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Category Archives: Integrative Medicine

A Floating Tiki Bar Sets Sail on the Potomac This Spring – Eater DC

Posted: May 2, 2022 at 2:00 am

A teal-blue tiki bar will float along the Potomac this spring and summer with the debut of the Potomac Tiki Club. The party-on-the-water craft is set to sail out of Georgetown Harbor, with room for 18 passengers, a semi-circular bar with seating, and a bathroom on board.

The floating tiki bar is from the founders of Sea Suite Cruises, who previously launched the first set of Potomac pedal boat bars dubbed Paddle Club. Now, this new, engine-powered 90-minute cruise will pass by landmarks like Georgetown University, The Kennedy Center, Watergate Hotel, the Lincoln Memorial, and the Washington Monument. Find canned cocktails, Anheuser-Busch beers, wine, and seltzer on board on Potomac Tiki Club, and passenger can bring food along. Book a cruise for $45 to $55 per person here.

A secluded back patio in the West End will soon turn into D.C.s newest wine garden. In early May, Bottles Wine Garden will open at 2500 Pennsylvania Avenue NW between Georgetown and Foggy Bottom. Sommelier Erika Parjus is responsible for the 43-bottle wine list, with a focus on female winemakers and low-intervention winemaking from the vineyard to the cellar. The design firm //3877 is creating an 70-seat patio with foliage-covered walls, wine barrels as tables, and porch swings, along with a 50-seat indoor space. Bottles Wine Garden is spearheaded by Angie Duran, formerly of Centrolina and Piccolina.

The healthful restaurant chain co-founded by integrative medicine expert, Dr. Andrew Weil, is now open in Gaithersburg. True Food Kitchen opened Monday, April 25, for lunch, dinner and weekend brunch at 221 Rio Boulevard in the Rio Lakefront development. Theres an outdoor garden patio filled with herbs with seats for 124 diners, while the dining room for 171 is outfitted with chairs made out of recycled plastic soda bottles. Gluten-free quinoa strawberry pancakes and wild-caught tuna tostadas are on the spring menu.

U Streets gallery and retail space Legacy is partnering with downtowns artsy Eaton Hotel for a monthly go-go showcase. Happening the last Wednesday of every month, the party kicks off at 8 p.m. Wednesday, April 27, with a concert by six-piece band T.O.B. and food and art for sale. Future concerts will include musicians curated from favorite D.C. go-go act like Backyard Band. Tickets to each monthly go-go installment of Return of the Mac are $25 in advance and $40 at the door.

The North Carolina-based company Bitty & Beaus Coffee will celebrate a grand opening on Saturday, April 30 for its new shop in Washington. Located at 3207 M Street NW, the franchise is the 12th store for the brand. The Wright family founded Bitty & Beau (named after their two children with Down syndrome) in 2016, paving a path for people with intellectual and developmental disabilities to find meaningful employment.

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The #1 Best Supplement to Take, Says Science Eat This Not That – Eat This, Not That

Posted: May 2, 2022 at 2:00 am

There's so many supplements on the market promising a way to better health, but it's hard to know which ones really work. While there's no magic pill to pop that cures all, there are certain supplements that can help improve specific aspects of health. Eat This, That Not! Health spoke with experts who share which supplements are the healthiest to take and why. (Be sure to ask your doctor about what's right for you before starting any supplement regime.) Read onand to ensure your health and the health of others, don't miss these Sure Signs You've Already Had COVID.

Dr. Jacob Hascalovici, the chief medical officer and pain specialist with Clearing explains, "Most people can get the vitamins and minerals they need directly from their food (which increases the importance of eating a balanced, comprehensive diet). That being said, certain groups of people may want to consider certain supplements. If you are pregnant or trying to become pregnant, for example, it's important to make sure you're getting enough folic acid (vitamin B9). Vitamin B12 can help vegetarians who may not be ingesting enough of it naturally. And along with aging comes higher risks of osteoporosis and nutritional imbalances, so if you are past 50, you might consider vitamin D and calcium. Each person has their own unique nutritional needs, which is why supplements are not really a one-size-fits-all kind of thing."

Dr. Hascalovici says, "Vitamins and supplements are not regulated by the same FDA protocols as medication is, and thus may not be as uniform or as comprehensively tested. In addition, some supplements, such as St. John's wort can interact with other medications and supplements, sometimes with negative consequences. It's also possible to ingest too much of certain vitamins and minerals, such as iron, vitamin A and even vitamin D. Finally, drinking too much and having certain health conditions, among other things, can impact how well your body is able to use supplements. For many reasons, it's best to talk to your doctor or nutritionist before starting on vitamins and supplements."

Dr. Michael Hirt, a Board Certified Nutrition from Harvard University and Board Certified in Internal Medicine and is with The Center for Integrative Medicine in Tarzana California reveals, "Boron is a trace mineral that is naturally found in very small amounts in fruits and vegetables. The foods richest in boron include avocados, apricots, currants, raisins, prunes and most nuts. The largest natural deposits of boron (called borates) are found only in California and Turkey. Over the last 20 years, researchers have documented a consistent decline in our average dietary boron consumption for reasons that remain unclear. Since nearly all life forms on Earth require access to nutritional boron, this decline in boron consumption is concerning. Scientists now believe that the very evolution of planetary life depended heavily on boron metabolism for the genesis of DNA. Modern nutritional medicine has discovered many benefits of boron supplementation including the promotion of bone health. Boron can trigger bone-building activity and direct calcium, magnesium and vitamin D from our blood and into our bones. While boron does not create sex hormones like testosterone and estrogen, it does improve the effectiveness of our hormones by improving the availability of these hormones and by reducing their clearance from the blood.. Boron does this while simultaneously reducing the risks of prostate cancer in men and breast cancer in women. Unchecked inflammation is one of the key drivers of human disease, including heart disease, strokes, arthritis, and cancer. Boron has been shown to significantly reduce the levels of one of the major inflammatory markers, C-Reactive Protein. Lower inflammation levels today are likely to help protect you from many diseases tomorrow. A typical dose for boron supplementation is 3mg, but clinical doses of boron up to 20mg have been used therapeutically. As always, check with your healthcare professional before adding any supplement, at any dose. A dose of boron today won't help you feel better tomorrow, but if you stick with boron, you may be amazed by what this little-known, miracle mineral can do."6254a4d1642c605c54bf1cab17d50f1e

Dr. Hascalovici says, "B vitamins influence a lot in the body, from liver function to stress and mood stabilization. A lack of it may lead to fatigue, weakness, cramping, anemia, skin cracking, and more. Vegetarians and vegans should ensure they're ingesting enough B vitamins, particularly vitamin B12. Nutritional yeast is a great source of vitamin B12; salmon contains it, too. The NIH lists specific recommended doses of the B vitamins, which is a helpful place to start. While the B vitamins are water soluble, it is possible to overdo them over time, which can result in nerve problems."

Dr. Hascalovici shares, "Magnesium supports your thyroid and can help stabilize serotonin, which can impact your moods. It can also support your blood pressure and help control inflammation. If you're seeking more magnesium, oat bran, wheat germ, fluffy greens, and nuts are your friends. Supplements are recommended for some people, but not everyone."

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Daniel Powers, MS with The Botanical Institute shares, "Ashwagandha is a supplement that has been growing more and more popular over the past few years. And for good reason, studies show that this adaptogenic herb helps to build your body's resilience to stress. Ashwagandha has also been shown to help to improve sleep quality. In today's fast-paced culture, ashwagandha provides relaxing benefits that we can all use a bit more of.. Ashwagandha can be taken daily. The recommended dose is ~300mg of Ashwagandha extract.. It's best taken before bed as it can help to wind your brain down and help you get a full night of sleep."

RELATED: Doing This After Age 60 is "Unhealthy," Say Physicians

Dr. Suzanna Wong. a licensed Doctor of Chiropractic and health expert with Twin Waves Wellness says, "Zinc affects everything from your immune system, to hair and nail health and skin/wound healing. If you are deficient you could experience hair loss, lots of colds and illnesses, diarrhea, loss of taste, smell and appetite and poor wound healing. Taking zinc helps your body to have a strong immune system, as well as having a role in your overall metabolism."

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How Does Hypnosis Work? Here’s What the Science Says – TIME

Posted: May 2, 2022 at 2:00 am

When you think about hypnosis, what do you visualize? For many, its a clock-swinging magician or a comedy act that forces an unwitting volunteer to make embarrassing public admissions on stage.

But hypnosis has a surprisingly robust scientific framework. Clinical research has shown that it can help relieve pain and anxiety and aid smoking cessation, weight loss, and sleep. It can help children and adolescents better regulate their feelings and behaviors. Some people can even use self-hypnosis to manage stress, cope with lifes challenges, and improve their physical and emotional health.

Hypnosis creates a non-judgmental immersive experience, says Dr. David Spiegel, a Stanford University psychiatrist and leading researcher of hypnosis. Its been used in various forms for centuries, but it wasnt until 1843 that the Scottish surgeon Dr. James Braid popularized the term hypnosis. Braids central discoverythat concentration can guide the brain toward a more suggestible statewas and remains controversial. But physicians have continued to test and teach the technique over the centuries with great success, Spiegel says.

Today, a psychologist, psychiatrist, or other healthcare professional certified in hypnotherapy will first screen a potential client for their ability to be hypnotized using a validated suggestibility scale. (Not everyone is equally susceptible to hypnosis, but research has found that about two-thirds of adults are.) The hypnotherapist will talk with them about what sort of sensory experiences make them feel safe, like a lakeshore retreat or a beach vacation. Then, the hypnotherapist will conjure that imageryfocusing, for example, on the salt spray of the ocean, seagulls calling overhead, and sun-kissed skinto help the person go deeper into the calming visualization. If done right, the patients physical surroundings will melt away.

The result is a powerful combination of dissociation, immersion, and openness to new experiences, which culminates in what was once called a trance, but which modern hypnotherapists simply refer to as a hypnotic state. It can be achieved in just a few minutes, Spiegel says.

Such scene-setting techniques can create the ideal stage for positive transformation, says Binghamton University psychology professor Steven Jay Lynn. During hypnosis, people are more open to the suggestions of the hypnotherapist, whether those ask the patient to detach themselves from a past painful experience or visualize a solution to their problem. For some people, these changes may be catalyzed in a one- or two-hour session. For others, hypnotherapy or self-hypnosis may be a regular part of their mental health care. Hypnosis can modify consciousness in many ways, Lynn says.

This state of deep relaxation isnt particularly difficult for most people to dive into or emerge from. Its similar to a flow state, Spiegel says, or an altered state of consciousness in which a person is so immersed in a given activity, their focus narrows and their sense of time shifts. Its also reminiscent of what happens during meditation, except instead of training people to tune into the present moment, hypnosis makes them more receptive to suggestion. Like meditation practice, many people are capable of doing hypnosis on their own, Spiegel says. In 2020, he co-founded Reveri, a subscription-based self-hypnosis app thats structured a lot like Calm or Headspace. A user can access recordings that guide them into a hypnotized state, after which theyre given suggestions or statements that lead them toward a goal the person selects before the session. We do it all the time, Spiegel says of entering and exiting these mental states, but in hypnosis you do it more.

Brain-imaging studies have helped to illuminate what happens inside the hypnotized brain, though much still remains a mystery. During hypnosis, activity in a brain region that helps people switch between tasks quiets down, Spiegel says. This same region seems to disconnect from another area responsible for self-reflection and daydreamingwhich may be why hypnotized people arent worried about who they are or what theyre doing. Researchers have also found that hypnosis can calm brain regions that help control autonomic functions like heart rate, blood flow, and breathing. This is likely what leads to the physical relaxation thats a hallmark of hypnosis, Spiegel says.

One of the most interesting modern applications of hypnosis is in the operating room, says Lorenzo Cohen, director of the Integrative Medicine Program at the University of Texas MD Anderson Cancer Center. For some localized breast cancer surgeries, namely lumpectomies, the center lets patients choose between general anesthesia or a localized anesthetic and hypnotherapy. Those who choose the second option remain fully awake during their surgery, but a hypnotherapist first helps them enter a state of deep relaxation, or hypnosedation, Cohen says. The local [anesthesia] should be doing its thing, Cohen says. The rest is in your head.

More than 30 clinical trials have affirmed the use of hypnosedation, says Cohen (who is also researching the practice). Studies have shown that people who received hypnosedation experienced less preoperative anxiety, required less pain medication during surgery, and reported less post-operative pain intensity, nausea, fatigue, and discomfort than people who chose general anesthesia, Cohen says. The hypothesis is that the patients who are under general anesthesia, even though theyre not conscious, are having an intense stress response, he says. This can suppress an immune system that, in cancer patients, is already compromised by the disease and its treatments. When patients choose hypnosis, Cohen believes the bodys fight-or-flight response may be reduced.

Despite the mounting evidence, hypnosis is not without skeptics. Randomized controlled trials have found that hypnosis can help with pain and anxiety associated with a range of medical conditions, but even the best studies cant meet the gold-standard of a double-blind design, Spiegel says. While patients and practitioners can be kept in the dark about what pill theyre administering or receiving, its almost impossible to design a study where neither side knows hypnosis is being delivered, he adds.

And historically, the power of hypnosis hasnt always been wielded responsibly. The imaginative potential of hypnosis has been shown to create false memoriessometimes with devastating effects. At least 27 states ban hypnotically-elicited testimony from appearing in court. Hypnotherapists should avoid using the technique to recover memories, Lynn says.

But when conducted by a trained professional and properly applied, modern hypnotherapy can provide powerful results. Susceptibility to suggestion is often viewed as a liability or a weakness, Spiegel says, but its really a strength.

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Nemacolin Is An Under-The-Radar Luxury Resort That You Should Put On Your Bucket List – Forbes

Posted: May 2, 2022 at 2:00 am

Who knew that one of the most interesting luxury resorts in the U.S. is in rural Pennsylvania? In 1987, 84 Lumber Company founder Joseph A. Hardy, III bought some land southeast of Pittsburgh in an area that had been established by William F. Rockwell in 1960 as Nemacolin Trails Hunting Reserve and Lodge. The town was named after Chief Nemacolin, hereditary chief of the Delaware Nation, and Hardys Nemacolin resort in nearby Farmington is now a destination hotel and retreat run by his daughter Maggie Hardy Knox and her son, PJ Magerko. The creative, whimsical, and welcoming property offers the widest range of diverse activities and experiences I have ever seen in one location, including a world-class art collection, a huge spa, several destination restaurants, and all manner of outdoor activities for all ages and in all seasons.

The Chateau, designed after The Ritz Paris, is one of five accommodation types at Nemacolin,

Its possible to design an itinerary around one of several themes family luxury, romantic getaway, meditative retreat but its also ok to just arrive and follow your nose, mixing and matching, deciding as you go. On my recent too-short visit there, I was able to cover a lot of territory, from dining at the exquisite Forbes Five-Star restaurant Lautrec, helmed by Kristin Butterworth, to to taking a deep-dive docent-led tour of the art collection, which includes not only the likes of Botero and Stella but also a chunk of the Berlin Wall, to visiting the Holistic Healing Center, where Dr. Jerry Lin, DACM, Dipl.OM, L.Ac. practices holistic medicine across a range of therapies, including Traditional Chinese Medicine and Acupuncture.

A detail from a slab of the Berlin Wall housed in the front of Nemacolin's Chateau.

The first important decision to make is which of the five accommodation types to situate yourself in. In addition to townhomes and larger estate properties, there are three hotel choices, each distinct in nature. The Lodge is the most casual, while The Chateau is the most formal, and Falling Rock is the most secluded and exclusive. I stayed at The Chateau, which is the first building you come upon when entering the property, and its designed after the Ritz Paris. The lobby is grand ornate and floral, with a bar amidst the seating areas with an indoor route through a sea of art to The Lodge next door. (For parts of the property further afield, a fleet of shuttles is at the ready to transport guests wherever theyd like to go.)

The Chateau's lobby bar is a wonderful gathering place before dinner for a glass of wine or a ... [+] cocktail.

Rooms in The Chateau are vast, high-ceilinged affairs with thick walls that seem practically soundproof. The top floor of the building has a private club, as well as a private art collection for guests of the club to enjoy. Marble bathrooms, which feel more spacious than some New York City studio apartments, have deep soaking tubs and walk-in showers.

The Spa at Nemacolin is a deeply relaxing place for restoration and quiet.

The propertys spa is a serious highlight. I whiled away the entire morning there with a deep tissue massage followed by matcha tea service by the fire in the lounge. Its becoming clear, at this point in my visit, that space and time are abundant here at Nemacolin, and both generously offered to guests at every turn.

Dr. Jerry Lin oversees the Holistic Healing Center at Nemacolin, offering a wide range of customized ... [+] wellness programs.

I was also able to spend some time at another healing venue on property, the Holistic Integrative Therapy Center, where Dr. Lin not only customizes wellness programs for all patients, but he is also able to offer free and reduced-fee services and education to staff. (The employees of Nemacolin that I spoke with all said, to a person, that the company treats them as valued team members much like family, and this mindset was most evident during the pandemic, when the management did everything in their power to keep staff employed.)

Afternoon tea is served by appointment at Nemacolin.

Dining at Nemacolin is an equally wide-ranging experience. A multi-course meal at Lautrec, served in the shadow of several original Toulouse-Lautrec paintings, is not to be missed. Chef Butterworths style is equal parts refined and inviting, and her prix-fixe menus offer both vegetable-forward and more classic French-style dishes. The world-class wine list has hard-to-find French wines dating back to the middle of the last century.

The tableside Champagne cart is the perfect way to begin a dinner at Lautrec.

In between all the dining and relaxing, theres a ropes course, mini-golf, axe-throwing, and both indoor and outdoor swimming.

Its impossible to encompass in one story, not to mention experience in just one brief visit, all that Nemacolin offers. And now that pandemic restrictions are beginning to lift, live events are back on, and Nemacolin will once again host Dive & Drag: Pride 2022! On June 11th, Susanne Bartsch returns to Nemacolin for a celebration of transformation and inclusion at the propertys outdoor sports and entertainment venue, The Peak, with a drag show performance. You can find full details here.

To book a room or house or to make a dinner reservation, visit the Nemacolin website.

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Genexa Launches the First Ever Clean Acetaminophen Pain Relief Products for Adults – Business Wire

Posted: May 2, 2022 at 2:00 am

ATLANTA--(BUSINESS WIRE)--For the first time ever, adults can opt for a clean alternative with the same efficacy as its counterparts in the medicine aisles. Launched today, Genexas Acetaminophen Extra Strength and Acetaminophen PM caplets have the same active ingredients and dosages of current category leaders but without artificial dyes, synthetic fillers and other artificial preservatives. Genexa Acetaminophen Extra Strength has 500mg of the pain reliever acetaminophen, the same dosage found in Extra Strength Tylenol, and Genexa Acetaminophen PM has 500mg of the pain reliever acetaminophen and 25 mg of diphenhydramine HCl, the same dosage found in Tylenol PM.

Prior to Genexas pain reliever launch, consumers had no choice but to opt for the other acetaminophen products on the market that contain artificial inactive ingredients such as propylene glycol, FD&C red no. 40 aluminum lake and titanium dioxide. Made with clean inactive ingredients, Genexa Acetaminophen Extra Strength is used to temporarily relieve minor aches and pains due to the common cold, headache, backache, minor pain of arthritis, toothache, muscular aches, premenstrual and menstrual cramps and temporarily reduce fever. Genexa Acetaminophen PM provides temporary relief of occasional headaches and minor aches and pains with accompanying sleeplessness.

Now consumers do not have to choose between efficacy and clean ingredients. Our mission of putting people over everything means providing options to those who care about knowing the ingredients in what they are taking, said CEO and Co-Founder David Johnson. Were bringing options to peoples medicine cabinets they have never had before because we believe that it's time to evolve the decades-old formulas in our everyday medicines without compromising on efficacy.

Artificial dyes, talc, sorbitol, high fructose corn syrup, propylene glycol, titanium dioxide, and common allergens like gluten and lactose, are just some of the inactive ingredients and fillers commonly found in OTC medicine. Genexa has created and published an Ex List which includes all of these ingredients and countless other fillers that it vows to never use in their products.

In my experience, more and more frequently I am seeing that my patients are doing their best to avoid eating foods that contain artificial additives like dyes, preservatives, and assorted other fillers. They have shared with me that they long for medicines that are effective but not full of artificial fillers. I am so happy to finally have a medicine I can recommend to them, noted Genexa Medical Advisor Taz Bhatia M.D., a board-certified integrative medicine physician and wellness expert, and Founder of CentreSpring MD. This groundbreaking product launch from Genexa is an exciting moment for both the industry and for patients across the country, finally delivering a real choice for people pursuing clean living who are in need of a pain reliver.

Genexas product launches offer new innovation and a forward-thinking approach that will help serve as a catalyst to the entire consumer pharmaceutical industry, noted Brian Perkins, Chairman of Genexa and former Worldwide Chairman of Consumer Pharmaceuticals and Nutritionals at Johnson & Johnson. Consumers deserve options and transparency in their medicine and Genexa is delivering on this need."

With a shared belief in making clean medicine accessible to all, Walmart is the exclusive mass retailer for Genexas acetaminophen products. These SKUs also retail at CVS, Amazon and Genexa.com, among others. You can find other Genexa products in over 45,000 retailers nationwide.

Recently recognized by Fast Company for its disruptive work in the consumer pharmaceutical space, Genexa was named the No. 1 Most Innovative Company in Wellness for 2022 by the publication. Genexa is also backed by celebrity investors including Gwyneth Paltrow, Chris Pratt, Katherine Schwarzenegger, Donald Glover, Lily Aldridge, Jennifer Meyer, Regina Hall, Sanaa Lathan, Don Cheadle, Bridgid Coulter, Lana Parrilla, Patrick Schwarzenegger, Tony Kanal, Zoey Deutch, and Nikki Reed all of whom share in Genexas brand mission to put people over everything.

Genexas medicines span most traditional categories of OTC treatment including cold and flu, analgesics, digestion and allergy for infants, children and adults. Genexas products are manufactured in accord with the relevant FDA guidelines and are Non-GMO Project Verified and gluten-free. Many are certified organic and vegan as well. As a Certified B-Corporation, Genexa is committed to using business as a force for good, meeting rigorous standards of social and environmental performance, accountability, and transparency.

For more information, visit Genexa.com.

ABOUT GENEXA

Founded by two dads on a mission to revolutionize the medicine aisle, Genexa makes medicine with the same active ingredients people need, but without the artificial ones they dont. Genexa believes people deserve choices. Thats why their business is built on the commitment to put people over everything. All of Genexas products are made to the highest standards of medicine with no artificial dyes, common allergens, or unnecessary inactive ingredients. Its real medicine, made clean. With a commitment to innovation at every turn, Genexa was recently named to Fast Companys prestigious list of the Worlds Most Innovative Companies in 2022. Learn how Genexa is putting people over everything, in everything they do, at Genexa.com.

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Where to Care for Your Dog’s Weary Bones – Mpls.St.Paul Magazine

Posted: May 2, 2022 at 2:00 am

Acupuncture and chiropractic care

Just like in humans, arthritis affects many aging pets and can be debilitating. Fortunately, many pets respond well to acupuncture and chiropractic treatments. Dr. Shantel Julius of Julius Rehabilitation & Integrative Veterinary Services (Hastings, 612-636-9575) made monthly house calls to adjust Chester, one of our writers dogs, for years. His owner says you could see his ridiculously long basset hound spine straighten immediately. Chiropractic for Everybody (952-484-5460) also treats dogs and cats at its clinics in the Twin Cities, Rochester, and St. Cloud.

If dogs could purr, theyd be doing it on Niky Bonds massage table. The Knotty Dogs Canine Massage (651-301-5556) owner and certified canine massage practitioner drops by your home for up to an hour of ultimutt relaxation that can also increase flexibility. Want a DIY option? Dive down a YouTube rabbit hole to learn a little tui na (pronounced twee-nah). The traditional Chinese massage technique used on people and pets means push and grasp and relies on finger pressure at acupuncture points to address patterns of disharmony in the body and promote mobility.

Pets cant tell us what hurts, but digital thermography can. A Digatherm camera lets vets pinpoint where pets radiate the most energy, which can signal pain. Theres no radiationjust information. Ask your vet about this tech the next time Scooter doesnt seem right.

Underwater treadmills are great for rehabilitating and strengthening muscles, and honestly, theyre dang adorable, too. Get jogging at Twin Cities Animal Rehab and Sports Medicine (Burnsville, 952-224-9354) and University of Minnesotas Veterinary Medical Center (Como Park, St. Paul, 612-626-8387).

It sends an electromagnetic pulse to damaged tissue to trigger the bodys anti-inflammatory response and promote cellular repair. Best of all, you can do it at home. Push the button on a necklace-like device called the Assisi Loop and your pupll get a 15-minute treatment while also looking a little like Flavor Flav (assisianimalhealth.com).

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NIH Awards Wake Forest University School of Medicine $4 Million Grant to Study Chronic Pain and Opioid Use Disorder – Newswise

Posted: May 2, 2022 at 2:00 am

Newswise WINSTON-SALEM, N.C. April 25, 2022 Between 40% and 60% of patients who have an opioid use disorder (OUD) also experience chronic pain. While both of these conditions have been studied separately, very little research has been done to address the needs of patients who have both.

To fill this gap, researchers at Wake Forest University School of Medicine have been awarded a five-year, $4 million grant through the National Institutes of Health (NIH) Helping End Addiction Long-term (HEAL) Initiative.

With the grant, researchers will create an Integrative Management of Chronic Pain and OUD for Whole Recovery (IMPOWR): Coordination Center for a network of clinical research centers that includes the University of New Mexico, Yale University, Albert Einstein College of Medicine and the University of Pittsburgh.

Through the Center, the School of Medicine will coordinate and support the network in the development, evaluation and implementation of patient-centered interventions with each research center conducting two to three clinical trials.

Traditionally, treatments for these conditions have been very siloed, said Dr. Meredith C.B. Adams, principal investigator and assistant professor of anesthesiology at Wake Forest University School of Medicine. There are interventions to treat chronic pain. There are interventions for opioid use, misuse or disorder, but what about treatments for people who have both? Our objective is to find effective interventions to make sure were addressing patient pain while also avoiding an escalation of opioid use disorder.

Another key component of the project will be decreasing stigma associated with these conditions, improving health equity and diminishing health disparities through educational development.

Part of addressing this crisis is understanding patient and community needs, Adams said. Many people with co-occurring chronic pain and opioid use disorder do not seek treatment because of the stigma associated with these conditions. We hope to change that.

The NIH HEAL Initiative, which launched in 2018, was created to find scientific solutions to stem the national opioid and pain public health crises.

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From Immune Function and Cognition to Cardiovascular Health and Cancer Prevention – Health Benefits of Tea Revealed by Researchers from Across the…

Posted: May 2, 2022 at 2:00 am

New Findings Behind the Science of Each Sip Released at Sixth International Scientific Symposium on Tea and Human Health

NEW YORK, April 27, 2022 /PRNewswire/ -- Leading nutrition scientists from around the world convened yesterday to present the latest evidence supporting the role of tea in promoting optimal health. With new findings from the international scientific community consistently lending credibility to tea's healthy properties, speakers at the Sixth International Scientific Symposium on Tea and Human Health provided a comprehensive update of recent research on the benefits of tea consumption on human health. As the second most consumed beverage in the world next to water, over 159 million Americans are drinking tea on any given day.

"There is a growing body of research from around the world demonstrating that drinking tea can enhance human health in many ways," said symposium chair, Jeffrey Blumberg, PhD, an active Professor Emeritus in the Friedman School of Nutrition Science and Policy at Tufts University. "True teas which include black, green, white, oolong, and dark can contribute significantly to the promotion of public health. Evidence presented at this symposium reveals results - ranging from suggestive to compelling - about the benefits of tea on cancer, cardiometabolic disease, cognitive performance, and immune function."

The Chemistry in Your CupTea contains flavonoids, naturally occurring compounds that have antioxidant properties. Tea flavonoids provide bioactive compounds that help to neutralize free radicals which may damage elements in the body, such as genetic material and lipids, and contribute to chronic disease. Tea also contains L-theanine, an amino acid that is for the most part, uniquely found in tea.

Tea and Immune Function"Tea may help support your immune system and increase your body's resistance to illnesses," says Dayong Wu, MD, PhD, Nutritional Immunology Laboratory in the USDA Jean Mayer Human Nutrition Research Center on Aging at Tufts University. "In the event you do become sick, tea can help your body respond to illness in a more efficient way by ridding itself of the infection and may also alleviate its severity when they happen."

In a comprehensive review of the published data on this topic presented at the symposium, Wu concluded that green tea/catechins have been shown to help the host fight against a variety of pathogens by decreasing the pathogen's ability to infect the host and helping the host's immune system spring into action. Green tea/catechins have also been shown to improve autoimmune disorders by promoting self-tolerance, suppressing autoantigen-induced inflammatory attacks, and enhancing tissue repair.

Tea and Cognitive FunctionWhen it comes to cognitive function, it turns out tea may offer significant benefits. "There is strong evidence that tea and its constituents seem to be beneficial under conditions of stress. The most profound cognitive domain that tea seems to act upon is attention and alertness," explains Louise Dye, PhD, Professor of Nutrition and Behaviour at the University of Leeds. "With these effects on attention, tea is an optimal beverage of choice during a time of elevated stress and burnout worldwide."

In her review of published research on this subject, Dye revealed that evidence from randomized controlled trials supports the conclusion that tea consumption can produce short term acute beneficial effects on attention measured by objective tests such as the attention switching test and on subjective reports of alertness. Studies consistently show beneficial effects of a high dose of L-theanine, together with a lower dose of caffeine, on attention task performance. These findings indicate that the unique combination of caffeine and L-theanine that is found in tea can improve attention.

Tea and the Prevention of Cognitive DeclineWith no effective drug treatments for dementia, prevention is key. It is estimated that 40 to 50% of dementia could be prevented through changes in lifestyle factors. In a review of published research on tea and cognitive decline, Jonathan Hodgson, PhD, Professor at the Institute for Nutrition Research at Edith Cowan University, explains that "there is growing evidence that as little as 1 to 2 cups of tea daily could significantly reduce risk of vascular dementia and potentially Alzheimer's disease."

Recent high-quality data from long-term, prospective cohort studies indicate that higher intakes of tea starting at as little as 1 cup daily and up to 5 to 6 daily are associated with reduced risk for dementia. Data from these studies also find that moderate intakes of the flavonoids present in tea are associated with reduced risk for cognitive decline. Maximal benefits of tea may be obtained from as little as 2 to 4 cups per day, with little additional benefits with higher intakes. Results of these studies also suggest that the protection provided may be strongest for protection against vascular dementia, one of the most common forms of dementia.

Tea and Cancer PreventionIn examining existing data on tea and cancer prevention, higher intakes of tea consumptions may reduce the risk of some cancers. There is evidence that tea flavonoids may act via antioxidant, anti-angiogenesis, and anti-inflammatory mechanisms as well modifying the profile of gut microbiota. Tea is a beverage rich in flavonoids, which are bioactive compounds with several anticarcinogenic properties in experimental studies. Suggestive evidence indicates tea consumption may reduce risk of biliary tract, breast, endometrial, liver, and oral cancer.

"While more research needs to be done to determine the exact dosage, the conclusion we can share is that higher intakes of tea consumptions may reduce the risk of some forms of cancer," says Raul Zamora-Ros, PhD, Principal Investigator at the Unit of Nutrition and Cancer at IDIBELL.

Tea and Cardiovascular HealthCardiometabolic diseases, like diabetes and heart disease, are the number one cause of death worldwide, and tea consumption may be inversely associated with adverse cardiometabolic outcomes, according to results from population studies. Based on an extensive and variety of scientific research designs, 2-cups of unsweet tea per day has the potential to mitigate cardiometabolic disease risk and progression in adults.

In an extensive review on cardiovascular health and tea, research demonstrated each cup of daily tea consumption was associated with an average 1.5% lower risk of all-cause mortality, 4% lower risk of cardiovascular disease (CVD) mortality, 2% lower risk of CVD events, and 4% lower risk of stroke events.

"When you look at all the different biomarkers and mechanisms that tea is affecting, this bountiful beverage is one which consumers can easily add to better their diet and create a healthier and longer life for themselves," explains Taylor Wallace, PhD, Principle and CEO at the Think Healthy Group and a Professor in the Department of Nutrition and Food Studies at George Mason University.

Tea and Dietary GuidanceTo support the growing evidence of tea as a health promoting beverage, clearer recommendations are needed in the current US dietary guidance. "There may be other herbals and botanical products that can deliver health benefits, but none of them are as systematically studied as Camellia sinensis true tea," says Mario Feruzzi, PhD, Professor and Chief of the Section of Developmental Nutrition in the Department of Pediatrics at the University of Arkansas for Medical Sciences. "With true teas white, green, black and oolong - you're dealing with thousands of years of traditional use, 60-70 years of systematic study which, in the last 15-20 years, has ramped up to the point where we have very definitive data."

Dietary guidance will provide more accurate and relevant direction for consumers in the context of the diversity of tea and other flavonoid containing foods.

Sixth International Scientific Symposium on Tea and Human HealthThe Sixth International Scientific Symposium on Tea and Human Health was co-sponsored by the American Cancer Society, American Institute for Cancer Research, American Nutrition Association, American Herbal Products Association, Osher Center for Integrative Medicine at the Harvard Medical School and the Linus Pauling Institute at Oregon State University. To download the media kit please click here.

About the Tea Council of the USA:The Tea Council of the USA is a non-profit association that was formed in 1950 as a joint partnership between tea packers, importers and allied industries within the United States, and the major tea producing countries. It functions as the promotional arm of the tea industry with a primary goal of increasing overall awareness of tea by providing information about its many positive attributes. One of the Council's primary objectives is the dissemination of key scientific findings about tea to the public. The Tea Council does this in several ways including: funding scientific meetings to bring tea researchers from around the world together to share key information and identify next steps for future research projects; and working with health organizations and international scientists to disseminate information about potential positive health effects of tea consumption on a public level.

Contact:

Christina Deecken[emailprotected](212) 941-4906

Eva Walper[emailprotected](212) 941-4906

SOURCE The Tea Council of the USA

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The future of health care: What to expect – CT Insider

Posted: May 2, 2022 at 2:00 am

The last couple of years have seen a seismic evolution in the health care industry. The onset of the COVID-19 pandemic led not just to technological advances such as mRNA vaccines out of necessity it also triggered a quantum leap in how medical practitioners at all levels approach providing care, including an almost overnight revolution in virtual consultations and telemedicine.

To get a glimpse at where all of this may be headed next, we spoke to doctors and health industry experts around the state. Here are 10 changes they see on the horizon, from who you'll deal with (more assistants and women doctors) to how (the return of house calls?)

Your medical care team will expand

The U.S. faces a critical physician shortage, and by 2034, the gap between physician supply and demand will range from 37,800 to 124,000, with shortfalls in both primary and specialty care, according to the Association of American Medical Colleges. Patients in Connecticut should expect to see advanced practice providers (APPs), including physician assistants (PAs), nurse practitioners (NPs), certified nurse midwives (CNM) and certified registered nurse anesthetists (CRNA) filling that gap. These licensed health care providers diagnose and treat patients, prescribe medications and perform or assist with surgical procedures.

APPs undergo extensive education at the undergraduate and graduate school level, with training in both medicine and soft skills such as communication, listening, leadership, compassion and professionalism. On a basic level, NPs, Advanced Practice Registered Nurses (APRNs) and CRNAs are registered nurses with advanced clinical training; a PA is trained following a disease-centered medical model like physicians. The number of people in each profession is expected to grow quickly 31 percent between 2019 and 2029 for PAs and 45 percent for NPs, according to the U.S. Bureau of Labor Statistics.

The need for additional providers came into greater focus during the COVID-19 pandemic, which led to delays in other medical care. That left patients and providers trying to catch up on services, including screenings and chronic-condition follow-up, says Johanna DAddario, president of the Connecticut Academy of Physician Assistants. In many cases, PAs have availability to see patients who need urgent appointments when the physician is not available, she says. It might be helpful for patients to know that PAs work closely with physicians in a team approach, and are able toarrange forthe patient to see the physician as soon as possible when needed.

The medical community is aware of the doctor shortage, but medical school seats are limited. PAs, meanwhile, dont have to do a residency like doctors and can get out into the workforce more quickly than physicians, says DAddario, a physician assistant at Yale New Haven Hospital, but were still limited by the number of seats in PA programs across the country. Physicians, PAs and NAs all need training sites. We have to be very cognizant of not overburdening the current medical system with students.

I work with PAs, nurse practitioners and APRNs. They play a very important role in my own practice, says cardiologist Dr. Bruce T. Liang, interim CEO of UConn Health. If I see a new patient, the next visit could be with a nurse practitioner or a PA. We alternate. Theres mutual respect and dependence. We work as a team. Theresa Sullivan Barger

You might pay a medical membership fee

The future of health care for some looks a lot like health care did a century ago, as doctors fed up with dealing with insurance companies are opening direct primary care (DPC) practices that dont take insurance. Instead, people pay a monthly membership fee for access to their doctor for physicals and sick visits, and, potentially, discounts on medications, tests and health screenings.

In todays health-care delivery system, most private practice primary care doctors have been absorbed by large consortiums. With the fee-for-service, insurance-billing model, clinicians are reimbursed the same amount, whether they spend 10 minutes or 30 minutes with a patient.

Primary care docs have become the gatekeepers. They are loss leaders for hospital consortiums, says Dr. Tonya Cremin, founder of Balance Family Medicine in Monroe. In the fee-for-service model, primary care practitioners send patients to specialists such as a cardiologist for hypertension and an endocrinologist for a thyroid issue, she says. By contrast, Cremin treats people from all walks of life with a full range of health conditions, just like her family doctor did in the small town in which she grew up. When she encounters a challenging case, she checks in with a network of providers to see if her patient needs to see a specialist. As a doctor of osteopathic medicine, she says, she practices holistic, integrative medicine. It saves everybody time and money, she says. Four patients texted her while she was on vacation with what she termed simple problems, she says; she was able to help them and save them a trip to urgent care.

In addition to Balance Family Medicine, the other membership-based practice in Connecticut is 4 Elements Direct Primary Care in South Windsor and Rocky Hill. (There are five hybrid practices in the state which offer a combination of direct primary and fee-for-service care.) Direct primary care is different from concierge medical care, which caters to wealthier patients. Both state DPC practices serve uninsured, middle-class and affluent patients.

DPC practitioners dont need the staff to process claims and argue with the insurance companies for coverage and payment, says Dr. Vasanth Kainkaryam, an internist, pediatrician and the founder of 4 Elements. Some patients pay a monthly fee directly, while some patients membership fees are paid by their employer. Depending on the age of a patient, 4 Elements monthly fees range from $35 or $40 for people under age 40 to $100 for those 65 and older. Cremin charges a flat $100 monthly fee that covers annual physicals, sick visits, disease prevention and maintenance.

Both doctors patients have access to them through in-person visits, phone calls and texting. DPC practices help people save money on prescription medications, lab tests and screenings, Kainkaryam says. After working as a chief medical officer for a large community health center, Kainkaryam says, he learned about the DPC model and was hooked. This is such a better way of giving care, he says. I do house calls. When the weathers nice, well sit outside in the backyard of my office.

When a patient joins my practice, I spend an hour getting to know them, he says. Annual physicals last about 90 minutes, he adds, because health and wellness extend beyond what happens in the office.

According to a study by the Society of Actuaries, DPC patients demand for health services is 53 percent less than patients of traditional practices, they have a 41 percent lower use of emergency departments and 20 percent fewer hospitalizations. In traditional practices, doctors carry a patient load of 2,0003,000 patients and spend an average of 10 minutes with a patient, he says, leaving them little time to get a full picture of what each individual patient is dealing with.

The DPC model may keep some primary care providers from leaving practice, since it allows physicians to spend time with patients and still make a living. Everyone wins, Kainkaryam says. The patient wins because they have direct access to their doctor. The doctor wins because they control their practice. TSB

Demand for mental health care will expand

While the pandemic has caused demand for mental health services to outpace supply, there have been a few upsides. Interest in some careers in mental health is on the rise, a growing societal openness about anxiety and depression has lowered stigma, and patients comfort with virtual visits has skyrocketed. However, at least in the short term, mental health professionals are feeling burnt out and retiring early, and many therapists and psychiatrists positions at Connecticut hospitals go unfilled.

Even with an increase in tele-therapy services, some low-income residents are unable to access therapy, since an internet connection and a smartphone or tablet are required. Increasingly, psychiatrists, psychologists and mental health therapists are switching to private pay and refusing to take health insurance, says Dr. Charles Herrick, network chair of psychiatry for Nuvance Health, further reducing access for less affluent residents.

Mental health care has always been poorly reimbursed and poorly paid, he says. The paperwork demands are so onerous. Mental health clinicians dont have to take insurance, so they dont. More than 50 percent of psychiatrists dont take Medicare or Medicaid. The problem of providers not taking insurance is especially pronounced in southern Fairfield County, he says.

All the hospitals are struggling with staffing. Were down six psychiatrists, he says. I have interviewed so many psychiatrists. They can pick and choose. We are often competing against one another. To address staffing shortages, he says, he applied for and received designation for Danbury and Norwalk as an underserved region and was granted the U.S. State Departments permission to recruit psychiatrists from outside the country with J-1 visas.

On the good-news front, tele-mental health has been so well received by patients and clinicians that its expected to continue. In a UConn Health survey of more than 500 patients, more than 90 percent of adults said they liked virtual therapy and would like the option of it continuing, says psychiatrist Dr. Neha Jain. Its especially beneficial to residents of rural parts of the state where there are fewer mental health providers and to those concerned about the stigma associated with mental health, she says.

She expects behavioral health care to become a hybrid system where people alternate between in-person and virtual visits while also allowing their therapists access to smartphone data that tracks patients movement. For example, clinicians can collect data from patients phones that shows whether theyre leaving their homes. Suppose someone is depressed and has stopped going out? The app is a way for me to track that data, Jain says, and check in with a patient.

However, some mental health apps are unregulated and may not protect users privacy, according to a study published in 2018 in Behavioral Sciences & the Law. I advise people to do their research into who has built this app, Jain says. Are their physicians or institutions familiar with this app? TSB

More screen time with your doctor

Telemedicine isnt a practice that started with the pandemic. The idea of seeing a doctor remotely existed for years before COVID-induced lockdowns temporarily shut down some doctors offices for in-person visits. But it had a hard time catching on, says Jaclyn OConnor, an internal medicine physician and section chief of telehealth at Bridgeport Hospitals Bridgeport and Milford campuses.

Its always difficult to have people accept and adopt new technologies, but COVID sort of provided a need for it, OConnor says. I dont think its going anywhere.

A report released late last year by the U.S. Department of Health and Human Services seems to back that up. The report found that Medicare visits conducted via telehealth skyrocketed between 2019 and 2020, from 840,000 to 52.7 million. The pandemic is largely deemed responsible for that jump, but the Centers for Medicare and Medicaid also announced that it will continue to pay for some telehealth services that were temporarily added to its coverage during the pandemic. These include video-based mental health visits provided by Rural Health Clinics and Federal Health Centers.

OConnor says she hopes the additional spotlight placed on telehealth during the pandemic will also get providers and patients alike thinking about the wide variety of ways in which this technology can be used. We have always thought about telehealth as the next best thing, she says. If you couldnt get there in person, you could settle for this. Now were talking about providing better care to patients than we were before.

For instance, she says, at Bridgeport Hospital and Lawrence + Memorial Hospital in New London (which, like Bridgeport, is part of the Yale New Haven Health system), patient rooms are hardwired with telehealth technology. This allows the cameras associated with televisions in these rooms to accept telehealth calls from providers, including specialists.

Despite the growing interest and innovations in telehealth, there are still some limitations to seeing patients remotely, says Dr. Frank Illuzzi, Hartford HealthCare Medical Groups medical director for Fairfield County. I think this is a tool thats here to stay, he says. I still think its important to see a doctor for regular visits. There are some things telemedicine cant do. Its really hard to listen to someones heart and lungs over the phone. Amanda Cuda

Acquisitions and mergers will continue

Youll see more consolidation of health systems. But will the legislature step in to provide oversight?

Yale New Haven Health recently announced its intention to buy three more hospitals in Connecticut. If they do as they intend, Yale will own nine hospitals. Hartford HealthCare currently owns eight.

That, according to Lynn Ide, mirrors a nationwide trend of health care consolidation in which independent doctors offices are bought by larger groups, a practice called vertical consolidation, and hospital groups buy other hospital groups, called horizontal consolidation.

Now theres a situation where often the hospital is part of a larger system where you live or the two hospitals are both part of larger systems and the doctors and clinics and specialists are all owned by the hospital networks, also, says Ide, director of program and policy at the Universal Health Care Foundation of Connecticut. So it puts consumers in a really difficult position.

Only a few decades ago, Ide says, there were dozens of independent hospitals in Connecticut. Now all but six are part of a larger network. The result is sometimes a consolidation of health care services. At Sharon Hospital, for example, owner Nuvance which was itself formed by the merger of two large health care systems announced its intention to end maternity services. Patients would instead be sent to Poughkeepsie or Danbury.

Consolidation also raises issues around insurance coverage, Ide says. Patients are often only allowed to use health care providers who have an existing relationship with their insurance carrier. In 2015, Hartford HealthCare was negotiating with Anthem Blue Cross Blue Shield, and Anthem wanted to include Hartford in their network of providers, but they couldnt come to an agreement, she says. And so, for a period of time, everybody who lived in my part of the state, in the greater Windham area, had no choice of a doctor to go to because, literally, almost all the practices were owned by Hartford HealthCare.

There is, however, some interest in setting up what Ide calls guardrails. A bill, considered by the state legislature this year, would increase penalties for providers that end services before the state Office of Healthcare Strategy gives its blessing. It would also increase funding to that agency, so it might develop a statewide plan for health care access.

That, Ide says, was surprising. In my years working on this issue, I have never seen the state show so much interest in this issue, she said. Im discouraged, though, because I feel like it may be too late, like the cat may be out of the bag now. Jordan Fenster

The return of the house call?

Dr. Srinivasulu Conjeevaram understands that, for some people, leaving home to see a doctor isnt feasible. The other day a patient called saying, My dad I cant get him out, he just had a heart attack, and needs follow-up help, Conjeevaram says. I help a lot of people who need care and cant get out to the doctor.

Conjeevaram provides medical care in the home to clients all over Connecticut through his Hartford-based business Aakaish Health Care. His practice is one of several throughout the state that provides in-home visits with a doctor or other care provider.

In 1930, house calls by doctors were fairly standard, as about 40 percent of visits happened in patients home, according to the American Academy of Family Physicians. By 1950, though, the number dropped to 10 percent and fell below 1 percent by the mid-90s. That number started to pick up in recent years, according to a 2018 survey by the health care company Landmark Health, which found that about 13 percent of doctorsreported making regular house calls.

Some groups, including the American Academy of Family Physicians, believe the practice is making a comeback. Last year the Academy published an article stating that the U.S. is experiencing a resurgence of home-based primary care. The organization sees several factors at play including the aging U.S. population, an increase in patients who are homebound, and the acknowledgment of the value of house calls by the public and health care industry.

Still, others question house calls growth potential, as technology-assisted home care, including telehealth, can replace some in-person visits.

In his practice, Conjeevaram sees everyone from those suffering from flu to older people who need repeated house calls. He says house calls have a benefit to both the doctor and the patient. Doctors, himself included, have more flexibility in when they see patients, and patients can get help without leaving the home.

But there are drawbacks, Conjeevaram says, including that providers such as himself have to drive all over to see patients. And, sometimes, home care providers cant get to a patient as quickly as they like. It might take a month or so, he says. Its basically how acute the situation is and can you accommodate somebody.

Thats partly why Dr. Jaclyn OConnor says that the nature of what constitutes a house call is changing. House calls will exist where you will have a provider in your home, but theyre going to be there virtually, says OConnor, an internal medicine physician and section chief of telehealth at Bridgeport Hospitals Bridgeport and Milford campuses.

She points to such programs as Hospital at Home, in which patients are admitted to a hospital from their home, but doctors perform their rounds using audio and video visits.

I think house calls are going to look very different moving forward, OConnor says. AC

There will be more women doctors

Nationally, the percentage of female medical students topped 50 percent in 2019, and women have made up more than half of the UConn School of Medicine for at least the past decade, says its dean, Dr. Bruce T. Liang, interim CEO of UConn Health.

Weve seen more qualified women applicants than men applicants, he says, which is a primary reason. Women make good doctors, says Liang, a cardiologist, and patients will benefit from more women physicians. I have learned a lot from my women doctor colleagues. They tend to be more well-rounded with a holistic approach and in listening to patients, he says. Gathering [the patients] social history becomes so important, and if you miss an element of the social history, that can affect the diagnosis.

A study of primary care physicians in the New England Journal of Medicine, published in 2020, showed that women doctors spend 16 percent more time with patients than male doctors.

Having more women doctors will change health care for the better, says Dr. Raman Gill-Meyer, hospitalist-clinician educator in the department of medicine at Norwalk Hospital. Men and women physicians learn from each other, breaking down stereotypical roles, she says. I think women have some innate traits; theyre empathetic, good listeners and skilled at connecting with patients, she says. The more comfortable patients are sharing information with their doctors, the better they can be helped by their doctors.

While, historically, women doctors have tended to be obstetricians and gynecologists, pediatricians and primary care physicians, more women are entering specialties dominated by men, such as urology and orthopedics. Nationally, while only 7 percent of orthopedic surgeons attending physicians are women, 14 percent of orthopedic doctors in training are women, says UConn Healths Dr. Katherine Coyner, an orthopedic surgeon who leads hands-on programs quarterly to introduce girls and young women to medicine and engineering. They get their hands on drills and saws, and learn about orthopedic surgery, says Coyner, a former college basketball player with a 1-year-old child.

Women doctors lives often mirror their patients lives they may also be raising children and running a household while working, and they understand the stress and challenges of balancing multiple roles. Or, Coyner says, they bring an added level of understanding such as a moms need to run to relieve stress or that shoulder pain may make it difficult for a patient to put on her bra. TSB

New vaccine tech is on the way

The technology on which Pfizer and Moderna based their COVID vaccines is being used to develop a variety of treatments, and is being hailed by some as the future of medicine.

I am extremely excited that mRNA technology will expand to many other viruses, including the flu, including combination vaccines, says Scott Roberts, associate medical director of infection prevention at Yale New Haven Hospital. Theyre even trying mRNA vaccines for RSV, and Im sure theyll look at it and HIV and many other viruses.

I think the opportunities are really endless.

Respiratory syncytial virus (RSV) is a common respiratory illness that usually causes mild, cold-like symptoms, but it has proven resistant to vaccines. Theres been a lot of discussion about why vaccines havent really worked with the RSV virus, Roberts says. Maybe its just the virus itself, the way it functions in the human body.

But mRNA technology has made that elusive vaccine seem possible. Recent trials achieved over 90 percent efficacy, Roberts says, something I never would have thought at the beginning of the pandemic.

I think it really speaks to the value of the technology and the opportunity that these vaccines do lend us.

Erol Fikrig is employing the technology in a more creative way. Weve been using mRNA since 2019, about eight months before the pandemic occurred, he says.

The Yale School of Medicine researcher had been working on a vaccine for Lyme disease, with only limited success. Then he attended a conference in Ireland where he met Drew Weissman, who Fikrig calls one of the worlds mRNA vaccine experts.

Fikrig, with Weissmans assistance, has developed a way to combat Lyme disease, not by targeting the pathogen, but its delivery system, the deer tick. Deer ticks feed for as much as 48 hours, but the bite is silent it does not itch or hurt which gives the Lyme bacteria time to go from the tick into the blood. Fikrigs mRNA-based vaccine makes that tick bite red and itchy, causing the victim to remove the tick before the virus has a chance to migrate.

Wed been trying the old, traditional protein-based vaccine for quite some time, Fikrig says. The mRNA vaccine makes you eliminate all those steps. You dont need to make the protein; your body makes the protein. So, in terms of discovery, it made things a lot easier for us for sure. JF

Surgery will become less of a pain

Technology will make your surgery less invasive, more pain-free and less likely to require a hospital stay, says Dr. Maxwell Laurans, vice president of surgical services at Yale New Haven Hospital. I think were going to see advances in technologies that allow us to do new kinds of surgeries, existing surgeries more safely and to move what are typically considered inpatient surgeries to the ambulatory setting, he says.

You now have the ability to put the patients imaging up onto a screen. The image is more reliable and the machine is portable, so it can be used in an outpatient surgical center, Laurans says.

More subtle advances include using TAP (transversus abdominis plane) blocks to numb part of a patients body and avoid narcotics such as morphine. Recovering from narcotics is a main reason for an overnight stay. If you minimize those medications and use these other strategies, now youre taking an operation that used to take four to six hours, lose half a liter of blood and stay in the hospital four days make it safer and the patient goes home at the end of the day and recovers at home, he says.

Nurses will be able to spend more time with patients and less on paperwork with voice-recognition devices that take dictation.

Dr. Nita Ahuja, chair of the Department of Surgery at the Yale School of Medicine and the Yale Medicine board, says you wont see many technological advances theyll be inside you. We will continue to see innovations in cardiac and vascular surgery with increasingly complex stents, and we will start to adopt more innovative approaches to grafts that look quite different to the open heart procedures we have now, she says.

Advances in shrinking tumors before surgery will make cancer surgery more effective, Ahuja says. She also predicts the use of non-human organ transplants that will expand our organ supply and further democratize access.

Your watch and even the blanket keeping you warm will be more high-tech than ever, says Dr. Charles Odonkor, co-director of clinical research at the Wearable Health Lab at the Yale School of Medicine.

These days you have watches that can monitor heart rate, oxygen-saturation levels and can send a signal to the doctor if youre having a seizure, he says. A smart ring can sense vital signs as well, and smart patches can be wirelessly connected to an app on your phone and can monitor what your sugar levels are, he says.

Blankets will be able to auto-regulate body temperature, keeping patients warm and sensing where there may be pressure ulcers developing, Odonkor says. This will be great for patients in nursing homes, he says.

Smart shirts will send out a signal if you are having an attack of atrial fibrillation. But Odonkor believes accuracy, communication between devices and privacy must be improved. There are still a lot of false positives and user errors, and concern that constantly checking a device will increase heart rate. Ed Stannard

Well inch toward preventative care

Insurance plans have historically reimbursed clinicians for treating diseases, ordering tests and prescribing medications when early warning signs appear, not for taking the time to talk to patients about what they can do to reduce the risk of diseases in the first place.

While a full overhaul to prioritize prevention is a long way off, technological advances and medical school training are beginning to shift some patient care toward preventative treatment. In the U.S., a third of all deaths are from heart disease or stroke, according to the U.S. Centers for Disease Control and Prevention. Yet 80 percent of heart attacks and strokes are preventable, says Dr. John Glenn Tiu, a UConn Health cardiologist.

Blood tests will increasingly be used to spot heart disease and cancer risk and manage it once its detected. For example, in addition to the standard lipid panel clinicians order as part of routine annual physicals, if patients have a family history of heart disease or early warning signs, doctors can order a lipoprotein (a) blood test to determine whether the patient is at increased risk for heart-related diseases.

Although not yet fully FDA approved, the Galleri blood test uses artificial intelligence to check the blood for signs of cancer. It was 63 percent effective at identifying 12 types of cancers including hard-to-detect cancers such as pancreatic, ovarian and esophageal at stages 1 to 3, according to a study partially funded by the tests maker, GRAIL Inc. Doctors can prescribe the $950 test, not covered by insurance, for those with a high risk for cancer.

The U.S. Preventive Services Task Forces recommendations for when to start standard cancer screenings such as mammograms and colonoscopies now suggest beginning at younger ages, 35 and 45, respectively, while other standard screening tools, such as the EKG, are no longer a routine part of annual physicals, says Dr. Aesha Patel, family medicine physician at New Canaan Primary Care. Some patients who are overweight and at risk for heart attack, stroke and diabetes can be prescribed medications for weight loss, which can boost the effectiveness of exercise and healthy diet, she says.

Despite the important role diet plays in preventing many of the biggest killers, medical schools traditionally left nutrition education to dietitians. Thats changing at the UConn School of Medicine, says the schools dean, Dr. Bruce T. Liang. Medical students are now taught nutritional science and preventative measures such as exercise, physical therapy, access to fresh air and a break from environmental stressors, he says. Based on research in recent decades into introducing preschoolers to healthy lifestyle practices to prevent cardiovascular disease, pediatricians are sharing with parents the link between healthy habits formed in early childhood and later heart health, Tiu says. TSB

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New details behind the body’s response to tuberculosis could lead to a more effective vaccine – EurekAlert

Posted: May 2, 2022 at 2:00 am

BOSTON More than 1.7 billion peopleor a quarter of the worlds populationare infected with Mycobacterium tuberculosis, the bacterial strain that causes tuberculosis (TB). For years, scientists have been working to develop an effective vaccine, but current TB vaccines are only partially protective. New research by a team including investigators at Massachusetts General Hospital (MGH), Massachusetts Institute of Technology (MIT), the Ragon Institute of MGH, MIT and Harvard, and the Harvard T.H. Chan School of Public Health (Harvard Chan) has identified helpful and unhelpful aspects of the immune response that determine whether the body can keep TB infections under control. The findings, which are published in Immunity, may be helpful for designing a more effective vaccine.

Although the bodys immune system can often keep M. tuberculosis infections under control so that people dont experience any symptoms, there were more than 10 million active cases in 2017, with 1.6 million TB-related deaths. In response to active infection, which usually attacks the lungs, the body forms granulomastiny clusters of immune cells and other tissue-resident cells. In some granulomas, immune activity promotes bacterial clearance, but in others, bacteria persist and grow. These different granuloma responses can even be seen in the same individual.

Identifying which cellular and molecular features associate with bacterial control could potentially point to new therapeutic and prophylactic strategies for TB, says cosenior author Alex K. Shalek, PhD, a principal investigator who conducts research through the Ragon Institute of MGH, MIT and Harvard as well as through the Institute for Medical Engineering and Science, the Department of Chemistry, and the Koch Institute for Integrative Cancer Research at MIT and the Broad Institute of MIT and Harvard. To do so, Shalek and his colleagues used their single-cell profiling tools and teamed up with scientists in the lab of JoAnne Flynn, PhD, at the University of Pittsburgh School of Medicine, who had helped develop a monkey model that recapitulates the features of human TB and had also devised ways to track and quantify bacterial load and killing in individual granulomas.

With TB, the immune response is pretty good but not great, and until recently, the field has tackled that problem with very rudimentary tools. This collaboration is bringing the very best tools and the very best minds to bear on a really hard, really important problem that most of the world ignores because it primarily impacts the global poor, says cosenior author Sarah Fortune, MD, chair of the Department of Immunology and Infectious Diseases at Harvard Chan and an associate member of the Ragon Institute.

The collaborators efforts revealed that bacterial persistence occurs in granulomas enriched with certain cellsspecifically mast, endothelial, fibroblast and plasma cellsthat signal amongst themselves via particular pathways. Granulomas that supported bacterial clearance are characterized by other kinds of cellsincluding type 1-type 17, stem-like, and cytotoxic T cellsand use other types of signaling pathways.

Our findings highlight new targetssuch as specific cell subsetsto guide next-generation vaccines, says Shalek. We can also begin to consider how we might directly manipulate entire granulomas through modulating intercellular signaling to combat the bug more effectively.

Fortune stresses that until the COVID-19 pandemic, TB was the leading cause of death from infectious disease worldwide. An effective vaccine is the only way that we are really going to control TB, which shares many of the features that has made controlling COVID-19 hard: its airborne transmission, its infection in many people, and its ability to transmit before people are diagnosed, she says. Unlike COVID-19, which is caused by a virus, TB is caused by bacteria, and current treatment involves multiple months of aggressive antibiotic therapy. This studys new insights into how the immune system clears, or in some cases helps, TB are critical in figuring out what a new vaccine should do, says Fortune.

This work was supported by the Bill and Melinda Gates Foundation, Searle Scholars Program, the Beckman Young Investigator Program, Sloan Fellowship in Chemistry, the National Institutes of Health, the American Lung Association, the National Science Foundation, Fannie and John Hertz Foundation Fellowship, and Wellcome Trust Fellowship.

About the Massachusetts General HospitalMassachusetts General Hospital, founded in 1811, is the original and largest teaching hospital of Harvard Medical School. The Mass General Research Instituteconducts the largest hospital-based research program in the nation, with annual research operations of more than $1 billion and comprises more than 9,500 researchers working across more than 30 institutes, centers and departments. In August 2021, Mass General was named #5 in theU.S. News & World Reportlist of "Americas Best Hospitals." MGH is a founding member of the Mass General Brigham health care system.

Experimental study

Animals

Multimodal profiling of lung granulomas in macaques reveals cellular correlates of tuberculosis control

27-Apr-2022

A.K.S. reports compensation for consulting and/or SAB membership from Merck, Honeycomb Biotechnologies, Cellarity, Repertoire Immune Medicines, Third Rock Ventures, Hovione, Relation Therapeutics, FL82, Empress Therapeutics, Ochre Bio, and Dahlia Biosciences.C.L. is a shareholder and consultant for Honeycomb Biotechnologies. T.K.H. is a shareholder and consultant for nference, inc.

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