Category Archives: Preventative Medicine

The relationship between rheumatoid arthritis (RA), the most prevalent autoimmune disease, and the risk of developing primary open-angle glaucoma (POAG) invites further investigation. While there's evidence that's indicated autoimmunity may be associated with neurodegeneration in glaucoma, evidence linking these 2 conditions is scarce.

A team of investigators, led by Seung Hoon Kim, MD, JD, Department of Preventative Medicine, Yonsei University College of Medicine, perfomed a cohort study to determine if rheumatoid arthritis is associated with increased risk of primary open-angle glaucoma among older, Korean adults.

At the conclusion of the cohort study, with hazard ratios ranging from 1.44-2.12, the results suggest that adults with rheumatoid arthritis are at a higher risk of subsequently developing glaucoma. Investigators believe in the possibility of a common pathophysiological pathway between RA and POAG that could be immune mediated and warrants further examination.

To analyze the association between these conditions, investigators conducted a nationwide propensity-matched cohort study with data from the Korean National Health Insurance Service-Senior cohort from 2002-2013. The data analysis occurred from November 2020-July 2021.

Development of primary open-angle glaucoma was the main outcome. The cumulative incidence of POAG was calculated using the Kaplan-Meier method, and its incidence rate was estimated with a Poisson regression. The association between rheumatoid arthritis and risk of POAG was examined through a Cox proportional hazards regression model.

Among the 10,245 patients, 2049 patients with seropositive rheumatoid arthritis, and 8196 time-dependent, propensity score-matched, risk-set controls were included. Most of the population was women (73.1%) and the mean age was 67.7 years.

Investigators reported that the cumulative incidence of primary open-angle glaucoma was higher among patients in the rheumatoid arhtritis group, which had a total of 86 patients develop glaucoma by the conclusion of the study. The group displayed an incidence rate of 981.8 cases of glaucoma per 100,000 person years (95% CI, 794.3-1213.7 cases per 100,000 person years).

The control group had 254 cases of glaucoma with an incidence rate of 679.5 cases per 100,000 person years (95% CI, 600.8-768.3 cases per 100000 person years). These findings led investigators to conclude that patients with RA were more likely to experience subsequent glaucoma compared with those without RA (hazard ratio [HR], 1.44; 95% CI, 1.13-1.84).

Risk of primary open-angle glaucoma was especially increased among patients with rheumatoid arthritis 2 years into the follow-up period (HR, 1.83; 95% CI, 1.28-2.61), and among patients who were 75 years of age or older (HR, 2.12; 95% CI, 1.34-3.35).

"These findings suggest that RA is associated with a higher risk of developing POAG, especially within 2 years after diagnosis or among patients aged 75 years or older," investigators wrote. "There may be a common pathophysiological pathway between RA and POAG that is possibly immune mediated, and the nature of this association warrants further investigation."

The article, "Development of Open-Angle Glaucoma in Adults With Seropositive Rheumatoid Arthritis in Korea" was published in JAMA.

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Rheumatoid Arthritis Linked to Development of Glaucoma - MD Magazine

A tiger died on Wednesday during a medical procedure, the Minnesota Zoo announced Thursday.

Its with heavy hearts that we share that on Wednesday, during a routine medical procedure, the Zoos 12-year-old male Amur tiger experienced cardiac failure, a news release states. Despite heroic emergency efforts of veterinarians, animal health technicians and zookeepers, he did not survive.

This is a profound loss.

Amur tigers, historically known as Siberian tigers, are native to the Russian Far East and neighboring areas of China. The name change reflects a portion of its current wild habitat range along the Amur River, according to the Minnesota Zoo. The Amur tiger is an endangered species, with fewer than 500 believed to remain in the wild. There are approximately 103 of these tigers in accredited zoos. The median life expectancy for tigers, both in the wild and in zoos, is approximately 14 to 16, according to the Association of Zoos & Aquariums (AZA).

Of this tigers origins, the Minnesota Zoo says that he was born at a zoo in the Czech Republic in 2009, where he was given the name Putin. He spent his first six years at a zoo in Denmark before coming to the Minnesota Zoo in Apple Valley in 2015 via Delta Airlines.

More recently, in light of the Russian invasion of Ukraine, the tigers name was a talking point since its assumed he is named after Russian president Vladimir Putin.

It is common practice to maintain the given names of adult animals that come from other zoological institutions because the animals have a history of responding to names during daily training sessions, said Zach Nugent, a zoo spokesman, in an email. Training is used to encourage recall, response, and voluntary participation in day-to-day care, enrichment activities and medical procedures. In light of recent global events, the Zoo team had discussed a change to his name but had not done so yet as he was responsive to his name and it is an important part of his training, welfare and care.

Back in 2015, Putin was brought to the Minnesota Zoo as a recommendation of the Amur Tiger Global Species Management Plan.

His genetically important legacy lives on as he has sired multiple cubs, including one born in 2017 at the Minnesota Zoo, the Minnesota Zoo said in its statement.

That cub, Vera, was born on April 26, 2017, to Sundari, an Amur tiger who had also been born at the Minnesota Zoo, in 2012. Sundari, now 9 years old, still lives at the Minnesota Zoo, while Vera was transferred to Omahas zoo in Nebraska in 2019.

Putin was considered one of the most genetically valuable Amur tigers in a North American breeding program, according to the news release about Veras birth.

It was in part because of that role thatPutin was undergoing a preventative health exam that included the collection of samples to assist with breeding efforts at the recommendation of the Association of Zoos and Aquariums (AZA) Amur Tiger Species Survival Plan.

So what happened?

This was a routine procedure that is a vital part of our care and conservation work for tigers, said Dr. Taylor Yaw, the Minnesota Zoos Chief of Animal Care, Health and Conservation, in the statement. We plan weeks ahead for these types of exams. All necessary precautions were taken, and the team did everything within their power to save this animal.

A full medical and animal care team was present throughout the entire procedure at the Zoo, Nugent said. It was led by four board-certified specialists in zoological medicine including a veterinarian certified in both zoological medicine and emergency and critical care medicine; in addition, there were animal health technicians and the animal care team on hand.

The team worked tirelessly for more than an hour administering CPR, Nugent said, but despite their rescue efforts, cardiac ultrasound revealed the left-side of the heart was no longer functional.

A necropsy, another term for autopsy, is being conducted at the Veterinary Diagnostic Lab at the University of Minnesota, according to the Minnesota Zoo.

Well continue to learn more in the days and months ahead, Yaw said in the statement.

Meanwhile, those who knew Putin are grieving.

Today is an incredibly hard day for all of us at the Minnesota Zoo and we will be mourning for quite some time, said Minnesota Zoo Director John Frawley in the statement. Our Zoo has played a key role in global tiger conservation throughout our history and we currently are co-leaders of the Tiger Conservation Campaign, which has raised millions of dollars for tiger conservation. While this loss is great, we can be proud of our efforts past, present, and future to advance tiger conservation worldwide.

Info: Learn more about the Tiger Conservation Campaign, co-led by the Minnesota Zoo, at Support.mnzoo.org/tigercampaign.

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MN Zoo: Putin the tiger dies after heart fails during medical procedure - St. Paul Pioneer Press

Your 60s can be a great decade filled with many active and productive years, but making the right lifestyle choices is key to staying healthy. As you get older, facing health concerns is a reality, but practicing positive changes can help maintain good health mentally and physically. Eat This, Not That! Health spoke with experts who revealed their tips for staying in shape after 60 and explained what bad behaviors can lead to poor health. Read onand to ensure your health and the health of others, don't miss these Sure Signs You've Already Had COVID.

Dr. Taylor Graber, an MD Anesthesiologist and owner of ASAP IVs says, "As we get older, our levels of energy decrease, including metabolic precursors to energy production (ATP) like NAD+. As these energy levels decrease, there can be a natural tendency to decrease levels of physical activity and live a more sedentary lifestyle. These can include exercising and being outside less. It is important to fight these urges as we get older and continue activities. These have several benefits including social interaction, physical fitness and improving cardiovascular health, and even decreasing age related declines in bone density and strength. This simple fact, of continuing to go for walks, low intensity weightlifting, golfing, tennis, and others, can improve Vitamin D exposure and help to preserve overall health. Stay active! Aim for 30-60 minutes of activity per day."

RELATED: Here's How to Stop Aging, Say Experts

Dr. Seema Bonney, the founder and medical director of the Anti-Aging & Longevity Center of Philadelphia says, "It's important to manage weight, blood pressure, cholesterol, and to engage in appropriate preventative screenings."

RELATED: If You Notice This on Your Body Have Your Heart Checked

"Maintaining a nutrient rich diet is critical as we age," says Dr. Bonney. "Food is medicine and thus properly fueling our bodies will provide energy, boost immunity, enrich bone, eye, and vascular health, reduce inflammation, help prevent chronic health conditions, and support weight management. It is never too late to make changes to your diet. Conversely, a diet high in sugars, unhealthy fats, processed and packaged foods contributes to poor health and can be a huge factor in the onset of chronic disease, cognitive decline, and inflammation."

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According to Dr. Bonney, "A sedentary lifestyle accelerates aging, age-related diseases and may diminish life expectancy. Exercise has been proven to help prevent heart disease and type 2 diabetes. Exercise boosts immunity, improves mood and more. Even light exercise such as walking, can be a powerful and preventative tool for disease management. There is a correlation between exercise and cognitive health. Regular moderate-intensity exercise can help improve your thinking and memory. It stimulates physiological changes such as reductions in insulin resistance and inflammation. Exercise also encourages production of growth factors, which affect the growth of new blood cells in the brain. Exercise can improve mood and sleep and thereby decrease stress and anxiety. We encourage our patients to get curious about their daily movement, track their steps, experiment with new types of exercise, and make it fun. This is a critical part of their longevity plan."6254a4d1642c605c54bf1cab17d50f1e

RELATED: If You Notice This on Your Body, Have Your Arms Checked

Dr. Bonney explains, "Social isolation can create a serious risk for future cognitive decline and emotional distress. In one study it was reported that 1/3 of adults over age 45 feel lonely and of adults over age 65 are socially isolated. This isolation may stem from living alone, loss of family/friends, loss of connection through retirement, chronic illness and more. The health risks associated with less social connection: less physical activity, increased risk of dementia, greater risk of heart disease, emotional distress such as depression and anxiety. Generally, people with healthy and supportive relationships live longer. People are generally happier, engaged and mentally sharper through meaningful interactions with others. We are social beings. Connection with family, friends, group, volunteer work, neighbors, church etc. We as physicians need to be sure to address social isolation as it can have a detrimental effect on overall health and wellbeing and certainly be a factor in disease and aging."

RELATED: How Long Do COVID Symptoms Last?

Dr. Bonney says, "Everyone ages differently and lifestyle plays a major role in the changes that one may experience. Many people will notice physical changes such as; skin fragility, achy joints particularly if inactive, slower metabolism, changes to your vision/hearing, and sex-related hormones decline, but sex can be better than ever with less distractions and more time. Emotionally people in their 60's tend to be happier, they are more resilient to stress, being more experienced. With age comes an improved ability to regulate emotions. The growth of new brain cells continues well into your 60's, however memory can start to fade. You can continue to improve brain health by getting regular mental stimulation, social interaction, and physical activity."

RELATED: I'm a Doctor and This is the #1 Sign You Have High Blood Sugar

"Your 60's are a big decade, many times involving transition from work to retirement, giving you more time to focus on you, your health, your family, your passions and travel," says Dr. Bonney. "Optimizing your health and creating a longevity plan prior to your 60's will serve as a foundation for a decade of experiences and freedom. Nutrition, social connection, physical activity, preventative medicine, sleep and stress management will pave the way for your 60's and beyond." And to protect your life and the lives of others, don't visit any of these 35 Places You're Most Likely to Catch COVID.

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Doing This After Age 60 is Unhealthy, Say Physicians Eat This Not That - Eat This, Not That

SAN FRANCISCO, March 24, 2022--(BUSINESS WIRE)--InterVenn Biosciences, a clinical technology company leveraging AI-powered glycoproteomics to transform the future of healthcare, today announced that James Almas, MD, has joined the companys Board of Advisors. Dr. Almas, who is VP & National Medical Director of Clinical Effectiveness at Laboratory Corporation of America Holding (Labcorp), is advising InterVenn on reimbursement strategy, health economics, coding, and other foundational activities required for commercialization of novel diagnostic tests for the clinical market.

Dr. Almas is a board-certified pathologist with years of experience in hospitals, independent laboratories, and Centers for Medicare & Medicaid Services (CMS). He recently served as Medical Director of the Molecular Diagnostic Services Program (MolDX) program at Palmetto GBA, one of the nation's largest providers of high-volume claims and transaction processing, contact center operations and technical services to the federal governments Medicare program. Dr. Almas oversaw coverage and reimbursement through the program for 28 states for Medicare.

Prior to that service, Dr. Almas was a medical officer in the Coverage and Analysis Group at CMS. At CMS, he was responsible for the National Coverage Determinations in the area of laboratories and was involved with the parallel review process (with the US Food and Drug Administration) for the Foundation Medicine application. Dr. Almas also previously served as the College of American Pathologists/American Medical Associations Current Procedural Terminology (CPT) - Advisor to the CPT Editorial Panel.

"Dr. Almas is an industry reimbursement expert with a long track record and extensive experience that will be extremely valuable to InterVenn and will and help to accelerate the preparation of the suite of innovative glycoproteomics-based tests we are bringing to market," said Aldo Carrascoso, CEO of InterVenn. "Were very pleased to have Dr. Almas join our prestigious Board of Advisors, as we gear up for the next phase of our commercialization efforts."

"Im excited to join InterVenns Board of Advisors and to have the opportunity to work with the companys leadership team to help advance its glycoproteomics solutions for clinical decision support across the treatment continuum," said Dr. Almas. "InterVenns tools and technologies have the potential to transform healthcare by earlier detection of disease, significantly better predictive capabilities, and reduction of costs for providers and payors."

Story continues

InterVenn has developed the worlds first technology platform to interrogate and decode the glycoproteome which will help accelerate the shift from the healthcare industrys traditional focus on disease management to the new realm of preventive care and health management. InterVenn is using its perspectIV platform to create a robust pipeline of accessible, clinically validated tests and diagnostic applications that are designed to provide novel, accurate insights to improve patient outcomes.

About InterVenn Biosciences

InterVenn Biosciences is a clinical technology company leveraging AI-powered software to unlock the value of glycoproteomics to develop transformational healthcare solutions. The glycoproteome is a source of life-critical information about human biology that has the potential to significantly improve patient outcomes, but which has remained inaccessible due to its vast complexity. InterVenn is pioneering a new AI-powered platform to decode and unlock the potential of the glycoproteome for the first time in history. To optimize this entirely new layer of biology, the company has developed a platform, leveraged directly or through collaborations with its partners, capable of producing a robust pipeline of powerful clinical applications, ranging from early disease screening, diagnostics and disease/therapy monitoig tools to the discovery of novel drug targets and therapeutics. InterVenn will ultimately transform the concept of personalized, predictive, and preventative care into a tangible, patient-centered reality. For more information, visit http://www.intervenn.com.

View source version on businesswire.com: https://www.businesswire.com/news/home/20220324005382/en/

Contacts

Anthony PetrucciBioscribeanthony@bioscribe.com 512-581-5442

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Veteran Healthcare Executive and Reimbursement Expert Joins InterVenn Biosciences Board of Advisors - Yahoo Finance

ARLINGTON HEIGHTS, Ill. March 21, 2022 (Newswire.com)

TheAmerican College of Osteopathic Family Physicians (ACOFP), theACOFP Education and Research Foundation and theAuxiliary to the ACOFP recognized 2022 award winners at the ACOFP 59th Annual Convention & Scientific Seminars, March 17-20.

ACOFP award recipients include:

In addition, ACOFP bestowed Master Preceptor Awards on:

Finally, as part of the OFP Editorial Awards, ACOFP recognized Adel Elnashar, OMS-IV, and Zachary Lodato, OMS-III, as Student Authors of the Year for their article, Adult Hearing Loss: Applying the Five Models of Osteopathic Medicine to Diagnose and Treat; Justin Chin, DO, who was awarded Resident Paper of the Year for Perceptions of the Osteopathic Profession in New York Citys Korean Communities; and Jack Italiano III, DO, RT (R), and Adam Bitterman, DO, FAAOS, who were awarded Attending Paper of the Year for Heel Pain With an Osteopathic Component.

The ACOFP Education & Research Foundation honored Ravin Patel, DO, with the Sander A. Kushner, DO, FACOFP Memorial Osteopathic Family Medicine Resident Award, as well as the Namey/Burnett Preventative Medicine Writing Award winners, which include:

The Auxiliary to the ACOFP recognized Lissie Arndt, PhD, OMS-IV, as the Marie Wiseman Outstanding Osteopathic Student of the Year. Kensley Grant, OMS-II; Evan Starr, OMS-II; and Mereze Visagie, OMS-II, received the Emerging Osteopathic Student Leader Awards. Fourteen other osteopathic medical students were honored with the Osteopathic Family Medicine Student Awards.

*****

About the American College of Osteopathic Family Physicians

Founded in 1950, the American College of Osteopathic Family Physicians (ACOFP) is a community of more than 18,000 current and future family physicians that champions osteopathic principles and supports its members by providing resources such as education, networking and advocacy, while putting patients first. ACOFP empowers its members with education and resources that allow them to adapt to new models of care and quickly changing government policy. For more information, visitwww.acofp.org.

About the ACOFP Education & Research Foundation

Founded in 1986, the ACOFP Education & Research Foundation promotes osteopathic family physician leadership, strives to improve public health and advocates for greater awareness of osteopathic family medicine principles and practices. Dedicated to furthering members goals and ensuring the future of tomorrows osteopathic leaders, the ACOFP Foundation achieves its objectives by identifying and securing funds from various sources.For more information, visitacofpfoundation.org.

About the Auxiliary to the ACOFP

Spouses and significant others of osteopathic physicians formed the Auxiliary to the ACOFP, promoting and supporting public health and educational activities in national and community health endeavors.For more information, visitacofp.org/auxiliary.

Press Release ServicebyNewswire.com

Original Source:American College of Osteopathic Family Physicians Honors Outstanding Members of the Profession

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American College of Osteopathic Family Physicians Honors Outstanding Members of the Profession - Digital Journal

The association of e-cigarettes, or vaping, with erectile dysfunction is another reason for urologists to advise their patients on quitting all types of tobacco use. But how can urologists get the message through to their patients when smoking is highly addictive, and oftentimes, patients misrepresent their true smoking status?

In this interview, Omar El Shahawy, MD, MPH, PhD, discusses patient counseling in regard to e-cigarette use or vaping by using data from a recent study on evaluating the association of e-cigarette use and erectile dysfunction.1 He stresses the importance of maintaining a non-judgmental outlook as a clinician and working with patients to set goals for ultimately reaching the goal of complete tobacco and nicotine cessation. Dr. El Shahawy is an assistant professor in the department of population health, and affiliated faculty in the division of global health at the New York University School of Global Public Health in New York City, New York.

My research focus is evaluating the risk and benefits of alternative tobacco products on health, in the context of smoking cessation and smoking harm reduction. While there is abundant evidence that smoking cigarettes impacts health overall, particularly with erectile dysfunction for adult men, there are [also] several [other] causes for erectile dysfunction, like cardiovascular disease, hypertension, [or] psychological distress. Tobacco use is a major cause for that as well, and there is evidence for adose response relationship. The more you smoke, then the more prone you are to experience or report having erectile dysfunction. Now with e-cigarette use being on the rise among adult smokers [who are] using it [to try] to reduce the harms of smoking or trying to quit, my co-authors and I tried to better understand whether there is a connection between e-cigarette use and erectile dysfunction. Particularly, this is important now because the e-cigarettes that are available in the market are quite efficient in delivering nicotine. Actually, some of the e-cigarettes available in the market deliver way higher nicotine than what's in combustible cigarettes at this point. So, we thought that it's imperative to try to understand what the impact of using e-cigarettes could be on a population level. And for that, we decided to do this study.

We decided to use a national dataset representing the whole United States, which is a very big strength for the study in comparison to using data from a clinical setting because it's subject to some biases. The notable finding [was] that using e-cigarettes on a daily basis posed a risk for erectile dysfunction. [Using e-cigarettes, but particualry on daily basis] was associated with more than doubling the risk of reporting erectile dysfunction. We did a lot of different types of analyses, looking at what we call sensitivity analysis in survey studies to [determine] whether there [were differences] by excluding people who've had cardiovascular disease, for example, from the sample, limiting only for patients under 65 and so forth. All different types of analysis [revealed] findings [that] were very robust, and the association was maintained throughout.

But something that was surprising is that the association with erectile dysfunction was not statically signfianct among current cigarette smokers in this study , but is was significant among former smoking. And there are several ways to look at that to really undertand the data with the known limitation of using a crossectional survey rather than a cohort design. Although this is [a] collective sample from the whole United States, you have people, for example, from states like New York or California where taxes are high and [the] frequency of smoking is low. In other settings, [maybe] that frequency per user is still high. We've looked at that, but we didn't find a particular association and there is limitations for how much we can probe to all this because of the sample sizeand the power you have with more combinations in the sample. Overall, a potential reason could be the advancements in our tobacco control efforts so far. People maybe smoking less than they used to per day, compared to 10 or 20 years ago. But there's also other possible explanations, like what we call the healthy smoker syndrome. People are more likely to quit smoking when they feel the detreimantal impact of smoking on their health in general. [daily vapiung then] could be also associated with erectile dysfunction [or] it could be the other causes that former smokers have experienced because of their smoking history or otherwise. So, that's why maybe we found that this association still exists among former smokers rather than current smokers.

A foundational component of my program of research and what we try to apply to grant funding is to try to contextualize the full risks and benefits of using e-cigarettes, whether it's for smoking harm reductions among populations where it's very hard to get them to quit, or to understand what the extent the harm would be. What kind of frequency of using e-cigarettes is relatively safe? Are there differences between types of e-cigarettes that you use and the way it can impact health? Is it just the nicotine or it could be other constituents of the E-liquid or the vape that people use that could cause bad effects on health? So, there are several plans to address some of these questions, but immediately, what we're already working on with other colluegues and [what] we're going to be submitting soon, [are] 2 papers. [One is] looking at [the] association of dual use of cigarette and e-cigarettes, which was people who maintain using cigarettes while vapingwith erectile dysfunction. [The other is looking at] the different patterns of tobacco use, like people who use one product versus multiple products, which is another proxy of frequent use of tobacco. We found significant associations in both of these studies, and we're probably going to be published in the next few months.

We should always screen for tobacco use, of course, and with that, I would say proper screening is something that needs to happen. It's not just by asking patients, "Do you smoke?" Even when you ask patients [this], some patients may perceive themselves [differently and answer] "No, I don't smoke. I just have a cigarette ocassioally and do not precieve themselves as smokers, or I just smoked last week, or something like that." So, it's good to standardize the way that we screen for that, and to also probe [about] other products. It's good to be very specific, and to ask, "Have you used any tobacco in the last 30 days?" If they say "no," probe with asking about e-cigarettes as well because a lot of people do not perceive e-cigarettes as a type of tobacco. From a regulatory perspective it is, but from the public's or the user's perspective, [they think,] "No, I'm not using tobacco; it's just e-cigarettes." It is always good to probe because e-cigarettes may be a less harmful option, for example, but it's not with no harm in the absolute sense. What we know is that e-cigarettes could be less harmful to the degree [that] it could substitute smoking for somebody who smokes. So, if you get one of your patients, for example, to switch to e-cigarettes because it's maybe less harmful than smoking cigarettes, it is really less harmful [to] the degree [that] this substitution happened. [It] doesn't mean that people could switch to e-cigarettes and just use [them] frequently because then this would present its own set of harms and detrimental effects [on] health with this frequent use. It should be basically used to get over the craving of smoking , which is how harm reduction works and then eventually it is best to stop every-tobacco at some point. So, I would say that the advice would be to probe [on] different types of tobacco and to try to advise anybody to completely quit all nicotine products eventually. Whether it is e-cigarettes or other products, the goal should be complete tobacco cessation.

I think the interaction between the patient and a physician [should not be] judgmental and be [more] from a supportive manner. [That] is really a key in getting patients to take that advice from physician [to] heart and [set goals]. So, when you apply the five A's, which [are] the framework for counseling for smoking cessation, for example, you first ask the patient very specifically whether they currently smoke any tobacco or smoked any tobacco in the past 30 days [and] probe to e-cigarettes as well. You should then move toward follow up activities, which is [when] you [advise] patients to quit [and] link this advice that you're going to give to the patient to their current health situation for example, or something that it important to them. So, if you have a patient that, for example, has erectile dysfunction, it is good to mention, "Well, this could be connected to your smoking, or this could be connected to your e-cigarette use." Explaining to [patients] how this could impact their health directly is something important for the patient to be able to have that 'ah-ha' moment. The most important thing is to do it in a non-judgmental manner, and to always bridge to be more of a goal setting with the patient. Smoking is very much a chronic disease, and there is a lot of relapse, so [it's important that we are] encouraging patients. For example, [we can ask] a simple question like, "How much do you want to quit smoking right now, on a scale from one to 10?" When a patient says, "3," which is quite low, [we] shouldn't be judgmental. Any number could be reflected upon in a positive way. [We can] say, "Okay, It's good that it's not a 2. So, how could [we] help you to make it a 5 or a 6? What would help you to try to quit next month or in the near future?" This sort of non-judgmental counseling with the patient, or advice, would usually motivate the patients eventually to try to quit and discuss their challenges openly with their doctors and encourage them if they relapse. On average, for a smoker to quit completely takes an average of 9 to 10 times of trying to quit. So, continuous support for the patient and goal setting is important.

Arranging follow up is the last point in the 5 A's. The goal setting for the patient is important. [We can] say, "When I see you in your follow-up visit the next 3 months, let's try to half [your use]. If you don't want to quit now, let's try to minimize the use or cut it by half." This supportive counseling [will have a] better impact in the long run [to get] patients to actually quit all tobacco and nicotine, rather than just giving very directive advice, and just [leaving] it at that. For the context of erectile dysfunction, in particular, there's something that we also highlighted [in this study]. Maybe it wasn't one of the big findings because it's something that's known, but it was very interesting to me to show impact of the protective factors against erectile dysfunction. We adjusted for other issues, like cardiovascular disease, hypertension, diabetes, [and] all that, in our analysis, but we also adjusted for physcial excersice frequency for example. And it was very interesting to me to see that physical exercise frequency on a weekly basis with all factors considered was incrementally and significantly protective against erectile dysfunction with increasing in frequency of physcial excersice. So, it's good to remind people to always be physically active. This is a protective factor, in general, against a lot of morbidity and disease.

I would say that [vaping] e-cigarettes is not risk free, but at the same time, we know that there is some angle of smoking harm reduction for it. So, if you have a patient that comes to you, and they've consistently tried to quit smoking cigarettes and they couldn't, and they asked about whether they [should] try e-cigarettes or not, that is a signal that they may be motivated or interested to try. Instead of say[ing], "Oh no, you should not try this. This is something that's you shouldn't do. Only use smoking cessation aids." If they've tried it before and failed, you could perhaps be more open to encourage them to try and see whatever may work. At the same time, give them clear advice to not use e-cigarettes excessively, and [emphasize that they're] using it only as a vehicle to try to quit eventually. [We can say], "If you do switch, then you shouldn't get stalled in this phase. You should try to eventually quit all nicotine and tobacco." This is more of a point that is very controversial, but so far, the evidence suggests that complete nicotine [or tobacco] cessation is the way to go of course. But if there is a phase where people could switch to a less harmful product as a way to eventually quit, that could be good advice that physicians could give at this point with the evidence that we know.

References

1. El-Shahawy O, Shah T, Obisesan OH, et al. Association of e-cigarettes with erectile dysfunction: The population assessment of tobacco and health study. Epub November 30, 2021. American Journal of Preventative Medicine. Doi: 10.1016/j.amepre.2021.08.004

See the rest here:
Patient counseling in regard to e-cigarettes and erectile dysfunction - Urology Times

Parental choice is a dominant theme in this years midterm elections, so some members of Congress have thrown their weight behind proposed new laws to stop school authorities from banning flavoured milk.

Republican congresswoman Elise Stefanik, an ally of former president Donald Trump, has introduced a bill that would require all schools participating in the National School Lunch Program to offer students at least one flavoured milk option or risk losing federal funding.

New York mayor Eric Adams.Credit:AP

Instead of taking away milk choices from students, my bill will give them better access to essential dairy nutrients critical for their development, Stefanik said in a statement. Let our New York students drink chocolate milk!

The lunch program provides low-cost or free lunches to about 30 million American children. Stefanik said her legislation, known as the Protecting School Milk Choices Act, would preserve the right of students to have chocolate milk while also protecting dairy farmers from future bans in New York, which is one of the largest dairy states in the nation.

Republicans dont have the majority in the House of Representatives, and therefore any bill put forward by the partys members would require Democrat support.

However, a bipartisan congressional group of New York politicians also wrote to Adams, urging the mayor to keep chocolate milk in New York school cafeterias and warning that for many NYC families, the meals children receive in schools are their only source of many recommended nutrients.

New York congresswoman Elise Stefanik.Credit:AP

While the congressional group argues, alongside Americas dairy industry, that low-fat flavoured milk increases school meal participation and gives children important nutrients, vegans and health professionals strongly disagree about the claimed benefits.

Cows milk is already high in natural sugar. In fact, it has 8 times more sugar than soy milk. So adding further sugar to give to children is completely irresponsible, given the epidemics of obesity and type 2 diabetes, said Josh Cullimore, the director of preventative medicine at the Physicians Committee for Responsible Medicine, which promotes a plant-based diet.

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Dairy products are also the No.1 source of saturated fat in the US diet, which is known to cause heart disease and Alzheimers disease.

Racial inequality further animates the debate because far more African Americans are lactose intolerant than white children.

Former Olympic cyclist Dotsie Bausch, co-founder of the anti-dairy lobby group Switch4Good, presented this argument to members of Congress during a trip to Washington last week when she lobbied for subsidised soy milk in schools. At present, students who do not want a dairy milk product as part of their lunch must have a note from their doctor or a parent.

The chocolate milk debate is only one of the politically heated disputes about parental rights in the lead up to the midterms.

The Florida legislature recently passed a Parental Rights Education Bill, which LGBTQ activists have dubbed the Dont Say Gay bill, as it would limit what some classrooms can teach about sexual orientation and gender identity.

And school libraries across the country have been forced to remove books about race and sexuality that some parents and conservative groups find too objectionable for students.

If New York City were to ban chocolate milk, it would follow in the footsteps of Washington and San Francisco. Los Angeles also banned chocolate milk about a decade ago but reversed the policy a few years later amid a public backlash.

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The latest item on Americas culture wars menu is ... chocolate milk - Sydney Morning Herald

In the last few years, the manufacturers have created novel aesthetic gadgets, resulting in a rise in demand for aesthetic treatments. In the next few years, technologically sophisticated goods such as non-invasive body sculpting devices that employ fat freezing technology, for example, are likely to generate profitable prospects. These innovations in the beauty industry are expected to propel the global aesthetic medicine market forward.

Read Report Overview https://www.transparencymarketresearch.com/aesthetic-medicine-market.html

The outbreak of global pandemic, COVID-19, had a huge impact on the aesthetic medicine business. At first, the market was adversely damaged by social distancing norms and a significant drop in consumer income. Due to reasons such as temporary closures of beauty salons, decreased product demand, and limited operations, the industry experienced a period of short-term negative growth.

On the other hand, remote working or work from home has increased the amount of time spent on Zoom calls. People are very concerned about their aesthetic appearance. This has resulted in a rise in cosmetic surgery demand, with Botox emerging as one of the most popular treatments. Cosmetic operations are also becoming more popular among patients due to the ease with which they may heal while staying at home. As a result, during the lockdown, the market for cosmetic medicine grew significantly resulting in increased demand in the global aesthetic medicine market.

In developing countries, there is a growing desire to seem youthful and fit, which has raised demand for cosmetic treatments. In nations like South Korea and India, cosmetic treatments including Botox injections, nose reshaping, and liposuction are gaining popularity.

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Aesthetic Medicine Market: Introduction

Aesthetics has been gaining importance in all aspects of everyday life in the last few years. It is a highly innovative branch of medicine. The aim of aesthetic medicine is to improve physical appearance and satisfaction of a patient by using minimally invasive or non-invasive procedures. Aesthetic medicine is recommended to healthy individuals who are dissatisfied with some minor deficiencies. Aesthetic medicine is also utilized to treat conditions such as eczema, allergies, and acne. Moreover, aesthetic treatment includes dermal fillers, microdermabrasion, venous treatment, body countering, cellulite treatment, and chemical peels.

Key Drivers, Restrains, and Opportunities of Global Aesthetic Medicine Market

Demand for cosmetic procedures across the world is increasing. It is estimated to further propel the aesthetic medicine market. Demand for various non-invasive or minimally invasive services such as laser resurfacing, aesthetic injectable, and other services is increasing alongside an increased consumer interest in skin texture and tone improvement.

Rise in awareness and demand for preventative procedures meant to offer anti-aging benefits of injectable products in early life is further anticipated to boost the aesthetic medicine market. Moreover, focus of market players on R&D investments is projected to lead to innovations in aesthetic medicines, thereby boost their demand. However, unfavorable reimbursement policies and the high cost of aesthetic procedures are estimated to hamper the market during the forecast period.

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The COVID-19 pandemic has significantly affected the aesthetic medicine industry. The COVID outbreak may have positive implications for the industry long-term regardless of causing reduced demand from primary end-users, limited operations, and closures of major end-user facilities. The market has witnessed the negative impact of COVID for the short-term due to widespread shutdowns, leading to significant challenges in manufacturing and the supply chain.

North America to Capture Major Share of Global Aesthetic Medicine Market

North America is anticipated to account for a major share of the global aesthetic medicine market during the forecast period owing to availability of advanced healthcare infrastructure, adoption of cosmetic procedures, and rising prevalence of skin disorders

The aesthetic medicine market in Asia Pacific is likely to expand at a rapid pace during the forecast period. This is attributed to rising consumer knowledge and increased interest in cosmetic procedures, rising medical tourism, and widened acceptance of aesthetic medicines.

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Key Players Operating in Global Aesthetic Medicine Market

The global aesthetic medicine market is highly fragmented, with the presence of large number of key players. These players hold major share in their respective regions.

Major players operating in the global aesthetic medicine market are listed below:

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Aesthetic Medicine Market to Witness Huge Growth by 2031 - Digital Journal

Before we enter the life stage of childbearing, we may never hear the word midwife. And, in many cases, we may not learn about what midwives offer, even when its relevant to our lives. What is a midwife and what does a midwife do, exactly?

A midwife is a trained health care provider that specializes in reproductive, maternity and newborn care, explains Director of Midwifery Services Karie Stewart, a Certified Nurse Midwife and Advanced Practice Nurse with the Department of Obstetrics and Gynecology with the University of Chicago Medicine.

Midwives can do all the things you might encounter during a routine gynecological visit, too. A midwife can provide physical exams, collect pap smears, administer well-woman care, catch babies, prescribe medication and provide referral services.

The training required to become a midwife varies from state to state, and there are a variety of types of midwives, including Certified Professional Midwives (CPM) and Certified Midwives (CM), which tend to focus on providing care in the home or a birth center, Stewart explains.

Certified Nurse Midwives (CNM) are advanced practice nurses and also have training as registered nurses. A new law passed in Illinois in 2021 allows professional midwives to be certified by the North American Registry of Midwives, licensed by the state after completing an accredited midwifery education program.

If youre seeking a patient-centered approach to your pregnancy and birth experience, you may consider a UChicago Medicine midwife. A midwifes patient-centered approach makes the patients voice, desires, wishes and experience the priority, Stewart says, adding that working with a midwife is truly a partnership in care during pregnancy, birth and after.

This approach encompasses developing a trusting relationship, includes shared decision making and establishing a hands-on approach that involves the patients partner, family, doula or labor and postpartum support team, she explains.

A key component of a UChicago Medicine midwifes approach is the support of the bodys own natural and intuitive process during labor, and providing judicious use of intervention only when appropriate. Midwives know how to support a natural labor and unmedicated birth, and they also know how to provide appropriate comfort techniques as needed and desired.

Whatever your circumstances, you may be looking to benefit from a warm, caring approach with a care provider who really understands you and your needs. A UChicago midwife can support you in your care, regardless of where you are in your childbearing and childrearing years. At UChicago Medicine, midwives are integral members of their OB/GYN care team, which means you can benefit from working with a midwife, in some cases, even if you have a medical condition that requires more specialized care.

Of course, this varies from patient to patient, but a midwife can even help you make decisions about when to involve more specialized care.

A midwife can be a huge asset to an OB/GYN practice, Stewart says. If a pregnant patient desires to have more individualized hands-on care, this can be provided within such a setting. If a midwife patient has a medical condition that requires collaboration with a physician, pregnant patients can still continue their midwifery care and experience depending on their condition. This allows for prenatal care via an interdisciplinary team.

Its comforting to know that you can continue a warm, caring relationship beyond having your baby, or even if you havent had a baby but want the patient-centered attention of a midwife for routine gynecological visits even when things arent always routine.

A midwife can play a very instrumental part in a womans gynecological care. A midwife is trained to educate, diagnose, manage and treat many normal and abnormal gynecological conditions, says Stewart. For example, midwives can collect pap smears, obtain vaginal specimens for biopsies, cultures for the treatment of infections, perform preventative care exams, prescribe medications and refer women for more specialized gynecological care.

As midwifery care continues to be part of the many options you have available for prenatal care, Stewart says she hopes that the profession can become more diverse.

While patients seek a provider who listens, advocates, is inclusive and practices patient-centered care, Stewart says that the diversification of the midwifery profession is necessary for patients to have the option to choose a midwife that they can relate to and that identifies with them.

Stewart adds, Many pregnant patients are having a hard time finding midwives they can identify with and have been requesting this for some time now.

Learn about UChicago Medicine and Comer Childrens unique approach to the care of women and children. Discover uchicagomedicine.org.

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What Is a Midwife? You Might Be Surprised by All They Do - Chicago Parent

REYNOLDSBURGWarm memories from his childhood on a farm have led Dr. Dennis Summers to the highest animal welfare position in the Ohio Department of Agriculture.

Summers was named Chief of the Division of Animal Health at ODA in December.

He was born and raised in Dresden,and spent his pre-teen years on his parents'600-acre cattle farm. As he approached his teen years, his parents moved. His father took a job with AEP in Conesvilleto spend more time with his children.

"I kind of got out of being around animals," he said, following the move. Summers and his future wife Angela Liggettgraduated from Tri-Valley High School in 1996, and Summers went off to The Ohio State University.

"I started out in the engineering program at Ohio State in 1996," he said. "I spent about two years in the program and realized it wasn't the right fit for me."

Thinking back to the happy memories of his childhood, he asked himself how to get back into agriculture. "I explored being a vet."

Unlike many who pursue the profession, Summers said he hadn't always wanted to be a vet, "but I was always fundamentally connected to it," he said of his early years on the family farm.

Late in his sophomore year he moved into the animal science program, and graduated two years later with abachelor ofscience inagriculture.

He applied to the highly competitive vet program at Ohio State, and started the program in 2002.

"I wanted to do what I saw the vets do when I was little," Summers said. "I went through all of vet school preparing myself to do large animal medicine."

While he was in school, he developed a particular interest in dairy work. "I was really attracted to dairy science, and dairy production medicine."

After graduation in 2006, Summers spent time in Vermont and Pennsylvania, doing a lot of work in dairiesbut also working with other barnyard animals. He even worked with more exotic species, like white-tail deer and elk.

In 2019, Summers decided he wanted to take the next step in his career to become board certified as a specialist. He spent a year studying before passing the two-day exam, and became a board-certified preventative medicine specialist through the American College of Veterinary Preventive Medicine.

The certification is focused on public health, such assafety and preventing zoonotic diseases, whichcan jump from animals to humans. "It is my job to think of things producers, the public and consumers can do to prevent themselves from getting sick. Our job is to understand the diseases livestock can carry that can make humans sick, and target preventative measures." He and his staff monitor diseases locally, across the country and across the world.

Using avian influenza as an example, Summers said his job would be to keep the keep poultry industry running and protect it from diseases. If there was an outbreak, "my job is to get rid of that disease, and help train producers to be proactive against transmission.

"If it does come here, my job is to get them through that event, and get those businesses back up and operating so we can get those products back out to the consumers."

Summers now oversees a large staff of inspectors, veterinarians and a diagnostic lab.

"Ohio has a national impact, agriculture is a billion-dollar industry," in the state, Summer said. "It is a huge poultry state, a huge hog producing state and a huge dairy producing state. There is a very strong beef economy, a very strong sheep and goat economy. Ohio is a big player nationally.

"There is a lot of energy and excitement with this position," Summers said. Having worked at ODA for seven years has helped him understand how the department interacts with the industries its works with.

"I love the people I work with and I love the industries we work with."

ccrook@gannett.com

740-868-3708

Social media:@crookphoto

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Dennis Summers' career takes him back to the farm - Zanesville Times Recorder