserted specific inserts from viruses that have come off the subcontinent," said Gail Bekker. A new component was also introduced to stimulate stronger immunity, known as an adjuvant.
Four criteria were set as measures of its likely effectiveness, including the level of T-cell and antibody response to fight the virus if it were to infect.
"It gives the tick on all four, it does look promising and it should launch," Gail Bekker said. "We wanted to see a particular immune picture that would suggest that a big efficacy trial would be likely to yield results," she said.
"[This] was like the gatekeeper of will we or will we not go ahead," Fauci said, "and the answer is 'yes'."
A larger-scale trial of the vaccine will now begin in 5,400 people across four sites in South Africa in November 2016 and run for three years. A fifth dose of the vaccine will also be given in hope of longer-lasting protection.
The Thai study showed 60% protection against HIV after one year, but this fell to 31% by the end of the trial. The team hopes the new regimen will bring protection levels back up.
"We want to get it up to 60% and keep it there," Fauci said. "That's the reason for the boost and the reason for the adjuvant," he said.
Experts have long been awaiting a vaccine showing enough efficacy to dent the numbers of people newly infected with HIV each year, which fell by 0.7% between 2005 and 2015, according to a study published Tuesday and presented at the conference.
"We're hoping this can be the first licensable vaccine regimen in the world," said Gail Bekker. She acknowledged that this is unlikely to occur purely as a result of the upcoming trial, but hopes the results will provide the evidence needed by manufacturers and vaccine regulators to take it further.
"I don't think we are going to treat [our] way out of this epidemic, " added Gail Bekker. "We are ultimately going to need a vaccine to shut it down."
The first vaccines made available are unlikely to provide enough protection for use on their own, but will instead be needed in combination with the plethora of prevention, treatment and social interventions already in use.
"A vaccine is still hugely important for the epidemic," said Sharon Lewin, director of the Peter Doherty Institute for Infection and Immunity. "Even though we have all these prevention options, nothing will be as good as a vaccine."
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Twist in Zika Outbreak: New York Case Shows Women Can Spread It to Men

The first case of female-to-male sexual transmission of the Zika virus has been documented in New York City, raising the prospect that the disease could spread more widely beyond the countries where it is already endemic and largely transmitted by mosquitoes.


For months, there has been growing concern about the dangers of sexual transmission, but until now the virus has been thought to pass only from men to women or between two men.


“This represents the first reported occurrence of female-to-male sexual transmission of Zika virus,” said a report issued on Friday by the federal Centers for Disease Control and Prevention and the New York City Department of Health and Mental Hygiene.


The evidence of a previously undocumented transmission means is the latest twist in a viral outbreak that continues to baffle and surprise leading experts. It is prompting officials to rethink, once again, the guidance for health care providers and the general public on how to limit the danger of infection, as the pool of those who could be at risk widens.


Much about how the virus works is a mystery, and it remains challenging to detect; 80 percent of those infected show no symptoms. For those who do get sick, the illness is often mild, and there is no treatment.


But Zika can pose a dire risk to pregnant women. It targets developing nerve cells in fetuses and can lead to a birth defect called microcephaly, in which babies are born with abnormally small heads and brain damage. It may also cause developmental problems after birth.


Zika is primarily transmitted by the yellow fever mosquito, Aedes aegypti, which thrives in warm, tropical climates. But 11 countries have documented cases of sexual transmission from a man to a woman. Among the 1,130 people who have received a Zika diagnosis in the continental United States, including 320 pregnant women, the C.D.C. has reported 15 cases of sexual transmission.

In a reflection of the urgency of the situation, White House officials joined with congressional leaders and public health officials this month to denounce the failure of lawmakers to provide much-needed funding to combat the virus. The legislative session in Congress ended on Thursday with lawmakers failing to provide money to fight it.

Continue reading the main story


“The more we learn about Zika, the more concerned we are,” Dr. Thomas R. Frieden, the director of the C.D.C., said during a recent conference call with reporters.

At least seven children have been born with birth defects and five pregnancy losses related to Zika in the United States. The lifetime cost of care is estimated to be $10 million for each sick child.


“Each case is a tragedy,” Dr. Frieden said. “A child that may never walk or live independently.”


The New York case is the first in which a man was infected by a woman, and it raises the prospect that other men — with no travel history to Zika-affected areas and no reason to suspect that they might have the virus — could become infected and pass the virus on, creating a new chain of transmission.


In the report, researchers found that a man, who was in his 20s and did not travel outside the United States during the year before his illness, contracted the virus after one instance of vaginal intercourse, without a condom, with a woman who had recently returned from a country where the virus is endemic.


Dr. Mary T. Bassett, the city’s health commissioner, said there were several factors in this case that might have raised the risk of infection: The man was uncircumcised, the woman was in the early stages of her illness when her viral load was high, and she was also at the beginning of her menstrual cycle.


The woman, described as being in her 20s and not pregnant, had sex with her partner the day she returned to the city. The report does not name the country she visited, but the virus is now widespread in nearly 50 countries throughout South America and the Caribbean.


“She reported having headache and abdominal cramping while in the airport before returning to N.Y.C.,” the report said. The next day she developed a number of symptoms associated with Zika, including fever, fatigue, a rash, back pain, swelling of the extremities, and numbness and tingling in her hands and feet.


She reported that her period, which began that day, was also heavier than usual.

Her primary care physician sent blood and urine samples to the city and state health department laboratories for testing. The tests detected the virus but not antibodies to it, which suggested she was newly infected; it takes four or five days for the body to begin producing antibodies.

Seven days after intercourse, the woman’s partner developed a fever, followed by a rash, joint pain and conjunctivitis. The report said the man had not had any other recent sexual partners or been bitten by a mosquito within a week before his illness.

Three days later, the man went to the same primary care physician who had diagnosed Zika in his partner. The physician sent samples of his urine to the same laboratories, and the virus was detected.

According to the report, the man “did not report noticing any blood on his uncircumcised penis that could have been associated with vaginal bleeding or any open lesions on his genitals immediately following intercourse.”
It is unclear if the virus was transmitted to the man by the woman’s menstrual blood or by vaginal fluids. If the virus was passed along through vaginal fluid, there is very little information on how long it might persist there or how great the risk of transmission during intercourse is.
The report cites a recent study of nonhuman primates where three nonpregnant females were found to have the virus present in vaginal fluid up to seven days after exposure.
“Further studies are needed to determine if the virus is also found in the vaginal fluid of humans and, if so, for how long,” the report said.
Zika has previously been known to be transmissible via semen, where it can persist for months. The current guidance from health officials is that men who may have been exposed either abstain from sex or use a condom for six months.

Women who are pregnant or trying to conceive are warned not to have unprotected sex with men who have been in areas where the virus is spreading during that time.

Even though it is just one case, the fact that the disease can be transmitted from women to men — widening the pool of those at risk — will have to be factored into the response from public health officials.

The Aedes aegypti mosquito remains the major means of infection. In the United States, that species is found mostly in the South and the Southwest, though its range can spread in the summer. That mosquito is not present in New York, but a similar species, the Asian tiger mosquito, could theoretically pose a threat of transmission, health officials have said.

In response, the city has stepped up its mosquito control and surveillance, and it will soon be starting a new public education campaign that will continue to highlight the risks posed by mosquitoes but with added emphasis on the risks of sexual transmission.
Source: NYtimes.com
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Can Running Make You Smarter?

strengthen your mind, you may first want to exert your leg muscles, according to a sophisticated new experiment involving people, mice and monkeys. The study’s results suggest that long-term endurance exercise such as running can alter muscles in ways that then jump-start changes in the brain, helping to fortify learning and memory.

I often have written about the benefits of exercise for the brain and, in particular, how, when lab rodents or other animals exercise, they create extra neurons in their brains, a process known as neurogenesis. These new cells then cluster in portions of the brain critical for thinking and recollection.

Even more telling, other experiments have found that animals living in cages enlivened with colored toys, flavored varieties of water and other enrichments wind up showing greater neurogenesis than animals in drab, standard cages. But animals given access to running wheels, even if they don’t also have all of the toys and other party-cage extras, develop the most new brain cells of all.

These experiments strongly suggest that while mental stimulation is important for brain health, physical stimulation is even more potent.

But so far scientists have not teased out precisely how physical movement remakes the brain, although all agree that the process is bogglingly complex.

Fascinated by that complexity, researchers at the National Institutes of Health recently began to wonder whether some of the necessary steps might be taking place far from the brain itself, and specifically, in the muscles, which are the body part most affected by exercise. Working muscles contract, burn fuel and pump out a wide variety of proteins and other substances.

The N.I.H. researchers suspected that some of those substances migrated from the muscles into the bloodstream and then to the brain, where they most likely contributed to brain health.

But which substances were involved was largely a mystery.

So for the new study, which was published last month in Cell Metabolism, the N.I.H. researchers first isolated muscle cells from mice in petri dishes and doused them with a peptide that affects cell metabolism in ways that mimic aerobic exercise. In effect, they made the cells think that they were running.

Then, using a technique called mass spectrometry, the scientists analyzed the many chemicals that the muscle cells released after their pseudo-workouts, focusing on those few that can cross the blood-brain barrier.

They zeroed in on one substance in particular, a protein called cathepsin B. The protein is known to help sore muscles recover, in part by helping to clear away cellular debris, but it had not previously been considered part of the chain linking exercise to brain health.

To determine whether cathepsin B might, in fact, be involved in brain health, the researchers added a little of the protein to living neurons in other petri dishes. They found that those brain cells started making more proteins related to neurogenesis.

Cathepsin B also proved to be abundant in the bloodstreams of mice, monkeys and people who took up running, the scientists found. In experiments undertaken in collaboration with colleagues in Germany, the researchers had mice run for several weeks, while rhesus monkeys and young men and women took to treadmills for four months, exercising vigorously about three times a week for approximately an hour or sometimes longer.

During that time, the concentrations of cathepsin B in the jogging animals and people steadily rose, the researchers found, and all of the runners began to perform better on various tests of memory and thinking.

Most striking, in the human volunteers, the men and women whose fitness had increased the most — suggesting that they had run particularly intensely — not only had the highest levels of cathepsin B in their blood but also the most-improved test scores.

Finally, because there’s nothing like removing something from the body to underscore how important it may be, the scientists bred mice without the ability to create cathepsin B, including after exercise. The researchers had those mice and other, normal animals run for a week, then taxed their ability to learn and retain information.

After running, the normal mice learned more rapidly than they had before and also held on to those new memories well. But the animals that could not produce cathepsin B learned haltingly and soon forgot their new skills. Running had not helped them to become smarter.

The lesson of these experiments is that our brains appear to function better when they are awash in cathepsin B and we make more cathepsin B when we exercise, says Henriette van Praag, an investigator at the National Institute on Aging at the N.I.H. who oversaw this study.

Of course, increases in cathepsin B explain only part of the benefits of exercise for the brain, she said. She and her colleagues plan to continue looking for other mechanisms in future studies.

They also hope to learn more about how much exercise is necessary to gain brain benefits. The regimen that the human runners followed in this study was “fairly intensive,” she said, but it’s possible that lighter workouts would be almost as effective.

“There is good reason to think,” she said, “that any amount of exercise is going to be better than none” for brain health.

Source:NY Times

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The Fastest Way To Pay Off $10,000 In Credit Card Debt

What's the best way to pay down a credit card balance as quickly as possible, while paying the least in interest, and without hurting your credit? What follows is a powerful method recommended by the most astute personal finance experts* to achieve exactly those objectives. It's extremely effective, completely legal, and leverages programs created by credit card issuers to your advantage. Follow these steps and start to become credit card debt-free.

Step 1: Use A Powerful Tool To Immediately Stop Paying Interest On Your Balance

Think of someone carrying a credit card balance like a patient who enters an emergency room bleeding badly. The first thing a doctor will do is stop the bleeding. It's no different when attacking a credit card balance; the first thing you do is stop the interest charges.

There's a simple way to do this, and it's brilliance is that it actually uses the banks' marketing offers to your advantage: find a card offering a long "0% intro APR balance transfer" promotional offer, and transfer your balance to it. These are cards which offer new customers a long period of time (often as much as 18 months) during which the card charges no interest on all balances transferred to it. We constantly track all the cards in the marketplace in order to find the ones currently offering the longest 0% intro periods.

If you need more motivation, just think of this: on a $10,000 balance, $150 of a $200 monthly payment would get vacuumed up by interest charges.** That leaves only $50 of your $200 that actually reduces your balance, the rest vanishing into bank pockets. That's just brutal. Use our reviews to find a card which offers the longest possible no-interest period while charging low, or even no fees. Moving your balances to the card you choose will stop the bleeding, allowing you to move on to step two.

Step 2: Power Through Your Balance During The 0% Period.

Once you've transferred your balances and put a stop to the interest charges, it's time to capitalize on the interest-free period to really break free of the debt. The best part of this is how simple it is: just keep making the payments you used to make when you had to pay big interest payments. Going back to the $10,000 example above, if you transferred that balance onto a card like the Chase Slate (which offers 15 months of 0% intro APR with no transfer fee) and maintained the same $200 monthly payment, you can see how much faster you'll be reducing your balance in the chart below.

As you can see, without using the 0% card, the same $200 monthly payments barely make any headway. It's like swimming upstream, or walking while taking a step back for every two steps forward. That's no way to swim or walk, and attempting to pay off your cards while paying high card interest rates is no way to manage your finances. Move your balances onto one of the cards below, stop getting crushed by interest, and start making real progress toward getting rid of your card debt.

Source: Lending Tree.com

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Cancer research could help the search towards an HIV cure

(CNN) HIV/AIDS is perhaps the most important global health crisis in modern history. Dramatic progress has been made in controlling the virus, but efforts to find a cure are still in its infancy.

To date only one individual, Timothy Brown, is known to have been cured of HIV infection.
The process that cured Mr. Brown, a dangerous and expensive stem cell transplant from a donor known to be immune to HIV, was related to his treatment for acute myeloid leukemia. It is not a practical route to cure others, but it did prove one critical point -- curing HIV is possible.
Finding a safe, affordable and scalable cure for HIV is a formidable challenge. Scientists have known for decades that HIV infection persists even when viral replication is effectively controlled by antiretroviral therapy. The virus can hide inside cells forever during therapy and re-emerge rapidly, and at any time, once treatment is stopped.
Despite these challenges, the quest to develop a cure for HIV has made remarkable advances over the past four years. Researchers have not been able to eliminate the virus from anyone except Mr. Brown, but in a handful of cases very early treatment with antiretroviral therapy has enabled an individual's immune system to control the virus, without any need for treatment. These rare "post-treatment controllers" stay off therapy for years without any evidence of the disease, raising the possibility that pathways to achieving lasting control of the infection in the absence of treatment—a remission using the cancer model—may be available for discovery.

Linking HIV to Cancer

The parallels between HIV and cancer are striking. We now know that controlling HIV in the absence of therapy will require the generation and maintenance of powerful CD8+ -- or "killer" - T cells that can target vulnerable parts of the virus. The challenge is remarkably similar to that in oncology, where the goal of innovative therapies is to generate killer T cells that recognize and clear cancer cells.
Many of the key immune pathways now being therapeutically manipulated to cure cancer were first discovered in studies of chronic viral infections, particularly HIV. For example, inhibitory pathways known as immune checkpoint blockers -- that control immune responses and ensure self-tolerance -- can reverse the brakes on killer T cells, enabling them to clear cancer (and presumably HIV-infected cells). Many people with once fatal cancers are now in long-term remission as a consequence of these new approaches.
Efforts are now underway to determine if these cancer therapies can be used to build up the immune system of patients with HIV in such a way that they too can achieve a durable and perhaps life-long treatment-free state of remission.
Both disciplines also struggle with the need to quantify the burden of disease. Cancer cells and HIV-infected cells are exceedingly difficult to distinguish from normal cells. They often also reside in tissues that are difficult to access. Intense efforts are therefore being aimed at quantifying the size, and distribution, of the disease in both disciplines, with often-similar approaches being taken.
Timothy Brown was cured by the work of a highly resourceful team of oncologists. His case illustrates that we need to do more to bring HIV and cancer research together -- incentivizing scientists to work across diseases and ensuring that research funding allows for these synergies.
Transformative advances in the cancer field may well provide inspiration for future directions of a strategy to guide those working towards an HIV cure.
Source: CNN
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Don't get burned: Are you using sunscreen right?

Still not wearing your sunscreen? Here are a few good reasons to start: Skin cancer is the most common cancer in the U.S. It's also the most preventable, says Clinical Associate Professor of Dermatology at NYU and Vice President of the Skin Care Foundation Dr. Elizabeth Hale, since regular use of sunscreen is one of the most effective prevention strategies around. What's more: 90 percent of skin damage (aka premature skin aging) is caused by UV exposure, says Hale. And (you guessed it) regularly wearing sunscreen is one of the best ways to stave off this wear and tear.

But even if you're fully committed to wearing sunscreen, good intentions aren't enough. In order to get the most protection from that bottle, it's critical you slather right. For those guilty of committing the 10 common sunscreen sins below, remember this: A little extra care will pay off big time in the end.
10 Worst Sunscreen Slip-Ups
1. You don't wear it every day.
If you only think to put on sunscreen on beach days or at pool parties, then you're not wearing it nearly often enough. "Most of the sun damage we get is from cumulative incidental damage," says Hale. Walking to work (or from work to a coffee shop), driving, even sitting by a window can all add up to cumulative damage over time. Get in the habit of putting on sunscreen every single day in order to have the best chance of staving off skin cancer and signs of aging, says Hale.
2. You don't wear enough.
To be adequately covered by sunscreen, a few pats isn't going to cut it. "Every inch of exposed skin should be covered every single day," says Hale. A good rule of thumb? If you're using a lotion-based sunscreen and the goal is to cover exposed skin all over your body, you should use approximately a shot glass' worth to give yourself a baseline coat. If you're walking to the office and just looking to cover your neck and arms, a quarter-sized dollop should do the trick. If you're using a spray, you should see an even sheen all over your skin before rubbing it in.
3. You don't reapply.
No matter how thoroughly you slather, you'll still need to put more on if you're planning to spend several hours outside. "The correct teaching is that you need to reapply sunscreen every two hours," says Hale. But if you're swimming or perspiring heavily, you should plan to reapply even more frequently. (Runners, listen up!)
4. You're using the wrong SPF.
There's a lot of conflicting information out there about which SPF level provides the right amount of coverage. "The American Academy of Dermatology still says 15 for regular days and 30-plus for pool days," says Hale. These attitudes are starting to shift a bit, however, and Hale recommends a daily broad-spectrum sunscreen of SPF 30 or higher. But no need to shell out for SPF 100. "Above SPF 30, there's a negligible difference," says Hale.
5. You don't know chemical from physical sunscreens.
Fun fact: There are two broad categories for sunscreen and the type you choose will influence when and how it should be applied. Chemical sunscreens work by absorbing the sun's rays, while physical sunscreens (such as zinc and titanium oxide) work by deflecting them, says Hale. For maximum effectiveness, chemical sunscreens should be applied directly onto the skin (i.e. before applying other body products) 30 minutes before heading outside in order for them to fully absorb into the skin. Physical sunscreens, on the other hand, can be applied over other body products and are effective immediately upon application.
6. You think your clothing's got you covered.
Just because your skin is covered by a layer of clothes doesn't necessarily mean it's protected from sun damage. "Unless you're wearing sun-protective clothing, regular clothes don't really afford enough sun protection," says Hale. For example, a white T-shirt only offers SPF 7. If it gets wet, that goes down to a measly SPF 3. For best protection, always use sunscreen in conjunction with your #OOTD. (It also helps to seek out shade and avoid being outside during peak sunlight hours.)
7. You're a sunscreen hoarder.
Got the same bottle of sunscreen tucked away in your medicine cabinet or under your car seat since 2013? (Guilty as charged.) While it's easy to think that you don't need a new bottle until the old one is done, the reality is a little more complicated. "Most sunscreens are good for up to two years," says Hale. "But if you keep it in your car or golf bag or another sweaty, hot environment then it destabilizes and the sunscreen is less effective." A good rule of thumb? If you're good about keeping sunscreen in a cool, dry place, it should keep for a year or two. But if you ever leave it exposed to the elements, replace it every season, Hale says.
8. You think your makeup's SPF is sufficient.
"It's great if your makeup has SPF, but it's really not enough," says Hale. For one thing, you might not be applying it with the same amount of coverage on different areas of your face. For another, it's rarely used on the neck and shoulders. In order to ensure you're adequately protected, Hale recommends using a moisturizing product with SPF before applying makeup on top.
9. You've got OTC interference.
Both over-the-counter and prescription body products or medications can make you more sensitive to the sun, says Hale. And that means you're more likely to burn. Two common examples are prescription doxycycline (an antibiotic prescribed for acne) and body products containing Retin-A and/or retinol. It's important to know that these products will make your skin more sensitive to sunlight, says Hale. If you're committed to using them, be sure to compensate by using a higher SPF (at least 30 or higher) and applying sunscreen more frequently.
10. You rely on 2-in-1 bug repellent/sunscreens.
"[Bug repellent and sunscreen] are very different and should be used very differently," says Hale. This is especially true because sunscreen needs to be applied much more frequently than bug spray. Hale recommends avoiding combination products and instead applying a base layer of sunscreen before using bug repellent.
The good news: Even if you're currently committing every sunscreen mistake in the book, it's never too late to adopt better sunscreen habits. Nail them down now, and you'll protect your health for years to come.
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The superpowered secret to get kids to eat veggies

(CNN)Apparently, marketing is key to get youngsters to eat more veggies.

Scientists have showed that marketing junk food and sugary drinks in commercials to children directly influences the amount of unhealthy foods those kids consume. But what happens when healthy foods are marketed in the same way?
Branded marketing tactics -- from banners to commercials -- nearly triple the likelihood of a child choosing to eat vegetables at lunch, according to a study published in the journal Pediatrics on Tuesday.
If elementary schools nationwide strategically implement these marketing interventions, children's nutrition at lunch will most likely improve, said Andrew Hanks, assistant professor of human sciences at Ohio State University and lead author of the study.
"To claim that their overall health will improve is more complicated, but it is a possibility," he said. "Strategic marketing can have powerful effects on food choices."
The researchers tested three marketing approaches in 10 public elementary schools in New York for six weeks. One approach involved displaying vinyl banners showing animated vegetable characters with super powers called "Super Sprowtz" around the salad bar in schools' cafeterias. The characters included Colby Carrot, whose eyes shoot orange laser beams, and Brian Broccoli, who flexes his arms.
nother approach involved showing short television segments about health education, delivered by the vegetable characters, in the school lunchrooms. The third approach combined the banner with the video segments. A control group experienced no marketing interventions.
The researchers found that almost 100% more students took vegetables from the salad bar when exposed to the banners alone. Before the banners, only about 12% of students took vegetables, but after the banners, about 24% of students did.
The banners combined with the videos, however, resulted in a whopping 239% increase in the number of students who visited the salad bar. So before the marketing, only about 10% of students took vegetables, but after, about 34% did.
However, the television segments alone did not have a significant impact on students' eating behaviors, the researchers noted.
"I was surprised to learn that the TV segments weren't effective," Hanks said.
"Based on the results, it seems that the banners were most effective," he added. "They were effective when used alone and carried the effect when used with the TV segments. The banners were most effective since they were placed right at the point of selection. The TVs were placed where space and electricity were available."
In a separate paper, a Canadian research team analyzed how similar marketing strategies for unhealthy foods and beverages can influence children's eating behaviors. The research was published in the journal Obesity Review on Tuesday.

Rules to make school lunches healthier are working, study finds

The researchers identified and reviewed 26 previous studies on children's food preferences and intake after they were exposed to food and non-food advertisements. In total, the studies included almost 6,000 children ranging in age from 2 to 18.

After analyzing the studies, the researchers found that children exposed to the marketing of unhealthy foods consumed significantly more. Being exposed to a five-minute advertisement was linked to eating nearly 4.5 grams more of junk food than otherwise, according to the paper. Similarly, children exposed to ads consumed 30 calories more of junk food than those not exposed to junk food ads.
The researchers also demonstrated that children 8 or younger seemed to be more susceptible to the impact of marketing.
"The findings from this review contribute to the growing body of research suggesting that the marketing of energy-dense, low-nutrition foods and beverages to children contribute to increased consumption of unhealthy calories -- an average of 30 calories more during or shortly after exposure to advertisements -- which puts children at increased risk for obesity and diet-related diseases later in life," said the paper's lead author, Bradley Johnston, director of Systematic Overviews through advancing Research Technology at the Hospital for Sick Children in Toronto and assistant professor at the University of Toronto.
On average, children are exposed to about five food commercials per hour while watching television, according to a 2010 study published in the American Journal of Public Health. The majority of those ads tend to feature unhealthy foods.
o get children to eat more fruit and vegetables, the Centers for Disease Control and Prevention advises parents to set an example by eating healthy foods along with their kids, as well as providing fruit and vegetables as snacks and during celebrations. Also, it helps when children work in gardens and grow their own produce.
However, many researchers are eager to see what would happen if more ads focused on healthy foods.
"We all know marketing works," Hanks said.
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13 Snacks That’ll Boost Your Metabolism!


You will never meet another person more in favor of the avocado and it should be in every weight loss plan and guide on how to lose weight. Avocados are high in fat but it is monounsaturated fat which is great for your body. The fat in avocados helps to raise your metabolism while dealing you a healthy serving of protein, fiber, and fat all in one tasty and handheld green skin. Make guacamole with low fat ingredients or merely add avocado to your sandwiches in order to get an instant boost to your diet.


High Fiber Cereal

Cereals that are high in fiber have been scientifically shown to be the perfect breakfast item for those people looking to improve their metabolism in a healthy way. According to the Journey of American Dietetic Association, women who ate cereal regularly were 30% less likely to be overweight. High fiber cereals digest slowly and also boost your metabolism, meaning they keep you full and energized much longer. The fiber in the cereal also keeps your insulin levels on the regular which prevents the addition of fat to your body, as well.


Adding low fat cheese to your fridge, sandwiches, and entrees can be a great way to spike your fat burning potential without ever having to sacrifice flavor for effectiveness. The boost of calcium and protein do wonders to your diet and the ease with which these cheeses can be integrated into a complex diet is almost impressive. There are trap cheeses, however, so stick to the low fat ones for the biggest fat burning effect.

Jalapeno Poppers

If you don’t mind adding a little bit of heat to your diet then consider Jalapeno poppers. Jalapenos are full of a chemical known as capsaicin that does wonders to your metabolism. The chemical will increase your heat rate, boost your metabolism, and make enduring the heat of the pper well worth it by the time you are done. Avoid heavily fried poppers, however, as they are heart attack traps waiting to happen. Opt for oven cooked snacks for the best middle ground between effect and tastiness.


Milk is an unorthodox addition to the metabolism boosting list of snacks but it fits in all the same. So long as you are getting good milk and avoiding chocolate or other artificial flavors you should be good. Milk is full of calcium and it helps you energize your complex carbohydrates. Switch out your bottle of soda at dinner with a glass of tasty milk. Milk will prevent weight loss and boost your fat burning abilities. Avoid adding cookies to your snack! if you want to boost the treat, however, you can add a splash of protein powder to make the snack into a filling meal with the same goal of losing weight.

Lean Meat

Beef has gotten a bad rep in the weight loss world thanks to foods like hamburgers, lasagna, and gigantic and juicy steaks. However, lean meats like beef, chicken, and turkey can all be looked at as supporters of metabolism growth. The big reason why these foods are so helpful in metabolism boosting is the fact that they take so long to digest and thus expend a large amount of energy. The protein that you will imbibe also means that you will be burning fat, not muscle, so that you will maintain a measure of your form and figure. Lean turkey, in the proper serving, can give you access to 26 grams of protein versus just 1 gram of fat and a total of 120 calories. This is an effective and life changing ratio.

Greek Yogurt

Get an extra blend of protein into your diet by adding Greek yogurt to your snack plans. Greek yogurt has almost 18 grams of protein per 6 ounces and it is usually devoid of all the filler and additives that is prevalent in other yogurt products. This is a quick filling way that works well with other snacks on this list. Adding in oats or berries can turn this snack to the maximum level of fulfilling. Avoid chocolate chips, in general but if you must then add only a few of the dark chocolate variety, which are full of antioxidants.


Garlic, though foul smelling, should be considered a must add in your diet. Garlic is full of health benefits that range against disease fighting all the way to immunity boosting. Not to be skimped over ,garlic also helps you to shed weight. Garlic is found in many common daily foods that lead to the body’s production of fat. Don’t eat garlic by the clove, however, as you must still opt for moderation. Add garlic to your pasta dishes as a way to get a lot of flavor while also doing your body a big favor. The Journal of Nutrition shows a direct link with calories burned during daily activities and meals that included garlic that were consumed prior to said activities. Make sure to bring some minty gum to get the smell out!


Just about any kind of berry will be at home in your metabolism boosting diet but we highlighted raspberries for a reason. Raspberries contain 8g of fiber by the cup and sit at only 60 calories per serving. This sweet little snack is perfect to round out on the go lunches or to add in the repertoire of picky eaters. Raspberries are sweet and easy to eat and most of all affordable at the supermarket. Stock up on raspberries or any other berry that is high in fiber (strawberries, blueberries) in order to reap the benefits down the line. To make this a minor treat add a little bit of whip cream and oats to your bowl. The oats will boost your fiber content while the whip cream will add some sweetness.


Oranges are a popular snack that have been the cornerstone to on the go lunches forever. This citrust fruit is stocked full of vitamin C that helps you to metabolize fat quicker than ever. Your daily dose of vitamin C should sit at 60 MG per day but if you consume upwards of 500 MG then you can see your fat burning abilities boost by almost 50%. Eat an orange with your pre-workout meal and reap the benefits when you start to sweat over the machines for the next hour. Studies show that eating oranges for 12 weeks will result in rapid weight loss.


At this point in the scientific advancements of nutrition salmon should be a staple in the diet of most people. This fish is full of great oils, nutritious, and loaded with Omega-3 Fatty Acids. Salmon helps to reduce your bodies leptin hormone levels and in turn prompts your body to burn more calories. Not only will eating salmon instead of red meat, for example, help you lose weight but it will also do wonders for your hair and skin. If you don’t like the taste of salmon or just fish in general you can instead opt for fish oil capsules. These capsules are easy to consume, lacking in odor, and an effective replacement for the actual salmon itself.

Green Tea

When speaking comparatively, green tea is goign to beat the heck out of most common beverage options available in the grocery store. From pop to sugar filled juices, there are very few ready to drink consumables that will help your metabolism. Green tea is a great replacement to coffee because it doesn’t rely on caffeine in order to boost your metabolism. A chemical called EGCG boosts the activity inside of your brain, kickstarts your nervous system, and starts the burning of calories that will last throughout the day. Green tea is a bland drink but can be spiced up with minor amounts of honey for a tasty lunch beverage.


Grapefruit has gotten a sort of gimmicky reputation thanks to the uber popular but ultimately failed grapefruit diet that circulated the internet a few years back. This failed diet doesn’t disprove how effective grapefruit is when used as a metabolism booster. This citrus laden fruit is filled with fiber t hat leaves you fuller for a longer period of time. The galacturonic acid inside of the grapefruit also helps your body breakdown stored fat in your body. Adding a grapefruit to your breakfast routine could go a long way toward cutting the LBs and looking better than ever.

Source: HealthTip.com

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Minister calls on health workers to be efficient

Koforidua, June 2, GNA - Mr Alex Segbefia, the Minister of Health, has urged health workers to uphold the tenets of the profession to meet the expectations of their clients.

     He said, though workers work under tight budgets and limited resources there is the need to maintain the standard of delivery in the sector.

     Mr Segbefia said this, when he paid a working visit to the Eastern Region, where he visited Koforidua Regional Hospital, Suhum Government Hospital, Nankese Health Centre and Akote CHPS Compound.

     He also paid a courtesy call on the Regional Minister.

      Ms Mavis Ama Frimpong, the Regional Minister said good health care is the bedrock of the general development of a country and expressed the hope that the visit by the sector minister would help address some of the health challenges in the area.

     She said though government is constructing health facilities across the 26 districts and municipalities of the region and more communities are waiting for their turn.

      She appealed for more CHPS compounds, polyclinics and district hospitals to be constructed to help improve health delivery in the region.

     Dr Mrs Charity Sarpong, Regional Health Director said, out of the 26 districts and municipalities, 18 of them have access to a district hospital and by the end of the year  all the various  zones in the region  would have a CHPS compound to help complement  health care delivery.

    She however said the region is faced with challenges such as inadequate staff, as well as logistics to help health workers work effectively.

     Dr Sarpong called for the building of a robust system to offer quality health services.

     Dr Kwame Anim Boamah, Medical Superintendent of the Koforidua Regional Hospital said the hospital strives for excellence in service delivery.

Source: GhanaWeb. com

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Doctor uses iPad to conduct remote surgery in Gaza

(CNN)In countries ravaged by conflict, providing international medical expertise on the ground can be almost impossible.

But a new software, called Proximie, is enabling surgeons to provide help from wherever they are in the world, all through the screen of an iPad.
"I see on my screen the surgical feed that is being captured by the camera in Gaza and I'm able to draw on my screen the incision that needs to be done," says Dr. Ghassan Abu-Sitta, Head of Plastic Surgery at the American University of Beirut Medical Center.

"Like being in the room"

Abu-Sitta has already used the Proximie software to lead two operations in the Gaza strip from his base in Beirut. From hundreds of miles away he showed colleagues how to negotiate a blast injury and operate on a congenital anomaly affecting the hand.
The software means that surgeons can demonstrate -- in real time -- the actions needing to be taken on the front line.
The procedure uses two smart phones or tablets connected to the internet which show a live camera feed of the operation. The surgeon sees this, and then marks on their device where to make incisions.
"That drawing shows up on my colleague's screen in Gaza and he follows my drawings by making the incisions where they appear on the screen," says Dr. Abu-Sitta, "It really is the equivalent of being there in the room with them."
With two thirds of the world's population lacking access to safe surgery, the time is ripe to develop new techniques to reach more remote areas.

A helping hand

Being able to watch surgery in progress could also make it a useful training aid.
"We want to be the platform for medical students to really engage in surgery," says Proximie co-founder Dr. Nadine Hachach-Haram. "Historically the old viewing galleries that happened in surgery where students could come in and learn and watch, they don't exist anymore.
"Surgery is very visual. You can read it in a book if you want but it's not the same as watching it live, so this is where our platform really fits in."
According to Peter Kim, Vice President of the Sheikh Zayed Institute for Pediatric Surgical Innovation, Proximie could be a positive addition to the range of other products using cameras and video for real-time sharing.
"I think the need and effort to share best practice and dissipate very siloed experiences in medicine should be supported," says Kim. "Those involved should be applauded for their effort but if it is a product with cost attached to it, the value must be clearly articulated."
Previously, Abu-Sitta and his staff were trying to help overseas surgeons by sending them audio recordings, photos and X-rays using the online messenger WhatsApp. But the new software is far more interactive, providing detailed images and patient information throughout the surgery.
"We wanted to push the idea that with only the minimum hardware, and minimum infrastructure you can still pull it off," says Abu-Sitta, "With just two tablets, iPad to iPad, we're able to perform this surgery."
Whether it's used for education or to conduct delicate surgeries in conflict zones, internet enabled software such as Proximie could be the future of surgery.
Source: Cnn.com
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Why strong friendships are key to men's mental health

CNN)For decades this Philadelphia physician lived a life inside his head, rarely expressing himself with his heart. He says his inability to open up wasn't good for his first marriage, or his second.

"I did not want to get divorced again, did not want to go through this thing with a broken family with kids," he says. "That was really very painful the first time."
This father of five, who wants to remain anonymous for his children's sake, looks back on his life and the mistakes he made.
"I frequently made assumptions and would mentally go over things in my head at home, all the time assuming that for example my wife was thinking or feeling something without asking her or checking in. I was living in sort of a delusional land for a while."
He says he felt frustrated about how to develop more intimacy in their relationship. Things got so bad that his second wife asked him to move out of the house.
"It was really a horrible experience," says the man, now 71. "It was lonely. I could be in my head all I wanted but it was deafening silence, lack of any kind of closeness... that actually helped me define what I really wanted primarily in my life, which was my relationship with my wife."
That was more than 20 years ago. It was a turning point that saved his marriage.
He and his wife went to a marriage counselor, but that wasn't enough to bring him out of his shell. Nor was one-on-one counseling.
So a therapist, psychiatrist Dr. Rob Garfield, recommended he join his "Friendship Lab," a therapeutic group of 5 to 7 men who learn how to become more comfortable opening up about their problems. They meet every other week with Garfield and his co-therapist, Jake Kriger, at the Men's Resource Center in Philadelphia. The two developed this model of group therapy 20 years ago.
"These are the same guys in their own community that can be functioning fairly well but personally feel disconnected," says Garfield, author of the 2015 book, "Breaking the Male Code: Unlocking the Power of Friendship."
Several of the men in the group have been members for more than 10 years. It helps participants learn to trust one another, communicate and open up.
Garfield says this physician who suffered from isolation is far from alone. He finds that many men, middle-aged and older, are a product of generations of male "coding."
"This is the way we're supposed to be: emotionally restrained, keeping things close to the vest, being in control, independent, competitive," he says. "These start from the time we're kids, as early as the age of three, and are reinforced through adulthood: the boy code, the guy code."
Garfield himself had great difficulty opening up decades ago. He went through a divorce and was starting a new career in his twenties.
"In men's group, it really accelerates their progress because they're getting support and actually hearing themselves kind of mirrored by other men, who on the surface look pretty good but are going through the same things," he says.
The Philadelphia physician, who asked that his name be withheld out of privacy concerns, has been a part of the friendship lab for 20 years.
"It's just a main venue that's safe for expression for anything that you wanted to bring up with the idea that you're not going to be judged, you're going to be heard, that you're going to get honest feedback from guys that you know, respect and like," he says.
"I didn't tend to have sustained relationships with men that would allow me to get into a lot of this personal information. I never had problems per se relating from a guy to a guy. As far as relating some of these issues, there wasn't really anybody I would trust. That I could tell them about anything that was on my mind."
Garfield, who teaches in the Department of Psychiatry at the University of Pennsylvania, designed a national survey in 2012 with a research group looking at the friendships of 380 men from a variety of age groups, races and ethnicities.
"Most guys have friends. In general the research shows men have as many friendships as women have but the quality is often very different. If a guy tells you he has a good friend, he may see them once every 3 to 5 years," says Garfield.
"What they wanted was more emotional intimacy in friendships to be able to express their feelings more."
Some men might also worry they will lose their romantic partner's respect by being too "soft." Garfield disagrees.
"My experience in getting feedback from women is that it's a relief. They're not thinking this guy is turning into a wimp," he says. "He's actually present and accounted for. He's showing up."
Dr. Garfield says one of his roles in the Friendship Lab is to help steer the men to talk using a language of emotion.
"Some men are actually able to do this fairly easily. Other men have to learn words like sad or shocked or hurt, these kinds of feeling words that actually put them in touch with raw emotions that they're feeling," says Garfield.
Garfield says the price of not opening up is not just profound depression but illness as well. Some men come to the group complaining of gastrointestinal problems or other issues like drinking too much.
"Many of these guys have physical kinds of problems that they don't really understand is connected with their isolation," says Garfield.
The Philadelphia physician says it took months to begin to trust others in the group, but after years that included annual sailing or other bonding day trips, he began to open up knowing that what they said in group was confidential and safe.
"The group itself is brutally honest. We're very interested in not discussing fluff in any way or small talk, and if someone is having a hard time expressing where they are, for whatever reason, it becomes pretty apparent because you've been working with these people for years. There's no hesitancy to call somebody else out to say listen, 'This really is not you. You're really being inhibited. What's going on?'"
Today the 71-year-old says he truly has happiness in his life because of this group.
"This is the best I've ever felt, which is really good. I feel more like a whole person rather than a shadow," he says.
"I felt grateful that they were giving me honest feedback so I could get out of my head and more into the reality of what was going on in my life. I think it was like peeling away sort of an onion, a little bit at a time."
Source: CNN.com
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What makes a good speller (or a bad one)?

(CNN)By the time he was 6 or 7 years old, Sameer Mishra was a pretty confident speller. His memory was sharp, he liked to read, and he actually enjoyed the weekly tests at school. While his parents drilled his older sister, a National Spelling Bee competitor, he'd angle for his own list of words.

Within a few years, he made it to the big bee in Washington, too. On his fourth and final trip there in 2008, he won by spelling the word "guerdon," meaning "something that one has earned or gained." Yes, Mishra is a good speller.
But everyone knows people who claim they're terrible at it and never were any good. They'd rather just use spellcheck, they say. To Mishra, they'll confess, embarrassed, "I misspelled 'banana' in the fifth-grade spelling bee" and just gave up.
So what is it that separates the spelling stars from the dictionary-deficient?
For those on stage at the National Spelling Bee this week, it often meant five hours a day memorizing words or studying etymology. For the perfectly good, non-bee spellers among us, it might mean they enjoyed reading from an early age.
But research published this year in the journal Brain suggests it has something to do with how some people's brains retrieve words -- or don't -- and how we manage to get them out -- or not.

The science of spelling

For as easy as the teens on stage make it look to spell "scherenschnitte" and "nunatak," there's a lot happening inside to produce each word.
Start with something a little simpler: "If I tell you a word like 'yacht' and ask you to spell it, maybe you can do it," said Brenda Rapp, a cognitive science professor at Johns Hopkins University and lead author of the Brain study.
If you heard the word and came up with y-a-c-h-t, it probably emerged from the areas of the brain that hold orthographic long-term memory, where spelling knowledge is stored.
If you're not familiar with the term of Dutch origin meaning a recreational watercraft, maybe you'd come up with something like y-o-t or y-a-h-t. You'd probably miss the "ch," but perhaps you'd identify a reasonable spelling that converts the sounds to letters, Rapp said. That process takes place in yet another part of the brain.
In either case, you had to hold those letters in mind, convert them into names or shapes and produce them in the right order. That, Rapp said, is orthographic working memory.
Each component plays a part in spelling a word, and each happens in a different part of the brain's left hemisphere.
Rapp and her colleagues studied 33 people who had trouble spelling after strokes. They struggled with long-term memory, working memory or both. The types of spelling errors they produced often depended on where their brains were damaged.
So what does that mean for those who just can't spell? People who haven't experienced a stroke or been diagnosed with something like dyslexia, which is closely related to dysgraphia, a word for poor spelling?
"To be a really good speller, all of these things need to be working well, and they need to be working well together," Rapp said. "You can imagine that in someone who is a poor speller, it suggests either one or more of these systems haven't fully developed, or they aren't interacting properly."
Human brains aren't specifically designed to do spelling or reading, like they are walking or speaking, Rapp said. Spelling and reading only stretch as far back as written language, several thousand years.
"They have to be learned," Rapp said. "They're not built in."
Most of us were trained in spelling and reading in school, but some will still see their emails marred by the angry red spellcheck lines. What you most often hear people complain about, Rapp said, is that they just can't see the word.
"For really poor spellers that otherwise seem like normal people of normal intelligence, it could be that ... for some reasons we don't understand, even though they had the same experience, they weren't able to create these long-term memory representations," she said.
That doesn't mean there's no hope of getting better or finding ways to cope.

Can you spell i-m-p-r-o-v-e-m-e-n-t?

More research is needed to zero in on which techniques works best to teach and learn spelling, but studying followed by testing has helped all of Rapp's stroke patients improve. Repetition -- "lots and lots of repetition" -- is key, she said.
6-year-old competes in Scripps National Spelling Bee



6-year-old competes in Scripps National Spelling Bee 03:45
"They study the word, then try to spell the word. They study the word, then try to spell the word. Study, spell, study, spell," Rapp said. "It's very important to test yourself."
For the youngest spellers, the key is getting the right words at the right time, said said J. Richard Gentry, an eduction consultant and author of "Raising Confident Readers." They're just learning to connect shapes with sounds and to store those patterns in their long-term memories. Some will still struggle, but a foundation that exposes children to bats, cats, hats and rats, for example, helps them move on to more complex sound and letter combinations, he said.
Spelling training has gotten more precise as research has improved, he said. No longer should students be presented with a jumble of words taken out of context. But neither does he believe that students should be tested on zingers used mostly in the course of a single reading or writing lesson.
"It's great that we're doing more writing, but spelling needs its own time, about 15 minutes a day," he said. "It's all about frequency and patterns."
And for adults who aren't aiming for spelling bee success? They can develop "spelling consciousness," Gentry said. That's what he calls an awareness that you should take the time to spell check an email or ask someone to read your memo before you send it.
"It's not their fault," Gentry said, especially if they have some form of dyslexia or were never really taught to do more than memorize the words on the test.
Even Mishra, the spelling bee champ, who recently graduated from Columbia University, said memorization can't be the only path to good spelling.
"I don't think it's possible to rote memorize the dictionary," he said.

The markers of spelling success

Mishra is attending the National Spelling Bee this week, and he still sees four qualities among the best-of-the-best spellers.
They're self-motivated and a little competitive. It's not about humbling the judges or besting other competitors, he said. The enemy is the dictionary, and the butterflies in their stomachs.
Second, they usually have a coach. It's an English teacher or a parent who helps them along the way, drilling them on words and keeping them on schedule. For Mishra, it was his sister, Shruti, who is now in medical school. When he hit a rough patch and struggled with the same words, she reminded him to run around outside or play video games.
"You can get frustrated, tired, exhausted," he said. "I needed someone to tell me: This is just a spelling bee."
Of course, it comes down to the work. The competitors are all intellectually curious, Mishra said. Great spellers are often avid readers, and they commit a lot of words to memory, but they'll also study prefixes, suffixes, foreign languages and definitions that will help them deduce how a word is spelled.
Just this week, after reading in Mishra's spelling bee bio that he's growing a beard, someone mentioned it was a "pogonotrophic fun fact." Mishra didn't know the word, but he knew that "pogo-" or "pogon-" referred to a beard and "-trophy" meant growing or development.
"It's pattern-building," he said. "A lot of really good spellers are really good at patterns."
Finally, Mishra said, great spellers persevere. Many competitors come back to the National Spelling Bee again and again until they've aged out of the competition. They inevitably leave off a letter or buckle after an intense round, but they don't give up and find something else to fill their time. "Grit" is what parents and educators call that quality nowadays.
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Eight things that happen when you quit alcohol

We all know too much alcohol is disastrous for the human body, though many studies have given us the OK to drink one to two glasses of wine per day, and see some health benefits.

There are even more reasons, however, to stop drinking alcohol completely. Here's what happens to your body when you begin to abstain.


A couple of glasses of pinot at night has a sedative effect on some people, making it easy to fall asleep. However, the quality of sleep you're getting in such a case is likely to be poor. A scholarly review of 27 different studies found that drinking will make you fall asleep quicker, but it'll soon affect the alpha wave patterns in your brain. The result is tossing, turning and waking up more often than usual throughout the night. Cut out alcohol completely and (after an initial period of adjustment) you should find you have longer, deeper sleeps every night.


One of the main reasons people stop drinking alcohol is because they want to start losing weight, because you're cutting out empty calories altogether. Alcohol serves no nutritional purpose: It doesn't give you energy like carbohydrates or feed your muscles like protein. When you cut it out, you cut out hundreds of calories per day that weren't giving you sustenance anyway.


Although the sugar in beverages like wine is fermented into alcohol (and most wines therefore contain no or little residual sugar), a lot of people are satiated by wine's sweet taste. Like sugar, alcohol also gives your brain a hit of pleasurable dopamine and makes your feel temporarily happier. So if you stop drinking alcohol, you'll remove that dopamine hit and might begin seeking it from other sources – such as chocolate. While entirely in your control, this is something to be aware of.


There is some evidence to suggest that light alcohol consumption (1-2 units per day) slightly speeds up your metabolism, but its effect is negligible if weight loss is a goal. Conversely, medium and heavy drinkers see their metabolisms slow significantly with alcohol consumption. Cutting out the drinks completely should see it speed up and make you burn energy more efficiently.


It is estimated that somewhere between 45 and 70 per cent of people with liver disease caused by alcoholism also have diabetes or a form of glucose intolerance. Alcohol wreaks havoc on your blood sugar levels by decreasing the effect of insulin in your body (potentially leading to insulin resistance). When you take booze out of your diet, this risk factor reduces because your body isn't impaired any more and can manage blood sugar levels effectively.


When you're drunk you slur your words, slow down your physical reactions, and your memory function doesn't work as well as usual. What may surprise you is that these effects linger long after you've sobered up, and staying off the sauce can bring your brain back up to optimal speed. In a study published by New Scientist, it was found that five weeks without alcohol improves cognitive function and concentration levels by 18 per cent, alertness by 9.5 per cent, and performance at work improves by 17 per cent.


Bodybuilders are usually teetotallers for good reason. According to a study in the American Journal of Physiology, alcohol consumption hinders workout protein consumption into the muscles, impairing the repair of muscles. Massey University research has even found that drinking alcohol also increases muscle soreness after weightlifting sessions. That's right: Not only does booze make your workouts less effective, it makes them hurt more afterwards, too.


In terms of disease risk, giving up alcohol changes your disease risk both for better and for worse. On one hand, your cancer risk goes down: Cancers of the liver, colon and rectum, breast, and mouth all have links to alcohol, and the more you drink, the higher your risk. Conversely, because light alcohol consumption – again, 1-2 units per day (but not more) – will reduce your risk of heart disease, that means dropping your intake to zero can, theoretically, raise that risk.

Source: Well and Good. com


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Research discovers mechanism that causes cancer cells to escape from the immune system

Under normal circumstances, the immune system recognizes and successfully fights cancer cells, eliminating them as they develop. However, sometimes the process breaks down and tumors form, and now we know why. Researchers at the Texas A&M Health Science Center found that when cancer cells are able to block the function of a gene called NLRC5, they are able to evade the immune system and proliferate, according to research published today in the Proceedings of the National Academy of Sciences (PNAS).

"We found the major mechanism of how cells escape from our and form tumors," said Koichi Kobayashi, M.D., Ph.D., professor at the Texas A&M College of Medicine and a lead author on the PNAS article. The discovery indicates NLRC5 as a novel biomarker for cancer patient survival and therapeutic response, as well as a potential target for new treatments.

"Cancer cells are born because of genetic changes, such as mutations or rearrangement of pieces of different chromosomes," Kobayashi said. "Because of this, all cancer cells have new, 'foreign' genes, which host T-cells generally detect as antigens. This anti-tumor system works very well."

Kobayashi and his colleagues discovered several years ago that NLRC5 regulates major histocompatibility complex (MHC) class I genes. These genes code for molecules on the surface of cells that present fragments of foreign proteins—such as those from a virus or bacterium— that have invaded the cell. These fragments notify a part of the immune system called cytotoxic T cells, triggering an immediate response from the immune system against that particular foreign antigen.

The novel finding in this study is that the same system should work to destroy cancer cells, but sometimes they find a way to disable the NLRC5 gene, thus enabling them to evade the immune system and form tumors.

"If MHC class I antigen presentation does not work, cancer cells will not be killed by T cells," said Sayuri Yoshihama, M.D., Ph.D., a fellow in Kobayashi's lab and first author of the paper. "We found that function and expression of NLRC5 is reduced in cancer cells by various mechanisms, and the result is immune evasion by ."

In fact, based on biopsy samples from 7,747 solid cancer patients in The Cancer Genome Atlas (TCGA) database, expression of this NLRC5 gene is highly correlated with cancer patient survival in various cancer types—especially melanoma, rectal cancer, bladder cancer, cervical cancer and head/neck cancer—with patients who survive longer tending to have greater expression of NLRC5. Among these, melanoma and bladder cancer displayed the most striking differences, with 5-year survival rates of 36 percent and 34 percent in the NLRC5-low expression group compared with 71 percent and 62 percent in the NLRC5-high expression group, respectively.

"With this finding of NLRC5 as an important biomarker for cancer, we can ultimately predict how long cancer patients can survive and how well cancer treatments might work for them," Kobayashi said. It might be especially relevant for melanoma patients, both because NLRC5 mutation rate is relatively high and because its levels of expression are highly predictive of survival for that cancer type.

The team plans to continue its research on the role of NLRC5 in cancer and is actively developing plans for commercialization of technology related to this discovery. A provisional patent application has been filed, and plans are underway to develop and validate a test that can, based on NLRC5 expression levels, be used to predict cancer patient survival and therapeutic response. The hope is that the test will give health care providers one more tool for determining the best treatment strategy for cancer patients to eliminate the burden of costly, unhelpful therapies.

Eventually, Kobayashi and his team hope this discovery might also lead to new therapeutic strategies for cancer.

"If we can regulate the activation of NLRC5 or its expression level, that could be a novel cancer treatment," Kobayashi said. "We hope that in several years, our research may identify potential drug candidates that can increase the levels of NLRC5 and thus help our own immune systems better fight the cancer."

Still, he advises caution. This mechanism of evading the immune system is not employed by every cancer cell, and the research still needs to be replicated in an animal model.

Cancer isn't the only surprising disease that can be affected by the immune system. Kobayashi's previous work in immune function and genetics focused on inflammatory bowel disease, such as Crohn's disease. They also study transplant medicine, trying to determine why some organs are rejected by the new host.

"We now know why cancer can escape from our immune system," Kobayashi said. "No other mechanism is as dramatic as we found. We envision the NLRC5 biomarker as allowing physicians to evaluate and determine the best treatment strategy for each , thus leading to better therapeutic outcomes for the more than 12 million people diagnosed with cancer each year."

Source: Medical Express News. com

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California boy, 7, who donated his hair to cancer patients for years diagnosed with 'aggressive' cancer

A 7-year-old California boy who has donated his hair to cancer patients was himself diagnosed with cancer, his parents said Sunday.

Doctors said Vinny Desautels has “Stage IV aggressive cancer” in growths on a hip, an eye, his nose and his right cheek, his father Jason told KTXL-TV.

 “Well, the veins from my hip are traveling to another place right behind my eye and it's making it squinty,” Vinny, who lives with his family in Roseville — near Sacramento — told the TV station.

The parents of 7-year-old Californian Vinny Desautels told a local TV doctors the boy was diagnosed with "aggressive Stage IV cancer."

He also explained his efforts over the past two years to help make wigs for people who have lost their hair while undergoing treatment. 

“I want to help people so they don't have to go to the doctors to fight cancer."

inny has donated his own hair for cancer patients for years before his own diagnosis.

Surgeons at a Sacramento hospital performed a bone marrow biopsy on Vinny Tuesday, and they’re waiting on pathology tests to identify his cancer and begin treatments, according to a GoFundMe page started by Vinny’s grandparents. The page had drawn over $357,000 from more than 8,000 donations Tuesday night.

“Praying for this sweet selfless boy!” one person wrote on the page. “Please God take this away from sweet Vinny.”

Vinny's grandparents posted this picture of Vinny and his father Jason Desautels on the family's GoFundMe page Tuesday. GoFundMe

Vinny's grandparents posted this picture of Vinny and his father Jason Desautels on the family's GoFundMe page Tuesday.

Doctors classify cancer that has spread to distant parts of the body as Stage IV, the highest such level, according to the National Cancer Institute. Vinny’s mother Amanda Azevedo told the TV station her son is a fighter.

“As long as we are doing this as a family, we got this,” Azevedo said.

Source: NY daily News

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Bullying is a 'serious public health problem,' report says

(CNN)It's time to recognize bullying as a serious public health issue, according to a new report from the National Academies of Sciences, Engineering and Medicine. But zero-tolerance policies aren't going to cut it.

"We need to understand that this is a public health problem faced by a third of our children," said Dr. Frederick Rivara, chairman of the committee compiling the report. "It has a major effect on their academic performance as well as their mental and physical health."

The effects of bullying

In addition to causing depression and anxiety and leading to alcohol and drug abuse into adulthood, the harmful effects of bullying manifest themselves physically in kids and teens by disrupting their sleep, causing gastrointestinal issues and headaches.
Researchers also noticed that bullying causes changes in the stress response system of the brain, affecting cognitive function and self-regulating emotions. Children who are bullied as well as those who bully others are more likely to contemplate or attempt suicide.
Bullies themselves are negatively impacted by their own behavior. They are more likely to be depressed, are at great risk for poor psychological and social outcomes and are more likely to engage in high-risk activities such as vandalism and theft.
Determining the scope of bullying hasn't always been easy due to differences in how it's defined or measured, but the committee looked at research suggesting that anywhere between 18% and 31% of kids are affected by bullying. Cyberbullying affected between 7% and 15% of kids, and it's on the rise.
There are also vulnerable subgroups at a higher risk for bullying, including kids who are obese or disabled, who identify as LGBT or who have fewer peers of the same ethnicity within their school.

What is bullying?

For the sake of having a consistent definition of what bullying means, the committee referred to the Center for Disease Control and Prevention's current definition: Bullying is any unwanted aggressive behavior(s) by another youth or group of youths who are not siblings or current dating partners that involves an observed perceived power imbalance and is repeated multiple times or is highly likely to be repeated, and bullying may inflict harm or distress on the targeted youth including physical, psychological, social or educational harm.
The report also focused on ages 5 to 18 years, in line with the CDC, because it's just as important to address bullying in early childhood as well as emerging adulthood.
Because cyberbullying is carried about by some of the same individuals and directed at the same targets, it is included within the broader definition rather than standing on its own. But Rivara acknowledged that more research needs to be done in order to understand cyberbullying and the most effective ways to combat it.
ven if cyberbullying isn't repetetive, which bullying often is by definition, it is still harmful because "a single perpetrating act on the Internet can be shared or viewed multiple times," according to the report.

How to prevent it

Given the proven short- and long-term "psychological consequences" for both the bullied and bullies themselves, the report committee determined which type of evidence-based programs can help to prevent it in the future. The report also includes suggested guidelines and policies for the future.
The recommendations include arriving at a consistent and comprehensive definition for bullying, more longitudinal studies about its prevalence, evaluating antibullying policies, developing and implementing evidence-based programs, and training and partnering with social media companies on policies to identify and respond to cyberbullying.
And it's time to shift away from zero-tolerance policies in schools and switch to Positive Behavioral Interventions & Supports or PBIS, which have a proven track record in more than 20,000 schools, according to committee member Catherine Bradshaw, a developmental psychologist and youth violence prevention researcher.
"Zero-tolerance policies were developed to address a variety of behaviors around bullying, but they don't work and may actually be harmful," Rivara said. "Under zero tolerance, bullies would be expelled or suspended. This decreases their chances of getting better or completing school and ultimately getting a job. They need help. With different programs, we can end the behavior but help them at the same time."
The PBIS programs have reduced rates of bullying, improved discipline and academic performance and created a better and healthier climate in the schools utilizing them, Bradshaw said. The programs focus on social emotional learning, which helps kids and teens to learn how to regulate their emotions, build empathy and identify the difference between teasing and bullying.
This can be used in conjunction with more intensive programs that are aimed at kids who are already involved in bullying, as a target or a perpetrator.
"Children need to be taught these skills like they would math and science," Bradshaw said.
But Bradshaw also said there is more room for utilizing innovation and technology to better identify and prevent bullying.
"We see a disconnect between the rates of bullying mentioned by kids and what adults are seeing and hearing," she said.
For that reason, the committee is calling for more data collection on bullying, like increased surveys among students, even if they are anonymous. Then, teachers can have a better idea of where the bullying is occurring and what type of bullying it is, and they can increase supervision. More research also needs to be done around bullies themselves, as well as bystanders.
As part of the training recommended by the committee, Bradshaw believes that more professional development models on bullying intervention could benefit from emerging technology. Role play through video games could seem more real and convincing to kids and adults working through scenarios as the bully, target or bystander, for example.

Preventing bullying outside school

Policies and programs need to transcend schools and reach the state level and federal agencies, the committee advised. All 50 states have adopted or revised laws to address bullying over the past 15 years, and almost all include cyberbullying. But the report encouraged state attorneys general to continually work with researchers on the best and most updated guidance for amending laws or creating new ones in anti-bullying campaigns.
Families were also a focus of the report.
Start the conversation at home before bullying occurs, Bradshaw said. Parents and families can provide critical emotional support, which helps kids open up about bullying that they are experiencing or witnessing. Family members can also help them cope and figure out how to handle and diffuse any situation that might arise, according to the report.
StopBullying.gov is a one-stop shop for kids, parents and teachers to learn the signs and symptoms of bullying, as well as strategies for stopping it, Bradshaw said.
What people learn about bullying early on can make a difference later.
"The important skills we're teaching kids now, when they're in school, are the same skills they need for life," Rivara said.
Source: CNN
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Fentanyl: The new heroin, but deadlie

Sacramento, California (CNN) America's addiction to opioid-based painkillers and heroin just got exponentially more dangerous. The most potent painkiller on the market, prescribed by doctors for cancer treatment, is being made illicitly and sold on the streets, delivering a super high and, far too often, death.

The drug, fentanyl, has been around since the 1960s. Its potency works miracles, soothing extreme pain in cancer patients who are usually prescribed patches or lozenges.
But an illicit version of the drug is flooding into communities across America, and casual users are finding out that their fentanyl pills and powder are delivering a powerful high that is easy to overdose on. It can even kill.
The Drug Enforcement Administration and the Centers for Disease Control say we have another national health crisis on our hands. These are just a handful of the people trying to stop it from taking more lives.

The mother

Natasha Butler had never heard of fentanyl before it killed her son, Jerome.
Natasha Butler stared hard at the pictures laid out in front of her.
But she averted her eyes when they lit on the one that still takes her breath away. It's the one that makes what happened real.
It's the one where the tubes, needles and respirator are all hooked up to her only son, Jerome, trying to keep him alive. They ultimately didn't.
"I'm dying inside," she said, her voice falling to a whisper and tears streaming down her face. "He was my firstborn. I had him when I was 15. We grew up together."
She had never heard of the substance that killed him. Doctors told her he died from an overdose of fentanyl, which experts say can be 100 times more potent than morphine and 50 times stronger than heroin.
"He came and told me it was an overdose. I'm like, 'An overdose of what?' It wasn't an overdose. This is murder," Butler said. "I taught my kids two things: God, and don't do drugs."
Jerome Butler had not been prescribed the highly controlled narcotic. His mother said she was told that an acquaintance had given Butler what her son thought was a pill of Norco, a less potent opioid-based painkiller, a mix of hydrocodone and acetaminophen.
The sellers knew, Butler alleges, that "the pill had the fentanyl in it, and they killed my son."
Jerome was one of 10 people who died in just 12 days from fentanyl-laced pills in a sudden spike of deaths in Sacramento County, California, in March. More than 50 people overdosed on those pills in the first three months of the year but survived. Investigators are still looking for the source.
Similar clusters of fentanyl-related overdoses and deaths are appearing across the United States.
Like the DEA, the Centers for Disease Control and prevention has issued a health advisory and is stepping in to get health providers and first responders to report fentanyl-related overdoses as well as expand access to naloxone, the drug that counteracts deadly opioid overdoses.
The latest state statistics on fentanyl-related deaths compiled by the CDC tell a sobering story.
Ohio reported 514 fentanyl-related deaths in 2014, up from 93 the year before. Maryland reported 185 fentanyl-related deaths, up from 58 in a year's time. In Florida, the number of deaths jumped to 397 in 2014, from 185. New Hampshire had 151 reported deaths due to fentanyl alone in 2015, five times the number of deaths from heroin, according to the office of the state's chief medical examiner.
No one was more stunned to see those numbers than the mother freshly grieving her son's death from the drug. She didn't know that so many other families had suffered its deadly effects long before it hit hers until she started researching it.
"What are we doing? What are we doing about it?" Butler said, exasperated and weeping. "I'm willing to do everything that I can."
And that is just what Butler intends to do. She's on a mission to warn communities about the opioid-based drugs killing people at alarming rates across America.
She is talking to community groups and has called senators, the California governor, even the White House, looking to tell her story and to build a coalition to help stave off more deaths from opioid use, especially fentanyl.
"I'm mad at the person who sold it. I'm mad at the person who is compressing it. I'm mad at the state for not protecting our people," she said.
Since her son's death, she said, she's heard from so many young people who are addicted to painkillers such as Norco.
"If you feel you don't have that much strength, let's get together," she said. "We can build strength. We can make a difference. We have to."

he special agent

"Just micrograms can make a difference between life and death," DEA Special Agent John Martin said of illicit fentanyl.
Illicit fentanyl is a bestseller on the streets and a prolific killer. It is so potent that when law enforcement goes in to seize it, officers have to wear level A hazmat suits, the highest protection level made, the same kind of suits health care workers use to avoid contamination by the deadly Ebola virus.
"Just micrograms can make a difference between life and death. It's that serious," said DEA Special Agent John Martin, who is based in San Francisco. An amount the size of a few grains of sand of fentanyl can kill you. "All you have to do is touch it. It can be absorbed through the skin and the eyes."
One of the top priorities for Martin and his agency is to stop the flow of fentanyl and other opioids from flooding American communities.
It first showed up in deadly doses on the streets in 2007. The DEA traced the illicit fentanyl to a single lab in Mexico and shut it down. Fentanyl drug seizures subsided for a while, but in 2014, they spiked in 10 states.
It's been an uphill battle. Americans are buying it in record numbers, and highly organized drug cartels are spreading it far and wide.
What is curious is where the drug or elements to make it originate. Its street nickname is "China White" or "China girl," offering a hint at where most of it is coming from.
"DEA investigations reveal that Mexico-based drug cartels are buying fentanyl directly from China," Martin said.
And as far as profits go, the other opioids commonly sold on the streets -- heroin, hydrocodone, OxyContin and Norco -- can't even touch fentanyl.
Hydrocodone sells for about $30 a pill on the street. A fentanyl pill may look and cost the same but requires only a fraction of the narcotic to give users an even stronger reaction.
The DEA estimates that drug traffickers can buy a kilogram of fentanyl powder for $3,300 and sell it on the streets for more than 300 times that, generating nearly a million dollars.
Fentanyl is often trafficked through the cartels' standard maze of routes through Mexico and into the U.S. But sometimes it's simply ordered on the notorious dark web and shows up straight from China in the buyer's mailbox.
"We're using countless resources to deal with the threat," Martin said.
Seizures of the drug have jumped dramatically, which would seem to be good news for the DEA. But what it indicates is that there is more of it to seize than ever before.
"Everywhere from the Northeast corridor, down to New York, the Midwest and now we're seeing it here out on the West Coast. Fentanyl is everywhere right now," Martin said.
On the East Coast and in the Midwest, it's often sold as powder and mixed with heroin. On the West Coast, it is showing up mostly in pill form.
"It's feeding America's addiction to opioids," Martin said, adding that the cartels have figured out a way to make it more cheaply and easily than heroin.

The forensic scientist

California state Sen. Patricia Bates is pushing a bill that would put harsher penalties on high-volume sellers of fentanyl.
"They look like what you're getting from the pharmacy," forensic scientist Terry Baisz said. She was taken aback by just how much the counterfeit pills look like the ones sold by pharmaceutical companies.
After 26 years in the Orange County crime lab, south of Los Angeles, she has never seen anything like what is coming in these days. It worries her.
"I was shocked the first time I tested this stuff and it came back as fentanyl. We hadn't seen it before 2015," Baisz said, "and now we're seeing it a lot."
Fentanyl had entered Orange County, and it was killing people.
Wearing gloves and a lab coat, Baisz looked down at a tiny clear plastic bag under a glass hood with a ventilation system. It was pure fentanyl. A sneeze or deep breath could end in a deadly overdose, so testing it calls for strict protocols. But Baisz said it's the pills that worry her the most as a public threat.
"I wouldn't hold those in a sweaty palm for long. You're bound to get dosed," she said.
In her lab coat and gloves, she pointed to pills spread across a table. They were all labeled as various well-known pharmaceutical drugs. They looked like perfect replicas of the real deal. None was labeled as fentanyl, but that is what most of them actually were.
"Just one could kill you," Baisz said. "We have to test them. We can no longer rely on the database and our naked eye."

The lawmaker

California state Sen. Patricia Bates is pushing a bill that would put harsher penalties on high-volume sellers of fentanyl.
"It's so dangerous and so lethal, I had to get involved," California state Sen. Patricia Bates said. "Two minutes, and you could be in respiratory arrest and be dead. It's kind of like, get high and die."
Bates knows those details because the fentanyl overdose deaths started racking up in one of the areas she represents, South Orange County. She is trying to push through a bill that would put harsher penalties on high-volume sellers of fentanyl.
The bill "will enhance the penalties, by weight," Bates said. "We're talking about ... catching the big guys, because when you take them out of the food chain, you really do reduce the incidents of the trafficking and what's available on the streets."
She knows it's a tough sell in a time when California voters have passed laws to lessen prison sentences for nonviolent offenders. And, of course, there is the matter of prison overcrowding in the state. But Bates is pushing it forward because she is certain this is the next epidemic, similar to what is happening with heroin but more deadly.
"Addicts are migrating to fentanyl," she said, "They are driven to it because it's a quicker, bigger high. Yet it is something that you don't recover from when you get that super-high."

The drug counselor

When fentanyl began showing up in San Francisco in 2015, Eliza Wheeler helped get the word out on the streets about a new, very potent drug in town.
In San Francisco, the drug showed up in the form of white powder and then as pills labeled as Xanax. It turned out to be pure fentanyl. A health advisory warned that more than 75 people had experienced an overdose in July that year.
"People didn't know what it was," Wheeler said. They thought it was heroin, which is far less potent.
Though San Francisco has seen a sudden rise in fentanyl overdoses, the city did not experience the large number of deadly overdoses that other cities have.
Wheeler is a project manager at the DOPE Project (Drug Overdose Prevention and Education) in San Francisco. In cooperation with the city's health department, DOPE and other organizations flooded the streets with fliers warning that "white heroin," promising a super high, was super potent and potentially deadly. The fliers also advised drug users to carry around Narcan, the brand name for naloxone, which blocks or reverses the effects of opioid-based drugs. It is supposed to be used in an emergency such as an overdose.
Since 2003, DOPE has trained about 6,000 people on how and when to use Narcan. It can be administered with a needle or as a nasal spray. "We saved countless people by giving easier access to (Narcan) and informing them about the dangers right away," Wheeler said.
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The San Francisco Department of Public Health sent out a health advisory crediting groups like DOPE with saving lives.
"If you want to do something that will keep people from dying and impact the crisis immediately, then lawmakers should help make more naloxone and training available to the public," Wheeler said.
Natasha Butler, who continues to grieve her only son, would like to see something else, too.
"We have an Amber alert to save children. Why not have a Jerome alert to warn people about this drug?"
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