Treatment Archives - First Washington News

January 14, 2023

Endometriosis cellular mapping could aid diagnosis, treatment

close up of women's face with white skin, green eyes, and brown hair — Researchers have analyzed almost 400,000 cells in order to build a detailed profile of endometriosis. Image credit: Westend61/Getty Images.

Endometriosis affects roughly 10{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} of people who menstruate.
In endometriosis, tissue similar to the uterine lining grows elsewhere in the body, causing painful, heavy periods, abdominal and pelvic pain, and a range of other symptoms.
More research is needed for this condition for which there is still no cure, diagnosis can take many years, and treatments are often ineffective.
New research analyzing almost 400,000 cells has revealed a detailed molecular profile of endometriosis, which may help improve diagnostic and therapeutic options for people with the condition.

Endometriosis is “a systemic disease that is often painful and chronic.” According to the World Health Organization (WHO), it affects around 190 million people — some 10{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} of people who menstruate worldwide.

People with the condition experience debilitating symptoms, due to the growth of tissue similar to the uterine lining, or endometrium, elsewhere in the body.

Symptoms may include:

heavy and painful periods
spotting between periods
pain during sexual intercourse or when emptying the bladder or bowels
abdominal, lower back, and pelvic pain
infertility.

Currently, there is no cure for endometriosis, but symptoms can be treated with medications, such as nonsteroidal anti-inflammatories (NSAIDs), birth control pills, hormonal IUD, surgery, or a combination of these treatments.

Dr. Steven Vasilev, board-certified integrative gynecologic oncologist and medical director of integrative gynecologic oncology at Providence Saint John’s Health Center and Professor at Saint John’s Cancer Institute in Santa Monica, CA, explained the issues to Medical News Today:

“Endometriosis diagnosis and treatment today remains surgical, based on removing or destroying endometriotic lesions growing on the peritoneum (internal skin-like lining of the body) and ovaries, combined with various hormonal modulations. There has not been a major clinical advance in endometriosis diagnosis and treatment outside these relatively narrow parameters in decades.”

Now, a new study led by researchers from Cedars-Sinai Medical Center in Los Angeles, CA, published in Nature Genetics, has analyzed almost 400,000 cells to generate cellular and molecular profiles of endometrial cells.

Its findings may lead to easier diagnosis and more effective treatments for endometriosis.

Although endometriosis affects 10{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} of people who menstruate, there is a lack of research into the condition. To date, there has been little cellular data about endometriosis.

This, says Dr. Kate Lawrenson, research scientist, co-senior and corresponding author of the study, and associate professor of obstetrics and gynecology and biomedical sciences at Cedars-Sinai, iswhy they undertook this research:

“Endometriosis has a devastating effect on so many people, and is remarkably common. Unfortunately, it is also one of the most underfunded diseases there is, and many basic questions remain unanswered — which is why this research provides a huge leap forward in understanding the biology of his disease.”

“I hope that work like ours can help bring conversations about endometriosis into the forefront, to improve awareness and also increase much-needed funding for endometriosis research,” she told MNT.

In this new study, the researchers used state-of-the-art methods to analyze more than 370,000 cells from 21 participants, 17 of whom had endometriosis and four who did not.

They sampled different tissues — peritoneal endometriosis, ovarian endometriomas, eutopic endometrium samples, and uninvolved ovary tissues. Eutopic endometrium and uninvolved ovary tissues came from people with and without endometriosis.

“The methodology of the study is basic molecular biology. It has done something I have not seen in other endometriosis studies, which is [to] try and break down the various characteristics of endometriosis-type cells depending on [the] body location of the lesion. It is cataloging the cell type and surrounding microenvironment,” Dr. G. Thomas Ruiz, OB/GYN lead at MemorialCare Orange Coast Medical Center in Fountain Valley, CA, not involved in this study, explained for MNT.

The researchers analyzed the cells using droplet-based single-cell RNA sequencing. This method identifies which genes are transcribed to make RNA, determining which proteins the cell makes.

By identifying which genes are transcribed, researchers can see differences between the types of cells under investigation.

Using this method, the researchers identified molecular differences between the major subtypes of endometriosis, including peritoneal endometriosis and ovarian endometrioma.

Dr. Lawrenson explained their findings: “We saw a number of differences when we compared endometriosis cells to endometrium. The endometriosis cells are responding differently to hormones and communicate differently with the immune system.”

“The fact that they are behaving so differently is really exciting, as it potentially provides us with new opportunities for therapeutic targeting,” she added.

“This atlas of molecular findings will help researchers move the ball forward towards achieving earlier diagnosis, differentiation between subtypes of endometriosis, a better understanding of the overlap with ovarian cancer in a small but significant percentage of endometriosis patients, and insights into eventual development of molecularly targeted therapy for endometriosis,” said Dr. Vasilev.

So could this research lead the way to new diagnosis and treatment methods? Dr. Lawrenson believes so, and is investigating potential diagnostics for the condition:

“We urgently need a blood test for endometriosis and this is now one of our top research priorities in the laboratory. We were encouraged to see that in endometriosis, multiple cell types overproduce the same genes, which should make it easier to detect those genes in the blood.”

The research discovered that endometriosis cells and normal cells respond differently to the immune system. New therapies that target the immune system might prove effective in treating the condition, as Dr. Lawrenson explained.

“Recent advances suggest that we might be able to treat endometriosis by correcting how the immune system responds to lesions. This is particularly exciting because there might be immune therapies used for other diseases that could be rapidly repurposed for the treatment of endometriosis,” she told MNT.

There is still a need for further research, and Dr. Ruiz suggested directions this research might take: “Endometrioma, superficial versus deep infiltrating had very specific cellular characteristics. The next step would be in vitro studies to see if various endometriosis cell types act differently to current hormone treatments.”

With the mapping of endometriosis, this research has highlighted potential diagnostic and treatment pathways for investigation — it can only be good news for the many people with this debilitating condition.

Posted on December 6, 2022
Hair loss treatment: Researchers pinpoint best supplements

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What does the scientific evidence say about using nutritional supplements to treat hair loss? Image credit: Socha/Getty Images.

Hair loss is a common problem, with nearly 80{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} of men and half of all women experiencing hair loss during their lifetime.

Although nutritional supplements are commonly used for treating hair loss, there are limited data on their efficacy and safety

A recent review summarizing data from 30 prior human studies suggests that nutritional supplements could potentially treat certain types of hair loss while having generally tolerable side effects.

The authors noted that these studies included a limited number of participants and showed variability in design, suggesting the need for larger randomized clinical trials.

A recent systematic review published in the journal JAMA Dermatology synthesized data from previous research, including randomized clinical trials, on nutritional supplements that could treat hair loss.

The study found that an array of supplements ranging from pumpkin seed oil, zinc, vitamin E, omega fatty acids, and certain commercial formulations like Viviscal and Nutrafol, among others, showed promise in the treatment of specific types of hair loss.

The studies included in the review were generally small and used subjective inclusion criteria, emphasizing the need for larger, more robust randomized clinical trials.

The hair growth cycle can be divided into three phases. The first phase, known as anagen, is characterized by the growth of hair and can last several years.

Around 85–90{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} of hair follicles in a normal scalp are in the anagen or growth phase. The growth phase is followed by catagen, the transition phase involving the slowing of hair growth.

The catagen phase lasts about 14 days and is followed by the telogen or resting phase which lasts 3–4 months. Hair growth remains dormant during the resting phase and is followed by hair shedding. A loss of about 50–100 hair strands normally occurs every day.

Hair shedding in excess of these normal values is referred to as hair loss or alopecia.

Hair loss can occur due to many reasons, including genetics, aging, autoimmune disease, hormonal changes, and stress. Some of the common types of hair loss include androgenetic alopecia, alopecia areata, and telogen effluvium.

Androgenetic alopecia, referred to as pattern baldness, is the most common cause of hair loss that is estimated to affect 50{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} of men and women by the time they reach the age of 50 years. Alopecia areata, another common form of hair loss, is an autoimmune disease that results in the loss of small patches of hair.

Telogen effluvium is characterized by hair follicles prematurely exiting the growth phase and entering the telogen phase. This results in excessive shedding of hair in the resting phase.

Telogen effluvium often appears in response to stress, illness, or the use of medications.

Treatment of hair loss generally requires addressing the underlying cause, such as nutritional deficiency or disease. There are also Food and Drug Administration (FDA)-approved medications for androgenetic alopecia, namely oral finasteride and topical minoxidil.

Due to the potential negative effects of finasteride in females, only minoxidil is also used for androgenetic alopecia in females.

However, both drugs are associated with adverse effects that may result in the discontinuation of their use. Specifically, finasteride can cause sexual dysfunction in men, whereas minoxidil is associated with dermatitis.

More recently, the FDA also approved baricitinib, a drug that modulates the immune system, for the treatment of severe alopecia areata.

Given the potential side effects associated with pharmacological treatments, there has been an interest in the use of alternative therapies, including nutritional supplements, for hair loss.

A recent study involving patients from a hair loss clinic showed that nearly 80{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} of individuals used nutritional supplements. However, there are limited data on the safety and efficacy of these supplements.

In the present study, the researchers summarized evidence from 30 prior human studies, including 17 randomized clinical trials, examining the effectiveness of various nutritional supplements in the treatment of hair loss.

They excluded studies involving hair loss due to nutritional deficiency, use of medications, trauma, or physical stress.

The researchers also categorized the studies according to the quality of evidence, with randomized clinical trials representing the highest level of evidence in the review.

Studies suggest that various types of hair loss, including alopecia areata, androgenetic alopecia, and telogen effluvium, are associated with oxidative stress and a deficiency of micronutrients such as vitamins.

While the review found some high-quality evidence to suggest that zinc could enhance hair growth in individuals with hair loss, evidence supporting a role for vitamin D and vitamin B12 in the treatment of hair loss was of lower quality.

Although biotin (vitamin B7) is a common ingredient in hair loss therapies, there was an absence of studies examining the effects of biotin as a standalone treatment.

However, results from randomized clinical trials suggest that tocotrienols, antioxidant compounds belonging to the vitamin E family, and a combination of fish oil (omega-3 and omega-6), blackcurrant seed oil, and antioxidants such as vitamin E and lycopene, could improve hair density in individuals with hair loss.

Androgenetic alopecia is associated with the excessive response of hair follicles to an androgen called dihydrotestosterone (DHT), which is derived from testosterone.

Among nutritional supplements that inhibit the formation of DHT, data from a randomized clinical trial suggests that pumpkin seed oil could stimulate hair growth in men.

A deficiency of other hormones, such as insulin-like growth factor-1 (IGF-1), is also associated with hair loss. Studies suggest that capsaicin, the active ingredient in chili peppers, and isoflavones, a subclass of antioxidant compounds, could potentially increase the levels of insulin-like growth factor-1.

In addition, a small randomized clinical trial showed that capsaicin and isoflavones together can enhance hair growth in individuals with alopecia.

Plant-based compounds that can modulate the immune response, such as glycyrrhizin (licorice) and extracts from the peony plant, have also shown promise in the treatment of individuals with alopecia areata, which is characterized by an immune response against hair follicles.

Similarly, studies also suggest that procyanidin B-2, an anti-inflammatory and antioxidant compound, derived from certain apple species, can also stimulate hair growth.

Multi-ingredient commercial formulations including Pantogar, Nourkrin, Viviscal, Nutrafol, and Lambdapil have also shown positive effects on hair growth in randomized clinical trials.

Pantogar includes keratin, the major protein in hair, and its building block L-cysteine, which could help promote hair growth.

Viviscal and Nourkirn contain proteins derived from marine animals that can facilitate hair growth. Nutrafol contains DHT synthesis blockers, antioxidants, and anti-inflammatory compounds, whereas Lambdapil contains L-cysteine, plant-derived silicon, and DHT synthesis blockers.

There is a lack of sufficient or high-quality evidence to support the role of other multi-ingredient commercial formulations such as Omni-Three and FORTI-5 in stimulating hair growth.

Besides having beneficial effects on hair growth, the interventions reviewed in the current study generally had mild side effects. These results suggest that nutritional supplements could potentially help treat certain types of hair loss.

However, the authors noted that the studies included in the review had several limitations. For instance, a majority of studies had a small sample size or used subjective reports of hair loss at baseline.

The authors also cautioned that some of the studies included in the review were funded by manufacturers of the nutritional supplements

The authors further noted concerns about the lack of FDA regulations that cover the efficacy, safety, and quality of supplements. Thus, nutritional supplements could potentially contain inefficacious or adulterated ingredients, with the latter resulting in side effects.

This requires dermatologists to work with patients to weigh the risks and benefits of such nutritional supplements.

Dr. Justin Rome, founder of the Barber Surgeons Guild, commented for Medical News Today that:

“While nutritional deficiencies can lead to hair loss, supplementation of vitamins such as biotin to those who are not deficient has not been shown to promote hair growth. Other novel ingredients may have a beneficial result in certain circumstances; however, they also may have no result or worse, potential adverse effects. It is important to note that nutritional supplements are not regulated by the FDA, which means they do not undergo the rigorous safety and efficacy testing as medications.”

Similarly, Dr. Thivi Maruthappu, consultant dermatologist at the Cadogan Clinic and lecturer in nutrition science, cautioned:

“Be careful when choosing supplements, look for high-quality clinical trials supporting their use. High doses of certain nutrients can actually be harmful for example excess Selenium, can lead to toxicity and even worsen hair shedding, and high dose biotin can trigger acne and interfere with blood tests, so it’s important to do your research before you buy.”

Maintaining a healthy diet could also play a critical role in preventing hair loss. Dr. Reid Maclellan, founder and CEO of Cortina, and adjunct faculty at Harvard Medical School, told us that “[i]ncreasing your intake of protein and iron in your diet can help prevent hair loss in both men and women.”

“Iron deficiency or being anemic is the most evident factor that can lead to hair loss as it can affect the follicles from producing proteins to make the hair grow,” he added.

“Some foods that you can incorporate into your diet that can help add to your hair loss prevention plan include bone broth, eggs, seaweed/ kelp, seeds (flax, sunflower, chia), fish oils, and berries. Avoid alcohol, sugar, and processed foods which are DHT blockers,” advised Dr. Maclellan.

Posted on May 29, 2022
Scombroid poisoning: Causes, symptoms, and treatment

Scombroid poisoning is a form of meals poisoning. It occurs when a particular person eats fish species that contains significant amounts of a chemical known as histidine.

Histidine is an amino acid that the natural way happens in fish. When individuals do not continue to keep the fish in a fridge, bacteria crack down the histidine and convert it into histamine.

Histamine is accountable for the toxicity that brings about scombroid poisoning, in accordance to the American Academy of Allergy, Asthma & Immunology (AAAAI).

When a individual consumes significant quantities of fish with histamine, they encounter signs that resemble an allergic response, these kinds of as hives. However, it is not a real allergy to a specific fish, in accordance to the Countrywide Cash Poison Center.

The issue typically is not long-expression or critical, according to the Foodstuff and Drug Administration (Fda). Mild scenarios often disappear on their possess with no procedure, but antihistamine medications may well aid some individuals.

A human being going through serious signs, these kinds of as chest pain or breathing issues, should go to an emergency home or simply call nearby emergency solutions.

Preserve reading through to study additional about the results in, indications, cure, avoidance, and outlook of scombroid poisoning.

The bring about of scombroid poisoning is consuming certain kinds of fish that have spoiled. Most commonly, in accordance to the Centers for Illness Handle and Prevention (CDC), the fish species included are:

tuna

mackerel

bluefish

mahi mahi, or dolphinfish

herring

sardine

amberjack

anchovies

marlin

These fish incorporate higher amounts of the chemical histidine, for every the AAAAI.

When men and women do not store the fish in a refrigerator, it outcomes in an overgrowth of microbes. The bacterial strains accountable for the situation develop enzymes that change histidine into histamine.

These strains contain individuals current in the pores and skin and intestines of the fish, for every 2012 investigate, this kind of as:

E. coli

Morganella morganii

Pseudomonas aeruginosa

Klebsiella species

When a particular person eats the fish with large amounts of histamine, their symptoms resemble an allergic response. Owing to this connection with histamine, scombroid poisoning is also referred to as histamine toxicity.

According to the AAAI, persons with lower degrees of the enzyme diamine oxidase are more likely to experience scombroid poisoning. This enzyme breaks down histamine from meals. So, a person with reduced concentrations of the enzyme might not split down the histamine as perfectly as a human being with larger ranges.

The poisoning is not owing to an allergy, so it is protected to eat the fish all over again as very long as it has been through refrigeration.

Signs and symptoms normally begin in just a handful of minutes to 2 several hours after consuming the fish, for every the Fda. The original types resemble an allergic response, this kind of as:

perspiring

facial flushing

peppery taste all over the throat and mouth

headache

dizziness

nausea

These original signs and symptoms may possibly progress to:

facial rash

inflammation

hives

shorter-phrase stomach pain and diarrhea

The indicators generally linger 4–6 hrs and seldom very last past 1–2 times, according to the Fda.

Medical practitioners often foundation a analysis on the situation, in accordance to the AAAAI. For example, a person’s indicators may possibly coincide with an outbreak that impacted numerous people today who ate fish purchased from the similar position.

Cure is dependent on the severity of scombroid poisoning. Gentle circumstances frequently disappear swiftly without the need of treatment. Antihistamines, these types of as diphenhydramine (Benadryl), might help some folks with the situation.

Serious situations demand a trip to the unexpected emergency space. In this article, remedy may perhaps incorporate the administration of intravenous fluids, oxygen, and other remedies.

Signs of a severe situation include things like:

upper body discomfort

difficulty breathing

inflammation of the tongue and mouth

If a man or woman has severe signs or symptoms that are not life threatening, it is most effective to see an allergist. They can help establish if the person is having an allergic response to the fish or if it is scombroid poisoning.

Because scombroid poisoning is not a accurate allergic reaction, it frequently does not need epinephrine injections or corticosteroids. It is also not an an infection, so antibiotics are not vital.

When a person catches their possess fish, the only reliable way to avoid scombroid poisoning is preserving the fish in a fridge established to 40°F (4°C) or reduce. Cooking or freezing the fish will not get rid of the histamine that triggers the indicators.

If an unique eats fish in a restaurant, there is no way to tell if it is spoiled. It normally does not have a apparent smell or style. Even so, a salty, sharp, or peppery taste could act as red flags that point out spoilage ensuing from histamine, for every the CDC.

On top of that, when another person will get scombroid poisoning from a restaurant or fish marketplace, they ought to report it to the general public wellness authorities for investigation. Elimination of the fish from distribution will avert even more outbreaks from the supply.

Scombroid poisoning outcomes from feeding on sure kinds of fish, these as tuna and mackerel, that have been through spoilage. Early signs or symptoms may perhaps consist of facial flushing and perspiring, whilst afterwards signs and symptoms may well incorporate hives and brief-phrase diarrhea.

Whilst the symptoms resemble an allergy, the condition is not a legitimate allergic response to a specific fish. It is protected to consume the fish yet again as very long as it has not spoiled.

Procedure depends on the severity. Delicate conditions generally solve on their possess. Antihistamines, this kind of as diphenhydramine (Benadryl), might enable some people.

Posted on April 1, 2022
New guidelines may improve diagnosis, treatment

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Endometriosis is a common gynecological situation that has an effect on 1000’s of women and women of all ages. Catherine McQueen/Getty Photos

Researchers in Europe have developed new tips for diagnosing and treating endometriosis.

They have produced sizeable updates to five critical regions in controlling the problem, which includes prognosis, cure, and recurrence.

The new guidelines could support people and clinicians superior realize and control the affliction.

Endometriosis is a condition in which tissue identical to the lining within the uterus grows outside the house the uterus. It affects all over 190 million — or 10{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} — of females and ladies of reproductive age all over the world.

Though some individuals with endometriosis are asymptomatic, frequent indications involve:

agonizing cramping, comparable to menstrual cramps

prolonged-phrase reduced again and pelvic agony

irregular intervals

bowel and urinary complications, including pain, diarrhea, constipation, and bloating

blood in the stool or urine

nausea and vomiting

fatigue

discomfort for the duration of intercourse

recognizing or bleeding among durations

infertility

While this is a prevalent situation, men and women often only get a diagnosis for it 8-12 a long time just after symptom onset. Extra precise guidelines could strengthen diagnosis and cure for people with the problem.

In a modern report, the European Culture of Human Copy and Embryology (ESHRE) formulated new clinical follow guidelines for diagnosing and dealing with endometriosis.

“These recommendations offer much better ways to manage and deal with endometriosis for medical professionals and hope and ease and comfort for millions of women of all ages who have felt frustrated and determined by this debilitating condition,” Dr. Sherry Ross, OB/GYN and Women’s Health and fitness Pro at Providence Saint John’s Wellness Center in Santa Monica, CA, advised Health care Information Nowadays.

Analysis

In the earlier 2014 recommendations, laparoscopy — a surgical procedure involving smaller inclusions in the abdomen to insert a digicam — was regarded as the gold standard diagnostic resource.

Thanks to modern breakthroughs in imaging modalities, operative risk, minimal entry to very-qualified surgeons, and economic implications, the ESHRE now only endorses laparoscopy if imaging results are damaging and treatment plans unsuccessful or inappropriate.

Agony remedy

The current guidelines now advocate GnRH agonist or GnRH antagonist therapies — which stop the ovaries from building sexual intercourse hormones by desensitizing the pituitary gland — as a next-line treatment method possibility.

They also say that NSAIDs may perhaps assist postoperative ache, the pointers note that this may perhaps affect conception if taken repeatedly.

Infertility therapy

Prolonged use of GnRH agonists prior to assisted replica techniques (ARTs) — such as in vitro fertilization — is no for a longer time advised to increase fertility owing to unclear added benefits.

In the meantime, the Endometriosis Fertility Index (EFI) was extra as a treatment method phase to assistance patients decide how to achieve pregnancy postsurgery.

Recurrence

The current pointers advise hormone remedies, together with combined hormonal contraceptives for at the very least 18-24 months after surgery to stop a recurrence.

They increase that Art does not maximize recurrence in women of all ages with deep endometriosis — a single nodule larger sized than 1 centimeter (cm) in diameter outside the house the uterus or close to the lessen 20 cm of the bowel.

In conversation with MNT, Dr. Yen Hope Tran, OB/GYN at MemorialCare Orange Coast Health-related Heart in Fountain Valley, CA, famous that the tips also advocate surgeons “perform cystectomy as a substitute of drainage and coagulation, as cystectomy cuts down recurrence of endometrioma and endometriosis-involved ache.”

Adolescence

“Often, endometriosis manifests in adolescence, even early adolescence, but teens are not likely to know that their ache and other signs or symptoms are not the norm,” said Dr. Tran. “Period discomfort in the course of this time is not usual.”

“Teens and their physicians frequently never handle endometriosis — or endo signs and symptoms — in the number of meetings they are probably to have. I obtain it beneficial to ask about them acquiring to miss out on lessons/skip university for the reason that of their signs and symptoms,” she additional.

When diagnosing and treating adolescents, the tips advise clinicians very carefully investigate achievable danger components for endometriosis, such as positive loved ones record, obstructive genital malformations, early first menstruation, and a quick menstrual cycle.

To treat endometriosis in adolescents, they propose hormonal contraceptives or progesterone as initially-line hormone treatment.

The American University of Obstetricians and Gynecologists recommends NSAIDs as the mainstay of suffering aid for adolescents with endometriosis.

The Entire world Wellbeing Group (WHO) also endorses that if GnRH agonists are viewed as for adolescents and younger women, the possible side results and prolonged-time period health and fitness risks must initial be reviewed with a clinician in a secondary or tertiary environment.

“[The guidelines emphasize] preservation of fertility. Adolescents with endometriosis should really be informed of the risk of turning into infertile so that they can make a extra informed selection about early surgical intervention, preservation of oocytes, and other actions should really they ever want to have young children,” explained Dr. Tran.

The ESHRE hopes that the new recommendations will aid equally people and healthcare pros in much better knowing and dealing with endometriosis.

When asked what the key points are for people and clinicians to be mindful of from these pointers, Dr. Tran stated:

“Endometriosis is a really serious disease. It triggers possibly as a lot as 50{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} of all cases of infertility [and] each individual case is diverse. Any correlation in between receiving pregnant and going through relief of endometriosis signs or symptoms are regarded as rare, and volume to wishful contemplating.”

“Endometriosis recurs quite commonly, and no a single therapy is correct for each individual client or each circumstance. Later on in lifestyle, different remedies may perhaps be called for. You’re never ever out of the woods with endometriosis. Destruction from endo carries on to induce complications for females even soon after menopause,” she described.

“Talk to your health care provider, really don’t place off therapy. Reduction from symptoms is possible. Preservation of fertility wants to start out straight away endometriosis is major and need to be taken seriously,” she concluded.

Posted on February 16, 2022
New combo of antibiotic plus steroid treatment may relieve COVID-19

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New exploration explores a novel COVID-19 treatment method mix involving antibiotics. nevodka/Getty Photographs

A smaller research suggests that treating clients who have moderate or significant COVID-19 with ceftazidime or cefepime, in addition the steroid dexamethasone, is as successful as regular treatment.

The antibiotic-in addition-steroid procedure was linked with fewer facet outcomes as opposed with typical treatment, which can include 7 or much more distinctive medicines.

Lab tests and computer system simulations discovered that equally antibiotics inhibit a critical enzyme employed by SARS-CoV-2, the virus that results in COVID-19.

Even so, there is now no evidence from clinical trials that antibiotics are successful from the virus, and specialists alert that overuse promotes antibiotic resistance.

Healthcare industry experts are normally keen to worry that antibiotics are ineffective against viral infections, with some uncommon exceptions.

Antibiotics have saved the lives of thousands and thousands of people because they came into common use early in the 20th century, but overuse accelerates the evolution of bacterial resistance to the drugs.

In accordance to the Facilities for Disease Control and Prevention (CDC), there are more than 2.8 million situations of antibiotic-resistant an infection and 35,000 resulting deaths per year in the United States by yourself.

For that reason, there are serious concerns that overprescribing antibiotics to sufferers with COVID-19 — in the absence of any proof of a bacterial coinfection — encourages the unfold of antibiotic resistance.

In the United Kingdom, the National Institute for Wellness and Treatment Excellence reports that less than 8{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} of people today hospitalized with COVID-19 also have a bacterial an infection.

But 1 research in the U.K. observed that all over 85{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} of COVID-19 individuals obtain therapy with an antibiotic through their healthcare facility keep.

All through the pandemic, there experienced been early hopes that the antibiotic azithromycin may possibly be an effective cure for COVID-19. On the other hand, a new Cochrane assessment of scientific trials found no proof for this.

So the findings of a small review that indicates possibly of two antibiotics, in mixture with the steroid dexamethasone, may perhaps be an helpful remedy for the condition are controversial.

The examine associated 370 patients with moderate or significant COVID-19 who were admitted to Beni-Suef University Clinic in Beni Suef, Egypt.

Researchers randomly assigned the clients to 3 groups:

procedure with cefepime additionally dexamethasone: 124 people

procedure with ceftazidime as well as dexamethasone: 136 people

common COVID-19 treatment method, as suggested in Environment Health Group (WHO) suggestions and the Egyptian management protocol, with 7 or much more medication: 110 people

The signify recovery time for people acquiring therapy with cefepime or ceftazidime was 12 times and 13 times, respectively, whilst the signify recovery time with normal remedy was 19 days.

The scientists emphasize that the study was not a medical trial and that there were being insufficient numbers of sufferers in every team to draw organization conclusions.

Nevertheless, they also conducted lab exams and laptop or computer simulations, which recommended that these two antibiotics inhibit the exercise of a protease enzyme termed M^professional. M^professional is an critical component of a virus’s daily life cycle — a lessened action of the enzyme impairs the replication amount of the virus.

The analyze seems in the journal Antibiotics.

Cefepime and ceftazidime are wide-spectrum, beta-lactam antibiotics in the class identified as cephalosporins. Equally are on the WHO’s Knowledgeable watchlist, indicating there is a high probable for micro organism to develop resistance to them.

Nonetheless, in their paper, the scientists argue that applying existing antibiotics with confirmed antiviral possible from COVID-19 could in fact hold off the emergence of antibiotic resistance.

Ahmed M. Sayed, Ph.D., a pharmacist at Nahda University in Beni Suef and 1 of the authors, told Healthcare News These days that making use of antibiotics that have both antiviral and antibacterial outcomes could stay clear of resistance to other antibiotics.

“Usually, higher respiratory tract viral bacterial infections are related with secondary bacterial bacterial infections that require antibiotics coverage,” stated Dr. Sayed.

“Accordingly, if we use only a specific established of wide-spectrum antibiotics — that have more antiviral possible like the two studied antibiotics in our post — in these types of sorts of bacterial infections, we will preserve, to some extent, other necessary antibiotics from the swift development of bacterial resistance, and speed up the patient’s recovery fee,” he described.

He argued that working with the full arsenal of antibiotics from bacterial coinfections will make these other medicines extra ineffective.

In contrast, medicines, such as cefepime and ceftazidime, which may have a number of therapeutic advantages, could lower the amount of other vital treatments and their associated side effects.

The authors accept that their study only concerned a single healthcare facility and was much too small to attract agency conclusions.

“Of course, the study needs a significantly greater quantity of patients to get extra strong results,” mentioned Dr. Sayed.

He claimed they are organizing a multisite clinical demo of these antibiotics that will contain a more substantial quantity of patients and be far more very likely to supply statistically major findings.

In their paper, the scientists also notice that their laptop or computer simulations and lab results could deliver beneficial prospects for developing a lot more powerful antiviral medicines that concentrate on the M^professional enzyme of SARS-CoV-2.

For dwell updates on the hottest developments about the novel coronavirus and COVID-19, click below.

Posted on November 25, 2021
Are fasting-mimicking diets the future of cancer treatment?

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Could fasting-mimicking diets help treat cancer? 10’000 Hours/Getty Images

A recent study investigated the safety, tolerability, and metabolic- and immune-related effects of fasting-mimicking diets (FMDs) in participants with cancer.

The results demonstrated that metabolic and immune changes were consistent with improved cancer outcomes, but they did not prove effectiveness.

More research is necessary to determine whether FMD-induced metabolic and immune effects improve the efficacy of standard cancer treatment and reduce mortality.

Changes in the types and amount of food a person eats can have positive effects on health and aging. Some evidence suggests that prolonged fasting may activate protective cellular mechanisms.

Scientists believe that these effects are partially due to temporary reductions in glucose, insulin, and insulin-like growth factor 1 (IGF-1). IGF-1 is a hormone that regulates growth, controls skeletal muscle metabolism, and rebuilds muscles in the human body.

As IGF-1 regulates cell growth and division, cell death, and cell survival, it may also promote the growth of cancerous tumors.

Preliminary studies with periodic cycles of prolonged fasting demonstrated antitumor effects, enhanced response to anticancer therapy, and protection of healthy cells from chemotherapy-induced damage.

However, complying with prolonged fasting and severe calorie restrictions may be challenging and have safety issues.

With this in mind, scientists have developed a “fasting-mimicking diet (FMD),” which is low in calories, sugars, and protein. The aim is to achieve effects similar to those that animal studies have shown to occur through fasting while preventing nutrient deficiencies.

The latest study is the first trial to investigate FMD in people with cancer.

The findings appear in the journal Cancer Discovery.

Lead author Dr. Claudio Vernieri, Ph.D., a medical oncologist and director of the Metabolic Reprogramming in Solid Tumors program at the FIRC Institute of Molecular Oncology (IFOM), explained to Medical News Today:

“Based on […] striking preclinical data, we decided to test if a severely calorie-restricted dietary regimen, which we specifically designed for use in oncology, could be well-tolerated by cancer patients and if [it] was sufficiently potent to modulate relevant metabolic and immunologic parameters.”

The researchers gave 101 participants with cancer an identical FMD for 5 days. The participants consumed up to 600 calories on day 1 and up to 300 calories on days 2–5. They followed this period of caloric restriction with 16–23 days of refeeding to regain the lost weight. The individuals then repeated these regimens every 3 or 4 weeks for up to eight cycles.

On average, participants went through four of these FMD cycles.

The study included people who had different types of cancer in various stages and were taking different anticancer treatments. It excluded individuals who were underweight or had a high risk of malnourishment.

In the 99 participants whom the team assessed, FMD reduced serum glucose levels by 18.6{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809}, serum insulin by 50.7{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809}, and serum IGF-1 by 30.3{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809}. These results were independent of the type of cancer, anticancer treatment, and stage of cancer.

The researchers assessed insulin levels because evidence suggests that this hormone stimulates cancer cell growth. Similarly, some evidence suggests that higher serum glucose levels also promote cancer progression.

After 5 days, the blood samples of 38 FMD-treated participants showed a significant decline in specific white blood cells called myeloid cells that are associated with immune suppression. They also had increased numbers of cytotoxic T cells, immune cells that can kill cancer cells. Both of these changes were independent of anticancer treatment.

The researchers then focused on a subset of 13 participants who had advanced triple-negative breast cancer and were receiving first-line cytotoxic chemotherapy (ChT). They compared immune changes between those receiving both ChT and FMD and 13 participants receiving ChT alone.

In the dual treatment group, the scientists measured similar immune effects: decreases in immunosuppressive myeloid cells and increases in activated CD8+ T cells, which are a type of cytotoxic T cell. In the group that took ChT alone, these immune changes were not present.

The study also reported an interim analysis of immune responses to FMD in 22 people with early stage breast cancer awaiting surgery. These participants started FMD 12–15 days before their surgery.

In these individuals, FMD produced similar metabolic changes, namely decreases in blood glucose, insulin, and IGF-1. The researchers also observed significant immune changes, which indicated the activation of an anticancer environment at the tumor level.

Dr. Vernieri told MNT, “The most relevant finding of the study is that our fasting-mimicking diet regimen boosts the immune system by activating specific immune cells that are clearly recognized as crucial in recognizing and killing cancer cells.”

One of the study’s strengths is that FMD safely produced the desired anticancer metabolic and immunologic changes across all study participants, regardless of the type of cancer, cancer severity, and anticancer treatment.

“The main limitation of our study,” Dr. Vernieri explained, “is the fact that the heterogeneity of enrolled patients does not allow [us] to conclude about the antitumor efficacy of the fasting-mimicking diet.”

MNT also spoke with Dr. Steven Vasilev, who was not involved in the study. Dr. Vasilev is an oncologist and medical director of Integrative Gynecologic Oncology at Providence Saint John’s Health Center in Santa Monica, CA. He is also a professor at Saint John’s Cancer Institute, which is also in Santa Monica.

Speaking about the challenges in interpreting the results, he said:

“You’re […] essentially trying to starve someone for some period of time, which leads to an incredibly complex immunological and metabolic response. Then [you’re] trying to figure out which [factor] is […] the one that’s responsible for returning tumor growth. And the answer is: It’s probably all of them, but you [don’t] know which one is the most essential.”

Dr. Vasilev explained that many cancer patients are already malnourished. For safety and ethical reasons, the current study did not include participants at high risk of malnourishment. This exclusion introduces bias, albeit necessary bias.

He also outlined a number of clinical limitations that need ironing out before doctors could use caloric restriction to treat cancer patients. For instance, he suggested that reducing calorie intake might have a negative effect on wound healing.

However, Dr. Vasilev also reiterated that much more research is necessary before this type of intervention enters the clinic.

Dr. Vernieri spoke with MNT about the next steps, saying, “Additional trials must be conducted in well-selected patient populations to clarify in which clinical contexts fasting-mimicking diet could be combined with standard anticancer therapies to improve their antitumor activity and efficacy.”

“In this perspective,” he continued, “we are conducting the phase 2, randomized trial BREAKFAST to investigate if combining severe calorie restriction with standard preoperative chemotherapy is capable of improving tumor responses in patients with limited-stage triple-negative breast cancer.”

He added, “I would like to highlight that to guarantee the safety of calorie restriction, patients should be managed by multidisciplinary teams with specific expertise in the field of fasting in oncology, and only in the context of clinical trials.”

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