Help Find the Missing Millions

Hepatitis is an inflammation of the liver. Viruses are the most common cause of hepatitis, but the condition can also be caused by other infections, heavy alcohol use, toxins, certain medications, and autoimmune disease. There are five main virus types that cause hepatitis—type A, B, C, D and E.

Hepatitis A and E are typically caused by ingesting contaminated food or water. Type B commonly occurs through contact with infected blood, semen or other bodily fluid through sex, sharing needles or other drug-injection equipment or from mother to baby at birth. Hepatitis type C is a blood-borne virus that is largely spread by sharing needles or other drug injection equipment. Hepatitis D, which is transmitted through contact with infectious blood, occurs only among people with hepatitis B infection.

Hepatitis B, C, and D afflict more than half a billion people worldwide and are responsible for more than a million deaths a year. Chronic infection with these viruses can lead to cirrhosis of the liver, end-stage liver disease, and liver cancer.

World Hepatitis Day is July 28th and is an opportunity to learn about the global burden of this disease and support efforts to combat viral hepatitis around the world. People can also find out if they should be tested or vaccinated for hepatitis A, B or C by taking CDC’s online Hepatitis Risk Assessment, which is based on CDC recommendations for the United States.

WORLD HEPATITIS DAY 2018 THEME: ELIMINATE HEPATITIS

In 2016, 194 governments adopted WHO’s Global Strategy on Viral Hepatitis, which includes a goal of eliminating hepatitis B and C by 2030, yet only a handful of countries are on track to meet these targets.

We are at a critical juncture. Unless we take action now, our chance to eliminate a cancer-causing illness will be missed. On WHD 2018, we are calling on all individuals and organizations to unite under the theme of “Eliminate Hepatitis” to drive action, build momentum and hold governments accountable. Because only together can we eliminate viral hepatitis by 2030.

WORLD HEPATITIS DAY 2018 CAMPAIGN: FIND THE MISSING MILLIONS

No one should have to live with viral hepatitis without knowing. Yet, globally more than 290 million men, women and children do. Unless there is a massive scale-up in screening, diagnosis and linkage to care, more people will become infected and lives will continue to be lost.

The World Hepatitis Alliance’s (WHA) global campaign – Find the Missing Millions – is a three-year global awareness-raising and advocacy campaign aimed at tackling the main barriers to diagnosis by putting civil society organizations and the affected community at the heart of the solution.

The Disease

The five hepatitis viruses – A, B, C, D and E – are distinct; they can have different modes of transmission, affect different populations, and result in different health outcomes.

  • Hepatitis A is primarily spread when someone ingests the virus from contact with food, drinks, or objects contaminated by feces from an infected person or has close personal contact with someone who is infected. Hepatitis A does not cause chronic liver disease and is rarely fatal, but it can cause serious symptoms. Hepatitis A can be prevented through improved sanitation, food safety, and vaccination.
  • Hepatitis B is often spread during birth from an infected mother to her baby. Infection can also occur through contact with blood and other body fluids through injection drug use, unsterile medical equipment, and sexual contact. The hepatitis B virus is common in sub-Saharan Africa, Asia and the Pacific Islands, but also has increased rates in the Amazon region of South America, the southern parts of eastern and central Europe, the Middle East and the Indian subcontinent. The hepatitis B virus can cause both acute and chronic infection, ranging in severity from a mild illness lasting a few weeks to a serious, chronic illness. If infected at birth or during early childhood, people are more likely to develop a chronic infection, which can lead to liver cirrhosis or even liver cancer. Getting the hepatitis B vaccine is the most effective way to prevent hepatitis B. WHO recommends that all infants receive the hepatitis B vaccine as soon as possible after birth, followed by 2-3 additional doses. In many parts of the world, widespread infant vaccination programs have led to dramatic declines of new hepatitis B cases.
  • Hepatitis C is spread through contact with blood of an infected person. Infection can occur through injection drug use and unsafe medical injections and other medical procedures. Mother-to-child transmission of hepatitis C is also possible. Hepatitis C can cause both acute and chronic infections, but most people who get infected develop a chronic infection. A significant number of those who are chronically infected will develop liver cirrhosis or liver cancer. With new treatments, over 90% of people with hepatitis C can be cured within 2-3 months, reducing the risk of death from liver cancer and cirrhosis. The first step for people living with hepatitis C to benefit from treatments is to get tested and linked to care. There is currently no vaccine for hepatitis C but research in this area is ongoing.
  • Hepatitis D is passed through contact with infected blood. Hepatitis D only occurs in people who are already infected with the hepatitis B virus. People who are not already infected with hepatitis B can prevent hepatitis D by getting vaccinated against hepatitis B.
  • Hepatitis E is spread mainly through contaminated drinking water. Hepatitis E usually clears in 4-6 weeks so there is no specific treatment. However, pregnant women infected with hepatitis E are at considerable risk of mortality from this infection.  Hepatitis E is found worldwide, but the number of infections is highest in East and South Asia. Improved sanitation and food safety can help prevent new cases of hepatitis E. A vaccine to prevent hepatitis E has been developed and is licensed in China, but is not yet available elsewhere.

Missing Millions

An estimated 290 million (89%) of the 325 million people living with viral hepatitis B and C are unaware that they are infected (WHO, 2017a), irrespective of gender, age, ethnicity or geography. This puts them at risk of unknowingly transmitting the virus to others and developing extrahepatic manifestations (e.g. autoimmune diseases, diabetes), liver complications, including fatal end-stage liver disease and liver cancer. Without a massive scale-up in awareness coupled with diagnostic services, to ensure that everyone infected gets tested, treatment rates will not increase and infection rates may rise (European Union HCV Collaborators, 2017).

Today, there is now a policy framework to combat and ultimately eliminate viral hepatitis. The United Nations’ Sustainable Development Goals (SDGs), adopted by all countries in 2015, call for combatting viral hepatitis (United Nations, 2015) and in 2016 the World Health Organization (WHO) adopted the Global health sector strategy on viral hepatitis, 2016–2021 (GHSS), which set the goal of eliminating viral hepatitis as a public health threat by 2030 and specifically for 30% of people infected to know their status by 2020 and 90% by 2030 (WHO, 2016). Thus, without  finding these “missing millions” and linking them to care, efforts to eliminate viral hepatitis will fail.

The “Find the Missing Millions” program, initiated by the World Hepatitis Alliance (WHA) in 2018, is a three-year effort intended to assist countries to reach the diagnosis targets they committed to when adopting the WHO viral hepatitis strategy. The program builds on the mission of WHA to “harness the power of people living with viral hepatitis to achieve its elimination” and this white paper highlights how involving civil society and the affected community can strengthen the response. While acknowledging the vast amount of work to date, including viral hepatitis testing guidance from clinical associations and technical agencies (AASLD, 2018; Chávez, 2013; EASL, 2018; Omata, 2016; WHO, 2017b), WHA, working with experts and key partners worldwide, developed a series of complementary recommendations, set out below, focusing on the role civil society and the affected community have in scaling up equitable diagnostic services to  nd the missing millions.

The Importance of Involving Civil Society and the Affected Community in the Response

People living with viral hepatitis and the affected community should be at the heart of every effort to eliminate viral hepatitis. Aside from fulfilling the need for trusted entities that consistently disseminate reliable information, civil society organizations bring fundamentally important perspectives and experiences which greatly enhance the effectiveness of strategies and programs.

In the context of addressing the barriers to diagnosis, a meaningful partnership with the affected community and civil society organizations can, amongst other things, contribute to the delivery of stronger awareness campaigns; strengthen innovative approaches to finding the undiagnosed through peer support services; help identify gaps within action plans which would otherwise be missed; and o er a platform to address stigma and discrimination, ensuring an equitable response so that the most vulnerable and marginalized are not left behind in the effort to eliminate viral hepatitis. As such, policy-makers should harness the voices of those affected by viral hepatitis, recognising them as vital partners in the elimination e ort.

Further, as more people living with viral hepatitis are aware of their diagnosis, they and those in their social environment can be part of the drive to prevent the disease by ensuring access to services, from prevention to testing to treatment and follow-up care, and by encouraging innovation, such as health systems reforms that facilitate new, more people-centered health services.

Methodology

Available research on the barriers to diagnosis of viral hepatitis and strategies to overcome them is limited to a small number of mainly high-income countries, or speci c regions and populations (Ishizaki, 2017). These studies are also limited with regard to the number and category of respondents. To address these data gaps, WHA conducted a global survey on the barriers to diagnosis of hepatitis B and hepatitis C.

WHA commissioned DJS Research, an independent research agency, to undertake a global consultation, in the form of an online survey that ran from 22 February to 21 March 2018. DJS Research sent approximately 3000 emails in English, French or Spanish to WHA member organizations, people living with viral hepatitis, medical professionals, policy-makers and other stakeholders. An open link to the survey was also provided on websites worldwide, which could be accessed by the wider hepatitis community.  Five hundred and sixty-one surveys were completed.

Following the online survey, telephone interviews were conducted with 17 respondents from Argentina, Australia, Brazil, Canada, Cyprus, Germany, Guatemala, Mali, Portugal, Spain, Switzerland, the United Kingdom and the United States of America. The interviews were designed to gather more detailed views on the barriers that were identified as major within the online survey.

The implications of the overall small sample size are that the data from individual regions can best be regarded as indicative and do not permit comparison or robust conclusions. Further, it is important to note that geographic representation in the survey is not proportionate to the prevalence and incidence of viral hepatitis in the different regions. Nonetheless, the  findings  provide useful avenues for exploration which then need to be adapted to the needs of each individual region. Details on barriers to the diagnosis of viral hepatitis B and C can be found in Find the Missing Millions: Barriers to Diagnosis Global Report (World Hepatitis Alliance, 2018).

The focus of the two-day global stakeholder consultation, held in London on 17–18 May 2018, was to further explore the role that civil society and the affected community can play in overcoming the identified barriers to diagnosis BOX 1 . Participants discussed the barriers to diagnosis identified by the survey and developed a set of recommendations; highlighting the unique role that civil society and the affected community have to play in a sustainable response.

Recommendations

 These recommendations should be considered complementary to WHO guidelines for viral hepatitis testing (WHO, 2017b) and the WHO Global health sector strategy on viral hepatitis, 2016-2021 (WHO, 2016) in that they set out to enhance the role of civil society and the affected community in overcoming the barriers to diagnosing viral hepatitis.

It is important to note that implementing these recommendations requires a multi-stakeholder response and this may mean policy-makers and other stakeholders will need to look beyond current partners. The response will be enhanced by involving not just those already engaged but also anyone who has contact with affected populations or populations at risk. This will vary depending on the setting but potential allies to consider include addiction specialists, nephrologists and hematologists, pharmacists, refugee and migrant support organizations, religious/cultural leaders who have played a role in developing and fostering health services, patient groups representing affected communities such as those with kidney disease, hemophilia or thalassemia and peers in general. Target groups may be different for e orts to combat hepatitis B versus hepatitis C and will likely differ by country or locality.

Overcoming the main barriers to diagnosis requires all stakeholders to engage in three main activities:

1.  Raising Awareness

Lack of public knowledge of the diseases, lack of knowledge among healthcare professionals and stigma and discrimination are all underpinned, in part, by a lack of awareness and so it is recommended that these three barriers should be collectively addressed.

When raising awareness, improving education and combatting stigma and discrimination, different strategies are required for different populations and, as WHO suggests, they will be dependent on the country context and may include promotion through the mass media (WHO, 2017b). In the GHSS it is stated that “Concerted advocacy e orts, particularly by political and community leaders, and a sound communication strategy are required to increase public and political awareness of the public health importance of viral hepatitis… and to mobilize action” (WHO, 2016).

Civil society and the affected community can enhance the response that WHO calls for by:

Partnering with stake holders to advocate for:

  • Health authorities to ensure continuous medical and professional education on viral hepatitis is provided from the early stages of training
  • Enabling frameworks such as anti-discrimination laws and their enforcement and redress of discriminatory acts
  • Decriminalization of drug use and homosexuality as punitive laws hamper public health efforts National governments to join all countries in upholding the commitment made at the 63rd World Health Assembly (2010) to use World Hepatitis Day to improve education and understanding of viral hepatitis

Partnering with stakeholders to take action to:

Promote the use of  findings  from national and/or WHO monitoring and evaluation frameworks to:

  • develop focused awareness strategies which target populations that are being left behind
  •  develop focused awareness strategies which target populations that are being left behind
  • create civil society-led shadow reports highlighting the experiences and expertise of civil society and the affected community to add further weight to national or WHO findings
  • Highlight in campaign materials that viral hepatitis is potentially a cancer-causing disease
  • Highlight that hepatitis can cause severe extrahepatic manifestations
  • Find influencers beyond the usual stakeholders that can help raise awareness (e.g celebrities and political leaders)
  • Create enabling environments where people living with viral hepatitis are able to share their stories in order to humanize the experience of living with viral hepatitis and reduce the stigma around it
  • Contribute to communication and awareness-raising campaigns by helping to formulate culturally speci c messaging to debunk myths, convey a sense of urgency, and reduce stigma
  • To ensure testing for hepatitis B and C is carried out alongside education on viral hepatitis so that awareness is increased in all people tested, not just those with viral hepatitis
  • Use the Find the Missing Millions campaign or other awareness-raising initiatives like World Hepatitis Day and NOhep to promote testing and improve understanding of viral hepatitis

2.  Making Testing More Accessible

The promotion of human rights and equity are core to both the SDGs (United Nations, 2015) and WHO initiatives to eliminate viral hepatitis. In particular these principles are evident within the guidance on access to testing, with WHO calling for testing services to be “accessible to the populations most affected” (WHO, 2017b). WHO further elaborates that: “Rapid expansion of programs to improve coverage should not compromise the quality of services, nor contribute to inequities in access to services and health outcomes” and “Actively engaging affected populations in developing strategies and programs should result in better targeted and acceptable services” (WHO, 2016).

Building on the foundation provided by WHO, civil society and the affected community can help national governments, national health institutions and other stakeholders to make testing more readily available by:

Partnering with stakeholders to advocate for:

  •  Development of a partnership response to viral hepatitis, where people living with the infections are included in ministerial and other global and national advisory structures
  • Better data to shape testing strategies so that they are targeted and client-centered
  • Available and effective testing, integrating both simple and appropriate testing technologies, while incentivizing testing at the primary care level
  • Provision of testing services through new models of care that allow for a “one-stop shop” experience where chronic infection can be confirmed and appropriate linkage to care implemented
  • Gaps in services to be addressed, specifically at sites where testing is not available or where it is underutilized
  • Broad availability of quality-assured rapid tests to screen for viral hepatitis

Partnering with stakeholders to take action to:

  •  Participate in the design of testing policies and strategies at the national level to ensure appropriate considerations that can enhance implementation are accounted for
  • Build the capacity of non-governmental organizations and community-based organizations, including patient groups, to test for viral hepatitis
  • Stimulate political will at all levels of government for increased access to testing
  • Help to ensure an equitable response by setting targets, especially for vulnerable populations, as they are frequently under-represented in testing efforts
  • Recruit peers from the affected communities to conduct testing, act as case managers, provide pre- and post-test counselling, provide reliable information to support those newly diagnosed and address transmission fallacies
Spotlight on peers:

Peer networks span multiple and intersecting groupings and have been successful in community mobilization. For example, peer involvement by community leaders or family members has been shown to promote access and subsequent participation in services for migrant populations, who are often cut o  from services, particularly where language and a fear of using services are barriers (Seedat, 2014; Sweeney, 2015).

The role of peers could extend beyond the current focus on testing and diagnosis to also serve to provide education on viral hepatitis, including how infection/reinfection occurs (Batchelder, 2017). For example, peer-driven testing campaigns for speci c populations such as people living with HIV (PLHIV), men who have sex with men (MSM), and people who inject drugs (PWID) can enable the scale up of diagnosis and treatment, as well as disseminate information on the distinct, available resources for those with a positive diagnosis to prevent stigmatization (Crawforth & Bath, 2013; Meyer, 2015; Scott, 2014; Sharma, 2015).

 3.  Removing Cost Barriers for Viral Hepatitis Testing

The WHA global survey found that out-of-pocket costs to patients were one of the principal barriers to diagnosis. To date, viral hepatitis testing costs have mainly been approached from a provider rather than user perspective in WHO initiatives (WHO, 2017b). However, the 4th strategic direction of the GHSS is: “Financing for sustainability: proposing strategies to reduce costs, improve efficiencies and minimize the risk of  financial hardship for those requiring the services” and the proposed priority actions for countries include reducing  financial barriers to patients by phasing out direct, out-of-pocket payments (WHO, 2016).

A coordinated and decided approach to curb this barrier is needed and civil society and the affected community can contribute by:

Partnering with stakeholders to advocate for:

  •  No, or limited and easily affordable, out-of-pocket costs for patients through inclusion of viral hepatitis services in health insurance schemes
  • Hepatitis testing and treatment to be included in universal health coverage packages, as set out by the Universal Health Coverage Forum in the Tokyo Declaration (2017)
  • The use of central procurement of quality-assured and affordable tests in order to obtain price-volume agreements
  • Leveraging of existing services in order to decrease investment costs for testing infrastructure and personnel, e.g. within HIV or other settings

 

Partnering with stakeholders to take action to:

  • Be a part of multi-stakeholder initiatives at the national level to inform the negotiation of pricing for diagnostic technologies and services
  • Assist in collecting and monitoring pricing data

Get Connected

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Sources:  Adapted from

WHA.org

CDC.org

WHO.org

 

References from WHA Whitepaper

American Association for the Study of Liver Diseases (AASLD) and Infectious Diseases Society  of America (2018). HCV Guidance: Recommendations for Testing, Managing, and Treating Hepatitis. Last Updated: May 24, 2018. Available from https://www. hcvguidelines.org/sites/default/ les/ full-guidance-pdf/HCVGuidance_ May_24_2018a.pdf, accessed 19 June 2018.

Batchelder AW, Cockerham-Colas L, Peyser D, Reynoso SP, Soloway I, Litwin AH (2017). Perceived benefits of the hepatitis C peer educators: a qualitative investigation. Harm Reduct J;14(1):67.

Chávez-Tapia NC, Ridruejo E, Alves de Mattos A, Bessone F, Daruich J, Sánchez-Ávila JF, et al (2013). An update on the management of hepatitis C: guidelines for protease inhibitor-based triple therapy from the Latin American Association for the Study of the Liver. Ann Hepatol;12 Suppl 2:s3-35.

Crawford S, Bath N (2013). Peer support models for people with a history of injecting drug use undertaking assessment and treatment for hepatitis C virus infection. Clin Infect Dis;57:S75–S79.

European Association for the Study of the Liver (2018). EASL Recommendations on Treatment of Hepatitis C 2018. J Hepatol. pii: S0168-8278(18)31968-8.

European Union HCV Collaborators (2017). Hepatitis C virus prevalence and level of intervention required to achieve the WHO targets for elimination in the European Union by 2030: a modelling study. Lancet Gastroenterol Hepatol;2(5):325-336.

Ishizaki A, Bouscaillou J, Luhmann N, Liu S, Chua R, Walsh N, et al (2017). Survey of programmatic experiences and challenges in delivery of hepatitis B and C testing in low- and middle-income countries. BMC Infect Dis.;17(Suppl 1):696.

Meyer JP, Moghimi Y, Marcus R, Lim JK, Litwin AH, Altice FL (2015). Evidence-based interventions to enhance assessment, treatment, and adherence in the chronic Hepatitis C care continuum. Int J Drug Policy;26(10):922-35.

Omata M, Kanda T, Wei L, Yu ML, Chuang WL, Ibrahim A, et al (2016). APASL consensus statements and recommendations for hepatitis C prevention, epidemiology, and laboratory testing. Hepatol Int;10(5):681-701

Scott HM, Pollack L, Rebchook GM, Huebner DM, Peterson J, Kegeles SM (2014). Peer social support is associated with recent HIV testing among young black men who have sex with men. AIDS Behav.;18(5):913–20.

Seedat F, Hargreaves S, Friedland JS (2014). Engaging new migrants in infectious disease screening: a qualitative semi-structured interview study of UK migrant community health-care leads. PLoS One; 9(10):e108261.

Sharma M, Ying R, Tarr G, Barnabas R (2015). Systematic review and meta-analysis of community and facility-based HIV testing to address linkage to care gaps in sub-Saharan Africa. Nature;528(7580):S77–85.

Sweeney L, Owiti JA, Beharry A, Bhui K, Gomes J, Foster GR, Greenhalgh T (2015). Informing the design of a national screening and treatment programme for chronic viral hepatitis in primary care: qualitative study of at-risk immigrant communities and healthcare professionals. BMC Health Serv Res;15:97.

United Nations (2015). Sustainable Development Goals. https:// sustainabledevelopment. un.org/?menu=1300 Universal Health Coverage Forum (2017). Tokyo Declaration on Universal Health Coverage: All Together to Accelerate Progress towards UHC. http://www.who.int/universal_health_coverage/tokyo- decleration-uhc.pdf?ua=1 World Health Organization (2016).

Global health sector strategy on viral hepatitis, 2016-2021. WHO: Geneva. http://www.who.int/ hepatitis/strategy2016-2021/ghss- hep/en/World Health Organization (2017a). Global hepatitis report, 2017. WHO: Geneva http://apps. who.int/iris/bitstream/handle/10665/255016/9789241565455- eng.pdf?sequence=1

World Health Organization (2017b).  Guidelines on hepatitis B and C testing. WHO: Geneva http:// apps.who.int/iris/bitstream/handle/10665/254621/9789241549981- eng.pdf?sequence=1

World Health Assembly (2010). 63rd World Health Assembly. Viral hepatitis. 21 May 2010. http://apps. who.int/gb/ebwha/pdf_ les/WHA63/ A63_R18-en.pdf

World Health Assembly (2014). 73th World Health Assembly. Hepatitis. 24 May 2014. http://www.wpro.who. int/hepatitis/wha67_r6-en.pdf

World Hepatitis Alliance (2018). Find the Missing Millions: Barriers to Diagnosis Global Report, http:// www.worldhepatitisalliance.org/ missing-millions/wp-content/ uploads/2018/06/Find-the-Missing- Millions-Survey-Report-FINAL.pdf

 

 

 

Is Diabetes Reaching Epidemic Proportions? Yes, but New Discoveries Offer Hope.

Diabetes has reached epidemic proportions in the U.S. – genetics, sugary diets and the lack of exercise all play a part. In a recent Instagram survey ( it is now the second largest search engine in the world, btw) it was found 97% of us know someone with diabetes.  That number surprised me, as I assumed it would be 100%.

The CDC reports the prevalence of diagnosed diabetes increased from 0.93% in 1958 to 9.40% in 2015. In 2015, 23.4 million people had diagnosed diabetes, compared to only 1.6 million, and it is estimated that number has now risen to above 30 million.   If current disease rates continue, one in three Americans will have diabetes by 2050. Over time, the condition can lead to kidney failure, limb amputations and blindness, among other complications.

The CDC report called the trend alarming, yet there is hope.

A Little History – Insulin Isolated in Toronto

On this day in 1958, at the University of Toronto, Canadian scientists Frederick Banting and Charles Best successfully isolate insulin–a hormone they believe could prevent diabetes–for the first time. Within a year, the first human sufferers of diabetes were receiving insulin treatments, and countless lives were saved from what was previously regarded as a fatal disease.

Diabetes has been recognized as a distinct medical condition for more than 3,000 years, but its exact cause was a mystery until the 20th century. By the early 1920s, many researchers strongly suspected that diabetes was caused by a malfunction in the digestive system related to the pancreas gland, a small organ that sits on top of the liver. At that time, the only way to treat the fatal disease was through a diet low in carbohydrates and sugar and high in fat and protein. Instead of dying shortly after diagnosis, this diet allowed diabetics to live–for about a year.

A breakthrough came at the University of Toronto in the summer of 1921, when Canadians Frederick Banting and Charles Best successfully isolated insulin from canine test subjects, produced diabetic symptoms in the animals, and then began a program of insulin injections that returned the dogs to normalcy. On November 14, the discovery was announced to the world.

Two months later, with the support of J.J.R. MacLeod of the University of Toronto, the two scientists began preparations for an insulin treatment of a human subject. Enlisting the aid of biochemist J.B. Collip, they were able to extract a reasonably pure formula of insulin from the pancreases of cattle from slaughterhouses. On January 23, 1921, they began treating 14-year-old Leonard Thompson with insulin injections. The diabetic teenager improved dramatically, and the University of Toronto immediately gave pharmaceutical companies license to produce insulin, free of royalties. By 1923, insulin had become widely available, and Banting and Macleod were awarded the Nobel Prize in medicine.

8 Amazing Breakthroughs Giving Us Hope

According to recent research, we’re not entirely sure how many diseases the label ‘diabetes’ covers. But no matter what causes our bodies to struggle with their blood sugar levels, it’s a serious condition that requires daily care.  Scientists have been working hard to find cures, new treatments, and better management techniques for the millions of people worldwide dealing with diabetes.

Here are a few of the latest developments you need to know about.

  1. Insulin producing implants made from stem cells

Clinical trials began last year for testing for ViaCyte’s PEC-Direct device; a credit-card sized implant containing insulin-producing cells derived from stem cells. Previous research had shown the implants could mature and function inside patients. Together with a cohort of volunteers who started testing in January, the new research should tell us soon whether the technology can help people with type-1 diabetes.

  1. Brand new beta cells

Type 1 diabetes develops when a person’s immune system wipes out insulin-producing beta cells in the pancreas. But it turns out that another type of immature beta cell has been hiding in our pancreases all along, and scientists think it might be possible to use these ‘virgin beta cells’ to restore the functionality of the pancreas.

  1. A common blood pressure medication

A drug on the World Health Organization’s list of essential drugs could have another purpose; blocking a molecule implemented in the autoimmune response that can give rise to type-1 diabetes.

Called methyldopa, the compound already has an important job treating high blood pressure in pregnant women and children. It’s left to be seen if it could help reduce the incidence of diabetes in some way, but the fact it’s already being used – rather than being stuck in the lab – makes for a promising find.

  1. A unique transplant

One woman with severe type 1 diabetes has spent a year without insulin injections thanks to an experimental transplant. Doctors implanted insulin-producing cells into a fatty membrane in the stomach cavity, and the success of the operation is paving the way towards more people receiving artificial pancreases.

  1. An extreme diet

A clinical trial conducted on just 298 volunteers in the UK last year found an intensive weight management program could put type-2 diabetes into remission for those who lose a significant amount of weight. The subjects were limited to roughly 850 calories a day for three to five months, consuming mostly soups and health shakes, before having more food introduced.

A similar study conducted on rats last year in the US also showed low calorie diets might help those who can stick to it reverse their condition.

  1. Glucose-monitoring contact lenses

Until we can nail down a cure, there will always been a need to monitor those messy blood glucose levels. Checking your tears for glucose using a smart contact lens, or monitoring your sweat with color changing ink, could be a whole lot less invasive than drawing blood. They’re not new ideas, but constant improvements in miniaturizing technology could mean these kinds of devices aren’t too far off.

  1. Loneliness could make us prone

While we can list a variety of genetic and lifestyle factors that affect a body’s growing resistance to insulin, there’s still a lot to learn. A study published late last year involving nearly 3,000 subjects aged 40 to 75 found there seems to be a significant relationship between social isolation and type-2 diabetes.

It’s not clear what the link might be, but having a few housemates or a local social group could make all the difference.

  1. Mexican cavefish evolved to be diabetic

While developing a resistance to insulin is bad news in humans, the pale, eyeless animal known as a Mexican cavefish evolved a new version of the insulin receptor that makes it harder for the hormone to bind.  This isn’t exactly a problem for the fish, which have also evolved other features to help it compensate. Studying its biology might help shine a light on how diabetes evolved in humans, and maybe even lead to new treatments.

  1. There is a gene for that (?)

By studying one family with rare blood sugar disorders, scientists have identified a gene mutation that can give rise to both high and low blood sugar. This discovery could lead to new treatments for diabetes.

Diabetes is a condition in which the body is unable to produce enough of the hormone insulin, or it cannot use it effectively.  As a result, blood sugar levels become too high.  It is estimated that around 30.3 million people in the United States are living with diabetes. Type 2 diabetes is the most common form, followed by type 1 diabetes.

One of the commonest forms of monogenic diabetes is maturity onset diabetes of the young, which accounts for approximately 2 percent of all diabetes cases in the U.S. among people under the age of 20;   but there are some rarer forms that account for just 1–4 percent of cases in the U.S. These are known as monogenic diabetes, and they arise from a mutation in a single gene that is passed down from one or both parents.  Such mutations impair the function of beta cells, which are cells in the pancreas that secrete insulin.

For this latest study, lead author Prof. Márta Korbonits — of the William Harvey Research Institute at Queen Mary University of London (QMUL) in the United Kingdom — and her colleagues studied a unique family, some members of which had diabetes, while others had insulinomas, or insulin-producing tumors in the pancreas.

Notably, diabetes is characterized by high blood sugar levels, while insulinomas cause blood sugar levels to become too low. How can both of these conflicting conditions run in the same family?  According to Prof. Korbonits and team, a single gene mutation is to blame.

MAFA mutation uncovered

By analyzing the genomes of the family, the researchers were surprised to find a single mutation in the MAFA gene that was present in both the family members with diabetes and those with insulinomas.  The MAFA gene normally regulates the production of insulin in beta cells. A mutation in this gene leads to the production of an abnormal MAFA protein, which seems to be more abundant in beta cells than normal MAFA proteins.

The researchers were able to confirm the presence of the MAFA gene mutation in another family, which also had members with both diabetes and insulinomas.  Overall, the results indicate that a mutation in the MAFA gene may be a cause of both high and low blood sugar levels, but precisely how the mutation causes such conditions remains unclear.

“We believe,” explains first study author Dr. Donato Iacovazzo, also of the William Harvey Research Institute at QMUL, “this gene defect is critical in the development of the disease and we are now performing further studies to determine how this defect can, on the one hand, impair the production of insulin to cause diabetes, and on the other, cause insulinomas.”

These results — now published in the Proceedings of the National Academy of Sciences — represent the first time that a mutation in the MAFA gene has been associated with disease, and the researchers believe that they could pave the way for new treatments for common and rare forms of diabetes.

“While the disease we have characterized is very rare, studying rare conditions helps us understand more about the physiology and the mechanisms underlying more common diseases. We hope that in the longer-term this research will lead to us exploring new ways to trigger the regeneration of beta cells to treat more common forms of diabetes.”

– Study co-author Prof. Sian Ellard, University of Exeter, U.K.

Overall Numbers, Diabetes and Prediabetes

  • Prevalence: In 2015, 30.3 million Americans, or 9.4% of the population, had diabetes.
    • Approximately 1.25 million American children and adults have type 1 diabetes.
  • Undiagnosed: Of the 30.3 million adults with diabetes, 23.1 million were diagnosed, and 7.2 million were undiagnosed.
  • Prevalence in Seniors: The percentage of Americans age 65 and older remains high, at 25.2%, or 12.0 million seniors (diagnosed and undiagnosed).
  • New Cases: 1.5 million Americans are diagnosed with diabetes every year.
  • Prediabetes: In 2015, 84.1 million Americans age 18 and older had prediabetes.
  • Deaths: Diabetes remains the 7th leading cause of death in the United States in 2015, with 79,535 death certificates listing it as the underlying cause of death, and a total of 252,806 death certificates listing diabetes as an underlying or contributing cause of death.

If your system seems to be handling sugar poorly, consider talking to a physician.  You can quickly find and connect with one in the largest ever healthcare ecosystem designed to vastly improve the relationship doctors and patients are meant to enjoy and find great value in….

Ready to get Lynked?  Go to HealthLynked.com to sign up for Free and start taking control of your healthcare today!

Sources

 

Diabetes: Surprising gene discovery could fuel new treatments

Published: Tuesday 16 January 2018 Written by: Honor Whiteman

 

8 Amazing Breakthroughs in Diabetes Research That Are Giving Us Hope

BY SIGNE DEAN & MIKE MCRAE

APRIL 02, 2018

 

 

 

Are We Infertile? Finding Help When Trying to Get Pregnant

Infertility happens when a couple cannot conceive after having regular unprotected sex.  It may be that one partner cannot contribute to conception, or that a woman is unable to carry a pregnancy to full term. It is often defined as not conceiving after 12 months of regular sexual intercourse without the use of birth control.

In the United States, around 10 percent of women aged 15 to 44 years are estimated to have difficulty conceiving or staying pregnant. Worldwide, 8 to 12 percent of couples experience fertility problems. Between 45 and 50 percent of cases are thought to stem from factors that affect the man.

Treatment is often available.

Causes in men

The following are common causes of infertility in men.

Semen and sperm

Semen is the milky fluid that a man’s penis releases during orgasm. Semen consists of fluid and sperm. The fluid comes from the prostate gland, the seminal vesicle, and other sex glands.

The sperm is produced in the testicles.

When a man ejaculates and releases semen through the penis, the seminal fluid, or semen, helps transport the sperm toward the egg.

The following problems are possible:

  • Low sperm count: The man ejaculates a low number of sperm. A sperm count of under 15 million is considered low. Around one third of couples have difficulty conceiving due to a low sperm count.
  • Low sperm mobility (motility): The sperm cannot “swim” as well as they should to reach the egg.
  • Abnormal sperm: The sperm may have an unusual shape, making it harder to move and fertilize an egg.

If the sperm do not have the right shape, or they cannot travel rapidly and accurately towards the egg, conception may be difficult. Up to 2 percent of men are thought to have suboptimal sperm.

Abnormal semen may not be able to carry the sperm effectively.

This can result from:

  • A medical condition: This could be a testicular infection, cancer, or surgery.
  • Overheated testicles: Causes include an undescended testicle, a varicocele, or varicose vein in the scrotum, the use of saunas or hot tubs, wearing tight clothes, and working in hot environments.
  • Ejaculation disorders: If the ejaculatory ducts are blocked, semen may be ejaculated into the bladder
  • Hormonal imbalance: Hypogonadism, for example, can lead to a testosterone deficiency.

Other causes may include:

  • Genetic factors: A man should have an X and Y chromosome. If he has two X chromosomes and one Y chromosome, as in Klinefelter’s syndrome, the testicles will develop abnormally and there will be low testosterone and a low sperm count or no sperm.
  • Mumps: If this occurs after puberty, inflammation of the testicles may affect sperm production.
  • Hypospadias: The urethral opening is under the penis, instead of its tip. This abnormality is usually surgically corrected in infancy. If the correction is not done, it may be harder for the sperm to get to the female’s cervix. Hypospadias affects about 1 in every 500 newborn boys.
  • Cystic fibrosis: This is a chronic disease that results in the creation of a sticky mucus. This mucus mainly affects the lungs, but males may also have a missing or obstructed vas deferens. The vas deferens carries sperm from the epididymis to the ejaculatory duct and the urethra.
  • Radiation therapy: This can impair sperm production. The severity usually depends on how near to the testicles the radiation was aimed.
  • Some diseases: Conditions that are sometimes linked to lower fertility in males are anemia, Cushing’s syndrome, diabetes, and thyroid disease.

Some medications increase the risk of fertility problems in men.

  • Sulfasalazine: This anti-inflammatory drug can significantly lower a man’s sperm count. It is often prescribed for Crohn’s disease or rheumatoid arthritis. Sperm count often returns to normal after stopping the medication.
  • Anabolic steroids: Popular with bodybuilders and athletes, long-term use can seriously reduce sperm count and mobility.
  • Chemotherapy: Some types may significantly reduce sperm count.
  • Illegal drugs: Consumption of marijuana and cocaine can lower the sperm count.
  • Age: Male fertility starts to fall after 40 years.
  • Exposure to chemicals: Pesticides, for example, may increase the risk.
  • Excess alcohol consumption: This may lower male fertility. Moderate alcohol consumption has not been shown to lower fertility in most men, but it may affect those who already have a low sperm count.
  • Overweight or obesity: This may reduce the chance of conceiving.
  • Mental stress: Stress can be a factor, especially if it leads to reduced sexual activity.

Laboratory studies have suggested that long-term acetaminophen use during pregnancy may affect fertility in males by lowering testosterone production. Women are advised not to use the drug for more than one day.

Causes in women

Infertility in women can also have a range of causes.

Risk factors

Risk factors that increase the risk include:

  • Age: The ability to conceive starts to fall around the age of 32 years.
  • Smoking: Smoking significantly increases the risk of infertility in both men and women, and it may undermine the effects of fertility treatment. Smoking during pregnancy increases the chance of pregnancy loss. Passive smoking has also been linked to lower fertility.
  • Alcohol: Any amount of alcohol consumption can affect the chances of conceiving.
  • Being obese or overweight: This can increase the risk of infertility in women as well as men.
  • Eating disorders: If an eating disorder leads to serious weight loss, fertility problems may arise.
  • Diet: A lack of folic acid, iron, zinc, and vitamin B-12 can affect fertility. Women who are at risk, including those on a vegan diet, should ask the doctor about supplements.
  • Exercise: Both too much and too little exercise can lead to fertility problems.
  • Sexually transmitted infections (STIs): Chlamydia can damage the fallopian tubes in a woman and cause inflammation in a man’s scrotum. Some other STIs may also cause infertility.
  • Exposure to some chemicals: Some pesticides, herbicides, metals, such as lead, and solvents have been linked to fertility problems in both men and women. A mouse study has suggested that ingredients in some household detergents may reduce fertility.
  • Mental stress: This may affect female ovulation and male sperm production and can lead to reduced sexual activity.

Medical conditions

Some medical conditions can affect fertility.

Ovulation disorders appear to be the most common cause of infertility in women.

Ovulation is the monthly release of an egg. The eggs may never be released, or they may only be released in some cycles.

Ovulation disorders can be due to:

  • Premature ovarian failure: The ovaries stop working before the age of 40 years.
  • Polycystic ovary syndrome (PCOS): The ovaries function abnormally and ovulation may not occur.
  • Hyperprolactinemia: If prolactin levels are high, and the woman is not pregnant or breastfeeding, it may affect ovulation and fertility.
  • Poor egg quality: Eggs that are damaged or develop genetic abnormalities cannot sustain a pregnancy. The older a woman is, the higher the risk.
  • Thyroid problems: An overactive or underactive thyroid gland can lead to a hormonal imbalance.
  • Chronic conditions: These include AIDS or cancer.

Problems in the uterus or fallopian tubes can prevent the egg from traveling from the ovary to the uterus, or womb.

If the egg does not travel, it can be harder to conceive naturally.

Causes include:

  • Surgery: Pelvic surgery can sometimes cause scarring or damage to the fallopian tubes. Cervical surgery can sometimes cause scarring or shortening of the cervix. The cervix is the neck of the uterus.
  • Submucosal fibroids: Benign or non-cancerous tumors occur in the muscular wall of the uterus. They can interfere with implantation or block the fallopian tube, preventing sperm from fertilizing the egg. Large submucosal uterine fibroids may make the uterus’ cavity bigger, increasing the distance the sperm has to travel.
  • Endometriosis: Cells that normally occur within the lining of the uterus start growing elsewhere in the body.
  • Previous sterilization treatment: In women who have chosen to have their fallopian tubes blocked, the process can be reversed, but the chances of becoming fertile again are not high.

Medications, treatments, and drugs

Some drugs can affect fertility in a woman.

  • Non-steroidal anti-inflammatory drugs (NSAIDs): Long-term use of aspirin or ibuprofen may make it harder to conceive.
  • Chemotherapy: Some chemotherapy drugs can result in ovarian failure. In some cases, this may be permanent.
  • Radiation therapy: If this is aimed near the reproductive organs, it can increase the risk of fertility problems.
  • Illegal drugs: Some women who use marijuana or cocaine may have fertility problems.

Cholesterol

One study has found that high cholesterol levels may have an impact on fertility in women.

Treatment

Treatment will depend on many factors, including the age of the person who wishes to conceive, how long the infertility has lasted, personal preferences, and their general state of health.

Frequency of intercourse

The couple may be advised to have sexual intercourse more often around the time of ovulation. Sperm can survive inside the female for up to 5 days, while an egg can be fertilized for up to 1 day after ovulation. In theory, it is possible to conceive on any of these 6 days that occur before and during ovulation.

However, a survey has suggested that the 3 days most likely to offer a fertile window are the 2 days before ovulation plus the 1 day of ovulation.

Some suggest that the number of times a couple has intercourse should be reduced to increase sperm supply, but this is unlikely to make a difference.

Fertility treatments for men

Treatment will depend on the underlying cause of the infertility.

  • Erectile dysfunction or premature ejaculation: Medication, behavioral approaches, or both may help improve fertility.
  • Varicocele: Surgically removing a varicose vein in the scrotum may help.
  • Blockage of the ejaculatory duct: Sperm can be extracted directly from the testicles and injected into an egg in the laboratory.
  • Retrograde ejaculation: Sperm can be taken directly from the bladder and injected into an egg in the laboratory.
  • Surgery for epididymal blockage: A blocked epididymis can be surgically repaired. The epididymis is a coil-like structure in the testicles which helps store and transport sperm. If the epididymis is blocked, sperm may not be ejaculated properly.

Fertility treatments for women

Fertility drugs might be prescribed to regulate or induce ovulation.

They include:

  • Clomiphene (Clomid, Serophene): This encourages ovulation in those who ovulate either irregularly or not at all, because of PCOS or another disorder. It makes the pituitary gland release more follicle-stimulating hormone (FSH) and luteinizing hormone (LH).
  • Metformin (Glucophage): If Clomiphene is not effective, metformin may help women with PCOS, especially when linked to insulin resistance.
  • Human menopausal gonadotropin, or hMG (Repronex): This contains both FSH and LH. Patients who do not ovulate because of a fault in the pituitary gland may receive this drug as an injection.
  • Follicle-stimulating hormone (Gonal-F, Bravelle): This hormone is produced by the pituitary gland that controls estrogen production by the ovaries. It stimulates the ovaries to mature egg follicles.
  • Human chorionic gonadotropin (Ovidrel, Pregnyl): Used together with clomiphene, hMG, and FSH, this can stimulate the follicle to ovulate.
  • Gonadotropin-releasing hormone (Gn-RH) analogs: These can help women who ovulate too early—before the lead follicle is mature—during hmG treatment. It delivers a constant supply of Gn-RH to the pituitary gland, which alters the production of hormone, allowing the doctor to induce follicle growth with FSH.
  • Bromocriptine (Parlodel): This drug inhibits prolactin production. Prolactin stimulates milk production during breastfeeding. Outside pregnancy and lactation, women with high levels of prolactin may have irregular ovulation cycles and fertility problems.

Reducing the risk of multiple pregnancies

Injectable fertility drugs can sometimes result in multiple births, for example, twins or triplets. The chance of a multiple birth is lower with an oral fertility drug.

Careful monitoring during treatment and pregnancy can help reduce the risk of complications. The more fetuses there are, the higher the risk of premature labor.

If a woman needs an HCG injection to activate ovulation and scans show that too many follicles have developed, it is possible to withhold the HCG injection. Couples may decide to go ahead regardless if the desire to become pregnant is very strong.

If too many embryos develop, one or more can be removed. Couples will have to consider the ethical and emotional aspects of this procedure.

Surgical procedures for women

If the fallopian tubes are blocked or scarred, surgical repair may make it easier for eggs to pass through.

Endometriosis may be treated through laparoscopic surgery. A small incision is made in the abdomen, and a thin, flexible microscope with a light at the end, called a laparoscope, is inserted through it. The surgeon can remove implants and scar tissue, and this may reduce pain and aid fertility.

Assisted conception

The following methods are currently available for assisted conception.

Intrauterine insemination (IUI): At the time of ovulation, a fine catheter is inserted through the cervix into the uterus to place a sperm sample directly into the uterus. The sperm is washed in a fluid and the best specimens are selected.

The woman may be given a low dose of ovary stimulating hormones.

IUI is more commonly done when the man has a low sperm count, decreased sperm motility, or when infertility does not have an identifiable cause. It can also help if a man has severe erectile dysfunction.

In-vitro fertilization (IVF): Sperm are placed with unfertilized eggs in a petri dish, where fertilization can take place. The embryo is then placed in the uterus to begin a pregnancy. Sometimes the embryo is frozen for future use.

Intracytoplasmic sperm injection (ICSI): A single sperm is injected into an egg to achieve fertilization during an IVF procedure. The likelihood of fertilization improves significantly for men with low sperm concentrations.

Sperm or egg donation: If necessary, sperm or eggs can be received from a donor. Fertility treatment with donor eggs is usually done using IVF.

Assisted hatching: The embryologist opens a small hole in the outer membrane of the embryo, known as the zona pellucid. The opening improves the ability of the embryo to implant into the uterine lining. This improves the chances that the embryo will implant at, or attach to, the wall of the uterus.

This may be used if IVF has not been effective, if there has been poor embryo growth rate, and if the woman is older. In some women, and especially with age, the membrane becomes harder. This can make it difficult for the embryo to implant.

Electric or vibratory stimulation to achieve ejaculation: Ejaculation is achieved with electric or vibratory stimulation. This can help a man who cannot ejaculate normally, for example, because of a spinal cord injury.

Surgical sperm aspiration: The sperm is removed from part of the male reproductive tract, such as the vas deferens, testicle, or epididymis.

Types

Infertility can be primary or secondary.

Primary infertility is when a couple has not conceived after trying for at least 12 months without using birth control

Secondary infertility is when they have previously conceived but are no longer able to.

Diagnosis

Most people will visit a physician if there is no pregnancy after 12 months of trying.

If the woman is aged over 35 years, the couple may wish to see a doctor earlier, because fertility testing can take time, and female fertility starts to drop when a woman is in her 30s.

A doctor can give advice and carry out some preliminary assessments. It is better for a couple to see the doctor together.

The doctor may ask about the couple’s sexual habits and make recommendations regarding these. Tests and trials are available, but testing does not always reveal a specific cause.

Infertility tests for men

The doctor will ask the man about his medical history, medications, and sexual habits and carry out a physical examination. The testicles will be checked for lumps or deformities, and the shape and structure of the penis will be examined for abnormalities.

  • Semen analysis: A sample may be taken to test for sperm concentration, motility, color, quality, any infections, and whether any blood is present. Sperm counts can fluctuate, so that several samples may be necessary.
  • Blood test: The lab will test for levels of testosterone and other hormones.
  • Ultrasound: This may reveal issues such as ejaculatory duct obstruction or retrograde ejaculation.
  • Chlamydia test: Chlamydia can affect fertility, but antibiotics can treat it.

Infertility tests for women

A woman will undergo a general physical examination, and the doctor will ask about her medical history, medications, menstruation cycle, and sexual habits.

She will also undergo a gynecologic examination and a number of tests:

  • Blood test: This can assess hormone levels and whether a woman is ovulating.
  • Hysterosalpingography: Fluid is injected into the woman’s uterus and X-rays are taken to determine whether the fluid travels properly out of the uterus and into the fallopian tubes. If a blockage is present, surgery may be necessary.
  • Laparoscopy: A thin, flexible tube with a camera at the end is inserted into the abdomen and pelvis, allowing a doctor to look at the fallopian tubes, uterus, and ovaries. This can reveal signs of endometriosis, scarring, blockages, and some irregularities of the uterus and fallopian tubes.

Other tests include:

  • ovarian reserve testing, to find out how effective the eggs are after ovulation
  • genetic testing, to see if a genetic abnormality is interfering with fertility
  • pelvic ultrasound, to produce an image of the uterus, fallopian tubes, and ovaries
  • Chlamydia test, which may indicate the need for antibiotic treatment
  • thyroid function test, as this may affect the hormonal balance

Complications

Some complications can result from infertility and its treatment. If conception does not occur after many months or years of trying, it can lead to stress and possibly depression.

Some physical effects may also result from treatment.

Ovarian hyperstimulation syndrome

The ovaries can swell, leak excess fluid into the body, and produce too many follicles, the small fluid sacs in which an egg develops.

Ovarian hyperstimulation syndrome (OHSS) usually results from taking medications to stimulate the ovaries, such as clomiphene and gonadotrophins. It can also develop after IVF.

Symptoms include:

  • bloating
  • constipation
  • dark urine
  • diarrhea
  • nausea
  • abdominal pain
  • vomiting

They are usually mild and easy to treat.

Rarely, a blood clot may develop in an artery or vein, liver or kidney problems can arise, and respiratory distress may develop. In severe cases, OHSS can be fatal.

Ectopic pregnancy

This is when a fertilized egg implants outside the womb, usually in a fallopian tube. If it stays in there, complications can develop, such as the rupture of the fallopian tube. This pregnancy has no chance of continuing.

Immediate surgery is needed and, sadly, the tube on that side will be lost. However, future pregnancy is possible with the other ovary and tube.

Women receiving fertility treatment have a slightly higher risk of an ectopic pregnancy. An ultrasound scan can detect an ectopic pregnancy.

Coping mentally

It is impossible to know how long treatment will go on for and how successful it will be. Coping and persevering can be stressful. The emotional toll on both partners can affect their relationship.

Some people find that joining a support group helps, as it offers the chance to talk to others in a similar situation.

It is important to tell a doctor if excessive mental and emotional stress develop. They can often recommend a counselor and others who can offer appropriate support. Online support from organizations such as Resolve can be helpful.

Outlook

For couples who experience fertility problems and those who wish to have children at an older age, there are more options available than ever before.

In 1978, the first baby was born as a result of IVF. By 2014, over 5 million people had been born after being conceived through IVF.

As new technology becomes available, fertility treatment is now accessible to more people, and success rates and safety are improving all the time.

Financing fertility treatment can also be costly, but there are programs that can help with this.

Finding Help

HealthLynked is a great platform for connecting and communicating with medical professionals who can guide and counsel you through the issues of infertility.  Create a free profile today and LYNK with physicians in your area immediately.

Ready to get Lynked?  Go to HealthLynked.com to get started for free…right away!

 

Source:

Debra Rose Wilson, PhD, MSN, RN, IBCLC, AHN-BC, CHT, Infertility in men and women, Medical News Today, 4 January 2018

 

#ivfjourney,#ivf,#fertilitytreatment,#fertility,#infertility,#friends,#ivfbaby,#ivfsuccess,#infertilitysucks

Awaken Your SuperHero Within | The Anti-Kryptonite Powers of Napping

At the Academy (Harvard on the Severn, Canoe U, Squid Tech), I was into napping.  Any time I could squeeze a few zzzzs into a day, especially after lunch, I would; and so would many others.  For me, I counted it as an essential escape from the rigors of military school, thinking if I slept half the day, I would be “away”from USNA half the time.

It wasn’t until much later I learned napping had other health benefits, too.

Sadly, napping is often frowned upon in our workaholic American culture. When we think of napping men, we think of Dagwood passed out on the couch after consuming a giant, delicious sandwich. Naps are thought to be habits of the lazy and unambitious, or the privilege of retirees with plenty of time on their hands. The person who falls asleep at his desk at work is laughed at and often fired.  And when we doze off, we feel guilty —  except in planes.  Always nap on planes!

In reality, the nap stigma is incredibly misplaced. Naps can be one of the most powerful tools for self-improvement; they can increase not only our health and well-being but our intelligence and productivity. This is something great achievers have known all along. History is full of famous nappers. Noted thinkers, creators and leaders, like Edison, JFK, Churchill, Aristotle, Margaret “Iron Lady” Thatcher, and Napoleon, all were ardent nappers.

Cats and Dogs Know Something You Don’t

Humans are among the few animals that take their sleep in one shot. The rest of the animal kingdom consists of polyphasic sleepers; they alternate sleep and wake cycles throughout a 24-hour period. Cavemen likely slept in multiple phases too, so someone was always up to keep an eye out for saber tooth tigers. While experimenting with a return to polyphasic sleep has become trendy in recent times, the ideal pattern for human sleep appears to be biphasic–a long stretch at night along with a shorter respite during the day.

The ancient Romans were biphasic sleepers; at sexta (the sixth hour or their noon) everyone would turn in for some midday shut eye. This is where we get the terms siesta and reposo — traditions once popular in Spain and Italy respectively but which have largely succumbed to the encroaching go-go-go Western business style.

While the pace of modern life may keep us from being the biphasic sleepers we were meant to be, the urge for a daytime snooze is still hardwired into our biology.  Many of us find it nearly impossible to get enough z’s at night, and sleep deprivation causes a host of bodily and mental ills, keeping us from performing at our best and enjoying life to the fullest.

I feel it every day, and stave it off with the obligatory midday caffeine injection.

Studies have shown when people are put into an environment that lacks any indication of time, they will fall into the long sleep at night/shorter nap during the day pattern. Thus, most of us are daily fighting tooth and nail against our body’s natural circadian rhythm.  Match this with the fact most Americans report being sleep deprived, and we are becoming a horde of drowsy zombies in mindless, relentless pursuit of espresso instead of brains.

While a good night’s sleep is essential, a daily nap can buoy us up when we’re not getting quite enough shut eye. And for those who already sleep well at night, a nap can take take the performance of your body and mind to the next level.

The Benefits of Napping

Increases alertness. When your eyelids are almost too heavy to keep open, you’re not doing your best work. Make time for a nap and then go back at it. A NASA study found a 40-minute nap increases alertness by 100%. Other studies have found that a 20-minute nap is more effective than either 200 mg of caffeine or a bout of exercise. Yet another study showed that pilots who were allowed to take a 25-minute nap (while the co-pilot manned the controls!) nodded off fives times less than their nap-deprived peers. They also made less errors during take-offs and landings.

Power naps are effective at making you more alert when you wake up because there’s very low risk of falling into a deep sleep or another sleep cycle that causes grogginess. Your brain shuts down just enough that when you wake up, you experience a jolt of alertness. Study after study has shown that people working night shifts or in high pressure jobs with long shifts are much more alert when given the opportunity to power nap, sometimes several times a day.

Beyond pilots and space jockeys, there are many jobs that require you to be alert and can be dangerous to yourself and others if you aren’t. Firefighters are a good example, though your job or situation doesn’t need to be that extreme to benefit from being alert as a result of a power nap. New parents learn to nap when their newborn does, even if it’s only for 10 minutes at a time, though other factors affect fatigue in that case. Regardless, research is solid in that power naps provide a higher level of alertness and even awareness than before catching those short z’s.

Studies have shown that if you break up your day with a nap, you will be as alert and energetic for the second part of your day as you were for the first. So, if you’ve got an event planned for after work, take a nap before going out on the town.

Improves learning and working memory. Naps improve your working memory. This type of memory is involved in working on complex tasks where you have to pay attention to one thing while holding a bunch of other things in your memory. Napping also improves your memory retention; during sleep, recent memories are transferred to the neocortex, where long-term memories are solidified and stored.

For many people, everything from power naps to 90-minute naps can be very restorative, resulting in improved memory and cognitive function. Some experts say that people who can nap properly—meaning being able to take a nap without falling into a deep sleep and waking feeling refreshed—benefit much more from these short naps than turning to energy drinks and caffeine. The nap allows them to reactivate their memory and organize information more easily.

Improved memory can be really helpful for people who have to absorb and remember a lot of information. Some require this for their jobs, but students are a prime example, and a lot of research has been done about the ways students can effectively absorb the mountain of information they’re required to learn during high school, university and college. Studies have shown that students who nap after a round of studying often wake up with a better memory of what they had been learning and reading before their nap. It’s almost like hitting reset on the brain, allowing you to remember things that you would have otherwise forgotten.

Prevents burnout and reverses information overload.  While we often refuse to take a nap because we feel like we have too much to do, studies have shown that putting in extra hours without rest dramatically reduces your productivity. It would be better to take a 30-minute nap and return to your work refreshed.

This was demonstrated in a study in which subjects performed a visual task over the course of four days. With each successive session, the subjects’ performance on the task deteriorated. But when the subjects were allowed to take a 30-minute nap after the second session, the decline in performance was halted. And after a one-hour nap, their performance actually improved in the third and fourth sessions.

Bigger companies have started to recognize the benefits of daytime napping and allow or even encourage employees to take a power nap. Some have even gone as far as to designate an area for napping. Not every company will jump on the bandwagon, but if you can go somewhere to grab a quick power nap during a lunch or early afternoon break, you could be more productive at work. But if you work the standard 9-5 shift, avoid taking naps mid to late afternoon because it could prevent you from falling asleep and sleeping well that night.

Heightens your senses and creativity. According to a foremost nap scientist (napologist? Napster? Napmeister?) Sara C. Mednick, napping can improve your sensory perception as effectively as a night of sleep. This means that steak tastes better, the sunset looks purtier, and Annie’s Song sounds even better after a good nap.

Napping also improves your creativity by both loosening up the web of ideas in your head and fusing disparate insights together.

Between your job, family responsibilities, personal relationships, social and volunteer commitments, and even just running errands, a lot of things drain you—both physically and mentally. This stress and exhaustion is a clear strain on your creativity, and it can seem almost hopeless to get back. But getting the creative juices flowing could come from taking a power nap. Stress takes it toll on the mind so shutting down with a nap could revive your mind and organize your thoughts, bringing your creativity back to you.

You don’t need to have what’s considered a creative job for waning creativity to negatively impact what you do at work. Power naps have been proven to help in this area, and a not-so-surprising amount of people struggle with it often. Every job requires some level creativity, from the obvious artistic requirements of graphic designers and architects to the deft creativity of administrative personnel organizing schedules or the insightfulness of an accountant balancing books. So, take a nap and see where your creativity goes — it could benefit you and your employer greatly.

Improves health. Sleep deprivation leads to an excess of the hormone cortisol in the body. Cortisol, known as the stress hormone, helps us deal with fight or flight responses. But excess cortisol increases glucose intolerance and abdominal fat, weakens the muscular and immune systems, stymies memory and learning, and decreases levels of growth hormone and testosterone in our bodies. These deleterious effects can lead to diabetes and heart disease.

When you sleep, you release growth hormone, the antidote to cortisol which which boosts your immune system, primes your sexual function, reduces stress and anxiety, and aids in muscle repair and weight loss. Napping gives your brain a chance to rest and your body a chance to heal.

The proof’s in the pudding. A study done with Greeks found those that took a 30-minute nap at least three times a week had a 37% lower risk of dying from a heart-related condition. Among working men their risk of death was reduced 64%! So, not only should you dance like Zorba the Greek, you should nap like him, too.

Improves mood. Odds are you know someone who is really cranky when they don’t get the sleep they need, or you might be that person. If so, you understand even more how important feeling rested is to your mood. Being tired can have a sort of snowball effect –  you are likely to feel grouchy, be short with those around you, or simply have a tough time focusing.  These and other physical and emotional reactions as a result of lack of sleep only continue to keep you in a bad mood or worsen it as the day or weeks go by.

The neurotransmitter serotonin regulates our mood, sleep, and appetites. It produces feeling of contentment and well-being. But when our bodies are stressed, higher levels of serotonin are used and the production of more is blocked. As a result, we can become anxious, irritable, depressed, overwhelmed, and easily distracted. According to Mednick, “napping bathes your brain in serotonin, reversing those effects and creating a more positive outlook.”

And the fact is, some days you just need that extra bit of shut eye. Whether you have a restless night or a stressful (and therefore tiring) week at work, a power nap can keep your spirits high. But if you have insomnia, sleep apnea, or other form of sleep condition, talk to your doctor before scheduling in any naps. People with these conditions aren’t usually encouraged to nap because of other health implications and risks, so speak to a professional first. Saves money. Instead spending $30 a week on Five Hour Energy or Starbucks, take a nap and boost your energy the natural and more effective way.

Lowers Stress.  Stress is inevitable at certain times of your life, but it doesn’t need to be constant. Research has shown that psychological pressure and stress can be reduced by taking a nap. Stress is hard on your body and getting rest from a nap after you experience an increase in stress has been linked to improved cardiovascular healing, lowering the possible effects of stress on your heart. In addition, the hormones released during a nap or night of sleep contribute to decreasing your level of stress.

A lot of people find it hard to fall asleep during the day, even when they need it or could really benefit from it. If you give napping a try and just can’t do it, don’t force it but consider still taking the time to lie down and relax. Similar to when you go to sleep, your mind has to reach a certain level of relaxation and your thoughts can’t be too loud. Achieving this during the day in place of a power nap has been shown to have similar benefits to that of actual napping, so keep that time set aside to reduce stress.

Reduced Risk of Depression.  Studies have linked people who get enough/the right amount of sleep to a lower chance of developing depression. And naps can help you get that perfect amount of rest if you don’t get it over night, so taking your power naps could be greatly beneficial to your mental and emotional health. Of course, everyone is different, and the amount of sleep needed will vary.  Get in tune with your body and figure out the length and amount of naps you need to help both your mind and body.

Similar to the reasoning for lower stress, naps give your body the rest it needs to function and perform at its best, and feeling your best all around plays a role in depression. Depression may also be reduced because stress can cause excess hormones linked to depression. Since naps can lower stress, it can then lower the risk of depression as well—napping can help balance hormones that cause mental health problems. Or even just considering the energy, alertness, reduced stress and increased productivity, the other benefits can contribute to improved mental health.

Reduced Risk of Cardiovascular Disease.  There’s still debate and differing opinions about whether or not naps can help reduce the risk of cardiovascular disease, but as research continues to link the two more experts are beginning to see the potential of it. It’s believed that regular naps can lower blood pressure, but even more staggering are the results of studies that have shown a significant decrease in the risk of dying from a heart attack. People in high stress jobs greatly benefit from the cardiovascular healing properties of naps because stress can strain the heart and increase the risk of cardiovascular problems.

Studies in countries that typically have a lower mortality rate and lower risk of heart disease emphasize the importance of not only getting your rest but being healthy in other ways—exercise and healthy diets are main contributors to heart health. When mixed in with regular power naps, this type of lifestyle is bound to reduce the risk of cardiovascular disease. So, if you haven’t tried napping, it’s not too late to enjoy the many possible benefits of rejuvenating and healing your body in many ways, and you may even help your heart.

It’s awesome. Seriously, people. Napping is awesome.  Take it from my new grandbaby.

Understanding the Stages of Sleep

All napping is good, but you can also tailor your nap to your specific needs. But before we delve into that, we need to talk about what each stage of sleep does for your mind and body.

There are five various stages of sleep, 1,2,3,4, and REM (Rapid Eye Movement). You cycle through them repeatedly as you sleep or nap: 1,2,3,4, 2, REM, 2,3,4,2, REM and so on. Each cycle lasts 90-100 minutes.

Stage 1: Lasting 2-5 minutes, this stage transitions you into sleep. Your thoughts and mental associations loosen up. This state of sort of wakeful dreaming has been used by artists and thinkers to cultivate rich ideas. We’ll cover this in-depth in a future post.

Stage 2: Motor skills and complex tasks you’ve been working on are solidified. Your energy and stamina are strengthened and senses sharpened. You spend about 50% of your sleep time in Stage 2.

Stages 3 and 4: In these stages you slide into Slow Wave Sleep. Your body stops releasing cortisol altogether and extra growth hormone goes to work restoring your body, repairing tissues, lowering stress, metabolizing fats and moving carbs out of your body. And your mind is cleared; memories that aren’t being used are pruned away, strengthening what remains and making room for new information. Information that you’ve recently and consciously learned such as the dates for a history test are solidified. You spend about 30% of your sleep time in Stages 3 and 4.

REM: During REM your brain shuttles your recently-made memories from their short term holding tank in the hippocampus to long term storage. The information is thus made permanent; if you don’t sleep soon after a learning session, you’ll lose much of what you studied. Creativity is given a boost as spatial orientation and perceptual skills are sharpened and the different insights and complex ideas you have swirling around in your melon are fused together. You spend about 20% of your sleep time in REM.

Tailoring Your Nap to Your Needs

According to Dr. Mednick, the perfect nap for everyone is 90 minutes long and taken between 1 and 3 in the afternoon. At this time, and at this length, your nap will consist of the optimal balance of all the different sleep stages. The ratio of the sleep stages in this nap exactly mirror that of nocturnal sleep. But of course, not everyone has an hour and a half to saw off during the day. And sometimes you want to tailor your nap to your particular needs on a particular day.

Note: These recommendations are based on an average adult sleep schedule (11-12 am to 6-8 am). If you’re a night owl or have a different sort of schedule, check out Dr. Mednick’s book, Take a Nap! It has a “nap wheel” and formula for calculating your perfect nap based on when you wake up and your particular needs.

You need a boost of creativity. Don’t know how many happy little clouds to add to your painting, and Bob Ross won’t be on until 3? Does writing your essay for English class feel, as Ronald Reagan put it, like crapping a pineapple? Then you need a dose of REM sleep, which increases your creativity. You’ll need a longer nap to get to the REM stage; and since potential REM peaks early in the day and declines from there, aim for something like a 90-minute nap before 2 pm.

You need stamina. Running a race that evening? Going from one job to the next? You need Stage 2 sleep which you can get in a 20-minute power nap. Don’t go down for any longer than 20 minutes though. We’ve all experienced naps that leave us groggy when we wake up. This is sleep inertia and happens when you awaken during Slow Wave Sleep. So, you need to wake up before you slip into Stage 3.

Studies have found that a 20-minute nap 8 hour after you wake up will boost your stamina more than sleeping an extra 20 minutes in the morning. So instead of hitting the snooze button, save those minutes for an afternoon siesta.

You need to relax. While REM sleep declines during the day, SWS increases. So, if you’re feeling stressed, shoot for a longer nap after 2 pm and ideally in the early evening, so your body can get a cortisol break and repair itself. Naps will not affect your nighttime sleep as long as you wake from your nap three hours before bedtime. 

You need to pull an all-nighter. Instead of downing can after can of Red Bull, try what researchers call the “prophylactic nap.” Taking a preventive nap in anticipation of sleep deprivation is more effective in maintaining cognitive performance and alertness than taking no nap at all, taking a nap when your sleep debt has already made you tired, and even taking multiple doses of caffeine. Any length of nap will help, but according to Mednick an hour and a half is the preventive nap sweet spot because “it will take you through a full cycle of sleep and bring you out in REM or Stage 2 Sleep, allowing you to avoid sleep inertia.” Keep in mind that the effects of a prophylactic nap only last 8-10 hours; nothing can keep your brain from starting to unravel if you skip two nights of sleep.

You need to ace a test. After you study and before test time, take a 90-minute nap. Stage 2 will increase your alertness, stages 3 and 4 will clear your mind of unnecessary clutter, solidify the things you just studied, and lower your stress, and REM sleep will move the information into permanent storage and sort through the complex information you just learned.

You need immediate alertness. Try a “caffeine nap.” Researchers at Loughborough University tested several ways to improve the alertness of drivers and found the “caffeine nap” to be the most effective method. You down a cup of coffee or other caffeinated beverage and then immediately hunker down for a 15 to 20-minute nap. Again, don’t go any longer or you’ll awaken with sleep inertia. The caffeine clears your body of adenosine, a chemical which makes you sleepy. It takes awhile for the caffeine to circulate through your system, so it doesn’t affect the quality of the nap. Instead, it kicks in in tandem with the refreshment you would feel upon awakening from a normal power nap. I’ve personally found the caffeine nap to be effective, especially when you’re crunched for time; it’s easier to get up and keeps you from the temptation of turning a 20-minute nap into an hour and a half session.

Squeezing in Nap Time

It would be awesome if offices took a cue from kindergarten and broke out cookies, milk, and nap mats once a day.  Maybe a little finger painting, too.

In the real world, it can be hard to catch some z’s at work. Getting caught asleep at your desk is not a good way to earn respect at your job, but most people get an hour for lunch.  You can easily eat for half that time, skip the double latte, and go take a snooze in your car for the other half. Tell your boss all about the benefits of napping and see if you can get a couch in some rarely-used room.

If you’re a student, toss embarrassment to the wind and curl up somewhere. If you can’t nap during the day, take a short pre-or post-dinner nap.

Remember, all you need to do it carve out 20 minutes somewhere in your day. One study showed that even a 6-minute nap improves memory function. So, you can even sneak one in while the guy at the desk next to you runs to the snack machine.

At the very least, learn to embrace the nap and the napping of others. Napping is not a character defect! Many great people have taken advantage of the benefits of napping. It is a wonderful, wonderful way to improve your life.

Get help Resetting and Recharging

If you are slacking in your sleep game, it places a tremendous strain on your nervous system, body and overall health. Damage from sleep deficiency can occur in an instant (such as a car crash), or it can harm you over time. For example, ongoing sleep deficiency can raise your risk for some chronic health problems. It also can affect how well you think, react, work, learn, and get along with others.

So, if you’re not sleeping well or aren’t feeling rested when you wake up in the morning, it’s important to talk to your doctor and ask if a sleep study is right for you.  To find a healthcare provider who is practiced in helping you get a good night’s rest, go to HealthLynked.com.  In our first of its kind healthcare ecosystem, you will find physicians and advice to help you stop counting sheep and possibly sneak in a little sleep here and there….maybe even get a doctor’s note for required rest!

So, reignite the day with a nap, and reinvigorate your healthcare with HealthLynked.  Get Lynked now for Free!

 

 

Sources: 

Take a Nap! Change Your Life by Sarah C. Mednick, Ph.D

Unleash the power of the Nap, Brett & Kate McKay | February 7, 2011, Last updated: May 28, 2018

 

July is Sarcoma Awareness Month – Raise Awareness for this “Forgotten Cancer”

If you see yellow ribbons around your community during the month of July, it may mean something different than the usual “Support Our Troops” many think of when first sighted. Instead, they could be displayed in honor of Sarcoma Awareness Month, observed each July.

Sarcoma is a soft-tissue cancer that may occur in a variety of the body’s soft tissues, including the nerves, muscles, joints, blood vessels, fat and more. Sarcoma may also occur in the bones.  Although rare in adults, making up just ONE percent of adult cancers, sarcoma is relatively common in children, accounting for fifteen percent of childhood cancer cases.  Bone and joint cancer is most frequently diagnosed among teenagers, while soft tissue cancers typically affect those 55 years or older.

Sarcoma is most often found in the arms and legs, where the majority of connective tissues are located, but it can occur virtually anywhere. Because the disease often starts deep in the body, it may not be noticeable until a large lump or bump appears — and at this point the cancer may be difficult to treat.

The Sarcoma Foundation of America (SFA) estimates that about 20 percent of sarcoma cases are curable by surgery while another 30 percent may be effectively treated with surgery, chemotherapy and/or radiation. However, in about half of cases, the disease is resistant to all form of treatments, highlighting an urgent need for new therapies.

Soft tissue sarcomas form in cartilage, fat, muscle, blood vessels, tendons, nerves, and around joints. Osteosarcomas develop in bone; liposarcomas form in fat; rhabdomyosarcomas form in muscle; and Ewing sarcomas form in bone and soft tissue.

In 2018, over 13,000 cases of soft tissue sarcoma and 3,400 cases of bone sarcomas are expected to be diagnosed in the United States, according to data from the National Cancer Institute’s Surveillance, Epidemiology, and End Results Program (SEER). Approximately 5,100 and 1,590 people are expected to die from soft tissue and bone sarcomas, respectively. The five-year survival rate for soft tissue sarcomas is 50 percent, while the survival rate is 66 percent for bone sarcomas.

Because sarcomas are difficult to distinguish from other cancers when they are found within organs, their incidence is probably underestimated, according to the National Cancer Institute.

 Fast facts on sarcoma

  • There are over 50 types of soft tissue sarcoma.
  • Symptoms may not be apparent; often, the only sign of sarcoma is a lump.
  • Pain may occur depending on where the tumor is located, or if it presses on nearby nerves.
  • Treatment, as for other forms of cancer, can include surgery, radiation therapy, and chemotherapy.

Symptoms of soft tissue sarcoma

People with soft tissue sarcomas often have no symptoms. There may be no signs until the lump grows to a large size and can be felt; however, even this may go unnoticed. The main symptoms are:

  • Pain – the most obvious symptom. Once the tumor affects local tissues, nerves, or muscles, it can be felt as pain in the general area.
  • Inflammation – the tumor grows and eventually affects the area with inflammation and swelling.
  • Location specific symptoms – inability to move limbs properly (if the sarcoma is on the arms or legs for example) and other impairments depending on the location.

Specific symptoms may reflect the particular type of sarcoma. For instance, tumors in the gastrointestinal system may bleed, so these sarcomas might produce symptoms like blood in the stool, or a stool that has a black, tarry appearance.

Types of sarcoma

Types of soft tissue sarcoma are defined by the specific tissue or location affected; they include:

  • Undifferentiated pleomorphic sarcoma – previously known as malignant fibrous histiocytoma – this tumor is most often found in the arms or legs but sometimes at the back of the abdomen.
  • Gastrointestinal stromal tumor (GIST) – this affects specialized neuromuscular cells of the gut.
  • Liposarcoma – sarcoma of fat tissue.
  • Leiomyosarcoma – affects smooth muscle in organ walls.
  • Synovial sarcomas – these are usually found around a joint in the arms or legs.
  • Malignant peripheral nerve sheath tumor – also known as neurofibrosarcoma, it affects the protective lining of the nerves.
  • Rhabdomyosarcoma – this forms in muscle and is a childhood cancer. While rare overall, it is a relatively common tumor in children.
  • Angiosarcomas – these develop in the cells of the blood or lymph vessels.
  • Fibrosarcomas – sarcomas that usually form in the limbs or on the trunk, forming from fibroblasts, the most common cell type in connective tissue.
  • Kaposi’s sarcoma – a sarcoma that affects the skin and is caused by a virus. The most common form of Kaposi’s sarcoma is related to AIDS.  Kaposi’s tumors often produce distinctive skin lesions but also affect other soft tissues.  Kaposi’s sarcoma is caused by the human herpesvirus 8.
  • Further examples – these include dermatofibrosarcoma protuberans, a skin lesion; epithelioid sarcoma, which often affects young adults’ hands or feet; myxoma, which affects older adults, usually in the arms and legs; mesenchymomas, which are rare and combine elements of other sarcomas and can be found in any part of the body; vascular sarcomas, containing many blood vessels; and malignant neurilemmoma (also known as schwannoma).  Sarcoma of the bone includes osteosarcoma, Ewing sarcoma, and chondrosarcoma.

Causes of sarcoma

The causes behind sarcoma are unknown, but there are some known risk factors. In adults, for instance, exposure to phenoxy acetic acid in herbicides or chlorophenols in wood preservatives may increase the risk. High doses of radiation are also known to cause sarcomas in some people, as are certain rare genetic alterations. The following inherited diseases are also associated with an increase sarcoma risk, according to SFA:

  • Li-Fraumeni syndrome, which is associated with alterations in the p53 gene
  • Von Recklinghausen’s disease (neurofibromatosis), which is associated with alterations in the NF1 gene

Having certain inherited disorders can increase the risk for other soft tissue sarcomas, including retinoblastoma, tuberous sclerosis, Werner syndrome, and nevoid basal cell carcinoma syndrome. Other risk factors for soft tissue sarcoma include past treatment with radiation therapy for certain cancers; exposure to certain chemicals, such as thorium dioxide, vinyl chloride, or arsenic; and long-term lymphedema in the arms or legs.

Past treatment with radiation can increase the risk of osteosarcoma and other types of bone cancers. Other risk factors for osteosarcoma include treatment with anticancer drugs called alkylating agents, having a certain change in the retinoblastoma gene, and having certain conditions including Paget disease, Diamond-Blackfan anemia, and Werner syndrome.

Tests and diagnosis of sarcoma

After understanding a patient’s medical history and completing a medical examination, medical imaging scans will help to inform a diagnosis, which will need to be confirmed through laboratory analysis of a tumor sample.

The following physical features should prompt a doctor to investigate:

  1. larger than 2 inches in diameter or growing in size
  2. fixed, immovable, or deep
  3. painful
  4. return of tumor previously removed

Medical imaging helps to locate, characterize, and give further information about a tumor to guide diagnosis. It may also be used to gauge the success of treatment or to look for spread of cancer.

Imaging techniques include X-rays, CT scan (computed tomography), MRI(magnetic resonance imaging), ultrasound, and PET (positron emission tomography).

Treatments for soft tissue sarcoma

The following treatment options can be used for sarcomas:

  • Surgery – the most common sarcoma treatment. It aims to remove the tumor and even some of the normal surrounding tissue. A biopsy sample is often taken at the same time to confirm the exact type of tumor.
  • Radiation therapy – this destroys cancer cells and may be done in addition to surgery, before or after the operation.
  • Chemotherapy – this could also be used in addition to surgery, though less often than radiation therapy.

Some soft tissue sarcomas have other available treatments, such as specific drug treatments, gene-targeted therapies, or biological therapies such as immunotherapy.

Treatment choice and intensity are also guided by the stage and grade of cancer, by the size of the tumor, and extent of any spread.

Prevention of sarcoma

Sarcoma is not typically preventable. Radiation therapy is a risk factor, so reducing exposure to it may be preventive, although a need for radiation therapy usually outweighs any subsequent sarcoma risk.

Observing Sarcoma Awareness Month

Sarcoma is still considered to be the “forgotten cancer.”  Efforts to encourage research and drug development are made more challenging due to a lack of awareness and understanding.  How as a community do we raise funds for vital research if people don’t know that this cancer exists?

Though the Sarcoma Foundation of America works tirelessly every day to raise awareness, during Sarcoma Awareness Month, they aim to further highlight the extraordinary challenges sarcoma patients face and the need for more sarcoma research and better sarcoma therapies.  Please join in efforts and pledge to bring awareness to your community.  Here are a few ways you can help highlight the need for ongoing research on sarcoma:

  • This July, take a moment to share a message via social media or speak with your friends and family about this relatively unknown condition.
  • Join sarcoma patients, survivors and their loved ones for the Steps to Cure Sarcoma.  Every dollar raised will be used to fund research, patient advocacy and education.
  • Take a moment to listen to a Sarcoma Awareness Month Public Service Announcement campaign. Share it online to raise awareness.
  • Get together with others in the sarcoma community and donate today!

Getting Help

Since sarcoma is a rare cancer, many people are unfamiliar with the disease and have not been affected personally. However, many children’s lives have been altered because of this disease, and advances in early detection and treatment could help save lives.

A number of clinical trails are underway for people with sarcoma. If you’ve been recently diagnosed, ask your doctor if a clinical trial, which could give you access to novel treatment options, is right for you.

Trying to find the right doctor to determine if that lump or new pain is something more than just a little annoying is made easy at HealthLynked.  We are the first ever social ecosystem designed to connect physicians and patients in a truly collaborative platform to Improve HealthCare.

Ready to get Lynked?  Sign up for free today and take control of your wellness!

 

Sources:

Han, MD, Seunggu.  “Sarcoma: Symptoms, types, treatments, and causes.” Medical News Today.  23 May 2017.

https://www.curesarcoma.org/sarcoma-awareness-month/

https://www.aacrfoundation.org/Pages/sarcoma_awareness_month.aspx

https://www.gatewaycr.org/gateway-blog/posts/2017/july/july-is-sarcoma-awareness-month-what-is-sarcoma/

 

 

 

How is Excess Body Fat Priming Our Brains for Mental Decline?

As today marks the 81st birthday of Krispy Kreme – an American doughnut company and coffeehouse chain based in Winston-Salem, North Carolina built off an ancient, secret cajun recipe – it seems a fitting day to talk about obesity, fat, and its effect on the brain.  Let’s start with “skinny fat”.

Sarcopenia, which is the loss of muscle mass, tends to happen naturally with age. So, in older people with sarcopenia, excess body fat may not be readily visible. But hidden fat, paired with muscle mass loss later in life, could predict Alzheimer’s risk, researchers warn, and Sarcopenic obesity may exacerbate the risk of other cognitive decline later in life.

A recent study — the results of which have been published in the journal Clinical Interventions in Aging — has found that sarcopenia and obesity (independently, but especially when occurring together) can heighten the risk of cognitive function impairments later in life.

The research was conducted by scientists at the Comprehensive Center for Brain Health at the Charles E. Schmidt College of Medicine of Florida Atlantic University in Boca Raton.

“Sarcopenia,” explains senior study author Dr. James Galvin, “has been linked to global cognitive impairment and dysfunction in specific cognitive skills including memory, speed, and executive functions.”

“Understanding the mechanisms through which this syndrome may affect cognition is important as it may inform efforts to prevent cognitive decline in later life by targeting at-risk groups with an imbalance between lean and fat mass.”

Dr. James Galvin

“They may benefit from programs addressing loss of cognitive function by maintaining and improving strength and preventing obesity,” he adds.

Beware sarcopenic obesity

The scientists analyzed health-related data collected from 353 participants — aged 69, on average — all of whom registered to take part in community-based studies on aging and memory.

To establish whether or not there was a link between sarcopenic obesity — that is, the presence of excess body fat in conjunction with muscle mass loss — and cognitive decline, the team assessed participants’ performance on tests evaluating cognitive function, including the Montreal Cognitive Assessment and animal-naming exercises.

Also, the participants’ muscle strength and mass were evaluated through grip strength tests and chair stands, and they also underwent body compositions assessments, which looked at muscle mass, body mass index (BMI), and the amount of body fat.

The researchers discovered that the participants with sarcopenic obesity had the poorest performance on cognition-related tests.  The next poorest performance on cognition tests was seen in people with sarcopenia alone, followed by participants who only had obesity.

Both when occurring independently and when occurring in concert, obesity and loss of muscle mass were linked with impaired working memory — which is the type of memory we use when making spontaneous decisions on a daily basis — as well as less mental flexibility, poorer orientation, and worse self-control.

Keep changes in body composition in check

The scientists explain that obesity could exacerbate the risk of cognitive decline through biological mechanisms that influence vascular health, metabolism, and inflammation.

Moreover, they warn that in people who already face impaired executive functioning, obesity might also impact energy resources through poor self-control that affects nutrition.

As for sarcopenia, the researchers note that it could influence brain mechanisms related to conflict resolution skills and selective attention.

Based on the study’s findings, Dr. Galvin and his colleagues are particularly concerned that a mix of sarcopenia and excess body fat in older adults could become a serious public health issue, so they believe that any significant changes in body mass composition should be closely monitored to prevent negative health outcomes.

“Sarcopenia either alone or in the presence of obesity, can be used in clinical practice to estimate potential risk of cognitive impairment,” notes study co-author Magdalena Tolea.

But such health issues can be kept under control, and the risks associated with them averted, she suggests.

“Testing grip strength by dynamometry can be easily administered within the time constraints of a clinic visit, and body mass index is usually collected as part of annual wellness visits,” concludes Tolea.

How Aging and Obesity Prime the Brain for Alzheimer’s

According to another new study, the effects of natural aging processes, combined with those of obesity and a poor diet, affect certain brain mechanisms, thereby boosting the risk of Alzheimer’s. The new study, conducted on mice, uncovered how a high-fat, high-sugar diet renders the aging brain more vulnerable to Alzheimer’s.

Alzheimer’s disease is a neurodegenerative condition that is characterized primarily by memory loss and impaired cognition.  Some risk factors for the development of this disease are aging and metabolic conditions such as obesity and diabetes.  However, many of the biological mechanisms underlying the onset and progression of this disease remain unknown.

This is despite the fact that our understanding of the predisposing risk factors is growing all the time.  Now, Rebecca MacPherson, Bradley Baranowski, and Kirsten Bott — of Brock University in Ontario, Canada — have conducted a study that has allowed them to uncover some more of the mechanics at play in the development of this type of dementia.

The team worked with aging mice to investigate how a high-fat, high-sugar (HFS) diet that fueled obesity might also prime the brain for neurodegeneration in this sample.  Their findings are described in a paper now published in the journal Physiological Reports.

How unhealthful diets impact the brain

Specifically, the researchers examined how an HFS diet, in conjunction with the effects of normal biological aging, would affect insulin signaling, which helps to regulate the amount of glucose (simple sugar) absorbed by muscles and different organs.

They also looked at how this obesity-inducing diet might alter biomarkers relating to inflammation and cellular stress.

To understand the impact of an HFS diet on aging mice, the research team put some mice on a regular type diet, while others were given food that had a high fat and sugar content.

After the mice had been fed their respective diets for a period of 13 weeks, the team looked for signs of inflammation and measured cellular stress levels in two brain areas associated with memory and cognitive behavior: the hippocampus and the prefrontal cortex.

The researchers also compared the effects of an HFS diet on the brains of aging rodents’ baseline measurements effected on the brains of younger mice.

They found older mice on an obesity-inducing diet had high levels of brain inflammation and cellular stress, as well as insulin resistance in parts of the hippocampus linked to the development of Alzheimer’s disease.

Although more markers of insulin resistance were observed in the prefrontal cortices of mice that had been on an HFS diet, inflammation status and cellular stress markers remained the same.

The study authors hypothesize that “region-specific differences between the prefrontal cortex and hippocampus in response to aging with an HFS diet [suggest] that the disease pathology is not uniform throughout the brain.”

Obesity boosts aging’s negative effect

Notably, the researchers also found that brain inflammation levels had also increased in the mice that had been on a regular diet, compared with baseline measurements.

The researchers note that this could be taken as evidence of aging’s role as an independent risk factor in Alzheimer’s. Obesity, they add, boosts the risk by affecting key mechanisms in the brain.

“This study,” they claim, “provides novel information in relation to the mechanistic link between obesity and the transition from adulthood to middle age and signaling cascades that may be related to [Alzheimer’s] pathology later in life.”

“These results add to our basic understanding of the pathways involved in the early progression of [Alzheimer’s] pathogenesis and demonstrate the negative effects of an HFS diet on both the prefrontal cortex and hippocampal regions.”

Every day, there are physicians in the HealthLynked system ready to help those combating obesity and care for Alzheimer and dementia patients  to help them live the best lives possible.  If someone you love is showing signs of memory loss beyond what might be considered normal for their age, or if too many donuts have made their way into your system, go to HealthLynked.com to connect and collaborate with any number of specialists at the ready.

 

Ready to get Lynked and get help?  Go to HealthLynked.com today to register for free!

 

Adapted from:

Cohut, Maria. ”Skinny fat’ linked to cognitive decline, study warns.” Medical News Today, Friday 6 July 2018

Cohut, Maria. ”Aging, obesity may prime the brain for Alzheimer’s.” Medical News Today, Monday 2 July 2018

 

Will We Soon Reverse Diabetes and Obesity with Gene Therapy?

New research shows that gene therapy can completely reverse markers of Type 2 diabetes and obesity in rodents.  If the theory holds, small alterations to our genes could soon repair metabolic disorders such as obesity and Type 2 diabetes in humans.

The prevalence of diabetes, or the total number of existing cases, is on the rise in the United States and globally.  According to recent estimates, over 30 million U.S. adults had diabetes in 2015.

Although the number has been relatively steady in the past few years, rates of newly diagnosed cases among children and teenagers have increased sharply.  And, worldwide, the situation is even more alarming; the number of people with diabetes almost quadrupled between 1980 and 2014, according to the World Health Organization (WHO).

Now, new research brings much-needed hope of curing this metabolic disorder.  Scientists led by Fatima Bosch, a professor at the Universitat Autònoma de Barcelona (UAB) in Catalunya, Spain, have successfully reversed the disorder in rodents.  Prof. Bosch and her colleagues achieved this using gene therapy, a technique that introduces new genetic material into cells to create beneficial proteins or to offset the effects of malfunctioning genes.  The findings were published in the journal EMBO Molecular Medicine.

Using the FGF21 gene to reverse diabetes

Prof. Bosch and team designed two mouse models of obesity and type 2 diabetes. One was diet-induced, and the other one was genetically modified.  Using an adeno-associated viral vector as “transport,” the team delivered the fibroblast growth factor 21 (FGF21) gene.

This gene is responsible for encoding the FGF21 protein, which is seen as a “major metabolic regulator” that stimulates the absorption of blood sugar in adipose tissue.  By delivering this gene, the researchers stimulated the production of the protein, which caused the rodents to lose weight and lowered their insulin resistance — a major risk factor for type 2 diabetes. Additionally, the mice lost weight and the treatment reduced the fat and inflammation in their adipose tissue.

The fat content, inflammation, and fibrosis of the rodents’ livers were completely reversed, with no side effects. In turn, these improvements increased insulin sensitivity.  These beneficial effects were noted in both murine models. Also, the team found that administering FGF21 to healthy mice prevented age-related weight gain and led to healthy aging.

Gene therapy was used to alter three tissue types: liver tissue, adipose tissue, and skeletal muscle.  “This gives a great flexibility to the therapy,” explains Prof. Bosch, “since it allows [us] to select each time the most appropriate tissue, and in case some complication prevents manipulating any of the tissues, it can be applied to any of the others.”

“When a tissue produces FGF21 protein and secretes it into the bloodstream, it will be distributed throughout the body,” adds Prof. Bosch.

First reversion of obesity, insulin resistance

Study co-author and UAB researcher Claudia Jambrina explains that their findings are particularly significant given that “the prevalence of type 2 diabetes and obesity is growing at alarming rates around the world.”

The team also says that delivering FGF21 as a conventional drug would not yield the same benefits as gene therapy; firstly, the drug would have to be administered periodically for long-term benefits, and secondly, its toxicity would be high.  Using gene therapy, however, is free of side effects, and a single administration is enough to make the mice produce the protein naturally for several years.

“This is the first time that long-term reversion of obesity and insulin resistance have been achieved upon a one-time administration of a gene therapy, in an animal model that resembles obesity and type 2 diabetes in humans.”

First study author Veronica Jimenez, a UAB researcher

“The results demonstrate that it is a safe and effective therapy,” she adds. The next steps will be to “test this therapy in larger animals before moving to clinical trials with patients,” notes Prof. Bosch.  “[The] therapy described in this study,” she concludes, “constitutes the basis for the future clinical translation of FGF21 gene transfer to treat type 2 diabetes, obesity, and related comorbidities.”

Statistics and facts about type 2 diabetes

Diabetes mellitus, or diabetes, is a disease that causes high blood sugar. It occurs when there is a problem with insulin.

Insulin is a hormone that takes sugar from foods and moves it to the body’s cells. If the body does not make enough insulin or does not use insulin well, the sugar from food stays in the blood, resulting in high blood sugar.

Diabetes is a key health concern worldwide. In the United States, the rate of new cases rose sharply from the 1990s, but it fell between 2008 and 2015, and it continues to fall, according to the Centers for Disease Control and Prevention’s (CDC) National Diabetes Report, 2017. Meanwhile, the number of adults living with diabetes continues to rise.

The most common of diabetes is type 2. According to the CDC, 90 to 95 percent of people with diabetes in the United States have type 2. Just 5 percent of people have type 1.

Key facts

Diabetes is at an all-time high in the U.S. The CDC’s Division of Diabetes Translation states that 1 percent of the population, which is about a half of a million people, had diagnosed diabetes in 1958.

In 2015, around 9.4 percent of the population in the U.S. had diabetes, including 30.2 million adults aged 18 years and over. Nearly a quarter of those with the condition do not know they have it.

Between 1990 and 2010, the number of people living with diabetes more than tripled, and the number of new cases doubled every year.

Figures suggest that the incidence is levelling off and may even be falling, but it remains unclear whether this will continue as other factors come into play, such as the aging population.

The risk of developing diabetes increases with age.

The CDC report that 4.0 percent of people aged 18 to 44 years are living with diabetes, 17 percent of those aged 45 to 64 years, and 25.2 percent of those aged over 65 years.

Causes

Type 2 diabetes is thought to result from a combination of genetic and lifestyle factors.

The exact cause is unknown, but risk factors appear to include:

  • excess body fat
  • high blood pressure or cholesterol
  • having a close family member with the condition
  • a history of gestational diabetes
  • higher age

As obesity has become more prevalent over the past few decades, so too has the rate of type 2 diabetes. In 2013, more than 1 in 3 people in the U.S. were considered to have obesity, and over 2 in 3 were either overweight or had obesity.

In 1995, obesity affected 15.3 percent of Americans, and in 2008, the figure was 25.6 percent. From 1998 to 2008, the incidence of diabetes increased by 90 percent.

Although the link between obesity and diabetes is well known, the reasons they are connected remain unclear. A report in the Journal of Clinical Endocrinology and Metabolism asks why obesity does not always lead to diabetes, given the established link between the two conditions.

The same report notes that the location of body fat appears to play a role. People with more fat in the upper body area and around the waist are more likely to get diabetes than those who carry their body fat around the hips and lower body.

Diabetes and ethnicity

Rates of diabetes vary between ethnic groups.

There may be a combination of factors, including:

  • genetics
  • health conditions
  • lifestyle
  • finances
  • environment
  • access to healthcare

The CDC’s National Diabetes Statistics Report, 2017, found that, among people aged 20 years and over, diabetes affects:

  • 7.4 percent of Non-Hispanic whites
  • 8.0 percent of Asian Americans
  • 12.1 percent of Hispanics
  • 12.7 percent of Non-Hispanic Blacks
  • 15.1 percent of American Indians and Alaska Natives

Why diabetes is serious

Diabetes can have serious health consequences.

The ADA report that more Americans die from diabetes every year than from AIDS and breast cancer combined.

According to the CDC, 79,535 deaths occur each year due to diabetes. The number of fatalities related to diabetes may be underreported.

Why and how does diabetes damage the body and cause complications?

The ADA says:

  • Adults with diabetes are significantly more likely to die from a heart attack or stroke.
  • More than a quarter of all Americans with diabetes have diabetic retinopathy, which can cause vision loss and blindness.
  • Each year, nearly 50,000 Americans begin treatment for kidney failure due to diabetes. Diabetes accounts for 44 percent of all new cases of kidney failure.
  • Each year, diabetes causes about 73,000 lower limb amputations, which accounts for 60 percent of all lower limb amputations (not including amputations due to trauma).

Costs

Because of its high prevalence and link to numerous health problems, diabetes has a significant impact on healthcare costs.

The productivity loss for reduced performance at work due to diabetes in 2012 was 113 million days, or $20.8 billion, according to the ADA.

Diabetes cost the U.S. $327 billion in 2017, including $237 billion in medical costs and $90 billion in reduced productivity.

However, this number does not include:

  • the millions of people who have diabetes but are undiagnosed
  • the cost of prevention programs for people with diabetes, which are not counted under standard medical costs
  • over-the-counter medications for eye and dental problems, which are more common in people with diabetes.
  • administrative costs for insurance claims
  • the cost of reduced quality of life, lost productivity of family members, and other factors that cannot be measured directly

Because diabetes affects various parts of the body, the medical costs span different areas of specialty. The ADA report that:

  • 30 percent of medical costs associated with diabetes are for circulation problems that reduce blood flow to the limbs
  • 29 percent of medical costs associated with diabetes are for kidney conditions
  • 28 percent of medical costs associated with diabetes are for nervous system conditions

Despite its complications, people can manage their diabetes with a comprehensive plan that includes lifestyle changes and proper medical care. If they control their blood sugar levels well, many people with diabetes can lead full, active lives.

Difference between types 1 and 2

In type 1 diabetes, the immune system attacks the cells in the pancreas that make insulin. As a result, the body does not produce insulin, and people with this condition must take insulin by injection or pump every day.

Type 1 diabetes usually develops in children or young adults, but it can occur at any age. There is no known way to prevent type 1 diabetes, and there is no cure.

In 2011-2012, around 17,900 children under the age of 18 years received a diagnosis of type 1 diabetes in the U.S., or around 49 children each day. Type 1 diabetes affects around 1.25 million American adults and children.

People with type 2 diabetes may still have insulin in their bodies, but not enough for proper blood sugar control. Or, the body may not be able to use the insulin it has properly. As a result, blood sugar levels can become too high.

Typically, adults are diagnosed with type 2 diabetes, but children can get it too. Certain factors increase a person’s risk of getting type 2 diabetes, including:

  • obesity
  • older age
  • a family history of diabetes
  • lack of exercise
  • problems with glucose metabolism

The annual relative increase for type 1 diabetes in 2002-2012 in the U.S. was 1.8 percent, but the annual increase for type 2 diabetes was 4.8 percent.

If diabetes or any other medical concern has you  running a little slow, join our ecosystem designed to support your well being.  Here, at HealthLynked, we are building a network that connects patients to physicians in ways never before possible for the purpose of Improving HealthCare.

Ready to get Lynked and take control of your well being?  Go to HealthLynked.com to get started, for free, today!

Adapted from:

[1]  Murrell MD, Daniel.  “Statistics and facts about type 2 diabetes.” Medical News Today. 12 June 2018

[2]  Sandoiu, Ana. “Type 2 diabetes, obesity may soon be reversed with gene therapy.”  Medical News Today, 12 July 2018

Loneliness – A Gene Deep Epidemic that Raises Health Risks and Can Be Spread

A 2016 survey of more than 2,000 American adults found 72 percent report having felt a sense of loneliness, with nearly a third (31 percent) experiencing loneliness at least once a week. The survey was conducted online by Harris Poll on behalf of the American Osteopathic Association in September.

Isolation is often an underlying factor in many of the most common health conditions, including chronic pain, substance abuse and depression, according to osteopathic physicians.

Long working hours, increased use of social media—in many cases surpassing in-person interaction—and a mobile workforce traveling or living far from family contribute to the high rates of loneliness, noted Jennifer Caudle, DO, assistant professor of family medicine at Rowan University School of Osteopathic Medicine.

“Loneliness is an invisible epidemic masked by our online personas, which are rarely representative of our real emotions,” said Dr. Caudle. “It’s important for patients to understand how their mental and emotional well-being directly affects the body. By taking a whole-person approach to care, osteopathic physicians are trained to address these underlying issues that can quietly erode patients’ health.”

Damage to the Immune Response

Research links loneliness to a number of dysfunctional immune responses, suggesting that being lonely has the potential to harm overall health.

In one study, researchers found that people who were more lonely showed signs of elevated latent herpes virus reactivation and produced more inflammation-related proteins in response to acute stress than did people who felt more socially connected.

These proteins signal the presence of inflammation, and chronic inflammation is linked to numerous conditions, including coronary heart disease, Type 2 diabetes, arthritis and Alzheimer’s disease, as well as the frailty and functional decline that can accompany aging.

Reactivation of a latent herpes virus is known to be associated with stress, suggesting that loneliness functions as a chronic stressor that triggers a poorly controlled immune response.

“It is clear from previous research that poor-quality relationships are linked to a number of health problems, including premature mortality and all sorts of other very serious health conditions. And people who are lonely clearly feel like they are in poor-quality relationships,” said Lisa Jaremka, a postdoctoral fellow at the Institute for Behavioral Medicine Research at Ohio State University and lead author of the research.

“One reason this type of research is important is to understand how loneliness and relationships broadly affect health. The more we understand about the process, the more potential there is to counter those negative effects – to perhaps intervene. If we don’t know the physiological processes, what are we going to do to change them?”

The results are based on a series of studies conducted with two populations: a healthy group of overweight middle-aged adults and a group of breast cancer survivors. The researchers measured loneliness in all studies using the UCLA Loneliness Scale, a questionnaire that assesses perceptions of social isolation and loneliness.

Jaremka presented the research at the Society for Personality and Social Psychology annual meeting in New Orleans.

The researchers first sought to obtain a snapshot of immune system behavior related to loneliness by gauging levels of antibodies in the blood that are produced when herpes viruses are reactivated.

Participants were 200 breast cancer survivors who were between two months and three years past completion of cancer treatment with an average age of 51 years. Their blood was analyzed for the presence of antibodies against Epstein-Barr virus and cytomegalovirus.

Both are herpes viruses that infect a majority of Americans. About half of infections do not produce illness, but once a person is infected, the viruses remain dormant in the body and can be reactivated, resulting in elevated antibody levels, or titers – again, often producing no symptoms but hinting at regulatory problems in the cellular immune system.

Lonelier participants had higher levels of antibodies against cytomegalovirus than did less lonely participants, and those higher antibody levels were related to more pain, depression and fatigue symptoms. No difference was seen in Epstein-Barr virus antibody levels, possibly because this reactivation is linked to age and many of these participants were somewhat older, meaning reactivation related to loneliness would be difficult to detect, Jaremka said.

Previous research has suggested that stress can promote reactivation of these viruses, also resulting in elevated antibody titers.

“The same processes involved in stress and reactivation of these viruses is probably also relevant to the loneliness findings,” Jaremka said. “Loneliness has been thought of in many ways as a chronic stressor – a socially painful situation that can last for quite a long time.”

In an additional set of studies, the scientists sought to determine how loneliness affected the production of proinflammatory proteins, or cytokines, in response to stress. These studies were conducted with 144 women from the same group of breast cancer survivors and a group of 134 overweight middle-aged and older adults with no major health problems.

Baseline blood samples were taken from all participants, who were then subjected to stress – they were asked to deliver an impromptu five-minute speech and perform a mental arithmetic task in front of a video camera and three panelists. Researchers followed by stimulating the participants’ immune systems with lipopolysaccharide, a compound found on bacterial cell walls that is known to trigger an immune response.

In both populations, those who were lonelier produced significantly higher levels of a cytokine called interleukin-6, or IL-6, in response to acute stress than did participants who were more socially connected. Levels of another cytokine, tumor necrosis factor-alpha, also rose more dramatically in lonelier participants than in less lonely participants, but the findings were significant by statistical standards in only one study group, the healthy adults.

In the study with breast cancer survivors, researchers also tested for levels of the cytokine interleukin 1-beta, which was produced at higher levels in lonelier participants.

When the scientists controlled for a number of factors, including sleep quality, age and general health measures, the results were the same.  “We saw consistency in the sense that more lonely people in both studies had more inflammation than less lonely people,” Jaremka said.

“It’s also important to remember the flip side, which is that people who feel very socially connected are experiencing more positive outcomes,” she said.

Loneliness Can Add 30 Points To Your Blood Pressure

In another study conducted at the Center for Cognitive and Social Neuroscience at the University of Chicago, researchers found that if you are over 50 and lonely, you could be adding 30 points to your blood pressure and raising significantly your chances of suffering from hypertension.   The increase in blood pressure due to loneliness was present after taking into account a person’s emotional state (how sad or stressed the person was).

The older the lonely person gets, the higher his/her blood pressure seems to get, said the researchers.   Lead researcher, Louise Hawkley, said “The take-home message is that feelings of loneliness are a health risk, in that the lonelier you are, the higher your blood pressure. And we know that high blood pressure has all kinds of negative consequences.”

229 people were monitored in this study, aged 50-68. The participants had to answer a questionnaire which determined each person’s level of loneliness.

Hawkley said it is not as simple as that. She said “Remember, people can feel lonely even if they are with a lot of people. You can think of Marilyn Monroe or Princess Diana – there was certainly nothing lacking in their social lives, yet they claimed to have felt intensely lonely. They may want to go out and make friends, and yet they have a nagging lack of trust with whomever they want to interact with, or they may feel hostile. So, they end up behaving in ways that force potential partners away.”

Loneliness Is Gene Deep

Loneliness has a molecular signature is reflected in the lonely person’s DNA. This was the conclusion of a new US study by scientists at the University of California Los Angeles (UCLA) and other US academic centers.

The study is published in an issue of the journal, Genome Biology.  The researchers discovered a distinct pattern of gene expression in immune cells of people who are chronically extremely lonely.

Study author Steve Cole, associate professor of medicine at the Division of Hematology and Oncology at the David Geffen School of Medicine at UCLA, member of the Cousins Center for Psychoneuroimmunology, and member of UCLA’s Jonsson Comprehensive Cancer Center said in a press release that:

“What this study shows is that the biological impact of social isolation reaches down into some of our most basic internal processes: the activity of our genes.”  Cole and colleagues suggest that feelings of isolation are linked to changes in gene expression that drive inflammation, one of the first responses of the immune system.  They hope the study gives a framework for understanding how social factors and increased risk of heart disease, viral infections and cancer are linked.

Scientists already know that social environments affect health. People who are lonely and socially isolated die earlier.  What they don’t know is if the higher rate of death among lonely people is because of reduced social resources or because of the effect of isolation on their bodily functions, or perhaps both.

However, Cole and the other researchers found that changes in the way immune cells express their genes were directly linked to the “subjective experience of social distance”.  The differences were independent of other known risk factors like health status, weight, age and use of medication, they said.  “The changes were even independent of the objective size of a person’s social network,” said Cole.

Cole and colleagues enrolled 14 participants from the Chicago Health, Aging, and Social Relations Study and scanned their DNA using a chip technology called DNA microarrays that allowed them to survey all known human genes in the samples.  6 of the participants scored in the top 15 per cent of a well known psychological test for loneliness that was developed in the 70s called the UCLA Loneliness Scale.  The remaining 8 participants scored in the bottom 15 per cent of the Loneliness Scale.

The DNA survey showed that 209 gene transcripts (where the gene gets its code ready to start making proteins) were expressed differently between the two groups. All the genes coded for leucocytes, agents of the immune system.  78 of the gene transcripts were “over expressed” (resulting in too much protein) and 131 were “under expressed” (not enough protein) in the lonely individuals compared to the others.

The over expressed genes included many that control immune system functions like inflammation.  However, it was also interesting that the under expressed genes were those involved in antiviral responses and production of antibodies.

“These data provide the first indication that human genome-wide transcriptional activity is altered in association with a social epidemiological risk factor. Impaired transcription of glucocorticoid response genes and increased activity of pro-inflammatory transcription control pathways provide a functional genomic explanation for elevated risk of inflammatory disease in individuals who experience chronically high levels of subjective social isolation.”

Distinguishing between the various aspects of loneliness that are closely linked to these changes in gene expression, the scientists discovered:  “What counts at the level of gene expression is not how many people you know, it’s how many you feel really close to over time,” said Cole.  He added that the findings could identify molecular targets for blocking the negative health impact of social isolation.

Loneliness Can Spread Through Social Networks

A US study of social networks found that a person’s loneliness can spread to others, in that when they become lonely they move to the edge of the network and transmit feelings of loneliness to their few remaining friends who also become lonely, leading to an effect that the researchers described as an unravelling at the edges of our social fabric.

The study, which was sponsored by the National Institute on Aging, is the work of John T Cacciopo of the University of Chicago, James H Fowler of the University of California, San Diego, and Nicholas A Christakis of Harvard University and is about to be published in the December issue of the Journal of Personality and Social Psychology.

Cacciopo, a social neuroscientist and lead investigator on the study, is Tiffany and Margaret Blake Distinguished Service Professor in Psychology at Chicago. He told the press that:

“We detected an extraordinary pattern of contagion that leads people to be moved to the edge of the social network when they become lonely.”

“On the periphery people have fewer friends, yet their loneliness leads them to losing the few ties they have left,” he added.

Loneliness is often associated with mental and physical diseases that can shorten life, said Cacioppo, so it is important for us to recognize it and help people reconnect with their social group before they move to the edges.

He and his co-authors wrote that while previous studies have already shown that a person’s loneliness and the number of people they are connected to in a network are linked, we don’t know much about “the placement of loneliness within, or the spread of loneliness through, social networks”.

Using longitudinal data from a large-scale study, they found that loneliness, like a bad cold, spreads in groups: people share their loneliness with others.

Cacioppo and colleagues used data on 5,124 people in the second generation of participants from the Framingham Heart Study, which has been tracking the health of individuals and their descendants for more than 60 years. The data set included information taken every two to four years on participants’ friends and social contacts.

For the study, Cacioppo and colleagues charted the friendship histories of participants and linked them to their reports of loneliness. This showed a pattern of loneliness that spread as people reported fewer close friends, and that lonely people appeared to transmit loneliness to others, and then moved to the edges of their social networks.

“Loneliness is disproportionately represented at the periphery of social networks and spreads through a contagious process,” wrote the researchers.

For example, one pattern might start when a participant reports one extra day a week of loneliness. This is followed by similar reports among his or her next-door neighbors who are also close friends. The pattern of loneliness then spreads as the neighbors spend less time together.

“These reinforcing effects mean that our social fabric can fray at the edges, like a yarn that comes loose at the end of a crocheted sweater,” explained Cacioppo.

The researchers also found that:

  • Women were more likely to report “catching loneliness from others” than men (perhaps reinforcing findings from studies that suggest women rely more on emotional support than men).
  • Loneliness occurred in clusters and extended up to three degrees of separation.
  • A person’s chances of reporting increased loneliness were more likely to be linked to changes in friendship networks than changes in family networks.

The authors concluded that the study helps us better understand the social forces that drive loneliness.

Society may benefit by “aggressively targeting the people in the periphery to help repair their social networks and to create a protective barrier against loneliness that can keep the whole network from unraveling,” they added.

Other studies suggest that as people become lonely they trust other people less and less, and this leads to a cycle of less trusting and more loneliness, which leads to less trusting, and so on, and as time goes by it becomes harder and harder to make friends.

Cacioppo said researchers have seen this social tendency reflected in monkey colonies that drive out members who have been removed and then reintroduced.  He said such a pattern makes it all the more important for us to recognize and offset loneliness before it spreads.

Overcoming Loneliness

The first step in addressing loneliness is to determine whether those feelings are caused by depression. A physician can diagnose any existing mental health conditions and suggest treatment options. To limit loneliness, physicians recommend some simple steps to help increase real social engagement:

  1. Consider a digital cleanse. Social networks can offer real connections, but the curated platforms may over-emphasize the success of others, which can lead to feelings of inadequacy. For more empowering activities, consider enrolling in a continuing education course or spending time enjoying nature.
  2. Exercise with others. Participating in a running club, group fitness course or team sport can have dual benefits, creating opportunities to meet new people while also improving physical health. Many sports stores, churches and community groups offer free weekly activities including fun runs and yoga.
  3. Buy local. Developing a routine that includes visiting a local shopkeeper, coffee shop, farmers’ market or gym builds roots in the community. Creating relationships with local vendors can lead to a sense of shared history and camaraderie.
  4. Step out of your comfort zone. Introducing yourself to nearby neighbors or engaging with people in the building elevator—while initially uncomfortable—can begin the process of developing community and has the added bonus of alleviating loneliness for others.
  5. Change jobs, schools or cities. This drastic option is not always possible, and certainly not easy, but it may have the most significant impact. Start by identifying the culture that would best fit your personality and work toward a transition.

“Face-to-face communication is critical for emotional and mental health,” Dr. Caudle added. “Seeking out meaningful human interactions makes patients happier and, ultimately, healthier overall.”

Conclusion

Loneliness has negative effects on your immune system, creates a genetic signature and can spread through social networks.  Our digital addictions seem to be contributing to our disconnectedness.  Additional studies indicate loneliness significantly shortens lives and can lead to or magnify dementia and Alzheimer’s.

Today is National Cheer up the Lonely Day.  Visit with the lonely and bring happy things to talk about. Keep the conversation upbeat, and lively. When you leave, give a big hug and let them know you enjoyed the stay. Sending cards or making a phone call is okay if they live too far away to visit, but what a lonely person really needs is face to face time with other people.

If you are feeling lonely, other studies indicate you are more likely to see a physician with increased frequency.  At HealthLynked, we can connect you to those physicians who really care and want to spend time with you.

To find a physician you really, well, click with, click on this link and get Lynked today!  It is free, and a great way for you to begin taking control of your health!

 

Adapted from:

[1] Caldwell, Emily. The Immune System Taxed By Loneliness, Similar To The Effect Of Chronic Stress.  Medical News Today, Tuesday 22 January 2013

This work was supported by grants from the National Institutes of Health, the American Cancer Society Postdoctoral Fellowship and a Pelotonia Postdoctoral Fellowship from Ohio State’s Comprehensive Cancer Center.

Co-authors include Christopher Fagundes of the Institute for Behavioral Medicine Research (IBMR); Juan Peng of the College of Public Health; Jeanette Bennett of the Division of Oral Biology; Ronald Glaser of the Department of Molecular Virology, Immunology and Medical Genetics; William Malarkey of the Department of Internal Medicine; and Janice Kiecolt-Glaser of the Department of Psychiatry, all at Ohio State. Bennett, Glaser, Malarkey and Kiecolt-Glaser are also IBMR investigators.

[2] Lombardi, Yvonne. Loneliness Can Add 30 Points To Your Blood Pressure If You Are Over 50.  Medical News Today. Wednesday, 29 March 2006.

[3] Paddock, Catharine PhD.  Loneliness Is Gene Deep. Medical News Today. Friday, 14 September 2007

“Effects of loneliness on gene expression.”
Cole SW, Hawkley LC, Arevalo JM, Sung CY, Rose RM, Cacioppo JT.
Genome Biology 2007, 8:R189.
doi:10.1186/gb-2007-8-9-r189
Published online 13 September 2007 (provisional version).

[4]  Paddock, Catharine PhD.  Loneliness Can Spread Through Social Networks.  Medical News Today. Wednesday, 2 December 2009

“Alone in the Crowd: The Structure and Spread of Loneliness in a Large Social Network.”
John T Cacciopo, James H Fowler, Nicholas A Christakis.
Journal of Personality and Social Psychology, December 2009 (pre-publication proof).
DOI:10.1037/a0016076

[5] American Osteopathic Association.  Survey Finds Nearly Three-Quarters (72%) of Americans Feel Lonely: Osteopathic Physicians Say Silent ‘Loneliness Epidemic’ Contributes to Nation’s Health Woes. PRN. Oct 11, 2016.

 

 

 

 

 

 

 

 

The AntiBiotic Resistance Crisis and How the Platypus Might Save Us All

Although platypuses are deeply unusual animals, as researchers dig deeper into their biochemistry, it seems that they might hold the key to the growing problem of antibiotic resistance.

Antibiotic resistance is a topic that sits squarely in the center of medical researchers’ minds; it’s a huge concern.  In fact, many scientists consider it to be one of the “world’s most pressing public health problems.”

In a nutshell, antibiotic resistance occurs when a species of bacteria becomes immune to antibiotics.  Once bacteria have developed an ambivalence to these drugs, they are able to survive their onslaught and pass antibiotic-resistant genes onto the next generation.

But today, diseases that were once very easily treatable with antibiotics — such as pneumonia and tuberculosis — are becoming life-threatening.  The World Health Organization (WHO) pull no punches when they write, “Without urgent action, we are heading for a post-antibiotic era, in which common infections and minor injuries can once again kill.”

As we use these drugs more and more, an increasing number are becoming ineffective.  On this dimly lit and deeply worrying backdrop, the platypus waddles into the spotlight. Can this reclusive, semi-aquatic weirdo lift this sense of impending doom?

The peculiar platypus

The platypus needs no introduction, but I’ll give you one anyway because they’re just so pleasing to consider.

Platypuses are monotremes — that is, a subgroup of mammals that comprises just five species (the platypus and four species of the hedgehog-like echidna). The former is one of the most iconic and baffling animals on the planet.

She’s hairy and warm-blooded, similar to standard mammals, yet she lays eggs. She has a duck-like bill and a beaver-like tail, and she is one of the very few venomous mammals.

The strangeness doesn’t stop there, however; the female has two ovaries — no surprise — but only the left one actually works. Also, baby platypuses are born with teeth, but, at an early age, they all fall out, leaving a horny plate.

So, how on earth could such a natural oddity help to save the human race from the horrors of antibiotic resistance? Well, the answer might lie in its milk.

According to an earlier study, platypus milk contains unique antibacterial properties. The authors report that proteins in their milk “were effective in killing a broad range of bacterial pathogens.”

Investigating platypus milk in detail

Recently, a team of researchers from Australia’s Commonwealth Scientific and Industrial Research Organization (CSIRO) combined forces with Deakin University in Victoria, also in Australia. They wanted to examine the almighty prowess of platypus milk and attempt to understand why it’s so potent. Their results were recently published in the journal Structural Biology Communications.

In the laboratory, the scientists replicated the platypus milk protein responsible for its antibacterial powers and gave it a long, hard inspection. As Dr. Julie Sharp, from Deakin University, states, “We were interested to examine the protein’s structure and characteristics to find out exactly what part of the protein was doing what.”

Recreating a protein in the laboratory sounds, at first reading, to be a relatively simple job — but it’s not. Achieving this feat took the combined might of the Synchrotron, a cyclic particle accelerator, and the CSIRO’s ultra-hi-tech Collaborative Crystallisation Centre.

The magical, bacteria-slaughtering capabilities of the milk protein might come from its unique 3-D folding. The protein has a ringlet-like formation, thus earning it the nickname Shirley Temple. The intriguing format of the protein has not been seen in nature before.

“Platypus[es] are such weird animals that it would make sense for them to have weird biochemistry.”

Lead study author Dr. Janet Newman

Why is the platypus’s milk so powerful?

The platypus is a conundrum of a creature with miraculous milk.  Unlike the vast majority of mammals, the platypus has no nipples (which is yet another reason why platypuses are considered one of planet Earth’s oddest residents). So, without nipples, the mother platypus secretes milk from a patch of skin.

As an aside, baby platypuses — rather boringly — are officially called “baby platypuses.” However, there are more pleasing, if unofficial, names, including puggles and platypups, so feel free to use whichever you deem cutest.

I’ll stick with baby platypuses for the sake of maintaining some degree of scientific integrity. But as I was saying, since there are no teets, the mother’s milk comes into contact with the outside world, and the baby platypus must lick the milk from the surrounding hair.

Of course, this opens the young animals up to an unholy array of bacteria and other nasties. This, perhaps, is the reason that platypus milk needs to be so profoundly antibacterial.

Shirley Temple may open the door to other fields of study, too; Dr. Newman says, “Although we’ve identified this highly unusual protein as only existing in monotremes, this discovery increases our knowledge of protein structures in general and will go on to inform other drug discovery work done at the Centre.”

For now, we will have to wait and see how this new protein might be unleashed in the war against antibiotic resistance. Hopefully, the wait will not be a long one. God bless the platypups!


While we cannot yet guarantee you find a physician in our ever-growing network to supply you with platypus milk, you can certainly find one to help with any lingering infection you may have…or any other concern for which you should see a good doctor .  At HealthLynked, we are connecting patients and the physicians that care for them in a social ecosystem with a higher purpose – Improving HealthCare.

Ready to get Lynked?  Go to HealthLynked.c0m today to sign up for free and start taking control of your healthcare.

Sources:

Newman, Tim. “Platypus milk: The key to preventing deadly infections?”, Medical News Today, Wednesday, 21 March 2018

 

 

Is Working Long Hours Raising Your Risk for Diabetes?

Women who work 45 hours or more each week may be upping their risk of diabetes, new research finds. Men who work the same number of hours, however, are not affected.

While prior research has suggested a link between a long work week and an increased risk of diabetes, most of these studies focused on men.  Interestingly, this recent research seems to find the opposite effect in males: the longer the work week, the lower the incidence of diabetes.

For women who work 45 hours per week or more, though, their risk was considerably higher.  When compared with women who work 35–40 hours each week, they had a 63 percent higher risk of developing diabetes.

The authors of the new study, which was published in BMJ Open Diabetes Research and Care, looked at data from the 2003 Canadian Community Health survey, which included respondents aged 35–74.

They also looked at the Ontario Health Insurance Plan database for physician services, as well as the Canadian Institute for Health Information Discharge Abstract Database for hospital admissions.

In all, over 7,000 Canadian employees were included in the research. As well as looking at hours worked, the researchers also included other factors in their analysis, such as: sex, marital status, parenthood, ethnicity, place of birth, place of residence, long-term health conditions, lifestyle, weight, and body mass index (BMI).

They also considered unique workplace factors, such as shift work and the type of job the respondents did — for instance, whether it was predominantly active or sedentary.

Overall, the risk of diabetes was “only slightly reduced” when factors such as smoking and alcohol levels were considered.

While the researchers could not establish a definitive cause and effect from these data, they note that encouraging women to work fewer hours may be a key component of reducing the number of diabetes cases.

The shape of diabetes

Diabetes is a widespread issue around the world and impacts many lives. When someone has diabetes, their body does not utilize insulin properly; the pancreas increases production of the hormone until it can no longer keep up with the body’s demands.

This leads to higher-than-normal blood glucose levels and can eventually cause a wide range of problems throughout the body.

The American Diabetes Association say that over 30 million people in the United States have diabetes, and 7 million of these individuals are unaware of it.

Diabetes remains the seventh leading cause of death in the U.S., and, each year, doctors discover 1.5 million new cases. Worldwide, this number jumps to 425 million adults, with half remaining undiagnosed.

Diabetes prevention and management, then, are an essential facet of public health. Studies such as this one can help doctors to create guidelines that can positively impact the health of their patients and lead to fewer cases of diabetes down the road.

Limitations and next steps

Although the records used in this study did not distinguish between type 1 and type 2 diabetes, it is estimated that type 1 diabetes accounts for around 5 percent of cases among those aged 18 or over, so most of these cases were likely to be type 2.

In the future, if further studies agree with these findings, healthcare providers may recommend that women work 40 hours per week or under.

The study authors write, “Considering the rapid and substantial increase of diabetes prevalence…worldwide, identifying modifiable risk factors such as long work hours is of major importance to improve prevention and orient policy making, as it could prevent numerous cases of diabetes and diabetes-related chronic diseases.”


Ifworking long hours is causing you to feel poorly, consider talking to a physician.  You can quickly find and connect with one in the largest ever healthcare ecosystem designed to vastly improve the relationship doctors and patients are meant to enjoy and find great value in….

Ready to get Lynked?  Go to HealthLynked.com to sign up for Free and start taking control of your healthcare today!

Source:
Beyer, Monica. “Diabetes risk increased in women who work long hours.” Medical News Today. Sunday, 8 July 2018.