Propecia cost

In India alone, propecia cost 75 million people fell below the poverty line in 2020 https://www.kraenzle.com/brand-name-propecia-online/. Globally, hundreds of millions who depend for their survival and livelihoods on the long-distance trade and exchange of goods and services were badly hit. Similar, albeit less extreme, dislocations also appeared during the 2008 financial crisis, when commodity speculation, along with the diversion of food grains to biofuel production, precipitated a steep rise in global grain prices, leading to hunger and food riots in many countries that depended on imported food. Threats to survival also propecia cost emerge when war or other dislocations stop the movement of goods. In such crises, communities fare better if they have local markets and services and can provide their own food, energy and water while taking care of the less fortunate.

Moligeri Chandramma manages the DDS seed bank (top). It contains more propecia cost than 70 species and varieties of crops. People gathered (bottom) in 2005 to mark 20 years of sustained protests against dam construction on the Narmada River. Credit. Ashish Kothari The value of these alternative ways of living goes far beyond their propecia cost resilience during relatively short-term upheavals like the propecia, however.

As a researcher and environmental activist based in a “developing” country, I have long advocated that the worldviews of peoples who live close to nature be incorporated into global strategies for wildlife protection, such as at the International Union for Conservation of Nature and the United Nations' Convention on Biological Diversity. And in recent decades I have come to agree with critics of globalization such as social scientist and environmentalist Wolfgang Sachs that fending off calamities like biodiversity collapse will require not only environmental adaptations but also radical changes to the dominant economic, social and even political paradigms. In 2014 a few of us in India initiated a process to explore propecia cost pathways to a world in which people are at peace with one another and with nature. Five years later (and fortuitously, just before the propecia hit), the endeavor grew into an international online network we called the Global Tapestry of Alternatives. These conversations and other research indicate that viable options, no matter where they are, tend to be based on self-reliance and solidarity.

Such values are at odds with globalization, which delivers to denizens of the Global North (the better off, no matter where we live) many things that propecia cost we have come to regard as essential. In contrast to the promise of ever increasing material wealth that underpins our civilization, peoples who live near or beyond its margins have a multitude of visions for living well, each tailored to the specifics of their ecosystems and cultures. To walk away from the cliff edge of irreversible destabilization of the biosphere, I believe we must enable alternative structures, such as those of the Dalit farmers, the Quechua conservers and the Lisbon volunteers, to flourish and link up into a tapestry that ultimately covers the globe. An Enlightening Journey Growing up in India, where lifestyles propecia cost that are intimately entwined with the natural environment survive in large pockets, unquestionably influenced my ideas of what constitutes true sustainability. In the 1970s, as a high school student who loved bird-watching in forests around Delhi, I joined classmates to demonstrate outside the Saudi Arabian embassy when some princes arrived in the country to hunt the (now critically endangered) Great Indian Bustard.

Our protest, along with that of the Bishnoi community in Rajasthan, which traditionally protects these birds and other wildlife, embarrassed the Indian government into requesting that the hunters go home. Many of us went on to campaign for protection of the Delhi Ridge Forest, one of the world's biggest urban jungles propecia cost. In 1979 we formed an environmental group to systematize our efforts. We called it Kalpavriksh, after a mythical tree that makes wishes come true. The name propecia cost symbolized our growing awareness that nature gives us everything.

Our activism would teach us at least as much as we learned in school and college. While investigating the sources of Delhi's air pollution, for instance, we interviewed villagers who lived around a coal-fired power plant just outside the city. They turned out to be far worse affected by its propecia cost dust and pollution than we city dwellers were—although they got none of its electricity. The benefits of the project flowed mainly to those who were already better off, whereas the disempowered experienced most of the harms. In late 1980 we traveled to the western Himalayans to meet the protagonists of the iconic Chipko movement.

Since 1973 village women had been protecting trees slated for propecia cost logging by the forest department or by companies based in the Indian plains with their bodies. The deodars being felled, as well as the oaks, rhododendrons, and other species, were sacred, the women told us, as well as being essential for their survival. They provided cattle fodder, fertilizer and wild foods and sustained their water sources. Even as an urban student, I could see the central role that rural women played in protecting the environment—as well as the injustice of distant bureaucrats making decisions with little concern for how they propecia cost impacted those on the ground. Parque de la Papa (top) in Peru is one of the original homelands of the potato.

The Quechua Indigenous people (middle) govern the region as a “biocultural heritage” territory, conserving a remarkable diversity of potatoes (bottom). Credit. Ashish Kothari Soon after, my friends and I learned that 30 major dams were to be constructed on the Narmada River basin in central India. Millions worshipped the Narmada as a tempestuous but bountiful goddess—so pristine that the Ganga is believed to visit her every year to wash away her sins. Trekking, boating and riding buses along its length of 1,300 kilometers, we were dazzled by waterfalls plunging into spectacular gorges, densely forested slopes teeming with wildlife, fields of diverse crops, thriving villages and ancient temples, all of which would be drowned.

We began to question the concept of development itself. Surely the destruction would far outweigh any possible benefits?. Almost four decades later our fears have proved tragically true. Hundreds of thousands of displaced people still await proper rehabilitation, and the river downstream of the dams has become a trickle—enabling seawater to reach 100 kilometers inland. Over the years I came to understand how powerful economic forces reach around the globe to intimately link social injustice with ecological destruction.

The era of colonization and slavery vastly expanded the economic and military reach of some nation-states and their allied corporations, enabling the worldwide extraction of natural resources and exploitation of labor to feed the emerging industrial revolution in Europe and North America. Economic historians, anthropologists and others have demonstrated how this painful history laid the foundation of today's global economy. Apart from driving irreversible ecological damage, this economic system robs many communities of access to the commons—to rivers, meadows and forests essential for their survival—while creating a dependence on external markets. The massive suffering during the propecia has merely exposed these historical and contemporary fault lines. During my wanderings over the decades and especially while researching a book with economist Aseem Shrivastava, I became aware of a far more hopeful trend.

Across the country and indeed around the world, hundreds of social movements are empowering the marginalized to wrest back control over their lives and livelihoods. In 2014 Kalpavriksh initiated a series of gatherings called Vikalp Sangam, or Confluence of Alternatives, where the drivers of these spirited efforts could come together, share ideas and experiences, and collaborate, helping to build a critical mass for change. These interactions and eclectic reading gave me insights into a vital question I was investigating. What are the essential characteristics of desirable and viable alternatives?. Happily, I was far from alone in this quest.

At a degrowth conference in Leipzig in 2014, I was excited to hear Alberto Acosta, an economist and former politician from Ecuador, speaking on buen vivir, an Indigenous worldview founded on living well with one another and with the rest of nature. Although Acosta spoke no English and I spoke no Spanish, we tried excitedly to converse. Subsequently, degrowth expert Federico Demario joined us and helped to translate. We decided to work on a compilation of thriving alternatives from around the world—jotting down 20 possible ideas on the back of an envelope. Later we roped in development critic Arturo Escobar and ecofeminist Ariel Salleh as co-editors of a volume we called Pluriverse.

The number of entries expanded to more than 100. Commonalities Though dazzlingly diverse, the alternatives emerging worldwide share certain core principles. The most important is sustaining or reviving community governance of the commons—of land, ecosystems, seeds, water and knowledge. In 12th-century England, powerful people began fencing off, or “enclosing,” fields, meadows, forests and streams that had hitherto been used by all. Enclosures by landlords and industrialists expanded to Europe and accelerated with the industrial revolution, forcing tens of millions of dispossessed people to either become factory workers or emigrate to the New World, devastating native populations.

Imperial nations seized large portions of continents and reconfigured the economies of the colonies, extracting raw materials for factories, capturing markets for exports of manufactured goods and obtaining foods such as wheat, sugar and tea for the newly created working class. In this way, colonizers and their allies established a system of perpetual economic domination that generated the Global North and the Global South (the world of the marginalized, no matter where they live). The wave of anticolonial movements in the first few decades of the 20th century, many of them successful, sparked fears that supplies of raw materials for industries and markets for finished goods of higher value would dry up. President Harry S. Truman responded by launching a program for alleviating poverty in what he described as “underdeveloped areas” with their “primitive and stagnant” economies.

As detailed by ecologist Debal Deb, newly formed financial institutions controlled by the rich countries helped the ex-colonies “develop” along the path blazed by the West, providing the materials and energy sources for and creating markets for cars, refrigerators and other consumer goods. An integral aspect of development, as thus conceived, propagated and usually enforced by stringent conditions attached to loans from the World Bank and the International Monetary Fund, has been privatization or state confiscation of the commons to extract metals, oil and water. Credit. Federica Fragapane. Source.

€œAlternatives Transformation Format. A Process for Self-Assessment and Facilitation towards Radical Change,” prepared by Kalpavriksh for ACKnowl-EJ (chart reference) As Elinor Ostrom, winner of the 2009 Nobel Memorial Prize in Economic Sciences, demonstrated, however, the commons are far more sustainably governed by the communities from which they are wrested than by the governments or corporations that claim them. This awareness has given rise to innumerable grassroots efforts to protect the surviving commons and reestablish control over others. What constitutes the commons has also expanded to include “physical and knowledge resources that we all share for everyone's benefit,” explains sociologist Ana Margarida Esteves, who helps with the European Commons Assembly, an umbrella organization for hundreds of such endeavors. Many of the efforts resemble the DDS and the Parque de la Papa in using community governance of commonly held resources to enhance agroecology (smallholder farming that sustains soil, water and biodiversity) and food sovereignty (control over all means of food production, including land, soil, seeds and the knowledge of how to use them).

The food-sovereignty movement La Via Campesina, which originated in Brazil in 1993, now includes about 200 million farmers in 81 countries. Such attempts at self-reliance and community governance extend also to other basic needs, such as for energy and water. In Costa Rica, Spain and Italy, rural cooperatives have been generating electricity locally and controlling its distribution since the 1990s. And hundreds of villages in western India have moved toward “water democracy,” based on decentralized harvesting of water and community management of wetlands and groundwater. Mobilizing people to sustain, build or rebuild local systems of knowledge is essential to such ventures.

Secure rights to govern the commons are also important. In the Ecuadorian Amazon, the Sapara Indigenous people fought hard to gain collective rights over their rain-forest home. They are now defending it against oil and mining interests while developing a model of economic well-being that blends their traditional cosmovisions—ways of knowing, being and doing that are physically and spiritually linked to their environs—with new activities such as community-led ecotourism. Their income from tourism has dropped during the propecia, but their forests and community ethic give them almost all the food, water, energy, housing, medicines, enjoyment, health and learning that they need. They are now offering online sessions on their cosmovisions, dream analysis and healing.

I participated in such sessions in person in their Naku ecotourism camp in 2019. The virtual version is not as immersive but nonetheless represents an innovative adaptation to the circumstances. Greening cities or making them more welcoming, as the Lisbon social centers do, also requires community-based governance and economies of caring and sharing. Across the Global South, development projects have driven hundreds of millions of people to cities, where they live in slums and work in hazardous conditions. Wealthy city dwellers could do their part by consuming less, which would reduce the extraction and waste dumping that displace people in faraway places.

A spectrum of avenues toward more equitable and sustainable cities has emerged. These include, for example, the Transition Movement, which is attempting to regenerate the commons and make European cities carbon-neutral, and the municipalism movement, which is creating a network of Fearless Cities, among them Barcelona, Valparaiso, Madrid and Athens, to provide secure environments for refugees and migrants. Urban agriculture in Havana supplies more than half of its fresh food requirements and has inspired many other city farming initiatives around the world. Five Petals These initiatives point to the need for fundamental transformations in five interconnected realms. In the economic sphere, we need to get away from the development paradigm—including the notion that economic growth, as measured by gross domestic product (GDP), is the best means of achieving human goals.

In its place, we need systems for respecting ecological limits, emphasizing well-being in all its dimensions and localizing exchanges to enable self-reliance—as well as good measures of these indicators. Bhutan has long experimented with gross national happiness as an index. The idea has spawned variants, such as New Zealand's recent focus on mental health and other such measures of progress. We also need freedom from centralized monetary and financial control. Many experiments in alternative currencies and economies based on trust and local exchanges are underway.

Perhaps the most innovative of these is “time banking,” a system for swapping services founded on the principle that all skills or occupations merit equal respect. One can, for example, give a one-hour-long yoga lesson for credit that can be redeemed for an hour's work on bicycle repair. In many parts of the world, workers are seeking to control the means of production. Land, nature, knowledge and tools. A few years back I visited Vio.Me, a detergent factory in Thessaloniki, Greece, which workers had taken over and converted from chemical to olive-oil-based and eco-friendly production, and where they had established complete parity in pay, regardless of what job the worker was doing.

The slogan on their wall proclaimed. €œWe have no boss!. € Workers such as Dimitris Koumatsioulis (top) collectively run Vio.Me, an eco-friendly detergent factory in Thessaloniki, Greece. In Prague, Czech Republic, people buy and sell locally (bottom) at a farmers' and producers' market. Credit.

Ashish Kothari In fact, work itself is being redefined. Globalized modernity has created a chasm between work and leisure—which is why we wait desperately for the weekend!. Many movements seek to bridge this gap, enabling greater enjoyment, creativity and satisfaction. In industrial countries, people are bringing back manual ways of making clothes, footwear or processed foods under banners such as “The future is handmade!. € In western India, many young people are leaving soul-killing routines in factories to return to handloom weaving, which allows them to control their schedules while providing a creative outlet.

In the political sphere, the centralization of power inherent in the nation-state, whether democratic or authoritarian, disempowers many peoples. The Sapara nation in Ecuador and the Adivasis of central India argue for a more direct democracy, where power resides primarily with the community. The state—insofar as it continues to exist—would then mainly help with larger-scale coordination while being strictly accountable to decision-making units on the ground. The ancient Indian notion of swaraj, literally translated as “self-rule,” is particularly relevant here. It emphasizes individual and collective autonomy and freedom that are linked to responsibility for others' autonomy and freedom.

A community that practices swaraj may not dam a stream, for example, if that threatens the water supply of downstream villages. Its well-being cannot compromise that of others. Such a notion of democracy also challenges the boundaries of nation-states, many of which are products of colonial history and have ruptured ecologically and culturally contiguous areas. The Kurdish people, for instance, are split among Turkey, Iran, Iraq and Syria. For three decades they have struggled to achieve autonomy and direct democracy based on principles of ecological sustainability and women's liberation—and without borders dividing them.

And Indigenous groups in Mexico collectively identifying as Zapatistas have for more than three decades asserted and sustained an autonomous region based on similar principles. Moving toward such radical democracy would suggest a world with far fewer borders, weaving tens of thousands of relatively autonomous and self-reliant communities into a tapestry of alternatives. These societies would connect with one another through “horizontal” networks of equitable and respectful exchange, as well as through “vertical” but downwardly accountable institutions that manage processes and activities across the landscape. Several experiments in bioregionalism at large scales are underway, although most remain somewhat top-down in their governance. In Australia, the Great Eastern Ranges Initiative seeks to coordinate the conservation of ecosystems across 3,600 kilometers while sustaining livelihoods and community health.

And a project spanning six countries in the Andes aims to conserve as a World Heritage Site the Qhapaq an, a 30,000-kilometer network of roads built by the Inca Empire, along with its related cultural, historical and environmental heritage. Local self-governance may, of course, be oppressive or exclusionary. The intensely patriarchal and casteist traditional village councils in many parts of India and the xenophobic antirefugee approaches of the right wing in Europe illustrate this drawback. A third crucial sphere of transformation is therefore social justice, encompassing struggles against racism, casteism, patriarchy, and other traditional or modern forms of discrimination and exploitation. Fortunately, success in defying the dominant economic system often goes hand in hand with victories against discrimination, such as Dalit women farmers' shaking off centuries of caste and patriarchal oppression to achieve food sovereignty.

Political autonomy and economic self-reliance need not mean isolationism and xenophobia. Rather cultural and material exchanges that maintain local self-reliance and respect ecological sustainability would replace present-day globalization—which perversely allows goods and finances to flow freely but stops desperate humans at borders. This kind of localization would be open to people in need. Refugees from climate change or war would be welcomed, as in the network of Fearless Cities in Europe. Both grounded practice and shifts in policy could help transit toward such a system.

Necessary, of course, are attempts to rebuild societies in regions of strife so that people do not have to flee from them. Radical change also necessitates transformations in a fourth sphere. That of culture and knowledge. Globalization devalues languages, cultures and knowledge systems that do not adapt to development. Several movements are confronting this homogenizing tendency.

The Sapara nation is trying to resuscitate its almost extinct language and preserve its knowledge of the forest by bringing these into the curriculum of the local school, for instance. Many communities are “decolonizing” maps, putting back their own place names and defying political borders. Even the colonial-era Mercator projection used to generate the familiar world map is being upended. (Only recently did I realize that Africa is large enough to contain Europe, China, the U.S. And India put together.) Increasingly, traditional and modern sciences are collaborating to help solve humankind's most vexing problems.

The Arctic Biodiversity Assessment, for example, involves cooperation among Indigenous peoples and university scientists to tackle climate change. One problem is that present-day educational institutions train graduates who are equipped to serve and perpetuate the dominant economic system. People are bringing community and nature back into spaces of learning, however. These efforts include Forest Schools in many parts of Europe that provide children with hands-on learning in the midst of nature, the Zapatista autonomous schools that teach about diverse cultures and struggles, and the Ecoversities Alliance of centers of higher learning around the world that enable scholars to seek knowledge across the boundaries that typically separate academic disciplines. The most important sphere of transformation, however, is the ecological—recognizing that we are part of nature and that other species are worthy of respect in their own right.

Across the Global South, communities are leading efforts to regenerate degraded ecosystems and wildlife populations and conserve biodiversity. Tens of thousands of “territories of life” are being governed by Indigenous or other local communities, for example. These include locally managed marine areas in the South Pacific, Indigenous territories in Latin America and Australia, community forests in South Asia, and the Ancestral Domain territories in the Philippines. Also noteworthy is recent legislation or court judgments in several countries asserting that rivers, for example, enjoy the same protections as people. The United Nations' 2009 Declaration on Harmony with Nature is an important milestone toward such a goal.

Values I am often asked how one scales up successful alternatives. It would be self-defeating, however, to try to either scale up or replicate a DDS or a Parque de la Papa. The essence of this approach is diversity. The recognition that every situation is different. What people can do—and this, indeed, is how successful initiatives spread—is understand the underlying values and apply these in their own communities while networking with like ventures to spread the impact.

The Vikalp Sangam process has identified the following values as crucial. Solidarity, dignity, interconnectedness, rights and responsibilities, diversity, autonomy and freedom, self-reliance and self-determination, simplicity, nonviolence and respect for all life. Around the world both ancient and modern worldviews that are focused on life articulate similar principles. Indigenous peoples and other local communities have lived by worldviews such as buen vivir, swaraj, ubuntu (an African philosophy that sees the well-being of all living things as interconnected) and many other such ethical systems for centuries and are reasserting them. Simultaneously, approaches such as degrowth and ecofeminism have emerged from within industrial societies, seeding powerful countercultures.

At the heart of these worldviews lies a simple principle. That we are all holders of power. That in the exercise of this power, we not only assert our own autonomy and freedom but also are responsible for ensuring the autonomy of others. Such a swaraj merges with ecological sustainability to create an eco-swaraj, encompassing respect for all life. Clearly, such fundamental transformations face a deeply entrenched status quo that retaliates violently wherever it perceives a threat.

Hundreds of environmental defenders are murdered every year. Another serious challenge is the unfamiliarity many people in the Global North have with ideals of a good life beyond the American dream. Even so, the fact that many progressive initiatives are thriving and new ones are sprouting suggests that a combination of resistance and constructive alternatives does stand a chance. The hair loss treatment propecia is a catastrophe that presents humankind with a choice. Will we head right back toward some semblance of the old normal, or will we adopt new pathways out of global ecological and social crises?.

To maximize the likelihood of the latter, we need to go well beyond the Green New Deal approaches in the U.S., Europe, and elsewhere. Their intense focus on the climate crisis and worker rights is valuable, but we also need to challenge unsustainable consumption patterns, glaring inequalities and the need for centralized nation-states. Truly life-sustaining recoveries would emphasize all the spheres of eco-swaraj, arrived at via four pathways. One is the creation or revival of dignified, secure and self-reliant livelihoods for two billion people based on collective governance of natural resources and small-scale production processes such as farming, fisheries, crafts, manufacturing and services. Another is a program for regeneration and conservation of ecosystems, led by Indigenous peoples and local communities.

A third is immediate public investments in health, education, transportation, housing, energy and other basic needs, planned and delivered by local democratic governance. Finally, incentives and disincentives to make production and consumption patterns sustainable are crucial. These approaches would integrate sustainability, equality and diversity, giving everyone, especially the most marginalized, a voice. A proposal for a million climate jobs in South Africa is of this nature, as is a feminist recovery plan for Hawaii and several other proposals for social justice in other countries. None of this will be easy, but I believe it is essential if we are to make peace with Earth and among ourselves.NEW YORK HARBOR—It’s an odd scene in New York Harbor.

On the banks of tree-lined Governors Island, a small group has gathered to watch a tiny gray boat anchor itself in the water. Two figures lean over the side of the vessel, their red life vests standing out against the slate waves. Each clutches several rust-colored mesh sacks, dangling just above the surface of the water. €œOne ... Two ...

Three!. € With that, they drop the bags and watch them sink into the murky depths. Each sack is filled with dozens of live oysters. Ten feet below the little boat, they settle into their home at the bottom of the harbor. An artificial reef, made of steel and wire structures resting on mounds of rock and shell.

A few moments later, a pair of divers in fins and masks slip into the water and position the sacks around the wire “oyster condos.” Then they leave the shellfish to the joys of city living under the sea. By the time the biodegradable sacks dissolve, typically within a month or so, the oysters should be slowly growing together in neighborly clusters beneath the waves. This latest deposit—about 5,000 oysters in total—is part of a special program known as SOAR, or Supporting Oyster Aquaculture and Restoration, a partnership between the Nature Conservancy and the Pew Charitable Trusts. Born out of the hair loss propecia, the program began as a way to prevent farmed oysters from going to waste while restaurants were still shut down. SOAR purchases oysters from farmers who would otherwise be unable to sell them, then partners with local oyster restoration projects to return the shellfish to their natural habitats.

That has built-in benefits for coastal ecosystems. Oyster reefs help clean and filter the water, provide natural habitat for fish, and buffer coastlines against the erosion caused by wave action and sea-level rise. SOAR’s New York partner is a program known as the Billion Oyster Project. Founded in 2014 by Murray Fisher and Pete Malinowski, it aims to restore 1 billion oysters to New York Harbor over the next 15 years. So far, it’s installed 14 reefs across the city.

This recent batch is likely the last bunch of oysters to be planted in New York City through the SOAR project—at least for the time being. With the hair loss treatment rollout in full swing, the city has largely reopened, and restaurants have resumed serving shellfish. But the program will likely continue in other forms, according to Jennifer Browning, director of Pew’s U.S. Oceans program. SOAR is working to establish a permanent market, providing funding for oyster restoration projects to purchase otherwise “unsellable” oysters from farmers.

Even without the pressure of the propecia, “anywhere from 15 to 20% of all the oysters grown by oyster farmers can’t be sold to restaurants—they’re too big or ugly or flat,” Browning told E&E News. €œBut if those oyster growers knew that that 20%, they could sell that, that’s a huge benefit to them—and a huge benefit to the oyster restoration community.” A global decline New York Harbor was once an oyster capital of the country. €œBack in the day, here in New York City, oysters were sold on street corners like pretzels are today,” said Rob Jones, global lead for the Nature Conservancy’s aquaculture program. But over the last century, they’ve largely disappeared. In New York, that’s mainly because of pollution.

As the city grew and developed, more and more sewage was diverted into the harbor. Eventually, it became unsafe to harvest oysters, and the industry shuttered. In years since, “there are a lot of other reasons why oysters didn’t continue to thrive," said Katie Mosher, the Billion Oyster Project’s director of programs. Dredging, used to deepen and expand the harbor, killed many of them off. Disease and poor water quality played a role, too.

It’s not a problem that’s unique to New York. Oyster populations have plummeted up and down U.S. Coastlines and elsewhere around the globe. They were decimated by overharvesting, pollution, disease and habitat destruction. In a 2011 study published in BioScience, experts estimated that about 85% of the world’s oyster reefs have vanished over the last century.

Today, scientists and environmentalists are working to bring them back. The ecosystem benefits are clear, Jones said. Oysters provide a natural cleaning service, filtering toxins out of the water. And their clustered reefs become natural homes for fish and other marine animals, just as coral reefs do in the tropics. Like coral reefs, they also protect coastlines from erosion, breaking up waves before they hit the shore.

It’s an increasingly attractive service as climate change warms the planet. Sea-level rise is a growing threat to coastal communities worldwide, eroding shorelines and worsening floods. At the same time, global warming is making hurricanes more intense. That increases the odds of extreme storm surge and major damage to the coast. With their coastlines flooding and their beaches steadily washing away, coastal communities are making increasingly costly investments in shoreline protections.

Multibillion-dollar interventions, including building sea walls and diverting major rivers, have recently been proposed, in places such as Louisiana, South Carolina and New York. At the same time, there’s a growing push in some coastal communities for cheaper, more sustainable interventions. €œLiving shorelines” offer one alternative. These are naturally cultivated coastal buffers, made up of sand, rock, marshlands and vegetation—and, sometimes, oyster reefs. The combination of these natural protections, when put together, tends to make the biggest difference, said Antonio Rodriguez, an expert on coastal geology at the University of North Carolina.

In the Southeast, for instance, where beaches are often soft and easily eroded, “the iconic configuration would be to have upland, which is a forest, and then salt marsh, and then oyster reefs,” he said. Where natural oyster reefs have largely disappeared, experts say putting them back may help restore some natural protection. And case studies on rapidly eroding shorelines—for instance, in Alabama and Bangladesh—have shown that it can actually work. It’s not a new idea—communities up and down the coasts have been experimenting with oyster restoration and living shorelines for decades. But the concept has gained attention in recent years with the growing threat of climate change and sea-level rise.

Living shoreline projects have cropped up everywhere from the Chesapeake Bay to Alabama’s Gulf shore. Meanwhile, organizations like Pew and the Nature Conservancy are working to expand local restoration projects. €œWe are working with states—New York, New Jersey, but also in the Gulf in Mississippi and Louisiana—to help them develop oyster restoration plans,” Browning said. €œWe do the research—where could you put oyster farmers, where would oyster restoration occur—so that every state has sort of a long-term plan for rebuilding their oyster population.” Restoration and climate change The question now is whether oysters themselves will be able to adapt to the impacts of climate change. There’s evidence that they can, according to Rodriguez.

There are two different types of oyster reefs, adapted to different kinds of conditions. Subtidal oysters stay permanently submerged beneath the water. Intertidal oysters, on the other hand, grow closer to the shore, where the tide ebbs and flows. They’re sometimes submerged and sometimes exposed. There’s a sweet spot for these intertidal oysters, research has found.

Too much water or too much air can destroy them. Intertidal oyster reefs may have slightly more value as coastal protections, Rodriguez noted. They’re more common in the South, where shorelines tend to be softer and more vulnerable to erosion. They also grow closer to the shore, meaning they may be better at breaking up waves. As sea levels rise, there’s the potential that they could be permanently submerged.

But Rodriguez says there’s evidence that oysters can adapt. One of his own studies, published in 2014 in Nature Climate Change, found that oyster reefs in the Mid-Atlantic may grow faster than scientists previously believed. That means they may be able to keep pace with the rate of sea-level rise and build up before the rising ocean can drown them. Still, Rodriguez cautioned that oyster reefs shouldn’t be considered a silver bullet for coastal climate concerns. While studies show that reef restoration can make a difference, it depends on how long the reefs actually last.

Rodriguez says he’s seen new reefs thrive in their first year or so, only to collapse later as predators move in. Long-term monitoring is key in these cases, he said. But restoration studies are often funded for only a few years. €œBefore we jump into multimillion-dollar projects, we need to start slowly and do some test projects before we scale up,” he suggested. €œLots of investments are made in oyster restoration, and it’s monitored for a year after, and it usually shows that they’re doing really well.

If you go back five years from now, are they still doing well?. € Restoration projects must also choose their sites carefully, said John Grabowski, a marine scientist at Northeastern University. They must be mindful of water quality and the softness of sediments so oysters don’t catch diseases or get buried in mud. But there’s reason to believe that well-crafted restoration projects can have long-term success, Grabowski added. Follow-up studies, looking at restored reefs years or even decades after they were first planted, have found that some of them are still thriving.

€œThe studies that are out there that look longer-term definitely suggest that oyster restoration can sustain living reefs for much longer than just a year or two,” he said. That said, there are still untold threats from climate change. Without serious efforts to cut greenhouse gas emissions and curb global warming, oyster reefs and other coastal protections can only do so much. They may buffer shorelines against erosion, but they can’t halt the process—especially as sea-level rise accelerates and hurricanes intensify. €œOyster reefs can definitely reduce wave energy—when coupled with marshes, they can slow down coastal flooding—but my fear is that the system is gonna be overwhelmed, given the scale of the problem,” Grabowski said.

That doesn’t mean restoration projects shouldn’t continue. €œRemember, they provide a whole host of services, and even if they don’t fully stop coastal flooding, they’re filtering the water. They’re providing habitat for fishes and providing other important services,” he said. €œThose are services we shouldn’t forget about, even though climate change is the existential threat we’re all worried about.” Reprinted from E&E News with permission from POLITICO, LLC. Copyright 2021.

E&E News provides essential news for energy and environment professionals.Over the past century, many notable propeciaes have emerged from animals to cause widespread illness and death in people. The list includes the pathogens behind propecia influenza, Ebola, Zika, West Nile fever, SARS, and now hair loss treatment, brought on by the propecia hair loss. For all of these microbes, the animal species that served as the original source of spillover was hard to find. And for many, that source still has not been conclusively identified. Confirming the circumstances and key participants involved in the early emergence of an infectious disease is a holy grail of this type of scientific inquiry.

Difficult to track and even more difficult to prove. In ideal conditions, the first human cases involved in a zoonotic disease spillover (when a pathogen jumps from animals to humans) are reported in connection to animals present at the time of the event. This happens when the cluster of cases is large enough to be investigated and reported. But it is not necessarily the first time spillover occurred. Most spillovers are limited to more narrow animal-to-human cases.

Once pathogens start to spread by human-to-human transmission, the tracks leading back to the initial animal source grow faint and become nearly impossible to follow. Thus, animal sources for propeciaes that cause propecias often remain shrouded in mystery. For some propeciaes, animal sources have been implicated after years or decades of large-scale international investigations. For other propeciaes, animal sources are highly suspected, but enough evidence has yet to be produced to pinpoint an exact species or range of species. Typically, lines of evidence are drawn over time through a trove of peer-reviewed publications, each building on the research that came before it, using more precise methods to narrow the field of possible sources.

The scientific process is naturally self-correcting. Often seemingly contradictory hypotheses can initially flood the field, especially for high-impact outbreaks. But eventually, some of them are ruled out, and lines of investigation are narrowed. Frequently, this investigative research only points to a group of suspected species, possibly a few most likely genera or, more often, an entire taxonomic order. That is because the propecia has not actually been found in the suspected animal source in such cases.

The evidence instead revolves around closely related propeciaes or their most recent common ancestors, based on inferred evolutionary history. If a propecia was found in animal samples after the same pathogen caused widespread transmission among humans, it is possible that the propecia spilled from humans back into animals. That happens often enough with propeciaes that can infect a range of animal species that the possibility needs to be presumed until it is ruled out. The best way to rule out such spillback is to examine archives of specimens that were collected and stored prior to the initial outbreak. For these retrospective studies to work well, the specimens need to be the ideal type of samples, and they must come from the correct species and be stored in a way that allows scientists to recover the propecia of interest.

Most propeciaes of interest typically infect animal hosts for only a matter of days. Detection of propeciaes that cause propecias thus require sample sizes that are orders of magnitude higher than what is needed to detect endemic diseases or propeciaes that are long-lived in their host. One could get lucky, but rigor in scientific inquiry demands large sample sizes to power these types of analyses. Investigations into an animal source that immediately follow a viral emergence event have an additional challenge. Because an outbreak in animals likely would have preceded the outbreak in humans, s in animals would have already peaked.

Few or none of them would still be infected. Immediately post-outbreak, the probability of identifying in live animals could be especially low, thus requiring even larger sample sizes. In China, it is not surprising that scientists did not find hair loss in potential animal sources immediately after the human outbreak in Wuhan. Nor does that result indicate there is a problem with the wildlife spillover theory. This is a difficult search that takes time.

Immunologic evidence of previous can be detected in a possible animal host in the form of antibodies, but new serological assays must be developed for a new propecia. At best, this type of evidence is non-definitive—and at worst, it leads us in the wrong direction in the hunt. Antibody responses to propeciaes are notoriously cross-reactive. The serological assays will react in the same way to related propeciaes, both known and as yet unrecognized. These assays must be evaluated and validated in every species, and there is no gold standard test for a new propecia in a new animal.

Any efforts to apply new tests to animals would need to be verified with repeated testing and supporting data. As the scope of investigations broaden, other challenges must be met. Which species should be prioritized?. Which locations should be investigated?. Heading down the wrong path leads nowhere and wastes valuable time.

Viral s in animal populations are notoriously unpredictable, governed by dynamics that can only be uncovered with in-depth longitudinal studies after a propecia has been found. That brings us to the speed at which science works. Transdisciplinary collaborative research to investigate a novel propecia takes extra time. Detection techniques must be tailored to the new pathogen and customized to answer an array of research questions. Scientists are cautious about overinterpreting data and making unwarranted assumptions.

And in the midst of a propecia, understanding origins might not be the most pressing issue. During hair loss treatment, many scientists have pivoted to research that might help save lives this year—by modeling the trajectory of spread, characterizing hair loss variants and investigating the chances that the propecia could spill back into different animals that serve as a new viral reservoir, ultimately threatening people again. Timely exploration of the source of hair loss is important, but future propecia preparedness requires a deep understanding of the mechanisms involved in the emergence of a much wider array of propeciaes with propecia potential. With such knowledge, we will have better than a few vague and scattered clues the next time a novel disease emerges..

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Credit. IStock Share Fast Facts New @HopkinsMedicine study finds African-American women with common form of hair loss at increased risk of uterine fibroids - Click to Tweet New study in @JAMADerm shows most common form of alopecia (hair loss) in African-American women associated with higher risks of uterine fibroids - Click to Tweet In a study of medical records gathered on hundreds of thousands of African-American women, Johns Hopkins researchers say they have evidence that women with a common form of hair loss have an increased chance of developing uterine leiomyomas, or fibroids.In a report on the research, published in the December 27 issue of JAMA Dermatology, the researchers call on physicians who treat women with central centrifugal cicatricial alopecia (CCCA) to make patients aware that they may be at increased risk for fibroids and should be screened for the condition, particularly if they have symptoms such as heavy bleeding and pain. CCCA predominantly affects black women and is the most common form of permanent alopecia in this population.

The excess scar tissue that forms as a result of this type of hair loss may also explain the higher risk for uterine fibroids, which are characterized by fibrous growths in the lining of the womb. Crystal Aguh, M.D., assistant professor of dermatology at the Johns Hopkins University School of Medicine, says the scarring associated with CCCA is similar to the scarring associated with excess fibrous tissue elsewhere in the body, a situation that may explain why women with this type of hair loss are at a higher risk for fibroids.People of African descent, she notes, are more prone to develop other disorders of abnormal scarring, termed fibroproliferative disorders, such as keloids (a type of raised scar after trauma), scleroderma (an autoimmune disorder marked by thickening of the skin as well as internal organs), some types of lupus and clogged arteries. During a four-year period from 2013-2017, the researchers analyzed patient data from the Johns Hopkins electronic medical record system (Epic) of 487,104 black women ages 18 and over.

The prevalence of those with fibroids was compared in patients with and without CCCA. Overall, the researchers found that 13.9 percent of women with CCCA also had a history of uterine fibroids compared to only 3.3 percent of black women without the condition. In absolute numbers, out of the 486,000 women who were reviewed, 16,212 had fibroids.Within that population, 447 had CCCA, of which 62 had fibroids.

The findings translate to a fivefold increased risk of uterine fibroids in women with CCCA, compared to age, sex and race matched controls. Aguh cautions that their study does not suggest any cause and effect relationship, or prove a common cause for both conditions. €œThe cause of the link between the two conditions remains unclear,” she says.

However, the association was strong enough, she adds, to recommend that physicians and patients be made aware of it. Women with this type of scarring alopecia should be screened not only for fibroids, but also for other disorders associated with excess fibrous tissue, Aguh says. An estimated 70 percent of white women and between 80 and 90 percent of African-American women will develop fibroids by age 50, according to the NIH, and while CCCA is likely underdiagnosed, some estimates report a prevalence of rates as high as 17 percent of black women having this condition.

The other authors on this paper were Ginette A. Okoye, M.D. Of Johns Hopkins and Yemisi Dina of Meharry Medical College.Credit.

The New England Journal of Medicine Share Fast Facts This study clears up how big an effect the mutational burden has on outcomes to immune checkpoint inhibitors across many different cancer types. - Click to Tweet The number of mutations in a tumor’s DNA is a good predictor of whether it will respond to a class of cancer immunotherapy drugs known as checkpoint inhibitors. - Click to Tweet The “mutational burden,” or the number of mutations present in a tumor’s DNA, is a good predictor of whether that cancer type will respond to a class of cancer immunotherapy drugs known as checkpoint inhibitors, a new study led by Johns Hopkins Kimmel Cancer Center researchers shows.

The finding, published in the Dec. 21 New England Journal of Medicine, could be used to guide future clinical trials for these drugs. Checkpoint inhibitors are a relatively new class of drug that helps the immune system recognize cancer by interfering with mechanisms cancer cells use to hide from immune cells.

As a result, the drugs cause the immune system to fight cancer in the same way that it would fight an . These medicines have had remarkable success in treating some types of cancers that historically have had poor prognoses, such as advanced melanoma and lung cancer. However, these therapies have had little effect on other deadly cancer types, such as pancreatic cancer and glioblastoma.

The mutational burden of certain tumor types has previously been proposed as an explanation for why certain cancers respond better than others to immune checkpoint inhibitors says study leader Mark Yarchoan, M.D., chief medical oncology fellow. Work by Dung Le, M.D., associate professor of oncology, and other researchers at the Johns Hopkins Kimmel Cancer Center and its Bloomberg~Kimmel Cancer Institute for Cancer Immunotherapy showed that colon cancers that carry a high number of mutations are more likely to respond to checkpoint inhibitors than those that have fewer mutations. However, exactly how big an effect the mutational burden has on outcomes to immune checkpoint inhibitors across many different cancer types was unclear.

To investigate this question, Yarchoan and colleagues Alexander Hopkins, Ph.D., research fellow, and Elizabeth Jaffee, M.D., co-director of the Skip Viragh Center for Pancreas Cancer Clinical Research and Patient Care and associate director of the Bloomberg~Kimmel Institute, combed the medical literature for the results of clinical trials using checkpoint inhibitors on various different types of cancer. They combined these findings with data on the mutational burden of thousands of tumor samples from patients with different tumor types. Analyzing 27 different cancer types for which both pieces of information were available, the researchers found a strong correlation.

The higher a cancer type’s mutational burden tends to be, the more likely it is to respond to checkpoint inhibitors. More than half of the differences in how well cancers responded to immune checkpoint inhibitors could be explained by the mutational burden of that cancer. €œThe idea that a tumor type with more mutations might be easier to treat than one with fewer sounds a little counterintuitive.

It’s one of those things that doesn’t sound right when you hear it,” says Hopkins. €œBut with immunotherapy, the more mutations you have, the more chances the immune system has to recognize the tumor.” Although this finding held true for the vast majority of cancer types they studied, there were some outliers in their analysis, says Yarchoan. For example, Merkel cell cancer, a rare and highly aggressive skin cancer, tends to have a moderate number of mutations yet responds extremely well to checkpoint inhibitors.

However, he explains, this cancer type is often caused by a propecia, which seems to encourage a strong immune response despite the cancer’s lower mutational burden. In contrast, the most common type of colorectal cancer has moderate mutational burden, yet responds poorly to checkpoint inhibitors for reasons that are still unclear. Yarchoan notes that these findings could help guide clinical trials to test checkpoint inhibitors on cancer types for which these drugs haven’t yet been tried.

Future studies might also focus on finding ways to prompt cancers with low mutational burdens to behave like those with higher mutational burdens so that they will respond better to these therapies. He and his colleagues plan to extend this line of research by investigating whether mutational burden might be a good predictor of whether cancers in individual patients might respond well to this class of immunotherapy drugs. €œThe end goal is precision medicine—moving beyond what’s true for big groups of patients to see whether we can use this information to help any given patient,” he says.

Yarchoan receives funding from the Norman &. Ruth Rales Foundation and the Conquer Cancer Foundation. Through a licensing agreement with Aduro Biotech, Jaffee has the potential to receive royalties in the future..

Credit http://www.ec-vancelle.ac-strasbourg.fr/adm/?p=1 propecia cost. IStock Share Fast Facts New @HopkinsMedicine study finds African-American women with common form of hair loss at increased risk of uterine fibroids - Click to Tweet New study in @JAMADerm shows most common form of alopecia (hair loss) in African-American women associated with higher risks of uterine fibroids - Click to Tweet In a study of medical records gathered on hundreds of thousands of African-American women, Johns Hopkins researchers say they have evidence that women with a common form of hair loss have an increased chance of developing uterine leiomyomas, or fibroids.In a report on the research, published in the December 27 issue of JAMA Dermatology, the researchers call on physicians who treat women with central centrifugal cicatricial alopecia (CCCA) to make patients aware that they may be at increased risk for fibroids and should be screened for the condition, particularly if they have symptoms such as heavy bleeding and pain. CCCA predominantly affects black women and is the most propecia cost common form of permanent alopecia in this population. The excess scar tissue that forms as a result of this type of hair loss may also explain the higher risk for uterine fibroids, which are characterized by fibrous growths in the lining of the womb.

Crystal Aguh, M.D., assistant professor of dermatology at the Johns Hopkins University School of Medicine, says the scarring associated with CCCA is similar to the scarring propecia cost associated with excess fibrous tissue elsewhere in the body, a situation that may explain why women with this type of hair loss are at a higher risk for fibroids.People of African descent, she notes, are more prone to develop other disorders of abnormal scarring, termed fibroproliferative disorders, such as keloids (a type of raised scar after trauma), scleroderma (an autoimmune disorder marked by thickening of the skin as well as internal organs), some types of lupus and clogged arteries. During a four-year period from 2013-2017, the researchers analyzed patient data from the Johns Hopkins electronic medical record system (Epic) of 487,104 black women ages 18 and over. The prevalence propecia cost of those with fibroids was compared in patients with and without CCCA. Overall, the researchers found that 13.9 percent of women with CCCA also had a history of uterine fibroids compared to only 3.3 percent of black women without the condition.

In absolute numbers, out of the 486,000 women who were reviewed, 16,212 had fibroids.Within that population, 447 had CCCA, of which 62 had fibroids. The findings translate to a fivefold increased risk of uterine fibroids in women with CCCA, compared to age, sex and race propecia cost matched controls. Aguh cautions that their study does not suggest any cause and effect relationship, or prove a common cause for both conditions. €œThe cause propecia cost of the link between the two conditions remains unclear,” she says.

However, the association was strong enough, she adds, to recommend that physicians and patients be made aware of it. Women with this type of scarring alopecia should be screened not only for propecia cost fibroids, but also for other disorders associated with excess fibrous tissue, Aguh says. An estimated 70 percent of white women and between 80 and 90 percent of African-American women will develop fibroids by age 50, according to the NIH, and while CCCA is likely underdiagnosed, some estimates report a prevalence of rates as high as 17 percent of black women having this condition. The other authors propecia cost on this paper were Ginette A.

Okoye, M.D. Of Johns Hopkins and Yemisi Dina of Meharry Medical College.Credit. The New England Journal of Medicine Share Fast Facts This study clears up how big an effect the mutational burden has on outcomes to immune propecia cost checkpoint inhibitors across many different cancer types. - Click to Tweet The number of mutations in a tumor’s DNA is a good predictor of whether it will respond to a class of cancer immunotherapy drugs known as checkpoint inhibitors.

- Click propecia cost to Tweet The “mutational burden,” or the number of mutations present in a tumor’s DNA, is a good predictor of whether that cancer type will respond to a class of cancer immunotherapy drugs known as checkpoint inhibitors, a new study led by Johns Hopkins Kimmel Cancer Center researchers shows. The finding, published in the Dec. 21 New England Journal of Medicine, could be used to guide future propecia cost clinical trials for these drugs. Checkpoint inhibitors are a relatively new class of drug that helps the immune system recognize cancer by interfering with mechanisms cancer cells use to hide from immune cells.

As a result, the drugs cause the immune system to fight cancer in the same way that it would fight an . These medicines have had remarkable success in treating some types of cancers that historically propecia cost have had poor prognoses, such as advanced melanoma and lung cancer. However, these therapies have had little effect on other deadly cancer types, such as pancreatic cancer and glioblastoma. The mutational burden of certain tumor types has previously been propecia cost proposed as an explanation for why certain cancers respond better than others to immune checkpoint inhibitors says study leader Mark Yarchoan, M.D., chief medical oncology fellow.

Work by Dung Le, M.D., associate professor of oncology, and other researchers at the Johns Hopkins Kimmel Cancer Center and its Bloomberg~Kimmel Cancer Institute for Cancer Immunotherapy showed that colon cancers that carry a high number of mutations are more likely to respond to checkpoint inhibitors than those that have fewer mutations. However, exactly how big an effect the mutational burden has on outcomes to immune checkpoint inhibitors across many propecia cost different cancer types was unclear. To investigate this question, Yarchoan and colleagues Alexander Hopkins, Ph.D., research fellow, and Elizabeth Jaffee, M.D., co-director of the Skip Viragh Center for Pancreas Cancer Clinical Research and Patient Care and associate director of the Bloomberg~Kimmel Institute, combed the medical literature for the results of clinical trials using checkpoint inhibitors on various different types of cancer. They combined these findings with propecia cost data on the mutational burden of thousands of tumor samples from patients with different tumor types.

Analyzing 27 different cancer types for which both pieces of information were available, the researchers found a strong correlation. The higher a cancer type’s mutational burden tends to be, the more likely it is to respond to checkpoint inhibitors. More than half of the differences in how well cancers responded to immune checkpoint inhibitors could be propecia cost explained by the mutational burden of that cancer. €œThe idea that a tumor type with more mutations might be easier to treat than one with fewer sounds a little counterintuitive.

It’s one of those things that doesn’t sound right when propecia cost you hear it,” says Hopkins. €œBut with immunotherapy, the more mutations you have, the more chances the immune system has to recognize the tumor.” Although this finding held true for the vast majority of cancer types they studied, there were some outliers in their analysis, says Yarchoan. For example, Merkel cell cancer, a rare and highly aggressive skin cancer, tends to have a moderate number of mutations yet responds extremely well to checkpoint inhibitors propecia cost. However, he explains, this cancer type is often caused by a propecia, which seems to encourage a strong immune response despite the cancer’s lower mutational burden.

In contrast, the most common type of colorectal cancer has moderate mutational burden, yet responds poorly to checkpoint inhibitors for reasons that are still unclear. Yarchoan notes that these findings could help guide clinical trials to test checkpoint inhibitors on cancer types for which these drugs haven’t propecia cost yet been tried. Future studies might also focus on finding ways to prompt cancers with low mutational burdens to behave like those with higher mutational burdens so that they will respond better to these therapies. He and his colleagues plan to extend this line of research by investigating whether mutational burden might be a good predictor of whether cancers in individual patients might respond well propecia cost to this class of immunotherapy drugs.

€œThe end goal is precision medicine—moving beyond what’s true for big groups of patients to see whether we can use this information to help any given patient,” he says. Yarchoan receives funding from the Norman &. Ruth Rales Foundation and the Conquer Cancer Foundation. Through a licensing agreement with Aduro Biotech, Jaffee has the potential to receive royalties in the future..

What should my health care professional know before I take Propecia?

They need to know if you have any of these conditions:

• if you are female (finasteride is not for use in women)
• kidney disease or
• liver disease
• prostate cancer
• an unusual or allergic reaction to finasteride, other medicines, foods, dyes, or preservatives

Propecia hair boosting shampoo

As the Ventolin nebules price uae ceiling began crashing down around me, I reached for the hand propecia hair boosting shampoo beckoning me from above. I screamed as I attempted to grasp my rescuer's too-distant fingertips, afraid I would be buried alive. When my roommates woke me, my heart was still beating rapidly as propecia hair boosting shampoo I gripped the center beam of the cabin we were sharing, my body hanging maybe two feet off the floor.

It was the summer of 2009 and we were at Yosemite for a family reunion — a family I would marry into several years later. I was sharing the space with two other young women I didn't know well and making a terrific impression.As I hung from the ceiling, one of them held my waist while the other turned on the light. As everything propecia hair boosting shampoo slid back into focus, I knew, instantly, I wasn't in any danger.

Embarrassed from my late-night theatrical display, I dropped off the beam and scurried back to bed. The three of us erupted into laughter from the shock of it all. Experts may disagree on exactly what propecia hair boosting shampoo I experienced, but I have always referred to these sorts of episodes as night terrors.

Terrors of the Night More than just a nightmare, night terrors are marked by intense panic. The sufferer will often scream and flail about for a period lasting from a few minutes up to an hour, often startling the people around them. The episodes propecia hair boosting shampoo are more common in children, but an estimated 2 percent of the adult population is afflicted as well.

I have experienced night terrors (or something similar) my entire life, though they are usually not as dramatic as my cabin episode.After retelling this particular event to California-based sleep physician Kimberly Truong, however, she told me my experience didn't quite fit the night terror definition. €œWhat you're describing kind of blends into two different things,” she says.In a classic night terror, the sufferer doesn't typically remember a dream associated with their actions, she explains. Also, aside propecia hair boosting shampoo from some flailing, night terror sufferers tendto stay put.

€œMore complex behaviors — the climbing — actually leaks into the parasomnia world,” Truong says.Parasomnias are defined as disorders that cause unusual behaviors during sleep. They include night terrors, but sleep walking, sleep talking, sleep eating and even sleep sex are all different forms of parasomnias, too. Sleeping Soundly — Or NotNight terrors are known to occur in a stage propecia hair boosting shampoo of sleep known as N3.

This is a deep, dreamless sleep that takes place roughly half an hour to an hour after a person falls asleep. This stage of sleep is repeated through the night — but the longest period happens during the first sleep cycle, propecia hair boosting shampoo which is why most night terrors occur in the first half of the night. Children are also known to have more N3 stages, which is why night terrors are more common in youth.

From studying brain waves during sleep, doctors know adults who suffer night terrors are experiencing “micro-awakenings” in two sections of the brain, Truong says. One section is propecia hair boosting shampoo the motor cortex, which is responsible for movement. The cingulate cortex, which helps regulate emotions, is the other.

These little arousals are caused by a variety of factors, from breathing disorders — namely sleep apnea — to psychological issues like anxiety. Alcohol and other drugs are known to play a role, propecia hair boosting shampoo too. Sleep deprivation can also bring on a night terror, because when the body is overtired it will dip into a replenishing N3 stage quicker and stay there longer, Truong notes.

Why So Scared?. Although certain night terror triggers have been identified, there is still so much that has yet to be understood — like the propecia hair boosting shampoo best treatment options and why, for some, they even extend into adulthood. It's a source of frustration but also one of intrigue for those studying them.

€œThere's not a lot in medicine these days where we're still learning a whole lot,” Truong says. €œWe know so much about the heart propecia hair boosting shampoo. We know so much about the brain [and] the lungs on acellular level.

But sleep is actually still a propecia hair boosting shampoo big mystery and I find that really fascinating.”Because night terrors are uncommon in adulthood, there can be a stigma attached to them. Minnesota resident Shavaughn Ulven is looking to change that. €œMy friends make jokes or say 'Oh, it's just a nightmare,' or 'You're growing up, you'll get over it,' ” Ulven says.

Ulven, 31, has lived with regular night terrors her entire life — experiencing them an average of four propecia hair boosting shampoo nights per week. Typically, they manifest as the classic sit-up-in-bed-and-scream variety. But they can get more involved, too.

In one of those more memorable propecia hair boosting shampoo episodes, Ulven broke her nose. “I just ran out of bed, out of the bedroom and instead of hurtling down a hallway, I ran straight into a wall,” she said. €œI literally had to wake up my daughter and bring her to the emergency room so I could get my nose set.”In an effort to bring night terror sufferers together, Ulven started a support group on Facebook in 2014.

Now boasting more than 500 participants from around the world, the group provides propecia hair boosting shampoo a safe space for night terror sufferers to share coping mechanisms, treatment options or simply vent. Ulven herself has been on a variety of doctor-prescribed treatments and therapies forher night terrors, but they haven't gone away. In addition, sleep studies always come up normal because she never manages to experience a night terror when she takes the test.

Today, she copes by sleeping with a small light on so she can orient herself propecia hair boosting shampoo more quickly. Her doctors have told her to stay away from medication unless she injures herself again or someone else. Even with all that we don't know, however, Truong and Ulven both urge sufferers to see a doctor about their parasomnias — especially if they're putting themselves in danger.

€œSome people are propecia hair boosting shampoo waking up in the woods and not even knowing how they got there,” Ulven says. €œThis can be a very serious condition and this can lead to unwanted injuries. This can lead to death.”.

As the propecia cost ceiling https://vahybridloan.org/ventolin-nebules-price-uae began crashing down around me, I reached for the hand beckoning me from above. I screamed as I attempted to grasp my rescuer's too-distant fingertips, afraid I would be buried alive. When my roommates woke me, my propecia cost heart was still beating rapidly as I gripped the center beam of the cabin we were sharing, my body hanging maybe two feet off the floor.

It was the summer of 2009 and we were at Yosemite for a family reunion — a family I would marry into several years later. I was sharing the space with two other young women I didn't know well and making a terrific impression.As I hung from the ceiling, one of them held my waist while the other turned on the light. As everything propecia cost slid back into focus, I knew, instantly, I wasn't in any danger.

Embarrassed from my late-night theatrical display, I dropped off the beam and scurried back to bed. The three of us erupted into laughter from the shock of it all. Experts may disagree on exactly what I experienced, but I have always propecia cost referred to these sorts of episodes as night terrors.

Terrors of the Night More than just a nightmare, night terrors are marked by intense panic. The sufferer will often scream and flail about for a period lasting from a few minutes up to an hour, often startling the people around them. The episodes are more common in children, but an estimated 2 percent of the adult population propecia cost is afflicted as well.

I have experienced night terrors (or something similar) my entire life, though they are usually not as dramatic as my cabin episode.After retelling this particular event to California-based sleep physician Kimberly Truong, however, she told me my experience didn't quite fit the night terror definition. €œWhat you're describing kind of blends into two different things,” she says.In a classic night terror, the sufferer doesn't typically remember a dream associated with their actions, she explains. Also, aside from some flailing, night propecia cost terror sufferers tendto stay put.

€œMore complex behaviors — the climbing — actually leaks into the parasomnia world,” Truong says.Parasomnias are defined as disorders that cause unusual behaviors during sleep. They include night terrors, but sleep walking, sleep talking, sleep eating and even sleep sex are all different forms of parasomnias, too. Sleeping Soundly — Or NotNight terrors are known to occur propecia cost in a stage of sleep known as N3.

This is a deep, dreamless sleep that takes place roughly half an hour to an hour after a person falls asleep. This stage of sleep is repeated through the night — but the longest period happens during the first sleep cycle, which is why most night terrors occur in the first half propecia cost of the night. Children are also known to have more N3 stages, which is why night terrors are more common in youth.

From studying brain waves during sleep, doctors know adults who suffer night terrors are experiencing “micro-awakenings” in two sections of the brain, Truong says. One section is the motor cortex, which propecia cost is responsible for movement. The cingulate cortex, which helps regulate emotions, is the other.

These little arousals are caused by a variety of factors, from breathing disorders — namely sleep apnea — to psychological issues like anxiety. Alcohol and propecia cost other drugs are known to play a role, too. Sleep deprivation can also bring on a night terror, because when the body is overtired it will dip into a replenishing N3 stage quicker and stay there longer, Truong notes.

Why So Scared?. Although certain night terror triggers have been identified, there propecia cost is still so much that has yet to be understood — like the best treatment options and why, for some, they even extend into adulthood. It's a source of frustration but also one of intrigue for those studying them.

€œThere's not a lot in medicine these days where we're still learning a whole lot,” Truong says. €œWe know propecia cost so much about the heart. We know so much about the brain [and] the lungs on acellular level.

But sleep is actually still a big mystery and I find that really fascinating.”Because night terrors are uncommon propecia cost in adulthood, there can be a stigma attached to them. Minnesota resident Shavaughn Ulven is looking to change that. €œMy friends make jokes or say 'Oh, it's just a nightmare,' or 'You're growing up, you'll get over it,' ” Ulven says.

Ulven, 31, has lived with regular night propecia cost terrors her entire life — experiencing them an average of four nights per week. Typically, they manifest as the classic sit-up-in-bed-and-scream variety. But they can get more involved, too.

In one of those more memorable episodes, Ulven broke propecia cost her nose. “I just ran out of bed, out of the bedroom and instead of hurtling down a hallway, I ran straight into a wall,” she said. €œI literally had to wake up my daughter and bring her to the emergency room so I could get my nose set.”In an effort to bring night terror sufferers together, Ulven started a support group on Facebook in 2014.

Now boasting more than 500 participants from around the world, the group provides a safe space for night terror sufferers to share coping mechanisms, treatment propecia cost options or simply vent. Ulven herself has been on a variety of doctor-prescribed treatments and therapies forher night terrors, but they haven't gone away. In addition, sleep studies always come up normal because she never manages to experience a night terror when she takes the test.

Today, she copes by sleeping with a small light on so she can orient herself more quickly propecia cost. Her doctors have told her to stay away from medication unless she injures herself again or someone else. Even with all that we don't know, however, Truong and Ulven both urge sufferers to see a doctor about their parasomnias — especially if they're putting themselves in danger.

€œSome people are waking up in the woods and not even knowing how propecia cost they got there,” Ulven says. €œThis can be a very serious condition and this can lead to unwanted injuries. This can lead to death.”.

Propecia impotence permanent

Enlarge this image Delta Health Center, in rural northwest Mississippi, was founded propecia impotence permanent in the 1960s and is one of the country's first community health centers. Delta's leaders say community health centers all over the U.S. Are trusted institutions which can help distribute hair loss treatment propecia impotence permanent treatments.

Shalina Chatlani/Gulf States Newsroom hide caption toggle caption Shalina Chatlani/Gulf States Newsroom In the 1960s, health care for Black residents in rural Mississippi was meager. Most health systems were segregated. Although some hospitals did serve Black patients, they propecia impotence permanent struggled to stay afloat.

At the height of the civil rights movement, young Black doctors decided to launch a movement of their own. "Mississippi was third-world and propecia impotence permanent was so bad and so separated," says Dr. Robert Smith, "The community health center movement was the conduit for physicians all over this country who believed that all people have a right to health care." In 1967, Smith helped start Delta Health Center, the country's first rural community health center.

They put the clinic in Mound Bayou, a small town in the heart of the Mississippi Delta, in the northwest part of the state. The center became a national model and is now one of nearly 1,400 such clinics propecia impotence permanent across the country. These federally-funded health clinics (often called FQHCs) are a key resource in the states of Mississippi, Louisiana and Alabama, where about 2 in 5 Americans live in rural areas (throughout the U.S., about 1 in 5 Americans live in rural areas.) The hair loss treatment propecia has only exacerbated the challenges facing rural health care, such as lack of broadband access and limited public transportation.

For much of the treatment rollout, those barriers have made it difficult for providers, like community health centers, to get shots in the arms of propecia impotence permanent their patients. "I just assumed that [the treatment] would flow like water, but we really had to pry open the door to get access to it," says Smith, who still practices family medicine in Mississippi. Mound Bayou was founded by formerly enslaved people who became farmers, and it once had a thriving downtown.

The town is now dotted with shuttered or rundown banks, hotels and gas stations that were once some propecia impotence permanent of the first black-owned businesses in the state. Mitch Williams grew up on a Mound Bayou farm in the 1930s and 40s, and spent long days working the soil with his hands. "If you would cut yourself, they wouldn't put no sutures in, no stitches in it.

You wrapped propecia impotence permanent it up and kept going," Williams says. Healthcare across the Mississippi Delta was sparse and much of it was segregated. When the Delta Health Center started operations in 1967, it propecia impotence permanent was explicitly for all residents, of all races — and free to those who needed it.

Williams, 85, was one of its first patients. "They were seeing patients in the local churches. They had mobile units propecia impotence permanent.

I had never seen that kind of comprehensive care," he says. Enlarge this image Mitch Williams, 85, propecia impotence permanent grew up in Mound Bayou and became a patient after Delta Health Center opened. He later got a job at the health center and now serves on the clinic's Board of Directors.

He was photographed in an exhibit of the clinic's history, near a portrait of Andrew James, who was the center's director of environmental improvement. Shalina Chatlani / Gulf States Newsroom hide caption toggle caption Shalina Chatlani / propecia impotence permanent Gulf States Newsroom Residents really needed it. In the 1960s, many people in Mound Bayou and surrounding areas didn't have clean drinking water or indoor plumbing.

At the time, the 12,000 Black propecia impotence permanent residents who lived in the surrounding county of Bolivar faced unemployment rates as high as 75% and lived on an average annual income of just $900 (around $7,500 in today's dollars), according to a Congressional report. The area's infant mortality rate, back in the 1960s, was close to 60 for every 1000 live births — four times higher than the rate for affluent Americans. Delta Health Center employees helped people insulate their homes.

They built outhouses and provided food and sometimes even traveled to patients' homes to offer care, if someone didn't have propecia impotence permanent transportation. They believed these factors affected health outcomes too. Mitch Williams, who later worked for Delta Health, says he's not sure where the community would be today if it didn't exist.

"It's frightening propecia impotence permanent to think of it," he says. Half a century later, the Delta Health Center continues to provide accessible and affordable care in and around Mound Bayou, just as it did in the 1960s. That's because Black propecia impotence permanent Southerners still face barriers to health during the hair loss treatment propecia.

By April 2020, Black residents accounted for nearly half of all deaths in Alabama and over 70 percent of deaths in Louisiana and Mississippi. Public health data from May 2021 show that during the propecia, Black residents have consistently been more likely to die from hair loss treatment, given their share of the population. "We have a lot of chronic health conditions propecia impotence permanent here, particularly concentrated in the Mississippi Delta that lead to higher rates of complications and death with hair loss treatment," says Nadia Bethley, a clinical psychologist at the center.

"It's been tough." Delta Health Center has grown over the decades, from being housed in trailers in Mound Bayou, to a chain of 18 clinics across 5 counties. It's managed to vaccinate over propecia impotence permanent 5,500 people. The majority have been Black.

"We don't have the National Guard, you know, lining up out here, running our site. It's the people who work here," Bethley says propecia impotence permanent. Enlarge this image Rotonia Gates, a nurse, checks the temperature of Tonya Beamon of Renova, Miss.

On March 3. Beamon decided to get her hair loss treatment at the Delta propecia impotence permanent Health Center because she had heard good things about the staff. Shalina Chatlani/Gulf States Newsroom hide caption toggle caption Shalina Chatlani/Gulf States Newsroom The Mississippi Department of Health says it has prioritized health centers since the beginning of the rollout.

But Delta propecia impotence permanent Health CEO John Fairman says the center was only receiving a couple hundred doses a week in January and February. Delta Health Center officials say the supply became more consistent around early March. "Many states would be much further ahead had they utilized community health centers from the very beginning," Fairman says.

Building on existing community trust Fairman says his center saw success with vaccinations because propecia impotence permanent of its long-standing relationships with the local communities. "Use the infrastructure that's already in place, that has community trust," says Fariman. That was the entire point of the health center movement in the propecia impotence permanent first place, says Dr.

Robert Smith. He says states that were slow to use health centers in the treatment rollout made a mistake, and that now impacts their ability to get a handle on hair loss treatment in the most vulnerable communities. Enlarge this image propecia impotence permanent Civil rights veteran Dr.

Robert Smith at his home in Jackson, Miss. Smith and medical colleagues such as Dr. Count Gibson propecia impotence permanent and Dr.

Jack Geiger worked to establish federally-funded community health centers in the 1960s. The first two centers opened in urban Boston and propecia impotence permanent the rural town of Mound Bayou, Miss. Shalina Chatlani/Gulf States Newsroom hide caption toggle caption Shalina Chatlani/Gulf States Newsroom Regarding the slow dispersal of treatments to rural health centers, Smith called it "an example of systemic racism that continues." A spokesperson from Mississippi's department responded that it's "committed to providing treatments to rural areas, but given the rurality of Mississippi it is a real challenge." Alan Morgan, the president of the National Rural Health Association, says the low level of dose allocation to rural health clinics and community health centers early on is "going to cost lives." "With hospitalizations and mortality much higher in rural communities, these states need to focus on the hot spots, which in many cases are these small towns," Morgan says.

A report from the Kaiser Family Foundation found that people of color made up the majority of people vaccinated at community health centers, and the centers seem to be vaccinating people at similar or higher rates than their share of the total population. (The KHN newsroom, which collaborated to produce this story, is an editorially independent program of KFF.) The report adds that "ramping up health centers' involvement in vaccination efforts at the federal, state and local levels," could be propecia impotence permanent a meaningful step in "advancing equity on a larger scale." Equal access to care in rural communities is necessary to reach the most vulnerable populations, and is just as critical during this global health crisis as it was in the 1960s, according to Dr. Robert Smith.

"When health care improves propecia impotence permanent for Blacks, it will improve for all Americans," Smith says. This story comes from NPR's partnership with Kaiser Health News (KHN) and the three stations who make up the Gulf States Newsroom. Mississippi Public Broadcasting, WBHM in Birmingham, and WWNO in New Orleans.Enlarge this image Kelly Hans holds a box of Narcan nasal spray at the county's One-Stop Shop in Austin.

Mitch Legan/WTIU/WFIU News hide caption toggle caption Mitch Legan/WTIU/WFIU News propecia impotence permanent In 2015, Indiana's rural Scott County found itself in the national spotlight when intravenous drug use and sharing needles led to an outbreak of HIV. Mike Pence, who was Indiana's governor at the time, approved the state's first syringe exchange program in the small manufacturing community 30 minutes north of Louisville, as part of an emergency measure. "I will tell propecia impotence permanent you that I do not support needle exchange as anti-drug policy," he said during a 2015 visit to the county.

"But this is a public health emergency." In all, 235 people became infected with HIV over the course of the outbreak, most of them within the first year. In all of last year, there was one new case. Health officials credit the needle exchange for the dramatic drop-off propecia impotence permanent in cases.

But with cases the lowest in years, Scott County commissioners voted 2-1 on Wednesday to end the program. Commissioners President Mike Jones says the access to needles is leading to more overdoses in Scott County. Jones and the propecia impotence permanent other commissioner who voted to end the exchange say they can't live with a program that makes it easier to abuse drugs.

"I know people that are alcoholics, and I don't buy him a bottle of whiskey, and ... I have a hard time propecia impotence permanent handing a needle to somebody that I know they're going to hurt theirself with," Jones says. Scott County health officials say they're dismayed at the decision, which requires them to phase out the needle exchange by the end of the year.

Needle exchanges provide intravenous drug users with clean syringes and a place to dispose of used ones. Research shows they help propecia impotence permanent reduce the spread of infectious diseases like HIV and can help people overcome substance abuse by acting as an access point to health services for those who are unlikely to seek them out. Michelle Matern, Scott County's health administrator, doesn't want to see the syringe program end.

"I think a lot of people forgot propecia impotence permanent kind of what 2015 was like, and what we went through as a community," says Matern. Enlarge this image Hans goes through the contents of one of the kits the exchange provides intravenous drug users. Mitch Legan/WTIU/WFIU News hide caption toggle caption Mitch Legan/WTIU/WFIU News Residents have testified to the effectiveness of the exchange during recent meetings.

Former U.S propecia impotence permanent. Surgeon General Dr. Jerome Adams attended a commissioners' meeting in early May and praised Scott County's exchange as the propecia impotence permanent gold standard.

"I've seen syringe service programs all over the nation. I've been to Canada and seen how they do it over there," Adams said. "And the way you're doing it here is the way it's supposed to be done." The county's One-Stop Shop propecia impotence permanent in Austin, Ind., provides testing for HIV, hepatitis C or sexually transmitted s.

There's food and the people who work there can connect users with health insurance, housing and recovery opportunities. It serves around 170 people a month. "We don't call it a needle exchange anymore," Matern says propecia impotence permanent.

"We call it a 'syringe service program,' because we realize that it's a lot more than just exchanging used syringes for new ones." The two commissioners who are against the program say it enables drug users by providing supplies needed to inject drugs and is leading to overdoses. "It's aggravating for a first responder to Narcan somebody, and this is one propecia impotence permanent of the things I really struggle with is that there's no accountability," commissioner Mike Jones said during a recent meeting. "They walk out of the ER, there's no – nothing happens.

I mean, nothing happens." In a since-deleted Facebook post, commissioner Randy Julian referred to the program as "a welfare program for addicts." Carrie Lawrence, associate director of the Rural Center for AIDS/STD Prevention at Indiana University says eliminating the supply of clean syringes is not going to help people who are struggling with addiction stop injecting drugs. They're likely propecia impotence permanent to continue even with dirty needles. "That's how Indiana got known for our HIV outbreak," she says.

Closing the syringe exchange she says, "is putting more people at risk." Kelly Hans was struggling with addiction propecia impotence permanent before the outbreak and now works at the needle exchange as its HIV prevention outreach coordinator. She says getting rid of the program would be a huge blow to the county's recovery system. "I wish there would have been some place like this prior to the outbreak in 2015, when I was using and when I was a mess," she says.

"There was nowhere for propecia impotence permanent me to go to ask for help. Recovery wasn't very loud here in Scott County. So, I didn't even know who to go to." At THRIVE Recovery Community Organization in Scottsburg, 1,885 people from around the area reached out for help last year.

Over a quarter of them propecia impotence permanent were referred there by the county's needle exchange. The exchange provides Narcan and information to help people use drugs safely, both to prevent disease and avoid overdoses. Lawrence began researching the situation propecia impotence permanent in Scott County from the start.

She says the trust that has been built between the exchange and IV drug using community is what has made it effective. "You can't just throw up a tent in the middle of the parking lot to do this," she says. But the commissioners say there are treatments for HIV propecia impotence permanent and are frustrated they don't see more people in recovery from drug use.

"I don't know how you get to someone to say, 'Enough's enough,'" Mike Jones said at a recent meeting. Health officials have warned of what's happening in West Virginia, where cases of HIV and propecia impotence permanent hepatitis C are spiking as elected officials crack down on needle exchanges. In Scott County, Matern says they could transition to a harm reduction program without needles – sharing addiction resources and STD and HIV testing services.

But she doubts it will be as effective, because what gets people in the door is the needles. If the needle exchange is halted, she expects a rise in HIV cases to follow. Carrie Lawrence agrees.

"Given the history of the Scott County outbreak, another one could happen," she says..

Enlarge this image Delta Health Center, in rural northwest Mississippi, was founded in the 1960s and is propecia cost one of the country's first community health centers. Delta's leaders say community health centers all over the U.S. Are trusted institutions which can propecia cost help distribute hair loss treatments.

Shalina Chatlani/Gulf States Newsroom hide caption toggle caption Shalina Chatlani/Gulf States Newsroom In the 1960s, health care for Black residents in rural Mississippi was meager. Most health systems were segregated. Although some hospitals did serve Black patients, they propecia cost struggled to stay afloat.

At the height of the civil rights movement, young Black doctors decided to launch a movement of their own. "Mississippi was third-world and was so propecia cost bad and so separated," says Dr. Robert Smith, "The community health center movement was the conduit for physicians all over this country who believed that all people have a right to health care." In 1967, Smith helped start Delta Health Center, the country's first rural community health center.

They put the clinic in Mound Bayou, a small town in the heart of the Mississippi Delta, in the northwest part of the state. The center became a national model and is now one of nearly propecia cost 1,400 such clinics across the country. These federally-funded health clinics (often called FQHCs) are a key resource in the states of Mississippi, Louisiana and Alabama, where about 2 in 5 Americans live in rural areas (throughout the U.S., about 1 in 5 Americans live in rural areas.) The hair loss treatment propecia has only exacerbated the challenges facing rural health care, such as lack of broadband access and limited public transportation.

For much of the treatment rollout, those barriers have made it difficult for providers, like community health centers, to get shots in the arms of propecia cost their patients. "I just assumed that [the treatment] would flow like water, but we really had to pry open the door to get access to it," says Smith, who still practices family medicine in Mississippi. Mound Bayou was founded by formerly enslaved people who became farmers, and it once had a thriving downtown.

The town is now dotted with shuttered or propecia cost rundown banks, hotels and gas stations that were once some of the first black-owned businesses in the state. Mitch Williams grew up on a Mound Bayou farm in the 1930s and 40s, and spent long days working the soil with his hands. "If you would cut yourself, they wouldn't put no sutures in, no stitches in it.

You wrapped it up and kept going," Williams says propecia cost. Healthcare across the Mississippi Delta was sparse and much of it was segregated. When the Delta Health Center started operations in 1967, it was explicitly for all residents, propecia cost of all races — and free to those who needed it.

Williams, 85, was one of its first patients. "They were seeing patients in the local churches. They had mobile propecia cost units.

I had never seen that kind of comprehensive care," he says. Enlarge this image Mitch Williams, 85, grew up in Mound Bayou and became propecia cost a patient after Delta Health Center opened. He later got a job at the health center and now serves on the clinic's Board of Directors.

He was photographed in an exhibit of the clinic's history, near a portrait of Andrew James, who was the center's director of environmental improvement. Shalina Chatlani / Gulf States Newsroom hide caption toggle caption Shalina Chatlani / Gulf States Newsroom Residents really propecia cost needed it. In the 1960s, many people in Mound Bayou and surrounding areas didn't have clean drinking water or indoor plumbing.

At the time, the 12,000 Black residents who lived in the surrounding county of Bolivar faced unemployment propecia cost rates as high as 75% and lived on an average annual income of just $900 (around $7,500 in today's dollars), according to a Congressional report. The area's infant mortality rate, back in the 1960s, was close to 60 for every 1000 live births — four times higher than the rate for affluent Americans. Delta Health Center employees helped people insulate their homes.

They built outhouses and provided food and sometimes even traveled to patients' homes to offer care, if someone didn't have transportation propecia cost. They believed these factors affected health outcomes too. Mitch Williams, who later worked for Delta Health, says he's not sure where the community would be today if it didn't exist.

"It's frightening to think of it," propecia cost he says. Half a century later, the Delta Health Center continues to provide accessible and affordable care in and around Mound Bayou, just as it did in the 1960s. That's because Black Southerners propecia cost still face barriers to health during the hair loss treatment propecia.

By April 2020, Black residents accounted for nearly half of all deaths in Alabama and over 70 percent of deaths in Louisiana and Mississippi. Public health data from May 2021 show that during the propecia, Black residents have consistently been more likely to die from hair loss treatment, given their share of the population. "We have a lot of chronic health conditions here, particularly concentrated in the Mississippi Delta that lead to higher rates of complications and death with hair loss treatment," says Nadia Bethley, a clinical propecia cost psychologist at the center.

"It's been tough." Delta Health Center has grown over the decades, from being housed in trailers in Mound Bayou, to a chain of 18 clinics across 5 counties. It's managed propecia cost to vaccinate over 5,500 people. The majority have been Black.

"We don't have the National Guard, you know, lining up out here, running our site. It's the people who propecia cost work here," Bethley says. Enlarge this image Rotonia Gates, a nurse, checks the temperature of Tonya Beamon of Renova, Miss.

On March 3. Beamon decided to get propecia cost her hair loss treatment at the Delta Health Center because she had heard good things about the staff. Shalina Chatlani/Gulf States Newsroom hide caption toggle caption Shalina Chatlani/Gulf States Newsroom The Mississippi Department of Health says it has prioritized health centers since the beginning of the rollout.

But Delta propecia cost Health CEO John Fairman says the center was only receiving a couple hundred doses a week in January and February. Delta Health Center officials say the supply became more consistent around early March. "Many states would be much further ahead had they utilized community health centers from the very beginning," Fairman says.

Building on propecia cost existing community trust Fairman says his center saw success with vaccinations because of its long-standing relationships with the local communities. "Use the infrastructure that's already in place, that has community trust," says Fariman. That was the entire point of the health center movement in the first place, says Dr propecia cost.

Robert Smith. He says states that were slow to use health centers in the treatment rollout made a mistake, and that now impacts their ability to get a handle on hair loss treatment in the most vulnerable communities. Enlarge this image Civil propecia cost rights veteran Dr.

Robert Smith at his home in Jackson, Miss. Smith and medical colleagues such as Dr. Count Gibson and propecia cost Dr.

Jack Geiger worked to establish federally-funded community health centers in the 1960s. The first two centers opened in urban Boston and the propecia cost rural town of Mound Bayou, Miss. Shalina Chatlani/Gulf States Newsroom hide caption toggle caption Shalina Chatlani/Gulf States Newsroom Regarding the slow dispersal of treatments to rural health centers, Smith called it "an example of systemic racism that continues." A spokesperson from Mississippi's department responded that it's "committed to providing treatments to rural areas, but given the rurality of Mississippi it is a real challenge." Alan Morgan, the president of the National Rural Health Association, says the low level of dose allocation to rural health clinics and community health centers early on is "going to cost lives." "With hospitalizations and mortality much higher in rural communities, these states need to focus on the hot spots, which in many cases are these small towns," Morgan says.

A report from the Kaiser Family Foundation found that people of color made up the majority of people vaccinated at community health centers, and the centers seem to be vaccinating people at similar or higher rates than their share of the total population. (The KHN newsroom, which collaborated to produce this story, is an editorially independent program of KFF.) The report adds that "ramping up health centers' involvement in vaccination efforts at the federal, state and local levels," could be a meaningful step in "advancing equity on a larger scale." Equal access to care in rural communities is necessary to reach the most vulnerable populations, and is propecia cost just as critical during this global health crisis as it was in the 1960s, according to Dr. Robert Smith.

"When health care improves for Blacks, propecia cost it will improve for all Americans," Smith says. This story comes from NPR's partnership with Kaiser Health News (KHN) and the three stations who make up the Gulf States Newsroom. Mississippi Public Broadcasting, WBHM in Birmingham, and WWNO in New Orleans.Enlarge this image Kelly Hans holds a box of Narcan nasal spray at the county's One-Stop Shop in Austin.

Mitch Legan/WTIU/WFIU News hide caption toggle caption Mitch Legan/WTIU/WFIU News In 2015, Indiana's rural Scott County found itself in the national spotlight when intravenous drug use and sharing needles led propecia cost to an outbreak of HIV. Mike Pence, who was Indiana's governor at the time, approved the state's first syringe exchange program in the small manufacturing community 30 minutes north of Louisville, as part of an emergency measure. "I will tell you that I do not support needle exchange propecia cost as anti-drug policy," he said during a 2015 visit to the county.

"But this is a public health emergency." In all, 235 people became infected with HIV over the course of the outbreak, most of them within the first year. In all of last year, there was one new case. Health officials credit the needle exchange for the dramatic drop-off in propecia cost cases.

But with cases the lowest in years, Scott County commissioners voted 2-1 on Wednesday to end the program. Commissioners President Mike Jones says the access to needles is leading to more overdoses in Scott County. Jones and the other commissioner who voted to propecia cost end the exchange say they can't live with a program that makes it easier to abuse drugs.

"I know people that are alcoholics, and I don't buy him a bottle of whiskey, and ... I have a hard time handing a needle to somebody that I know they're going to propecia cost hurt theirself with," Jones says. Scott County health officials say they're dismayed at the decision, which requires them to phase out the needle exchange by the end of the year.

Needle exchanges provide intravenous drug users with clean syringes and a place to dispose of used ones. Research shows they help reduce propecia cost the spread of infectious diseases like HIV and can help people overcome substance abuse by acting as an access point to health services for those who are unlikely to seek them out. Michelle Matern, Scott County's health administrator, doesn't want to see the syringe program end.

"I think a propecia cost lot of people forgot kind of what 2015 was like, and what we went through as a community," says Matern. Enlarge this image Hans goes through the contents of one of the kits the exchange provides intravenous drug users. Mitch Legan/WTIU/WFIU News hide caption toggle caption Mitch Legan/WTIU/WFIU News Residents have testified to the effectiveness of the exchange during recent meetings.

Former U.S propecia cost. Surgeon General Dr. Jerome Adams attended a commissioners' meeting in early propecia cost May and praised Scott County's exchange as the gold standard.

"I've seen syringe service programs all over the nation. I've been to Canada and seen how they do it over there," Adams said. "And the way you're doing it here is the way it's supposed to be done." The county's One-Stop Shop in Austin, Ind., provides testing for HIV, hepatitis C propecia cost or sexually transmitted s.

There's food and the people who work there can connect users with health insurance, housing and recovery opportunities. It serves around 170 people a month. "We don't propecia cost call it a needle exchange anymore," Matern says.

"We call it a 'syringe service program,' because we realize that it's a lot more than just exchanging used syringes for new ones." The two commissioners who are against the program say it enables drug users by providing supplies needed to inject drugs and is leading to overdoses. "It's aggravating for a first responder to Narcan somebody, and this is one of the things I really struggle with is that there's no accountability," commissioner Mike Jones said during a recent meeting. "They walk out of the ER, there's no – nothing happens.

I mean, nothing happens." In a since-deleted Facebook post, commissioner Randy Julian referred to the program as "a welfare program for addicts." Carrie Lawrence, associate director of the Rural Center for AIDS/STD Prevention at Indiana University says eliminating the supply of clean syringes is not going to help people who are struggling with addiction stop injecting drugs. They're likely to continue even with dirty needles. "That's how Indiana got known for our HIV outbreak," she says.

Closing the syringe exchange she says, "is putting more people at risk." Kelly Hans was struggling with addiction before the outbreak and now works at the needle exchange as its HIV prevention outreach coordinator. She says getting rid of the program would be a huge blow to the county's recovery system. "I wish there would have been some place like this prior to the outbreak in 2015, when I was using and when I was a mess," she says.

"There was nowhere for me to go to ask for help. Recovery wasn't very loud here in Scott County. So, I didn't even know who to go to." At THRIVE Recovery Community Organization in Scottsburg, 1,885 people from around the area reached out for help last year.

Over a quarter of them were referred there by the county's needle exchange. The exchange provides Narcan and information to help people use drugs safely, both to prevent disease and avoid overdoses. Lawrence began researching the situation in Scott County from the start.

She says the trust that has been built between the exchange and IV drug using community is what has made it effective. "You can't just throw up a tent in the middle of the parking lot to do this," she says. But the commissioners say there are treatments for HIV and are frustrated they don't see more people in recovery from drug use.

"I don't know how you get to someone to say, 'Enough's enough,'" Mike Jones said at a recent meeting. Health officials have warned of what's happening in West Virginia, where cases of HIV and hepatitis C are spiking as elected officials crack down on needle exchanges. In Scott County, Matern says they could transition to a harm reduction program without needles – sharing addiction resources and STD and HIV testing services.

But she doubts it will be as effective, because what gets people in the door is the needles. If the needle exchange is halted, she expects a rise in HIV cases to follow. Carrie Lawrence agrees.

"Given the history of the Scott County outbreak, another one could happen," she says..

Hims vs propecia

A new paper discusses how stressful experiences - or psychedelic drugs - might produce profound mental change.Authors Ari Brouwer and Robin Lester Carhart-Harris, writing in the Journal hims vs propecia of Psychopharmacology, introduce the concept of 'pivotal mental states'. (Although this is a new term, the idea echoes earlier work).What is a pivotal mental state?. It's "a hyper-plastic state aiding rapid and deep learning that can mediate psychological transformation", or hims vs propecia in other words, a state in which beliefs, personality and mental health are prone to change. As they put it, these states "evolved to allow the experiencer a psychological ‘fresh start’, akin to a psychological ‘rebirth’".According to Brouwer and Carhart-Harris, these pivotal states may be triggered by severe psychological or physiological stress, but they can also be produced by drugs, especially psychedelics such as LSD or psilocybin (magic mushrooms).

Biologically, they say, stress and psychedelics have related effects on the brain in that stress upregulates 5HT2A serotonin receptors, which are the target of hims vs propecia drugs like LSD.The authors emphasize that pivotal mental states are neither helpful nor harmful in themselves. Rather, these states represent a psychological crossroads which can lead to many different destinations, from improved mental health, to serious disorders. Brouwer and Carhart-Harris hims vs propecia illustrate the idea of a pivotal mental state as a "moment of decision" with a rather beautiful piece of art showing a person facing two ways forward, one towards sunny health and the other, gloomy illness:From Brouwer and Carhart-Harris (2020)So what determines if the outcome of a pivotal state is good or bad?. The authors point to "contextual factors" - the social, psychological, and emotional environment, broadly speaking - as being key.

These need to be "treated with special attention and hims vs propecia therapeutic care (where possible) if an individual’s psychological wellbeing is to be safeguarded", and this applies to individuals on psychedelics as well as acute psychosis.I found this paper bold and thought provoking, although I'd have liked to see the pivotal mental state described in more detail. The authors point to drug experiences, some forms of psychosis and some spiritual experiences as examples, but I would have liked to see more detail on what the state looks like (or feels like) phenomenologically.I also didn't find the biological aspects of the paper, with the focus on 5HT2A receptors, to be entirely convincing. This is a complex issue and there are thousands of relevant scientific studies, but in a nutshell, I don't think we can equate the effect of stress with increased 5HT2A in all cases, and clearly stress does not always have the same effects as a dose of LSD, while hims vs propecia LSD effects are not identical with psychotic symptoms. Overall, the entire paper ends up raising more questions than it answers, and leaves the 'pivotal mental state' as something mysterious.

This is not necessarily hims vs propecia a bad thing - there can be value in describing a mystery, as a first step towards solving it. But there is a lot more work to do here.This article appeared in Discover’s annual state of science issue as “A Brief Guide to treatment Types.” Support our science journalism by becoming a subscriber.The hair loss treatment propecia likely plunged you into a world — specifically, the world of treatment development — that you didn’t know much about before. Maybe you’ve learned that treatments typically take years to hims vs propecia produce. Or maybe you’ve found yourself wondering how the roughly 200 hair loss treatments in development are supposed to work.Essentially, a treatment needs to trick your immune system into thinking there’s an .

That way, hims vs propecia you’ll develop an arsenal of tactics to kill off the pathogen, should it ever show up in your body. Live treatments release a somewhat nonfunctional version of the propecia into the body. If researchers tamper with it just right, the modified propecia can still provoke your immune system without getting you sick. One way to sap a propecia of some of its power is to grow it in another species, the way hims vs propecia researchers used chick embryo cells to create the measles treatment.

Developers can also neutralize the propecia by exposing it to heat or chemicals like formaldehyde, creating what’s known as an inactivated treatment.There are also treatments that make your own cells produce the crucial proteins that help fight a propecia. Two of these are hims vs propecia called DNA treatments and RNA treatments. DNA varieties can push the hair loss spike protein gene into your cells. Once it’s there, the DNA hims vs propecia is treated like your own genetic information.Your bodies make RNA — temporary copies of the gene — and from that template build the viral proteins.

RNA treatments, on the other hand, cut out a few steps in the production process. These treatments provide the RNA pattern as is, and cells assemble proteins from there.For an RNA hims vs propecia or DNA treatment to successfully work, it’s crucial that the genetic material gets inside your cells to the protein-generating machinery that will properly proliferate the viral protein. Sometimes, treatment developers make sure this happens by tucking the DNA or RNA into the genome of another propecia, using that pathogen as a kind of shipping container. These are hims vs propecia called viral vector treatments.

Don’t worry, you don’t get sick from the delivery — researchers disable the propecia to prevent that from happening.It’s also possible to create a treatment that does not force cells to make viral proteins, but instead delivers the proteins directly. Some companies are working on these kinds of hair loss treatments, a category generally called protein-based treatments.On the whole, hims vs propecia treatment developers spend a lot of time at the drawing board. The complexity of the immune system makes it a tough beast to wrangle. When it comes to hair loss, any of these treatment types could emerge from the pack — and ultimately help keep hair loss treatment at bay.It seems hard to believe that a basic human hims vs propecia sensation — one that can be evoked by a simple mosquito bite — still has scientists scratching their heads.

Yet despite centuries of study, understanding itching is still fraught.Itch, write two scientists in a review in the journal Immunity, “has been described as one of the most diabolical sensations. In Dante's Inferno, falsifiers were eternally punished by ‘the burning rage of fierce itching that nothing could relieve.’” Yet, the researchers note, “There have been very hims vs propecia few advances in itch treatment in over 360 years.”That’s finally starting to change. In the past decade, scientists have made strides toward understanding this infuriating sensation. They are untangling itchiness from other hims vs propecia noxious stimuli, such as pain.

They are even starting to distinguish one type of itch from another, by poking study participants with itch-inducing plant spikes or deleting itch-related genes from mice.This wide-ranging research is gradually going beyond an understanding of familiar acute histamine-driven itch — the mosquito or poison ivy variety — to reveal the complicated mechanisms and players involved in the often debilitating type of itching that lasts for weeks and sometimes years. Chronic itch, as it’s termed, can be generated by a multitude of factors, from chemicals secreted within the body to nerves gone haywire, and in many cases, has no known cause or cure.his inquiry is more than an academic exercise (or a quest to make mosquito welts recede faster). While acute itch is fleeting, chronic itch may plague some hims vs propecia 7 percent of people each year, and one in five people will experience it at some time in their lives. Beyond a maddening persistent urge to scratch, the condition can lead to depression, sleep deprivation and a drastic decrease in the quality of life.

€œIt can be as devastating hims vs propecia as chronic pain,” says Robert LaMotte, an itch researcher at the Yale School of Medicine.And pain is actually where the itch story starts.Identifying ItchFor much of the last century, itch was considered a lower-tiered version of pain. In the early 1920s, for example, Austrian-German physiologist and pain researcher Max von Frey documented in an influential study that a slight skin prick gave research participants the aftersensation of itch. This conceptual hims vs propecia model continued to feed the field of itch for decades.But eventually, the idea that itch was simply a subset of pain began to crumble. Scientists determined, for example, that they could not reliably turn a pain into an itch just by decreasing the pain’s intensity — or turn an itch to a pain by increasing the itch’s intensity.

Yet the nerves and pathways of pain and itch appeared to be hims vs propecia so similar and deeply intertwined that for years scientists lacked a clear understanding of how the two responses were wired into the body.Then, in 2007, the sensation of itching finally crawled out from under the shadow of pain and into its own light.That year, a seminal paper in Nature reported the first dedicated itch receptor — a protein on nerve cells in the central nervous system that responds specifically to itch but not pain, indicating that the sensation might travel its own separate pathway to the brain. Zhou-Feng Chen, at Washington University School of Medicine in St. Louis, and colleagues showed that mice engineered to lack genes for this receptor — called the gastrin-releasing peptide receptor — could still feel pain but barely felt itch, no matter hims vs propecia what the researchers tried.“This changed the paradigm,” says Brian Kim, a dermatologist and codirector of the medical school’s Center for the Study of Itch, who now works with Chen. Revealing itch as a sensation in its own right with a dedicated pathway was a crucial step forward in understanding it, he says.Since the discovery of this first itch receptor, researchers have discovered more cellular players involved in chronic itch, separating it out from acute itch.

They have learned, for example, that chronic and acute itch are hims vs propecia relayed by different sets of neurons that send signals along their own dedicated tracks in the nervous system. When researchers have simulated chronic itch in experiments with healthy volunteers, MRI scans reveal that the two itch types spur different patterns of brain activity.These most foundational observations reveal just how much more we have to learn about itch. But they also help create a path to bringing relief to those who hims vs propecia experience debilitating chronic cases. The sensation can be so bad that, for instance, some people with liver disease receive transplants precisely because of their itching.

Others choose to go off of essential cancer medications because of the itching the drugs can cause.And for years, researchers were focused on the low-hanging fruit hims vs propecia of histamine-driven itch, which is easier to study, in part because it is being driven by a single chemical compound. Experimenters could spread or inject known irritants on or into the skin, cuing the body to make histamines, producing that familiar welty reaction that can be soothed by antihistamines like cortisone. But most chronic itch (technically, itchiness that lasts more than six weeks) doesn’t involve histamines. And the routes — there are many — to chronic itch are far more complicated.There are many routes to itch, but scientists have uncovered two, independent hims vs propecia subtypes of neurons that relay the itch message to the spinal cord and brain.

The histamine pathway (left), which is involved primarily in acute itch, is engaged when a trigger such as a mosquito bite spurs the release of histamines by the body’s immune system, which activate histamine receptors. Non-histamine itch (right) can hims vs propecia be set off by a wide range of internal and external triggers, including immune system molecules such as cytokines, enzymes called proteases that cut up proteins and the antimalarial drug chloroquine. After a trigger activates receptors in either pathway, enzymes are kicked into gear that spur the opening of ion channels, prompting the nerve to fire and send the itch signal to the spinal cord and brain.Now, as scientists refocus their investigations on chronic non-histamine itch, they’re doing much of the research the old-fashioned way. By making people and animals itchy.Itch by ItchInitiating an itch is not as hims vs propecia simple as it seems.

One approach that’s been especially fruitful for zeroing in on non-histamine itch is to poke people with tiny hairs (or spicules) from a tropical plant called cowhage, or velvet bean.In a key series of experiments, LaMotte and his colleagues took about 10 of these spicules, which are a few microns wide at the tip, and inserted them about 0.2 millimeters into the skin of study participants. Every 30 seconds, for up to 20 minutes, the hims vs propecia thus-pricked people reported sensations they felt, such as pricking, burning or itching, as well as the intensity. The studies confirmed that an unusual compound within the minute hairs, called mucunain, rapidly causes itchiness but — unlike many plant-based itch-prompting compounds — doesn’t activate histamines. That makes cowage spicules a powerful way to investigate the circuitry of non-histamine itch and possibly provide insight into mechanisms for chronic itch.Next, LaMotte and his colleagues hims vs propecia incubated human cells with mucunain in lab dishes to tease apart which receptor proteins might be receiving and responding to the incoming itch.

They found responses in two types of such receptors — known as PAR2 and PAR4. Identifying itch-related receptors like hims vs propecia these can help get medicine closer to a potential treatment.To more fully understand the basics of itch and help disentangle it from pain, LaMotte and colleagues took a deep dive into the subtleties of the scratching behavior of mice. They learned where on the mouse body to inject their various irritants so as to reliably distinguish itchy types of scratching from pain types of scratching.More than a decade on, the researchers can take advantage of the many biological mechanisms underlying itch — such as receptors and nerve pathways — that are similar in mice and people. That means they can now move back and forth between the two, injecting similar chemicals, for example, hims vs propecia and tracking behavior (self-reports for humans, actions for mice) for intensity and duration.Meanwhile, the lab of Xinzhong Dong, an itch researcher at Johns Hopkins University, has used mice to pinpoint nerve endings that are truly itch-specific.

€œYou can activate those nerves, and you've got an itch sensation. You don't hims vs propecia feel pain,” he says. When he and his colleagues inactivated these dedicated itch neurons, mice were immune to itchy stimuli but still felt pain, the researchers reported in 2012 in Nature Neuroscience.Other researchers aim to unlock itch’s secrets with a more pure form of laboratory itch.Dermatology researcher Akihiko Ikoma, then of Kyoto University, and colleagues took a mechanical approach to the problem. Instead of relying on hims vs propecia chemical compounds, the team developed a small wire loop that vibrates at a specific frequency.

As the team described in 2013 in the journal PAIN, when the loop is touched to the fine hairs on people’s faces, it creates an itch that takes more than 10 minutes to completely dissipate. This work has helped scientists to pinpoint itch-specific neurons around the skin that work independently of histamines or various other chemicals that stimulate itching.The hope, for both methods, is to identify neurons and pathways specific to different kinds of itch. This will eventually help scientists investigate drugs that could relieve chronic itch in long-time sufferers.But there remains more to untangle about itching’s complex circuitry, with new receptors and nerve cells still being uncovered.A hims vs propecia Partnership With PainDespite all these advances — and despite the fact that itch is found throughout the animal kingdom, from fish to primates — “much of itch perception is still a mystery,” Dong and Hopkins colleague Mark Lay note in the 2020 Annual Review of Neuroscience.For one thing, even though there’s been progress, the intertwined nature of itch and pain is still difficult to untangle. One reason may be that both originated as self-protection.

Just as pain sends the signal to withdraw from something dangerous, itch prompts scratching, which could, for example, prevent s by shooing away hims vs propecia parasites. Scratching also appears to help recruit local immune cells that can fend off .Itch and pain also have a peculiar overlap that even occasional scratchers are familiar with. Scratching can generate mild pain, which can often override the sensation hims vs propecia of itch. Some researchers have proposed that when groups of neurons are activated — some of them itch-specific and some of them pain-specific — the pain stimulus, if strong enough, can mask the itch signals.And despite the new itch-only discoveries, many nerves do seem to be involved in communicating both painful and itchy stimuli.

The confusing overlap is exemplified in people with chronic conditions like atopic dermatitis hims vs propecia. In these cases, nerves in the skin become hyper-sensitive to itch, and perceive as itchy stimuli that are normally painful — or simply mechanical or thermal. This is similar to what’s experienced by hims vs propecia some people with chronic pain, where light touch can actually hurt. And basic nervous system malfunctions like a pinched or damaged nerve can generate pain in some people but itch in others.The overlap with pain is also present in the ways — still poorly understood — in which itch travels from the peripheral nerves in the skin to the spinal cord and up to the brain, Dong says.All of these lingering mysteries mean that itch — especially chronic itch — has been extremely difficult to effectively treat.

€œLike in pain, there's not just one painkiller that destroys all types of pain,” says Gil Yosipovitch, a dermatologist at the University of Miami and founder of the International hims vs propecia Forum for the Study of Itch.“I have patients who have a lot of complexities, and they require more than one pill or one cream, similar to patients who have chronic pain. And it requires a lot of time and patience.”For most of the population, itch is still a passing irritant, perhaps from bug bites in the summer or dry skin in the winter. But as a clinician and a research scientist, Kim says all of the suffering he sees from chronic itch keeps him working harder in the lab to understand this torturous sensation and correct too many years of inattention.“It’s just this cascade of hims vs propecia neglect,” he says.Katherine Harmon Courage is a freelance journalist, a contributor to Scientific American and Vox and the author of two books (Cultured and Octopus!. ).

She spends the summer as a favorite target of mosquitoes in hims vs propecia Colorado. You can follow her at @KHCourage.This article originally appeared in Knowable Magazine, an independent journalistic endeavor from Annual Reviews.When President Trump was diagnosed with hair loss treatment, one of the cutting-edge experimental therapies he received was a mixture of monoclonal antibodies. But now a treatment may soon be available. So are other therapies necessary or hims vs propecia valuable?.

And what exactly is a monoclonal antibody?. Over the past few months, the public has hims vs propecia learned about many treatments being used to combat hair loss treatment. An antiviral like remdesivir inhibits the propecia from replicating in human cells. Convalescent plasma from the hims vs propecia blood of donors who have recovered from hair loss treatment may contain antibodies that suppress the propecia and inflammation.

Steroids like dexamethasone may modify and reduce the dangerous inflammatory damage to the lungs, thereby slowing respiratory failure.The FDA issued emergency use authorization for Eli Lilly’s monoclonal antibody, called bamlanivimab, and Regeneron is waiting for FDA’s green light for its antibody treatment. Monoclonal antibodies are particularly promising in therapy because they can neutralize the hair loss propecia, which causes hair loss treatment, and block its ability to infect hims vs propecia a cell. This might be a lifesaving intervention in people who are unable to mount a strong natural immune response to the propecia – those over 65 or with existing conditions that make them more vulnerable.I’ve worked in public health and medical laboratories for decades, specializing in the study of propeciaes and other microbes. Even when hims vs propecia a treatment for hair loss treatment becomes available, I see a role for monoclonal antibody therapy in getting the propecia under control.Why Should We Care?.

Until a large percentage of a population has immunity to an infectious disease – either through a treatment or the unchecked spread through a community – the world must rely on other weapons in our war against the hair loss treatment propecia.Along with the previously mentioned therapies, monoclonal antibodies can offer us another tool to neutralize the propecia once it causes an .These man-made antibodies offer the world the possibility of immunotherapy similar to the use of convalescent plasma but with a more targeted and accurate action. While a treatment will ultimately help protect the public, vaccination will not be an instantaneous hims vs propecia event, delivering treatment to 100% of the population. Nor do we know how effective it will be.The impact of a treatment also isn’t instantaneous. It takes several weeks to generate a powerful antibody response hims vs propecia.

In the interim, monoclonal antibodies could help mop up propecia that is multiplying in the body.Antibody 101An antibody is a Y-shaped protein naturally produced by our body’s immune system to target something that is foreign, or not part of you. These foreign bodies are called antigens and can be found on allergens, bacteria and propeciaes as well as other things like toxins or a transplanted organ.A hims vs propecia monoclonal antibody treatment mimics the body’s natural immune response and targets foreign agents, like a propecia, that infect or harm people. There are also monoclonal antibodies that pharmaceutical companies have designed that target cancer cells. Monoclonal antibodies are one of most powerful types of medicine hims vs propecia.

In 2019 seven of the top 10 best-selling drugs were monoclonal antibodies.For President Trump, the experimental treatment made by the pharmaceutical company Regeneron included two antibodies.Typically the spike protein on the hair loss fits perfectly into the ACE2 receptor on human cells, a protein common in lung cells and other organs. When this connection happens, the propecia is able to infect cells and multiply inside them. But monoclonal antibodies hims vs propecia can slow or halt the by attaching to the viral spike protein before it reaches the ACE2 receptor. If this happens, the propecia becomes harmless because it can no longer enter our cells and reproduce.How Are Monoclonal Antibodies Created?.

Monoclonal antibodies hims vs propecia that neutralize the hair loss are complicated to manufacture and produce. They must be made inside cells taken from a hamster’s ovary and grown in gigantic steel vats. The antibodies that these hims vs propecia cells manufacture must then be extracted and purified. Unfortunately these monoclonal antibodies, which have been used for other illnesses for years, are often quite expensive.Regeneron’s two antibodies are targeted to the spike protein of hair loss – the protrusions on the surface of propecia that give it a crown-like look and are critical for infecting human cells.One of Regeneron’s two antibodies is a replica, or clone, of an antibody harvested from a person who recovered from hair loss treatment.

The second antibody was identified in a mouse that was biologically engineered to have a human hims vs propecia immune system. When this mouse was injected with the spike protein, its human immune system generated antibodies against it. One of the most effective mouse antibodies was then harvested and used to form part of this therapy.Eli Lilly’s monoclonal antibody therapy, hims vs propecia bamlanivimab, was identified from a blood sample taken from one of the first U.S. Patients who recovered from hair loss treatment.Both companies have in place large-scale manufacturing with robust, global supply chains in place to produce the monoclonal antibodies, with many global manufacturing sites to ramp up supply.

Eli Lilly has received FDA approval, and Regeneron is still awaiting hims vs propecia approval. Unfortunately, there will likely be a shortage of the antibodies in the early going of approvals.Monoclonal Antibodies Plus a treatmentMonoclonal antibodies will be able to complement treatments by offering rapid protection against . When they are given to an individual, monoclonal antibodies provide instantaneous protection for weeks to months hims vs propecia. treatments take longer to provide protection since they must challenge the immune system.

But the advantage of a treatment is that they usually provide hims vs propecia long-term protection.Regeneron’s and Eli Lilly’s products are both delivered by intravenous injection, after which the patient must be monitored by health care professionals. Since they offer immediate protection, the implications to treat or provide protection to high-risk populations is immense.These medicines have the potential to treat infected patients or prevent of essential health care and public health professionals on the front line of this propecia. Monoclonal antibodies could also be useful for older people, young children and immunocompromised people for whom treatments either don’t work or can be dangerous.Rodney E. Rohde is a hims vs propecia professor clinical laboratory science at Texas State University.

This article appeared on The Conversation and is republished under a Creative Commons license. Read the original here.Face coverings and social distancing are necessary for keeping the novel hair loss at bay, hims vs propecia but are propecia-related precautions affecting our ability to ward off other ailments down the road?. Health experts may not be able to say for sure yet, but there are ways to balance the two interests. Pro tip? hims vs propecia.

Get outside (preferably a good distance from people who don't live in your household) and take a deep breath. Your microbiome will hims vs propecia thank you. What is the Microbiome?. Our bodies play host to a wide array of microorganisms that make their hims vs propecia home on our skin and inside our guts, airways and other organs.

Their presence is so significant that the number of bacteria in our guts is actually greater than the number of human cells in the human body. The organisms' collective DNA is known as the microbiome and scientists have studied its effect on hims vs propecia everything from our social lives to our mental health.Put simply. The microbiome provides the immune system with information about potential intruders. It clues our body in on what is and isn't a threat and helps prepare our white blood cells hims vs propecia for battle.

Some of the microbiome is built up shortly after birth. A trip down the birth canal followed by months of breastfeeding helps babies form their unique hims vs propecia microbiome, but exposure to the natural environment in those first few years of life is crucial as well, experts say. €œAll of these organisms provide data for the immune system,” says Graham Rook, an immunologist and professor emeritus at University College London. €œIt's like hims vs propecia the brain.

It has to have data. And just like the brain, it needs the data early in life.” If the body fails to get the right messages about its environment, it may go rogue and attack things it shouldn't, leading to conditions like allergies, asthma and autoimmune disorders. Since the first few years of life are most crucial, Rook is especially concerned that if young children are not leaving their homes, they are not getting hims vs propecia the exposure to microbes they need. €œThat is why confining an infant to a high-rise apartment during hair loss treatment lockdowns is likely to be detrimental,” says Rook.

€œThe microbiome of a modern apartment is not a useful exposure.” The Daycare TestA recent study comparing different daycare settings in Finland demonstrated that simply enriching the outdoor play areas with elements of the natural environment had hims vs propecia a positive effect on the microbiomes in children. For four weeks in 2016, young children played on segments of forest floor and sod placed on top of the existing gravel. Instructors at the schools also engaged the children in activities such as planting gardens, resulting in average daily exposure of 90 minutes per day.The results indicated an increase in microbe biodiversity on the skin and in the guts of the children, and hims vs propecia a corresponding bump in immune system function. The study offers hope that even children in urban environments can build their microbiomes with some exposure to the natural world.

Animals Can Help Bring Exposure, Too “The most evidence-based strategy for improving your microbiome from an immunity [and] asthma hims vs propecia perspective is to get a cow,” says Rob Knight, a University of California, San Diego professor and co-founder of the American Gut Project. €œBut that isn’t especially practical if you live in an apartment in the city.”In studies completed by scientist Erika von Mutius, life on a farm and bacteria carried by cows, specifically, appeared to have the best benefit to humans, Knight says. Dogs and cats that spend time outdoors can also bring in some good microbes, experts say, which provides hims vs propecia another reason to adopt a pet while sheltering in place. Diet Also Plays a PartKnight says a diet promoting microbiome diversity would include a diverse range of plants and fermented foods, with limits on sugar and salt.

Rook adds that although building a healthy microbiome can be most crucial in the early years, studies indicate that adults can be affected as well.“Sick adults have less diverse gut microbiomes,” Rook hims vs propecia says, adding that a diverse diet and time in the natural environment are key to bolstering health. While it is true that humans pick up “data” from other humans and that is a missing piece of the equation now, Rook notes that he is far more concerned about young children who are not leaving their homes and getting exposure to microbes in their natural environments. And if you're worried that a lack of colds this year might lead to an immune system unprepared for next year's propeciaes, experts say that's not exactly hims vs propecia how it works. €œThere’s no evidence that exposure to pathogens per se is good,” Knight says.

€œCurrent thinking is that exposure to a wide range of harmless organisms from other people and the environment is good.”So, while the long-term health effects of social distancing might not be fully understood yet, embracing a lifestyle that includes healthy food choices and time spent hims vs propecia outdoors may be the best tools at our disposal right now. Rook also suspects that mask-wearing doesn't inhibit the ability to absorb what is needed from the outside world. €œPlenty of small particles from the natural environment are wafting into the lungs,” he says..

A new paper discusses how stressful propecia pill cost experiences - or psychedelic drugs - might produce profound propecia cost mental change.Authors Ari Brouwer and Robin Lester Carhart-Harris, writing in the Journal of Psychopharmacology, introduce the concept of 'pivotal mental states'. (Although this is a new term, the idea echoes earlier work).What is a pivotal mental state?. It's "a hyper-plastic state aiding rapid and deep learning that can mediate psychological transformation", or in propecia cost other words, a state in which beliefs, personality and mental health are prone to change. As they put it, these states "evolved to allow the experiencer a psychological ‘fresh start’, akin to a psychological ‘rebirth’".According to Brouwer and Carhart-Harris, these pivotal states may be triggered by severe psychological or physiological stress, but they can also be produced by drugs, especially psychedelics such as LSD or psilocybin (magic mushrooms). Biologically, they propecia cost say, stress and psychedelics have related effects on the brain in that stress upregulates 5HT2A serotonin receptors, which are the target of drugs like LSD.The authors emphasize that pivotal mental states are neither helpful nor harmful in themselves.

Rather, these states represent a psychological crossroads which can lead to many different destinations, from improved mental health, to serious disorders. Brouwer and Carhart-Harris illustrate the idea of a pivotal mental state as a "moment of decision" with a rather beautiful piece of art showing a person facing two ways forward, one towards sunny health and the other, gloomy illness:From Brouwer and propecia cost Carhart-Harris (2020)So what determines if the outcome of a pivotal state is good or bad?. The authors point to "contextual factors" - the social, psychological, and emotional environment, broadly speaking - as being key. These need to be "treated with special attention and therapeutic propecia cost care (where possible) if an individual’s psychological wellbeing is to be safeguarded", and this applies to individuals on psychedelics as well as acute psychosis.I found this paper bold and thought provoking, although I'd have liked to see the pivotal mental state described in more detail. The authors point to drug experiences, some forms of psychosis and some spiritual experiences as examples, but I would have liked to see more detail on what the state looks like (or feels like) phenomenologically.I also didn't find the biological aspects of the paper, with the focus on 5HT2A receptors, to be entirely convincing.

This is a complex issue and there are thousands of relevant scientific studies, but in a nutshell, I don't think we can equate the effect of stress with increased 5HT2A in all cases, and propecia cost clearly stress does not always have the same effects as a dose of LSD, while LSD effects are not identical with psychotic symptoms. Overall, the entire paper ends up raising more questions than it answers, and leaves the 'pivotal mental state' as something mysterious. This is not necessarily a bad thing - there can be value in describing a mystery, as a propecia cost first step towards solving it. But there is a lot more work to do here.This article appeared in Discover’s annual state of science issue as “A Brief Guide to treatment Types.” Support our science journalism by becoming a subscriber.The hair loss treatment propecia likely plunged you into a world — specifically, the world of treatment development — that you didn’t know much about before. Maybe you’ve propecia cost learned that treatments typically take years to produce.

Or maybe you’ve found yourself wondering how the roughly 200 hair loss treatments in development are supposed to work.Essentially, a treatment needs to trick your immune system into thinking there’s an . That way, you’ll develop an arsenal of tactics to kill off the pathogen, propecia cost should it ever show up in your body. Live treatments release a somewhat nonfunctional version of the propecia into the body. If researchers tamper with it just right, the modified propecia can still provoke your immune system without getting you sick. One way to sap a propecia of some of its power is to grow it in another species, the way researchers used propecia cost chick embryo cells to create the measles treatment.

Developers can also neutralize the propecia by exposing it to heat or chemicals like formaldehyde, creating what’s known as an inactivated treatment.There are also treatments that make your own cells produce the crucial proteins that help fight a propecia. Two of these are called propecia cost DNA treatments and RNA treatments. DNA varieties can push the hair loss spike protein gene into your cells. Once it’s there, the DNA is treated like your propecia cost own genetic information.Your bodies make RNA — temporary copies of the gene — and from that template build the viral proteins. RNA treatments, on the other hand, cut out a few steps in the production process.

These treatments provide the RNA pattern as is, and cells assemble proteins from there.For an RNA or DNA treatment to successfully work, it’s crucial that the genetic material gets inside your cells to the protein-generating propecia cost machinery that will properly proliferate the viral protein. Sometimes, treatment developers make sure this happens by tucking the DNA or RNA into the genome of another propecia, using that pathogen as a kind of shipping container. These are called viral vector propecia cost treatments. Don’t worry, you don’t get sick from the delivery — researchers disable the propecia to prevent that from happening.It’s also possible to create a treatment that does not force cells to make viral proteins, but instead delivers the proteins directly. Some companies are working propecia cost on these kinds of hair loss treatments, a category generally called protein-based treatments.On the whole, treatment developers spend a lot of time at the drawing board.

The complexity of the immune system makes it a tough beast to wrangle. When it comes to hair loss, any of propecia cost these treatment types could emerge from the pack — and ultimately help keep hair loss treatment at bay.It seems hard to believe that a basic human sensation — one that can be evoked by a simple mosquito bite — still has scientists scratching their heads. Yet despite centuries of study, understanding itching is still fraught.Itch, write two scientists in a review in the journal Immunity, “has been described as one of the most diabolical sensations. In Dante's Inferno, falsifiers were eternally punished by ‘the burning rage of fierce itching that nothing could relieve.’” Yet, the researchers note, “There have been very few advances in itch treatment in over 360 propecia cost years.”That’s finally starting to change. In the past decade, scientists have made strides toward understanding this infuriating sensation.

They are untangling itchiness from other propecia cost noxious stimuli, such as pain. They are even starting to distinguish one type of itch from another, by poking study participants with itch-inducing plant spikes or deleting itch-related genes from mice.This wide-ranging research is gradually going beyond an understanding of familiar acute histamine-driven itch — the mosquito or poison ivy variety — to reveal the complicated mechanisms and players involved in the often debilitating type of itching that lasts for weeks and sometimes years. Chronic itch, as it’s termed, can be generated by a multitude of factors, from chemicals secreted within the body to nerves gone haywire, and in many cases, has no known cause or cure.his inquiry is more than an academic exercise (or a quest to make mosquito welts recede faster). While acute propecia cost itch is fleeting, chronic itch may plague some 7 percent of people each year, and one in five people will experience it at some time in their lives. Beyond a maddening persistent urge to scratch, the condition can lead to depression, sleep deprivation and a drastic decrease in the quality of life.

€œIt can be as devastating as chronic pain,” says Robert LaMotte, an itch researcher propecia cost at the Yale School of Medicine.And pain is actually where the itch story starts.Identifying ItchFor much of the last century, itch was considered a lower-tiered version of pain. In the early 1920s, for example, Austrian-German physiologist and pain researcher Max von Frey documented in an influential study that a slight skin prick gave research participants the aftersensation of itch. This conceptual model continued to feed the field of itch for decades.But eventually, the idea that itch propecia cost was simply a subset of pain began to crumble. Scientists determined, for example, that they could not reliably turn a pain into an itch just by decreasing the pain’s intensity — or turn an itch to a pain by increasing the itch’s intensity. Yet the nerves and pathways of pain and itch appeared to be so similar and deeply intertwined that for propecia cost years scientists lacked a clear understanding of how the two responses were wired into the body.Then, in 2007, the sensation of itching finally crawled out from under the shadow of pain and into its own light.That year, a seminal paper in Nature reported the first dedicated itch receptor — a protein on nerve cells in the central nervous system that responds specifically to itch but not pain, indicating that the sensation might travel its own separate pathway to the brain.

Zhou-Feng Chen, at Washington University School of Medicine in St. Louis, and colleagues showed that mice engineered to lack genes for this receptor — called the gastrin-releasing peptide receptor — could still feel pain but barely felt itch, no matter what the researchers tried.“This changed the paradigm,” says Brian Kim, a dermatologist and codirector of the medical school’s Center for the Study of Itch, propecia cost who now works with Chen. Revealing itch as a sensation in its own right with a dedicated pathway was a crucial step forward in understanding it, he says.Since the discovery of this first itch receptor, researchers have discovered more cellular players involved in chronic itch, separating it out from acute itch. They have learned, for example, that chronic and acute itch propecia cost are relayed by different sets of neurons that send signals along their own dedicated tracks in the nervous system. When researchers have simulated chronic itch in experiments with healthy volunteers, MRI scans reveal that the two itch types spur different patterns of brain activity.These most foundational observations reveal just how much more we have to learn about itch.

But they also help create a path to bringing relief to those propecia cost who experience debilitating chronic cases. The sensation can be so bad that, for instance, some people with liver disease receive transplants precisely because of their itching. Others choose to go off of essential cancer medications because of the itching the drugs can cause.And for years, researchers were focused on propecia cost the low-hanging fruit of histamine-driven itch, which is easier to study, in part because it is being driven by a single chemical compound. Experimenters could spread or inject known irritants on or into the skin, cuing the body to make histamines, producing that familiar welty reaction that can be soothed by antihistamines like cortisone. But most chronic itch (technically, itchiness that lasts more than six weeks) doesn’t involve histamines.

And the routes — there are many — to chronic itch are propecia cost far more complicated.There are many routes to itch, but scientists have uncovered two, independent subtypes of neurons that relay the itch message to the spinal cord and brain. The histamine pathway (left), which is involved primarily in acute itch, is engaged when a trigger such as a mosquito bite spurs the release of histamines by the body’s immune system, which activate histamine receptors. Non-histamine itch (right) can be set off by a wide range of internal and external triggers, including immune system molecules such as cytokines, enzymes called proteases that cut propecia cost up proteins and the antimalarial drug chloroquine. After a trigger activates receptors in either pathway, enzymes are kicked into gear that spur the opening of ion channels, prompting the nerve to fire and send the itch signal to the spinal cord and brain.Now, as scientists refocus their investigations on chronic non-histamine itch, they’re doing much of the research the old-fashioned way. By making people and animals itchy.Itch by ItchInitiating an itch is not as propecia cost simple as it seems.

One approach that’s been especially fruitful for zeroing in on non-histamine itch is to poke people with tiny hairs (or spicules) from a tropical plant called cowhage, or velvet bean.In a key series of experiments, LaMotte and his colleagues took about 10 of these spicules, which are a few microns wide at the tip, and inserted them about 0.2 millimeters into the skin of study participants. Every 30 seconds, for up to 20 minutes, the thus-pricked people propecia cost reported sensations they felt, such as pricking, burning or itching, as well as the intensity. The studies confirmed that an unusual compound within the minute hairs, called mucunain, rapidly causes itchiness but — unlike many plant-based itch-prompting compounds — doesn’t activate histamines. That makes cowage spicules a powerful way to investigate the circuitry of non-histamine itch and possibly provide insight into mechanisms for chronic itch.Next, LaMotte and his colleagues incubated human cells with mucunain in lab dishes to tease apart which propecia cost receptor proteins might be receiving and responding to the incoming itch. They found responses in two types of such receptors — known as PAR2 and PAR4.

Identifying itch-related receptors like these can help get medicine closer to a potential treatment.To more fully understand the basics of propecia cost itch and help disentangle it from pain, LaMotte and colleagues took a deep dive into the subtleties of the scratching behavior of mice. They learned where on the mouse body to inject their various irritants so as to reliably distinguish itchy types of scratching from pain types of scratching.More than a decade on, the researchers can take advantage of the many biological mechanisms underlying itch — such as receptors and nerve pathways — that are similar in mice and people. That means they can now move back and forth between the two, injecting similar chemicals, for example, and tracking behavior (self-reports for humans, actions for mice) for intensity propecia cost and duration.Meanwhile, the lab of Xinzhong Dong, an itch researcher at Johns Hopkins University, has used mice to pinpoint nerve endings that are truly itch-specific. €œYou can activate those nerves, and you've got an itch sensation. You don't propecia cost feel pain,” he says.

When he and his colleagues inactivated these dedicated itch neurons, mice were immune to itchy stimuli but still felt pain, the researchers reported in 2012 in Nature Neuroscience.Other researchers aim to unlock itch’s secrets with a more pure form of laboratory itch.Dermatology researcher Akihiko Ikoma, then of Kyoto University, and colleagues took a mechanical approach to the problem. Instead of relying on chemical compounds, the team developed a small wire loop that vibrates propecia cost at a specific frequency. As the team described in 2013 in the journal PAIN, when the loop is touched to the fine hairs on people’s faces, it creates an itch that takes more than 10 minutes to completely dissipate. This work has helped scientists to pinpoint itch-specific neurons around the skin that work independently of histamines or various other chemicals that stimulate itching.The hope, for both methods, is to identify neurons and pathways specific to different kinds of itch. This will eventually help scientists investigate drugs that could relieve chronic itch in long-time sufferers.But there remains more to untangle about itching’s complex circuitry, with new receptors and nerve cells still being uncovered.A Partnership With PainDespite all these propecia cost advances — and despite the fact that itch is found throughout the animal kingdom, from fish to primates — “much of itch perception is still a mystery,” Dong and Hopkins colleague Mark Lay note in the 2020 Annual Review of Neuroscience.For one thing, even though there’s been progress, the intertwined nature of itch and pain is still difficult to untangle.

One reason may be that both originated as self-protection. Just as pain sends the signal to withdraw from something dangerous, itch prompts propecia cost scratching, which could, for example, prevent s by shooing away parasites. Scratching also appears to help recruit local immune cells that can fend off .Itch and pain also have a peculiar overlap that even occasional scratchers are familiar with. Scratching can generate mild pain, which propecia cost can often override the sensation of itch. Some researchers have proposed that when groups of neurons are activated — some of them itch-specific and some of them pain-specific — the pain stimulus, if strong enough, can mask the itch signals.And despite the new itch-only discoveries, many nerves do seem to be involved in communicating both painful and itchy stimuli.

The confusing overlap is exemplified in people propecia cost with chronic conditions like atopic dermatitis. In these cases, nerves in the skin become hyper-sensitive to itch, and perceive as itchy stimuli that are normally painful — or simply mechanical or thermal. This is similar to what’s experienced by some people with chronic propecia cost pain, where light touch can actually hurt. And basic nervous system malfunctions like a pinched or damaged nerve can generate pain in some people but itch in others.The overlap with pain is also present in the ways — still poorly understood — in which itch travels from the peripheral nerves in the skin to the spinal cord and up to the brain, Dong says.All of these lingering mysteries mean that itch — especially chronic itch — has been extremely difficult to effectively treat. €œLike in pain, there's not just one painkiller that destroys all types of pain,” says Gil Yosipovitch, a dermatologist at the University of Miami and founder of the International Forum for the Study of Itch.“I have patients who have a lot of complexities, and they require more than one pill or one cream, similar to patients propecia cost who have chronic pain.

And it requires a lot of time and patience.”For most of the population, itch is still a passing irritant, perhaps from bug bites in the summer or dry skin in the winter. But as a clinician and a research scientist, Kim says all of the suffering he sees from chronic itch keeps him propecia cost working harder in the lab to understand this torturous sensation and correct too many years of inattention.“It’s just this cascade of neglect,” he says.Katherine Harmon Courage is a freelance journalist, a contributor to Scientific American and Vox and the author of two books (Cultured and Octopus!. ). She spends the summer as a favorite target of mosquitoes in propecia cost Colorado. You can follow her at @KHCourage.This article originally appeared in Knowable Magazine, an independent journalistic endeavor from Annual Reviews.When President Trump was diagnosed with hair loss treatment, one of the cutting-edge experimental therapies he received was a mixture of monoclonal antibodies.

But now a treatment may soon be available. So are other therapies propecia cost necessary or valuable?. And what exactly is a monoclonal antibody?. Over the past few months, the public has learned about many treatments being used to combat hair loss treatment propecia cost. An antiviral like remdesivir inhibits the propecia from replicating in human cells.

Convalescent plasma from the blood of donors who have recovered from hair loss treatment may contain antibodies that suppress the propecia cost propecia and inflammation. Steroids like dexamethasone may modify and reduce the dangerous inflammatory damage to the lungs, thereby slowing respiratory failure.The FDA issued emergency use authorization for Eli Lilly’s monoclonal antibody, called bamlanivimab, and Regeneron is waiting for FDA’s green light for its antibody treatment. Monoclonal antibodies are particularly promising in therapy because they can neutralize the hair loss propecia, which causes hair loss treatment, and block propecia cost its ability to infect a cell. This might be a lifesaving intervention in people who are unable to mount a strong natural immune response to the propecia – those over 65 or with existing conditions that make them more vulnerable.I’ve worked in public health and medical laboratories for decades, specializing in the study of propeciaes and other microbes. Even when a treatment for hair loss treatment becomes available, I see a role for monoclonal antibody therapy in getting the propecia under control.Why Should propecia cost We Care?.

Until a large percentage of a population has immunity to an infectious disease – either through a treatment or the unchecked spread through a community – the world must rely on other weapons in our war against the hair loss treatment propecia.Along with the previously mentioned therapies, monoclonal antibodies can offer us another tool to neutralize the propecia once it causes an .These man-made antibodies offer the world the possibility of immunotherapy similar to the use of convalescent plasma but with a more targeted and accurate action. While a treatment will ultimately help protect the public, vaccination will not be an instantaneous event, delivering propecia cost treatment to 100% of the population. Nor do we know how effective it will be.The impact of a treatment also isn’t instantaneous. It takes several weeks to generate a propecia cost powerful antibody response. In the interim, monoclonal antibodies could help mop up propecia that is multiplying in the body.Antibody 101An antibody is a Y-shaped protein naturally produced by our body’s immune system to target something that is foreign, or not part of you.

These foreign bodies are called antigens and can be found on allergens, bacteria and propeciaes propecia cost as well as other things like toxins or a transplanted organ.A monoclonal antibody treatment mimics the body’s natural immune response and targets foreign agents, like a propecia, that infect or harm people. There are also monoclonal antibodies that pharmaceutical companies have designed that target cancer cells. Monoclonal antibodies propecia cost are one of most powerful types of medicine. In 2019 seven of the top 10 best-selling drugs were monoclonal antibodies.For President Trump, the experimental treatment made by the pharmaceutical company Regeneron included two antibodies.Typically the spike protein on the hair loss fits perfectly into the ACE2 receptor on human cells, a protein common in lung cells and other organs. When this connection happens, the propecia is able to infect cells and multiply inside them.

But monoclonal antibodies can slow or halt the by attaching to the viral spike protein before it reaches the ACE2 receptor propecia cost. If this happens, the propecia becomes harmless because it can no longer enter our cells and reproduce.How Are Monoclonal Antibodies Created?. Monoclonal antibodies that neutralize the hair loss are complicated to manufacture and produce propecia cost. They must be made inside cells taken from a hamster’s ovary and grown in gigantic steel vats. The antibodies that these cells manufacture must then be propecia cost extracted and purified.

Unfortunately these monoclonal antibodies, which have been used for other illnesses for years, are often quite expensive.Regeneron’s two antibodies are targeted to the spike protein of hair loss – the protrusions on the surface of propecia that give it a crown-like look and are critical for infecting human cells.One of Regeneron’s two antibodies is a replica, or clone, of an antibody harvested from a person who recovered from hair loss treatment. The second antibody was identified in a mouse that was biologically engineered to have a human propecia cost immune system. When this mouse was injected with the spike protein, its human immune system generated antibodies against it. One of the most effective mouse antibodies was then harvested and used to form part of this propecia cost therapy.Eli Lilly’s monoclonal antibody therapy, bamlanivimab, was identified from a blood sample taken from one of the first U.S. Patients who recovered from hair loss treatment.Both companies have in place large-scale manufacturing with robust, global supply chains in place to produce the monoclonal antibodies, with many global manufacturing sites to ramp up supply.

Eli Lilly has received FDA approval, and Regeneron is still awaiting approval propecia cost. Unfortunately, there will likely be a shortage of the antibodies in the early going of approvals.Monoclonal Antibodies Plus a treatmentMonoclonal antibodies will be able to complement treatments by offering rapid protection against . When they are given to an individual, monoclonal antibodies provide instantaneous propecia cost protection for weeks to months. treatments take longer to provide protection since they must challenge the immune system. But the advantage of a treatment is propecia cost that they usually provide long-term protection.Regeneron’s and Eli Lilly’s products are both delivered by intravenous injection, after which the patient must be monitored by health care professionals.

Since they offer immediate protection, the implications to treat or provide protection to high-risk populations is immense.These medicines have the potential to treat infected patients or prevent of essential health care and public health professionals on the front line of this propecia. Monoclonal antibodies could also be useful for older people, young children and immunocompromised people for whom treatments either don’t work or can be dangerous.Rodney E. Rohde is a professor clinical propecia cost laboratory science at Texas State University. This article appeared on The Conversation and is republished under a Creative Commons license. Read the original here.Face coverings and social distancing are necessary for keeping the novel propecia cost hair loss at bay, but are propecia-related precautions affecting our ability to ward off other ailments down the road?.

Health experts may not be able to say for sure yet, but there are ways to balance the two interests. Pro tip? propecia cost. Get outside (preferably a good distance from people who don't live in your household) and take a deep breath. Your microbiome will thank you propecia cost. What is the Microbiome?.

Our bodies play host to a wide array of microorganisms that make propecia cost their home on our skin and inside our guts, airways and other organs. Their presence is so significant that the number of bacteria in our guts is actually greater than the number of human cells in the human body. The organisms' collective DNA is known as the microbiome and propecia cost scientists have studied its effect on everything from our social lives to our mental health.Put simply. The microbiome provides the immune system with information about potential intruders. It clues our body in on propecia cost what is and isn't a threat and helps prepare our white blood cells for battle.

Some of the microbiome is built up shortly after birth. A trip down the birth canal followed by months of breastfeeding helps babies form their unique microbiome, but exposure to the natural environment in those first few years of life is crucial as well, experts say propecia cost. €œAll of these organisms provide data for the immune system,” says Graham Rook, an immunologist and professor emeritus at University College London. €œIt's like the brain propecia cost. It has to have data.

And just like the brain, it needs the data early in life.” If the body fails to get the right messages about its environment, it may go rogue and attack things it shouldn't, leading to conditions like allergies, asthma and autoimmune disorders. Since the first few years of life are most crucial, Rook is especially concerned that if young children are not leaving their homes, they are not propecia cost getting the exposure to microbes they need. €œThat is why confining an infant to a high-rise apartment during hair loss treatment lockdowns is likely to be detrimental,” says Rook. €œThe microbiome of a modern apartment is not a useful exposure.” The Daycare TestA recent study comparing different daycare settings in Finland demonstrated that simply propecia cost enriching the outdoor play areas with elements of the natural environment had a positive effect on the microbiomes in children. For four weeks in 2016, young children played on segments of forest floor and sod placed on top of the existing gravel.

Instructors at the schools also engaged the children in activities such as planting gardens, resulting in average daily exposure of 90 minutes per day.The results indicated an increase in microbe biodiversity on the skin and in the propecia cost guts of the children, and a corresponding bump in immune system function. The study offers hope that even children in urban environments can build their microbiomes with some exposure to the natural world. Animals Can Help propecia cost Bring Exposure, Too “The most evidence-based strategy for improving your microbiome from an immunity [and] asthma perspective is to get a cow,” says Rob Knight, a University of California, San Diego professor and co-founder of the American Gut Project. €œBut that isn’t especially practical if you live in an apartment in the city.”In studies completed by scientist Erika von Mutius, life on a farm and bacteria carried by cows, specifically, appeared to have the best benefit to humans, Knight says. Dogs and cats that spend time outdoors can also bring in some propecia cost good microbes, experts say, which provides another reason to adopt a pet while sheltering in place.

Diet Also Plays a PartKnight says a diet promoting microbiome diversity would include a diverse range of plants and fermented foods, with limits on sugar and salt. Rook adds that although building a healthy microbiome can be most crucial in the early propecia cost years, studies indicate that adults can be affected as well.“Sick adults have less diverse gut microbiomes,” Rook says, adding that a diverse diet and time in the natural environment are key to bolstering health. While it is true that humans pick up “data” from other humans and that is a missing piece of the equation now, Rook notes that he is far more concerned about young children who are not leaving their homes and getting exposure to microbes in their natural environments. And if propecia cost you're worried that a lack of colds this year might lead to an immune system unprepared for next year's propeciaes, experts say that's not exactly how it works. €œThere’s no evidence that exposure to pathogens per se is good,” Knight says.

€œCurrent thinking is that exposure to a wide range of harmless organisms from other people and propecia cost the environment is good.”So, while the long-term health effects of social distancing might not be fully understood yet, embracing a lifestyle that includes healthy food choices and time spent outdoors may be the best tools at our disposal right now. Rook also suspects that mask-wearing doesn't inhibit the ability to absorb what is needed from the outside world. €œPlenty of small particles from the natural environment are wafting into the lungs,” he says..

Propecia dosage for hair loss

Researchers at the University of Maryland School of Medicine (UMSOM) have conducted a study that has determined the role that a critical protein plays propecia dosage for hair loss in the development of hair cells. These hair cells are vital for propecia dosage for hair loss hearing. Some of these cells amplify sounds that come into the ear, and others transform sound waves into electrical signals that travel to the brain. Ronna Hertzano, MD, PhD, Associate Professor in the Department of Otorhinolaryngology Head and Neck Surgery at UMSOM and Maggie Matern, PhD, a postdoctoral fellow at Stanford University, demonstrated that the protein, called GFI1, may be critical for determining whether an embryonic hair cell matures into a functional adult hair cell or becomes a different cell that functions more like a nerve cell or neuron.The study was published in the journal Development, and was conducted by physician-scientists and researchers at the UMSOM Department of Otorhinolaryngology Head and Neck Surgery and the UMSOM Institute for Genome Sciences (IGS), in collaboration with researchers at propecia dosage for hair loss the Sackler School of Medicine at Tel Aviv University in Israel.Hearing relies on the proper functioning of specialized cells within the inner ear called hair cells.

When the hair cells do not develop properly or are damaged by environmental stresses like loud noise, it results in a loss of hearing function.In the United States, the prevalence of hearing loss doubles with every 10-year increase in age, affecting about half of all adults in their 70s and about 80 percent of those who are over age 85. Researchers have been focusing on describing the developmental steps that lead to a functional hair cell, in order propecia dosage for hair loss to potentially generate new hair cells when old ones are damaged.Hair cells in the inner earTo conduct her latest study, Dr. Hertzano and her team utilized cutting-edge methods to study gene expression in the hair cells of propecia dosage for hair loss genetically modified newborn mice that did not produce GFI1. They demonstrated that, in the absence of this vital protein, embryonic hair cells failed to progress in their development to become fully functional adult cells.

In fact, the genes expressed by these cells indicated that they were likely to develop into neuron-like cells."Our findings explain why GFI1 is critical to enable embryonic cells to progress into functioning adult hair propecia dosage for hair loss cells," said Dr. Hertzano. "These data also explain the importance of GFI1 in experimental protocols to regenerate hair cells propecia dosage for hair loss from stem cells. These regenerative methods have the potential propecia dosage for hair loss of being used for patients who have experienced hearing loss due to age or environmental factors like exposure to loud noise."Dr.

Hertzano first became interested in GFI1 while completing her M.D., Ph.D. At Tel propecia dosage for hair loss Aviv University. As part of her dissertation, she discovered that the hearing loss resulting from mutations in another protein called POU4F3 appeared to largely result from a loss of GFI1 in the hair cells. Since then, she has propecia dosage for hair loss been conducting studies to discover the role of GFI1 and other proteins in hearing.

Other research groups in the field are now testing these proteins to determine whether they can be used as a "cocktail" to regenerate lost hair cells and restore hearing."Hearing research has been going through a Renaissance period, not only from advances in genomics and methodology, but also thanks to its uniquely collaborative propecia dosage for hair loss nature among researchers," said Dr. Herzano.The new study was funded by the National Institute on Deafness and Other Communication Disorders (NIDCD) which is part of the National Institutes of Health (NIH). It was also funded by the Binational Scientific Foundation (BSF)."This is an exciting new finding that underscores the importance of basic research to lay the foundation for future propecia dosage for hair loss clinical innovations," said E. Albert Reece, MD, PhD, MBA, Executive Vice President for Medical Affairs, UM Baltimore, and the John Z.

And Akiko propecia dosage for hair loss K. Bowers Distinguished Professor and Dean, propecia dosage for hair loss University of Maryland School of Medicine. "Identifying the complex pathways that lead to normal hearing could prove to be the key for reversing hearing loss in millions of Americans." Story Source. Materials provided by propecia dosage for hair loss University of Maryland School of Medicine.

Note. Content may be edited for style and length.Researchers at Indiana University School of Medicine are learning more about how a person's genes play propecia dosage for hair loss a role in the possibility they'll suffer from alcoholic cirrhosis with the discovery of a gene that could make the disease less likely.Alcoholic cirrhosis can happen after years of drinking too much alcohol. According to the researchers, discovering more about this illness couldn't come at a more important time."Based propecia dosage for hair loss on U.S. Data, alcohol-associated liver disease is on the rise in terms of the prevalence and incidents and it is happening more often in younger patients," said Suthat Liangpunsakul, MD, professor of medicine, dean's scholar in medical research for the Department of Medicine Division of Gastroenterology and Hepatology, and one of the principal investigators of the study.

"There's a real public health problem involving the consumption of alcohol and people starting to drink propecia dosage for hair loss at a younger age."The team describes their findings in a new paper published in Hepatology. The GenomALC Consortium was funded by the National Institutes on Alcohol Abuse and Alcoholism (NIAAA), part of the National Institute of Health (NIH). This genome-wide association study began several years ago and is one of the largest studies related to alcoholic cirrhosis ever propecia dosage for hair loss performed. DNA samples were taken from over 1,700 patients from sites in the United States, several countries in Europe and Australia and sent to IU School of Medicine propecia dosage for hair loss where the team performed the DNA isolation for genome analysis.

The patients were divided into two groups -- one made up of heavy drinkers that never had a history of alcohol-induced liver injury or liver disease and a second group of heavy drinkers who did have alcoholic cirrhosis."Our key finding is a gene called Fas Associated Factor Family Member 2, or FAF2," said Tae-Hwi Schwantes-An, PhD, assistant research professor of medical and molecular genetics and the lead author of the study. "There's this convergence of findings now that are pointing to the genes involved in lipid droplet organization pathway, and that seems to be propecia dosage for hair loss one of the biological reasonings of why certain people get liver disease and why certain people do not."The researchers are anticipating to study this gene more closely and looking at its relationship to other, previously-discovered genes that can make a person more likely to develop alcoholic cirrhosis."We know for a fact those genes are linked together in a biological process, so the logical next step is to study how the changes in these genes alter the function of that process, whether it's less efficient in one group of people, or maybe it's inhibited in some way," Schwantes-An said. "We don't know exactly what the biological underpinning of that is, but now we have a pretty well-defined target where we can look at these variants and see how they relate to alcoholic cirrhosis."As their research continues, the team hopes to eventually find a way to identify this genetic factor in patients with the goal of helping them prevent alcoholic cirrhosis in the future or developing targeted therapies that can help individuals in a more personalized way. Story Source propecia dosage for hair loss.

Materials provided by Indiana University School of propecia dosage for hair loss Medicine. Original written by Christina Griffiths. Note. Content may be edited for style and length.Penn Medicine researchers have found that middle-aged individuals -- those born in the late 1960s and the 1970s -- may be in a perpetual state of H3N2 influenza propecia susceptibility because their antibodies bind to H3N2 propeciaes but fail to prevent s, according to a new study led by Scott Hensley, PhD, an associate professor of Microbiology at the Perelman School of Medicine at the University of Pennsylvania.

The paper was published today in Nature Communications."We found that different aged individuals have different H3N2 flu propecia antibody specificities," Hensley said. "Our studies show that early childhood s can leave lifelong immunological imprints that affect how individuals respond to antigenically distinct viral strains later in life."Most humans are infected with influenza propeciaes by three to four years of age, and these initial childhood s can elicit strong, long lasting memory immune responses. H3N2 influenza propeciaes began circulating in humans in 1968 and have evolved substantially over the past 51 years. Therefore, an individual's birth year largely predicts which specific type of H3N2 propecia they first encountered in childhood.Researchers completed a serological survey -- a blood test that measures antibody levels -- using serum samples collected in the summer months prior to the 2017-2018 season from 140 children (ages one to 17) and 212 adults (ages 18 to 90).

They first measured the differences in antibody reactivity to various strains of H3N2, and then measured for neutralizing and non-neutralizing antibodies. Neutralizing antibodies can prevent viral s, whereas non-neutralizing antibodies can only help after an takes place. Samples from children aged three to ten years old had the highest levels of neutralizing antibodies against contemporary H3N2 propeciaes, while most middle-aged samples had antibodies that could bind to these propeciaes but these antibodies could not prevent viral s.Hensley said his team's findings are consistent with a concept known as "original antigenic sin" (OAS), originally proposed by Tom Francis, Jr. In 1960.

"Most individuals born in the late 1960s and 1970s were immunologically imprinted with H3N2 propeciaes that are very different compared to contemporary H3N2 propeciaes. Upon with recent H3N2 propeciaes, these individuals tend to produce antibodies against regions that are conserved with older H3N2 strains and these types of antibodies typically do not prevent viral s."According to the research team, it is possible that the presence of high levels of non-neutralizing antibodies in middle-aged adults has contributed to the continued persistence of H3N2 propeciaes in the human population. Their findings might also relate to the unusual age distribution of H3N2 s during the 2017-2018 season, in which H3N2 activity in middle-aged and older adults peaked earlier compared to children and young adults.The researchers say that it will be important to continually complete large serological surveys in different aged individuals, including donors from populations with different vaccination rates. A better understanding of immunity within the population and within individuals will likely lead to improved models that are better able to predict the evolutionary trajectories of different influenza propecia strains."Large serological studies can shed light on why the effectiveness of flu treatments varies in individuals with different immune histories, while also identifying barriers that need to be overcome in order to design better treatments that are able to elicit protective responses in all age groups," said Sigrid Gouma, PhD, a postdoctoral researcher of Microbiology and first author on the paper.Other Penn authors include Madison Weirick and Megan E.

Gumina. Additional authors include Angela Branche, David J. Topham, Emily T. Martin, Arnold S.

Monto, and Sarah Cobey.This work was supported by the National Institute of Allergy and Infectious Diseases (1R01AI113047, S.E.H.. 1R01AI108686, S.E.H.. 1R01AI097150, A.S.M.. CEIRS HHSN272201400005C, S.E.H., S.C., E.T.M., A.S.M.

A.B., D.J.T.) and Center for Disease Control (U01IP000474, A.S.M.). Scott E. Hensley holds an Investigators in the Pathogenesis of Infectious Disease Awards from the Burroughs Wellcome Fund.Males and females share the vast majority of their genomes. Only a sprinkling of genes, located on the so-called X and Y sex chromosomes, differ between the sexes.

Nevertheless, the activities of our genes -- their expression in cells and tissues -- generate profound distinctions between males and females.Not only do the sexes differ in outward appearance, their differentially expressed genes strongly affect the risk, incidence, prevalence, severity and age-of-onset of many diseases, including cancer, autoimmune disorders, cardiovascular disease and neurological afflictions.Researchers have observed sex-associated differences in gene expression across a range of tissues including liver, heart, and brain. Nevertheless, such tissue-specific sex differences remain poorly understood. Most traits that display variance between males and females appear to result from differences in the expression of autosomal genes common to both sexes, rather than through expression of sex chromosome genes or sex hormones.A better understanding of these sex-associated disparities in the behavior of our genes could lead to improved diagnoses and treatments for a range of human illnesses.In a new paper in the PERSPECTIVES section of the journal Science, Melissa Wilson reviews current research into patterns of sex differences in gene expression across the genome, and highlights sampling biases in the human populations included in such studies."One of the most striking things about this comprehensive study of sex differences," Wilson said, "is that while aggregate differences span the genome and contribute to biases in human health, each individual gene varies tremendously between people."Wilson is a researcher in the Biodesign Center for Mechanisms in Evolution, the Center for Evolution and Medicine, and ASU's School of Life Sciences. advertisement A decade ago, an ambitious undertaking, known as the Genotype-Tissue Expression (GTEx) consortium began to investigate the effects DNA variation on gene expression across the range of human tissues.

Recent findings, appearing in the Science issue under review, indicate that sex-linked disparities in gene expression are far more pervasive than once assumed, with more than a third of all genes displaying sex-biased expression in at least one tissue. (The new research highlighted in Wilson's PERSPECTIVES piece describes gene regulatory differences between the sexes in every tissue under study.)Sex-linked differences in gene expression are shared across mammals, though their relative roles in disease susceptibility remain speculative. Natural selection likely guided the development of many of these attributes. For example, the rise of placental mammals some 90 million years ago may have led to differences in immune function between males and females.Such sex-based distinctions arising in the distant past have left their imprint on current mammals, including humans, expressed in higher rates of autoimmune disorders in females and increased cancer rates in males.Despite their critical importance for understanding disease prevalence and severity, sex differences in gene expression have only recently received serious attention in the research community.

Wilson and others suggest that much historical genetic research, using primarily white male subjects in mid-life, have yielded an incomplete picture.Such studies often fail to account for sex differences in the design and analysis of experiments, rendering a distorted view of sex-based disease variance, often leading to one-size-fits-all approaches to diagnosis and treatment. The authors therefore advise researchers to be more careful about generalizations based on existing databases of genetic information, including GTEx.A more holistic approach is emerging, as researchers investigate the full panoply of effects related to male and female gene expression across a broader range of human variation. Story Source. Materials provided by Arizona State University.

Original written by Richard Harth. Note. Content may be edited for style and length.Researchers at Yale have identified a possible treatment for Duchenne muscular dystrophy (DMD), a rare genetic disease for which there is currently no cure or treatment, by targeting an enzyme that had been considered "undruggable." The finding appears in the Aug. 25 edition of Science Signaling.DMD is the most common form of muscular dystrophy, a disease that leads to progressive weakness and eventual loss of the skeletal and heart muscles.

It occurs in 16 of 100,000 male births in the U.S. People with the disease exhibit clumsiness and weakness in early childhood and typically need wheelchairs by the time they reach their teens. The average life expectancy is 26.While earlier research had revealed the crucial role played by an enzyme called MKP5 in the development of DMD, making it a promising target for possible treatment, scientists for decades had been unable to disrupt this family of enzymes, known as protein tyrosine phosphatases, at the enzymes' "active" site where chemical reactions occur.In the new study, Anton Bennett, the Dorys McConnell Duberg Professor of Pharmacology and professor of comparative medicine, and his team screened over 162,000 compounds. They identified one molecular compound that blocked the enzyme's activity by binding to a previously undiscovered allosteric site -- a spot near the enzyme's active site."There have been many attempts to design inhibitors for this family of enzymes, but those compounds have failed to produce the right properties," Bennett said.

"Until now, the family of enzymes has been considered 'undruggable.'"By targeting the allosteric site of MKP5 instead, he said, "We discovered an excellent starting point for drug development that circumvented the earlier problems."The researchers tested their compound in muscle cells and found that it successfully inhibited MKP5 activity, suggesting a promising new therapeutic strategy for treating DMD.The research was supported by a National Institutes of Health grant through the National Institute of Arthritis and Musculoskeletal and Skin Diseases, as well as by the Blavatnik Fund for Innovation at Yale, which annually presents awards to support the most promising life science discoveries from Yale faculty.Bennett said that the Blavatnik funding, which is administered by the Yale Office of Cooperative Research, was critical in moving the research forward. "It resulted in a license with a major pharmaceutical company," he said, "and we hope they will rapidly move forward with the development of the new treatment."The finding has implications well beyond muscular dystrophy, he added. The researchers have demonstrated that the MKP5 enzyme is broadly implicated in fibrosis, or the buildup of scar tissue, a condition that contributes to nearly one-third of natural deaths worldwide."Fibrosis is involved in the end-stage death of many tissues, including liver, lung, and muscle," Bennett said. "We believe this enzyme could be a target more broadly for fibrotic tissue disease."The research team from Yale included Naftali Kaminski, the Boehringer-Ingelheim Professor of Internal Medicine and chief of pulmonary, critical care and sleep medicine.

Jonathan Ellman, the Eugene Higgins Professor of Chemistry and professor of pharmacology. Karen Anderson, professor of pharmacology and of molecular biophysics and biochemistry. Elias Lolis, professor of pharmacology. Zachary Gannam, a graduate student in pharmacology.

Kisuk Min, a postdoctoral fellow. Shanelle Shillingford, a graduate student in chemistry. Lei Zhang, a research associate in pharmacology. And the Yale Center for Molecular Discovery.

Story Source. Materials provided by Yale University. Original written by Brita Belli. Note.

Content may be edited for style and length.This story is part of a partnership that includes NPR and Kaiser Health News. This story can be republished for free (details). After shutting down in the spring, America’s empty gyms are beckoning a cautious public back for a workout. To reassure wary customers, owners have put in place — and now advertise — a variety of hair loss control measures. At the same time, the fitness industry is trying to rehabilitate itself by pushing back against what it sees as a misleading narrative that gyms have no place during a propecia.In the first months of the hair loss outbreak, most public health leaders advised closing gyms, erring on the side of caution.

As s exploded across the country, states ordered gyms and fitness centers closed, along with restaurants, movie theaters and bars. State and local officials consistently branded gyms as high-risk venues for , akin to bars and nightclubs. In early August, New York Gov. Andrew Cuomo called gym-going a “dangerous activity,” saying he would keep them shut — only to announce later in the month that most gyms could reopen in September at a third of the capacity and under tight regulations.New York, New Jersey and North Carolina were among the last state holdouts — only recently allowing fitness facilities to reopen.

Many states continue to limit capacity and have instituted new requirements.The benefits of gyms are clear. Regular exercise staves off depression and improves sleep, and staying fit may be a way to avoid a serious case of hair loss treatment. But there are clear risks, too. Lots of people moving around indoors, sharing equipment and air, and breathing heavily could be a recipe for easy viral spread.

There are scattered reports of hair loss cases traced back to specific gyms. But gym owners say those are outliers and argue the dominant portrayal overemphasizes potential dangers and ignores their brief but successful track record of safety during the propecia. Email Sign-Up Subscribe to KHN’s free Morning Briefing. A Seattle gym struggles to comply with new rules and surviveAt NW Fitness in Seattle, everything from a set of squats to a run on the treadmill requires a mask.

Every other cardio machine is off-limits. The owners have marked up the floor with blue tape to show where each person can work out.Esmery Corniel, a member, has resumed his workout routine with the punching bag.“I was honestly just losing my mind,” said Corniel, 27. He said he feels comfortable in the gym with its new safety protocols.“Everybody wears their mask, everybody socially distances, so it’s no problem here at all,” Corniel said.There’s no longer the usual morning “rush” of people working out before heading to their jobs.Under Washington state’s hair loss rules, only about 10 to 12 people at a time are permitted in this 4,000-square-foot gym.“It’s drastically reduced our ability to serve our community,” said John Carrico. He and his wife, Jessica, purchased NW Fitness at the end of last year.John and Jessica Carrico run NW Fitness, a small gym in Seattle that has struggled to stay afloat during the propecia.

Their membership has plummeted in recent months, in part because the gym has been closed and subject to strict hair loss requirements.(Will Stone)Meanwhile, the cost of running the businesses has gone up dramatically. The gym now needs to be staffed round-the-clock to keep up with the frequent cleaning requirements, and to ensure people are wearing masks and following the rules.Keeping the gym open 24/7 — previously a big selling point for members — is no longer feasible. In the past three months, they’ve lost more than a third of their membership.“If the trend continues, we won’t be able to stay open,” said Jessica Carrico, who also works as a nurse at a homeless shelter run by Harborview Medical Center.Given her medical background, Jessica Carrico was initially inclined to trust the public health authorities who ordered all gyms to shut down, but gradually her feelings changed.“Driving around the city, I’d still see lines outside of pot shops and Baskin-Robbins,” she said. €œThe arbitrary decision that had been made was very clear, and it became really frustrating.”Even after gyms in the Seattle area were allowed to reopen, their frustrations continued — especially with the strict cap on operating capacity.

The Carricos believe that falls hardest on smaller gyms that don’t have much square footage.“People want this space to be safe, and will self-regulate,” said John Carrico. He believes he could responsibly operate with twice as many people inside as currently allowed. Public health officials have mischaracterized gyms, he added, and underestimated their potential to operate safely.“There’s this fear-based propaganda that gyms are a cesspool of hair loss, which is just super not true,” Carrico said.Gyms seem less risky than bars. But there’s very little research either wayThe fitness industry has begun to push back at the propecia-driven perceptions and prohibitions.

€œWe should not be lumped with bars and restaurants,” said Helen Durkin, an executive vice president for the International Health, Racquet &. Sportsclub Association (IHRSA).John Carrico called the comparison with bars particularly unfair. €œIt’s almost laughable. I mean, it’s almost the exact opposite.

€¦ People here are investing in their health. They’re coming in, they’re focusing on what they’re trying to do as far as their workout. They’re not socializing, they’re not sitting at a table and laughing and drinking.”Since the propecia began, many gyms have overhauled operations and now look very different. Locker rooms are often closed and group classes halted.

Many gyms check everyone for symptoms upon arrival. They’ve spaced out equipment and begun intensive cleaning regimes.Gyms have a big advantage over other retail and entertainment venues, Durkin said, because the membership model means those who may have been exposed in an outbreak can be easily contacted.A company that sells member databases and software to gyms has been compiling data during the propecia. (The data, drawn from 2,877 gyms, is by no means comprehensive because it relies on gym owners to self-report incidents in which a positive hair loss case was detected at the gym, or was somehow connected to the gym.) The resultant report said that the overall “visits to propecia” ratio of 0.002% is “statistically irrelevant” because only 1,155 cases of hair loss were reported among more than 49 million gym visits. Similarly, data collected from gyms in the United Kingdom found only 17 cases out of more than 8 million visits in the weeks after gyms reopened there.Only a few U.S.

States have publicly available information on outbreaks linked to the fitness sector, and those states report very few cases. In Louisiana, for example, the state has identified five clusters originating in “gym/fitness settings,” with a total of 31 cases. None of the people died. By contrast, 15 clusters were traced to “religious services/events,” sickening 78, and killing five of them.“The whole idea that it’s a risky place to be … around the world, we just aren’t seeing those numbers anywhere,” said IHRSA’s Durkin.A study from South Korea published by the Centers for Disease Control and Prevention is often cited as evidence of the inherent hazards of group fitness activities.The study traced 112 hair loss s to a Feb.

15 training workshop for fitness dance instructors. Those instructors went on to teach classes at 12 sports facilities in February and March, transmitting the propecia to students in the dance classes, but also to co-workers and family members.But defenders of the fitness industry point out that the outbreak began before South Korea instituted social distancing measures.The study authors note that the classes were crowded and the pace of the dance workouts was fast, and conclude that “intense physical exercise in densely populated sports facilities could increase the risk for ” and “should be minimized during outbreaks.” They also found that no transmission occurred in classes with fewer than five people, or when an infected instructor taught “lower-intensity” classes such as yoga and Pilates.Linda Rackner with PRO Club in Bellevue, Washington, says the enormous, upscale gym has adapted relatively easily to the new hair loss rules. The fitness club’s physical size, extensive budget and technology have helped staffers maintain a fairly normal experience for their members.(Will Stone)Public health experts continue to urge gym members to be cautiousIt’s clear that there are many things gym owners — and gym members — can do to lower the risk of at a gym, but that doesn’t mean the risk is gone. Infectious disease doctors and public health experts caution that gyms should not downplay their potential for spreading disease, especially if the hair loss is widespread in the surrounding community.“There are very few [gyms] that can actually implement all the control measures,” said Saskia Popescu, an infectious disease epidemiologist in Phoenix.

€œThat’s really the challenge with gyms. There is so much variety that it makes it hard to put them into a single box.”Popescu and two colleagues developed a hair loss treatment risk chart for various activities. Gyms were classified as “medium high,” on par with eating indoors at a restaurant or getting a haircut, but less risky than going to a bar or riding public transit.Popescu acknowledges there’s not much recent evidence that gyms are major sources of , but that should not give people a false sense of assurance.“The mistake would be to assume that there is no risk,” she said. €œIt’s just that a lot of the prevention strategies have been working, and when we start to loosen those, though, is where you’re more likely to see clusters occur.”Any location that brings people together indoors increases the risk of contracting the hair loss, and breathing heavily adds another element of risk.

Interventions such as increasing the distance between cardio machines might help, but tiny infectious airborne particles can travel farther than 6 feet, Popescu said.The mechanics of exercising also make it hard to ensure people comply with crucial preventive measures like wearing a mask.“How effective are masks in that setting?. Can they really be effectively worn?. € asked Dr. Deverick Anderson, director of the Duke Center for Antimicrobial Stewardship and Prevention.

€œThe combination of sweat and exertion is one unique thing about the gym setting.”“I do think that, in the big picture, gyms would be riskier than restaurants because of the type of activity and potential for interaction there,” Anderson said.The primary way people could catch the propecia at a gym would be coming close to someone who is releasing respiratory droplets and smaller airborne particles, called “aerosols,” when they breathe, talk or cough, said Dr. Dean Blumberg, chief of pediatric infectious diseases at UC Davis Health.He’s less worried about people catching the propecia from touching a barbell or riding a stationary bike that someone else used. That’s because scientists now think “surface” transmission isn’t driving as much as airborne droplets and particles.“I’m not really worried about transmission that way,” Blumberg said. €œThere’s too much attention being paid to disinfecting surfaces and ‘deep cleaning,’ spraying things in the air.

I think a lot of that’s just for show.”Blumberg said he believes gyms can manage the risks better than many social settings like bars or informal gatherings.“A gym where you can adequately social distance and you can limit the number of people there and force mask-wearing, that’s one of the safer activities,” he said.Adapting to the propecia’s prohibitions doesn’t come cheapIn Bellevue, Washington, PRO Club is an enormous, upscale gym with spacious workout rooms — and an array of medical services such as physical therapy, hormone treatments, skin care and counseling. PRO Club has managed to keep the gym experience relatively normal for members since reopening, according to employee Linda Rackner. €œThere is plenty of space for everyone. We are seeing about 1,000 people a day and have capacity for almost 3,000,” Rackner said.

€œWe’d love to have more people in the club.”The gym uses the same air-cleaning units as hospital ICUs, deploys ultraviolet robots to sanitize the rooms and requires temperature checks to enter. €œI feel like we have good compliance,” said Dean Rogers, one of the personal trainers. €œFor the most part, people who come to a gym are in it for their own health, fitness and wellness.”But Rogers knows this isn’t the norm everywhere. In fact, his own mother back in Oklahoma believes she contracted the hair loss at her gym.“I was upset to find out that her gym had no guidelines they were following, no safety precautions,” he said.

€œThere are always going to be some bad actors.”This story is part of a partnership that includes NPR and Kaiser Health News. Carrie Feibel, an editor for the NPR-KHN reporting partnership, contributed to this story. Related Topics Multimedia Public Health States Audio hair loss treatment WashingtonThis story also ran on CNN. This story can be republished for free (details). CLEVELAND — Families skipping or delaying pediatric appointments for their young children because of the propecia are missing out on more than treatments. Critical testing for lead poisoning has plummeted in many parts of the country.In the Upper Midwest, Northeast and parts of the West Coast — areas with historically high rates of lead poisoning — the slide has been the most dramatic, according to the Centers for Disease Control and Prevention.

In states such as Michigan, Ohio and Minnesota, testing for the brain-damaging heavy metal fell by 50% or more this spring compared with 2019, health officials report.“The drop-off in April was massive,” said Thomas Largo, section manager of environmental health surveillance at the Michigan Department of Health and Human Services, noting a 76% decrease in testing compared with the year before. €œWe weren’t quite prepared for that.” Don't Miss A Story Subscribe to KHN’s free Weekly Edition newsletter. Blood tests for lead, the only way to tell if a child has been exposed, are typically performed by pricking a finger or heel or tapping a vein at 1- and 2-year-old well-child visits. A blood test with elevated lead levels triggers the next critical steps in accessing early intervention for the behavioral, learning and health effects of lead poisoning and also identifying the source of the lead to prevent further harm.Because of the propecia, though, the drop in blood tests means referrals for critical home inspections plus medical and educational services are falling, too.

And that means help isn’t reaching poisoned kids, a one-two punch, particularly in communities of color, said Yvonka Hall, a lead poisoning prevention advocate and co-founder of the Cleveland Lead Safe Network. And this all comes amid hair loss treatment-related school and child care closures, meaning kids who are at risk are spending more time than ever in the place where most exposure happens. The home.“Inside is dangerous,” Hall said.The CDC estimates about 500,000 U.S. Children between ages 1 and 5 have been poisoned by lead, probably an underestimate due to the lack of widespread testing in many communities and states.

In 2017, more than 40,000 children had elevated blood lead levels, defined as higher than 5 micrograms per deciliter of blood, in the 23 states that reported data.While preliminary June and July data in some states indicates lead testing is picking up, it’s nowhere near as high as it would need to be to catch up on the kids who missed appointments in the spring at the height of lockdown orders, experts say. And that may mean some kids will never be tested.“What I’m most worried about is that the kids who are not getting tested now are the most vulnerable — those are the kids I’m worried might not have a makeup visit,” said Stephanie Yendell, senior epidemiology supervisor in the health risk intervention unit at the Minnesota Department of Health.Lifelong ConsequencesThere’s a critical window for conducting lead poisoning blood tests, timed to when children are crawling or toddling and tend to put their hands on floors, windowsills and door frames and possibly transfer tiny particles of lead-laden dust to their mouths.Children at this age are more likely to be harmed because their rapidly growing brains and bodies absorb the element more readily. Lead poisoning can’t be reversed. Children with lead poisoning are more likely to fall behind in school, end up in jail or suffer lifelong health problems such as kidney and heart disease.That’s why lead tests are required at ages 1 and 2 for children receiving federal Medicaid benefits, the population most likely to be poisoned because of low-quality housing options.

Tests are also recommended for all children living in high-risk ZIP codes with older housing stock and historically high levels of lead exposure.Testing fell far short of recommendations in many parts of the country even before the propecia, though, with one recent study estimating that in some states 80% of poisoned children are never identified. And when tests are required, there has been little enforcement of the rule.Early in the propecia, officials in New York’s Erie County bumped up the threshold for sending a public health worker into a family’s home to investigate the source of lead exposure from 5 micrograms per deciliter to 45 micrograms per deciliter (a blood lead level that usually requires hospitalization), said Dr. Gale Burstein, that county’s health commissioner. For all other cases during that period, officials inspected only the outside of the child’s home for potential hazards.About 700 fewer children were tested for lead in Erie County in April than in the same month last year, a drop of about 35%.Ohio, which has among the highest levels of lead poisoning in the country, recently expanded automatic eligibility for its Early Intervention program to any child with an elevated blood lead test, providing the opportunity for occupational, physical and speech therapy.

Learning supports for school. And developmental assessments. If kids with lead poisoning don’t get tested, though, they won’t be referred for help.In early April, there were only three referrals for elevated lead levels in the state, which had been fielding nine times as many on average in the months before the propecia, said Karen Mintzer, director of Bright Beginnings, which manages them for Ohio’s Department of Developmental Disabilities. €œIt basically was a complete stop,” she said.

Since mid-June, referrals have recovered and are now above pre-propecia levels.“We should treat every child with lead poisoning as a medical emergency,” said John Belt, principal investigator for the Ohio Department of Health’s lead poisoning program. €œNot identifying them is going to delay the available services, and in some cases lead to a cognitive deficit.”propecia Compounds WorriesOne of the big worries about the drop in lead testing is that it’s happening at a time when exposure to lead-laden paint chips, soil and dust in homes may be spiking because of stay-at-home orders during the propecia.Exposure to lead dust from deteriorating paint, particularly in high-friction areas such as doors and windows, is the most common cause of lead exposure for children in the U.S.“I worry about kids in unsafe housing, more so during the propecia, because they’re stuck there during the quarantine,” said Dr. Aparna Bole, a pediatrician at Cleveland’s University Hospitals Rainbow Babies &. Children’s Hospital.The propecia may also compound exposure to lead, experts fear, as both landlords and homeowners try to tackle renovation projects without proper safety precautions while everyone is at home.

Or the economic fallout of the crisis could mean some people can no longer afford to clean up known lead hazards at all.“If you’ve lost your job, it’s going to make it difficult to get new windows, or even repaint,” said Yendell.The CDC says it plans to help state and local health departments track down children who missed lead tests. Minnesota plans to identify pediatric clinics with particularly steep drops in lead testing to figure out why, said Yendell.But, Yendell said, that will likely have to wait until the propecia is over. €œRight now I’m spending 10-20% of my time on lead, and the rest is hair loss treatment.”The propecia has stretched already thinly staffed local health departments to the brink, health officials say, and it may take years to know the full impact of the missed testing. For the kids who’ve been poisoned and had no intervention, the effects may not be obvious until they enter school and struggle to keep up.

Brie Zeltner. @BrieZeltner Related Topics Public Health CDC Children's Health hair loss treatment Michigan Minnesota New York Ohio StudyCan’t see the audio player?. Click here to listen on SoundCloud. The headlines from this week will be about how President Donald Trump knew early on how serious the hair loss propecia was likely to become but purposely played it down.

Potentially more important during the past few weeks, though, are reports of how White House officials have pushed scientists at the federal government’s leading health agencies to put politics above science.Meanwhile, Republicans appear to have given up on using the Affordable Care Act as an electoral cudgel, judging, at least, from its scarce mention during the GOP convention. Democrats, on the other hand, particularly those running for the U.S. House and Senate, are doubling down on their criticism of Republicans for failing to adequately protect people with preexisting health conditions. That issue was key to the party winning back the House in 2018.This week’s panelists are Julie Rovner of Kaiser Health News, Joanne Kenen of Politico, Mary Ellen McIntire of CQ Roll Call and Sarah Karlin-Smith of the Pink Sheet.Among the takeaways from this week’s podcast:The Affordable Care Act has become a political vulnerability for Republican officials, who have no interest in reopening the debate on it during this campaign.

Trump vowed before his 2016 election to repeal the law immediately after taking office and members of Congress had berated it for years. But they could not gain the political capital to overturn Obamacare.Trump’s comments to journalist-author Bob Woodward about holding back information on the risks of the hair loss propecia from the public may not have a major effect on the election since so many voters’ minds are already set on their choices. For many, the president’s statements are seen by partisans as identifying what they already believe. For Trump’s supporters, that he is protecting the public.

For his critics, that he is a liar.The number of hair loss treatment cases appears to have hit another plateau, but it’s still twice as high as the count last spring. Officials are waiting to see if end-of-the-summer activities over the Labor Day holiday will create another surge.The stalemate on Capitol Hill over hair loss relief funding shows no sign of easing soon. Republicans in the Senate are resisting Democrats’ insistence on a massive package, but it’s not exactly clear what the GOP can agree on.The treatment being developed by AstraZeneca ran into difficulty this week as experts seek to determine whether a neurological problem that developed in one volunteer was caused by the treatment. Some public health officials, such as NIH Director Francis Collins, said this helps show that even with the compressed testing timeline, safeguards are working.Nonetheless, another treatment maker, Pfizer, said it might still have its treatment ready before the election.The recent controversy at the FDA over the emergency authorization of plasma to treat hair loss treatment patients and the awkward decision at the Centers for Disease Control and Prevention to change guidelines for testing asymptomatic people have created a credibility gap among some Americans and played into concerns that the administration is undercutting science.Also this week, Rovner interviews KHN’s Elizabeth Lawrence, who reported the August NPR-KHN “Bill of the Month” installment, about an appendectomy gone wrong, and the very big bill that followed.

If you have an outrageous medical bill you would like to share with us, you can do that here.Plus, for extra credit, the panelists recommend their favorite health policy stories of the week they think you should read too:Julie Rovner. ProPublica’s “A Doctor Went to His Own Employer for a hair loss treatment Antibody Test. It Cost $10,984,” by Marshall AllenJoanne Kenen. The Atlantic’s “America Is Trapped in a propecia Spiral,” by Ed YongSarah Karlin-Smith.

Politico’s “Emails Show HHS Official Trying to Muzzle Fauci,” by Sarah OwermohleMary Ellen McIntire. The Atlantic’s “What Young, Healthy People Have to Fear From hair loss treatment,” by Derek ThompsonTo hear all our podcasts, click here.And subscribe to What the Health?. on iTunes, Stitcher, Google Play, Spotify, or Pocket Casts. Related Topics Elections Multimedia Public Health The Health Law hair loss treatment FDA KHN's 'What The Health?.

' NIH Podcasts Trump Administration U.S. Congress treatmentsSOBRE NOTICIAS EN ESPAÑOLNoticias en español es una sección de Kaiser Health News que contiene traducciones de artículos de gran interés para la comunidad hispanohablante, y contenido original enfocado en la población hispana que vive en los Estados Unidos. Use Nuestro Contenido Este contenido puede usarse de manera gratuita (detalles). El gobernador de Florida, Ron DeSantis, trató de aliviar el temor a volar durante la pandemia en un evento con ejecutivos de aerolíneas y compañías de alquiler de autos.“Los aviones simplemente no han sido vectores cuando se observa la propagación del hair loss”, dijo DeSantis en el encuentro en el Aeropuerto Internacional Fort Lauderdale-Hollywood el 28 de agosto.

“La evidencia es la evidencia. Y creo que es algo que la gente puede hacer con seguridad “, agregó.¿La evidencia es realmente tan clara?. La afirmación de DeSantis de que los aviones no han sido “vectores” de la propagación del hair loss es falsa, según expertos. Un “vector” disemina el propecia de un lugar a otro, y los aviones han transportado a pasajeros infectados a través de distintas regiones, lo que hace que los brotes de hair loss treatment sean más difíciles de contener.Joseph Allen, profesor asociado en la Universidad de Harvard y experto en exposiciones a propecia, calificó a los aviones como “excelentes vectores para la propagación viral” en una llamada de prensa.En contexto, DeSantis parecía estar haciendo hincapié en la seguridad de volar en avión en lugar del papel que desempeñaron los aviones en la propagación del propecia de un lugar a otro.Cuando se le consultó a la oficina del gobernador sobre datos que respaldaran los comentarios de DeSantis, el secretario de prensa Cody McCloud no presentó ningún estudio ni estadística.

En cambio, citó el programa de rastreo de contactos del Departamento de Salud de Florida y escribió que “no ha proporcionado ninguna información que sugiera que algún paciente se haya infectado mientras viajaba en un vuelo comercial”.El programa de rastreo de contactos de Florida se ha visto envuelto en una controversia sobre informes que denuncian que no tiene suficiente personal y que es ineficaz. CNN llamó a 27 residentes del estado que dieron positivo para hair loss treatment y descubrió que solo cinco habían sido contactados por las autoridades de salud. (El Departamento de Salud de Florida no respondió a las solicitudes de entrevista).Expertos aseguran que, en general, los aviones brindan ambientes seguros en lo que respecta a la calidad del aire, pero agregaron que el riesgo de infección depende en gran medida de las políticas que las aerolíneas puedan tener sobre los asientos de los pasajeros, el uso de máscaras y el tiempo de embarque.Según indicaron, el riesgo de contraer el hair loss en un avión es relativamente bajo si la aerolínea sigue los procedimientos de salud pública. Hacer cumplir la regla de usar máscara, espaciar los asientos disponibles y examinar a los pasajeros enfermos.“Si observas otras enfermedades, ves pocos brotes en aviones”, dijo Allen.

€œNo son los semilleros de infección que la gente cree que son”.Las aerolíneas señalan con frecuencia que los aviones comerciales están equipados con filtros de aire HEPA, recomendados por los Centros para el Control y Prevención de Enfermedades (CDC), que se utilizan en las salas de aislamiento de los hospitales.Los filtros HEPA capturan el 99,97% de las partículas en el aire y reducen sustancialmente el riesgo de propagación viral. Además, el aire en las cabinas se renueva por completo entre 10 y 12 veces por hora, elevando la calidad del aire por encima de la de un edificio normal.Debido a la alta tasa de renovación del aire, es poco probable que se contraiga el hair loss de alguien sentado a varias filas de distancia. Sin embargo, sí podría ocurrir el contagio de alguien cercano.“El mayor riesgo durante el vuelo sería si el pasajero se sienta cerca de alguien que pueda infectar”, dijo Richard Corsi, quien estudia la contaminación del aire en interiores y es decano de Ingeniería en Universidad Estatal de Portland.También es importante señalar que los sistemas de filtración de alta potencia de los aviones no son suficientes por sí solos para prevenir brotes. Si una aerolínea no mantiene libres los asientos del medio ni hace cumplir rigurosamente el uso de máscaras, volar puede ser bastante peligroso.

Actualmente, las aerolíneas nacionales que mantienen abiertos los asientos intermedios incluyen Delta, Hawaiian, Southwest y JetBlue.La razón de esto es que las personas infectadas envían partículas virales al aire a un ritmo más rápido que el que los aviones las expulsan fuera de la cabina. €œSiempre que tose, habla o respira, está enviando gotitas”, dijo Qingyan Chen, profesor de ingeniería mecánica en la Universidad Purdue. €œEstas gotas están en la cabina todo el tiempo”.Esto hace que las medidas de protección adicionales, como el uso de máscaras, sean aún más necesarias.Chen citó dos vuelos internacionales anteriores a la pandemia donde las tasas de infección variaron según el uso de mascarillas. En el primer vuelo, ningún pasajero llevaba máscaras y un solo pasajero infectó a 14 personas mientras el avión viajaba de Londres a Hanoi, Vietnam.

En el segundo vuelo, de Singapur a Hangzhou, en China, todos los pasajeros llevaban máscaras faciales.Aunque 15 pasajeros eran residentes de Wuhan con casos sospechosos o confirmados de hair loss treatment, el único hombre infectado en el recorrido se había aflojado la máscara en pleno vuelo y había estado sentado cerca de cuatro residentes de Wuhan que luego dieron positivo para el propecia.Pero, aunque volar es una actividad de riesgo relativamente bajo, se debe evitar viajar a menos que sea absolutamente necesario.“Cualquier cosa que te ponga en contacto con más personas aumentará el riesgo”, dijo Cindy Prins, profesora clínica asociada de Epidemiología en la Escuela de Salud Pública y Profesiones de la Salud de la Universidad de Florida.El verdadero peligro de viajar no es el vuelo en sí. Sin embargo, pasar por el control de seguridad y esperar en la puerta de embarque es probable que ponga a la persona en contacto cercano con otros y aumente sus posibilidades de contraer el propecia.Además, abordar, cuando el sistema de ventilación del avión no está funcionando y las personas no pueden mantenerse alejadas entre sí, es una de las partes más riesgosas. €œReducir este tiempo es importante para bajar la exposición”, escribió Corsi. €œHay que llegar al asiento con la máscara y sentarse lo más rápido posible”.Con todo, es demasiado pronto para determinar cuánta transmisión de persona a persona ha ocurrido en vuelos.Julian Tang, profesor asociado honorario en el Departamento de Ciencias Respiratorias de la Universidad de Leicester, en Inglaterra, dijo que está al tanto de varios grupos de infecciones relacionadas con los viajes aéreos.

Sin embargo, es un desafío demostrar que las personas contrajeron el propecia en un vuelo.“Alguien que presenta síntomas de hair loss treatment varios días después de llegar a su destino podría haberse infectado en casa antes de llegar al aeropuerto, mientras estaba en el aeropuerto o en el vuelo, o incluso al llegar al aeropuerto de destino, porque todo el mundo tiene un período de incubación variable”, dijo Tang.Katherine Estep, vocera de Airlines for America, un grupo comercial de la industria centrado en Estados Unidos, dijo que los CDC no han confirmado ningún caso de transmisión a bordo de una aerolínea estadounidense.La ausencia de transmisión confirmada no es necesariamente una prueba de que los viajeros estén seguros. En cambio, la falta de datos refleja el hecho de que Estados Unidos tiene una tasa de infección más alta en comparación con otros países, dijo Chen. Dado que tiene tantos casos confirmados, es más difícil determinar exactamente dónde alguien contrajo el propecia. Related Topics Noticias En Español Public Health hair loss treatment KHN &.

PolitiFact HealthCheckThis story also ran on NPR. This story can be republished for free (details). Nurses at Alta Bates Summit Medical Center were on edge as early as March when patients with hair loss treatment began to show up in areas of the hospital that were not set aside to care for them. Explore Our Database KHN and The Guardian are tracking health care workers who died from hair loss treatment and writing about their lives and what happened in their final days. The Centers for Disease Control and Prevention had advised hospitals to isolate hair loss treatment patients to limit staff exposure and help conserve high-level personal protective equipment that’s been in short supply.Yet hair loss treatment patients continued to be scattered through the Oakland hospital, according to complaints to California’s Division of Occupational Safety and Health. The concerns included the sixth-floor medical unit where veteran nurse Janine Paiste-Ponder worked.hair loss treatment patients on that floor were not staying in their rooms, either confused or uninterested in the rules.

Staff was not provided highly protective N95 respirators, said Mike Hill, a nurse in the hospital intensive care unit and the hospital’s chief representative for the California Nurses Association, which filed complaints to Cal/OSHA, the state’s workplace safety regulator. “It was just a matter of time before one of the nurses died on one of these floors,” Hill said.Two nurses fell ill, including Paiste-Ponder, 59, who died of complications from the propecia on July 17.The concerns raised in Oakland also have swept across the U.S., according to interviews, a review of government workplace safety complaints and health facility inspection reports. A KHN investigation found that dozens of nursing homes and hospitals ignored official guidelines to separate hair loss treatment patients from those without the hair loss, in some places fueling its spread and leaving staff unprepared and infected or, in some cases, dead.As recently as July, a National Nurses United survey of more than 21,000 nurses found that 32% work in a facility that does not have a dedicated hair loss treatment unit. At that time, the hair loss had reached all but 17 U.S.

Counties, data collected by Johns Hopkins University shows.California Nurses Association members had complained to Cal/OSHA about hair loss treatment patients being spread throughout Alta Bates Summit Medical Center and say the practice was a factor in Janine Paiste-Ponder’s illness and death.(National Nurses United)KHN discovered that hair loss treatment victims have been commingled with uninfected patients in health care facilities in states including California, Florida, New Jersey, Iowa, Ohio, Maryland and New York.A hair loss treatment outbreak was in full swing at the New Jersey Veterans Home at Paramus in late April when health inspectors observed residents with dementia mingling in a day room — hair loss treatment-positive patients as well as others awaiting test results. At the time, the center had already reported hair loss treatment s among 119 residents and 46 propecia-related deaths, according to a Medicare inspection report.The assistant director of nursing at an Iowa nursing home insisted April 28 that they did “not have any hair loss treatment in the building” and overrode the orders of a community doctor to isolate several patients with fevers and falling oxygen levels, an inspection report shows.By mid-May, the facility’s hair loss treatment log showed 61 patients with the propecia and nine dead.Federal work-safety officials have closed at least 30 complaints about patient mixing in hospitals nationwide without issuing a citation. They include a claim that a Michigan hospital kept patients who tested negative for the propecia in the hair loss treatment unit in May. An upstate New York hospital also had hair loss treatment patients in the same unit as those with no , according to a closed complaint to the federal Occupational Safety and Health Administration.

Email Sign-Up Subscribe to KHN’s free Morning Briefing. Federal Health and Human Services officials have called on hospitals to tell them each day if they have a patient who came in without hair loss treatment but had an apparent or confirmed case of the hair loss 14 days later. Hospitals filed 48,000 reports from June 21 through Aug. 28, though the number reflects some double or additional counting of individual patients.hair loss treatment patients have been mixed in with others for a variety of reasons.

Some hospitals report having limited tests, so patients carrying the propecia are identified only after they had already exposed others. In other cases, they had false-negative test results or their facility was dismissive of federal guidelines, which carry no force of law.And while federal Medicare officials have inspected nearly every U.S. Nursing home in recent months and states have occasionally levied fines and cut off new admissions for isolation lapses, hospitals have seen less scrutiny.The Scene Inside SutterAt Alta Bates in Oakland, part of the Sutter Health network, hospital staff made it clear in official complaints to Cal/OSHA that they wanted administrators to follow the state’s unique law on aerosol-transmitted diseases. From the start, some staffers wanted all the state-required protections for a propecia that has been increasingly shown to be transmitted by tiny particles that float through the air.The regulations call for patients with a propecia like hair loss treatment to be moved to a specialized unit within five hours of identification — or to a specialized facility.

The rules say those patients should be in a room with a HEPA filter or with negative air pressure, meaning that air is circulated out a window or exhaust fan instead of drifting into the hallway.Initially, in March, the hospital outfitted a 40-bed hair loss treatment unit, according to Hill. But when a surge of patients failed to materialize, that unit was pared to 12 beds.Since then, a steady stream of propecia patients have been admitted, he said, many testing positive only days after admission — and after they’d been in regular rooms in the facility.From March 10 through July 30, Hill’s union and others filed eight complaints to Cal/OSHA, including allegations that the hospital failed to follow isolation rules for hair loss treatment patients, some on the cancer floor.So far, regulators have done little. Gov. Gavin Newsom had ordered workplace safety officials to “focus on … supporting compliance” instead of enforcement except on the “most serious violations.”State officials responded to complaints by reaching out by mail and phone to “ensure the proper propecia prevention measures are in place,” according to Frank Polizzi, a spokesperson for Cal/OSHA.A third investigation related to transport workers not wearing N95 respirators while moving hair loss treatment-positive or possible hair loss patients at a Sutter facility near the hospital resulted in a $6,750 fine, Cal/OSHA records show.The string of complaints also says the hospital did not give staff the necessary personal protective equipment (PPE) under state law — an N95 respirator or something more protective — for caring for propecia patients.Nurse Janine Paiste-Ponder died July 17 of hair loss treatment.

Her colleagues held a vigil for her on July 21.(National Nurses United)Instead, Hill said, staff on floors with hair loss treatment patients were provided lower-quality surgical masks, a concern reflected in complaints filed with Cal/OSHA.Hill believes that Paiste-Ponder and another nurse on her floor caught the propecia from hair loss treatment patients who did not remain in their rooms.“It is sad, because it didn’t really need to happen,” Hill said.Polizzi said investigations into the July 17 death and another staff hospitalization are ongoing.A Sutter Health spokesperson said the hospital takes allegations, including Cal/OSHA complaints, seriously and its highest priority is keeping patients and staff safe.The statement also said “cohorting,” or the practice of grouping propecia patients together, is a tool that “must be considered in a greater context, including patient acuity, hospital census and other environmental factors.”Concerns at Other HospitalsCDC guidelines are not strict on the topic of keeping hair loss treatment patients sectioned off, noting that “facilities could consider designating entire units within the facility, with dedicated [staff],” to care for hair loss treatment patients.That approach succeeded at the University of Nebraska Medical Center in Omaha. A recent study reported “extensive” viral contamination around hair loss treatment patients there, but noted that with “standard” control techniques in place, staffers who cared for hair loss treatment patients did not get the propecia.The hospital set up an isolation unit with air pumped away from the halls, restricted access to the unit and trained staff to use well-developed protocols and N95 respirators — at a minimum. What worked in Nebraska, though, is far from standard elsewhere.Cynthia Butler, a nurse and National Nurses United member at Fawcett Memorial Hospital in Port Charlotte, on Florida’s west coast, said she actually felt safer working in the hair loss treatment unit — where she knew what she was dealing with and had full PPE — than on a general medical floor.She believes she caught the propecia from a patient who had hair loss treatment but was housed on a general floor in May. A similar situation occurred in July, when another patient had an unexpected case of hair loss treatment — and Butler said she got another positive test herself.She said both patients did not meet the hospital’s criteria for testing admitted patients, and the lapses leave her on edge, concerns she relayed to an OSHA inspector who reached out to her about a complaint her union filed about the facility.“Every time I go into work it’s like playing Russian roulette,” Butler said.A spokesperson for HCA Healthcare, which owns the hospital, said it tests patients coming from long-term care, those going into surgery and those with propecia symptoms.

She said staffers have access to PPE and practice vigilant sanitation, universal masking and social distancing.The latter is not an option for Butler, though, who said she cleans, feeds and starts IVs for patients and offers reassurance when they are isolated from family.“I’m giving them the only comfort or kind word they can get,” said Butler, who has since gone on unpaid leave over safety concerns. €œI’m in there doing that and I’m not being protected.”Given research showing that up to 45% of hair loss treatment patients are asymptomatic, UCSF Medical Center is testing everyone who’s admitted, said Dr. Robert Harrison, a University of California-San Francisco School of Medicine professor who consults on occupational health at the hospital.It’s done for the safety of staff and to reduce spread within the hospital, he said. Those who test positive are separated into a hair loss treatment-only unit.And staff who spent more than 15 minutes within 6 feet of a not-yet-identified hair loss treatment patient in a less-protective surgical mask are typically sent home for two weeks, he said.Outside of academic medicine, though, front-line staff have turned to union leaders to push for such protections.In Southern California, leaders of the National Union of Healthcare Workers filed an official complaint with state hospital inspectors about the risks posed by intermingled hair loss treatment patients at Fountain Valley Regional Hospital in Orange County, part of for-profit Tenet Health.

There, the complaint said, patients were not routinely tested for hair loss treatment upon admission.One nursing assistant spent two successive 12-hour shifts caring for a patient on a general medical floor who required monitoring. At the conclusion of the second shift, she was told the patient had just been found to be hair loss treatment-positive.The worker had worn only a surgical mask — not an N95 respirator or any form of eye protection, according to the complaint to the California Department of Public Health. The nursing assistant was not offered a hair loss treatment test or quarantined before her next two shifts, the complaint said.The public health department said it could not comment on a pending inspection.Barbara Lewis, Southern California hospital division director with the union, said hair loss treatment patients were on the same floor as cancer patients and post-surgical patients who were walking the halls to speed their recovery.She said managers took steps to separate the patients only after the union held a protest, spoke to local media and complained to state health officials.Hospital spokesperson Jessica Chen said the hospital “quickly implemented” changes directed by state health authorities and does place some hair loss treatment patients on the same nursing unit as non-hair loss treatment patients during surges. She said they are placed in single rooms with closed doors.

hair loss treatment tests are given by physician order, she added, and employees can access them at other places in the community.It’s in contrast, Lewis said, to high-profile examples of the precautions that might be taken.“Now we’re seeing what’s happening with baseball and basketball — they’re tested every day and treated with a high level of caution,” Lewis said. €œYet we have thousands and thousands of health care workers going to work in a very scary environment.”Nursing Homes Face Penalties More than 40% of the people who’ve died of hair loss treatment lived in nursing homes or assisted living facilities, researchers have found.Patient mixing has been a scattered concern at nursing homes, which Medicare officials discovered when they reviewed control practices at more than 15,000 facilities.News reports have highlighted the problem at an Ohio nursing home and at a Maryland home where the state levied a $70,000 fine for failing to keep infected patients away from those who weren’t sick — yet.Another facing penalties was Fair Havens Center, a Miami Springs, Florida, nursing home where inspectors discovered that 11 roommates of patients who tested positive for hair loss treatment were put in rooms with other residents — putting them at heightened risk.Florida regulators cut off admissions to the home and Medicare authorities levied a $235,000 civil monetary penalty, records show.The vice president of operations at the facility told inspectors that isolating exposed patients would mean isolating the entire facility. Everyone had been exposed to the 32 staff members who tested positive for the propecia, the report says.Fair Havens Center did not respond to a request for comment.In Iowa, Medicare officials declared a state of “immediate jeopardy” at Pearl Valley Rehabilitation and Care Center in Muscatine. There, they discovered that staffers were in denial over an outbreak in their midst, with a nursing director overriding a community doctor’s orders to isolate or send residents to the emergency room.

Instead, officials found, in late April, the assistant nursing director kept hair loss treatment patients in the facility, citing a general order by their medical director to avoid sending patients to the ER “if you can help it.”Meanwhile, several patients were documented by facility staff to have fevers and falling oxygen levels, the Medicare inspection report shows. Within two weeks, the facility discovered it had an outbreak, with 61 residents infected and nine dead, according to the report.Medicare officials are investigating Menlo Park Veterans Memorial Home in New Jersey, state Sen. Joseph Vitale said during a recent legislative hearing. Resident council president Glenn Osborne testified during the hearing that the home’s residents were returned to the same shared rooms after hospitalizations.Osborne, an honorably discharged Marine, said he saw more residents of the home die than fellow service members during his military service.

The Menlo Park and Paramus veterans homes — where inspectors saw dementia patients with and without the propecia commingling in a day room — both reported more than 180 hair loss treatment cases among residents, 90 among staff and at least 60 deaths.A spokesperson for the homes said he could not comment due to pending litigation.“These deaths should not have happened,” Osborne said. €œMany of these deaths were absolutely avoidable, in my humble opinion.” Christina Jewett. ChristinaJ@kff.org, @by_cjewett Related Topics California Health Industry Public Health States hair loss treatment Hospitals Lost On The Frontline Nursing Homes.

Researchers at propecia cost https://ilysesimonrd.com/resource_list/ the University of Maryland School of Medicine (UMSOM) have conducted a study that has determined the role that a critical protein plays in the development of hair cells. These hair cells are vital for hearing propecia cost. Some of these cells amplify sounds that come into the ear, and others transform sound waves into electrical signals that travel to the brain. Ronna Hertzano, MD, PhD, Associate Professor in the Department of Otorhinolaryngology Head and Neck Surgery at UMSOM and Maggie Matern, PhD, a postdoctoral fellow at Stanford University, demonstrated that the protein, called GFI1, may be critical for determining whether an embryonic hair cell matures into a functional adult hair cell or becomes a different cell that functions more like a nerve cell or neuron.The study was published in the journal Development, and was conducted by propecia cost physician-scientists and researchers at the UMSOM Department of Otorhinolaryngology Head and Neck Surgery and the UMSOM Institute for Genome Sciences (IGS), in collaboration with researchers at the Sackler School of Medicine at Tel Aviv University in Israel.Hearing relies on the proper functioning of specialized cells within the inner ear called hair cells.

When the hair cells do not develop properly or are damaged by environmental stresses like loud noise, it results in a loss of hearing function.In the United States, the prevalence of hearing loss doubles with every 10-year increase in age, affecting about half of all adults in their 70s and about 80 percent of those who are over age 85. Researchers have been focusing on describing the developmental steps that lead to a functional hair cell, in order to propecia cost potentially generate new hair cells when old ones are damaged.Hair cells in the inner earTo conduct her latest study, Dr. Hertzano and her team utilized cutting-edge methods to study gene expression in the hair cells of genetically modified newborn mice propecia cost that did not produce GFI1. They demonstrated that, in the absence of this vital protein, embryonic hair cells failed to progress in their development to become fully functional adult cells.

In fact, the genes expressed by these cells indicated that propecia cost they were likely to develop into neuron-like cells."Our findings explain why GFI1 is critical to enable embryonic cells to progress into functioning adult hair cells," said Dr. Hertzano. "These data also explain the importance of GFI1 in experimental protocols to regenerate hair cells propecia cost from stem cells. These regenerative methods have the potential of being used for propecia cost patients who have experienced hearing loss due to age or environmental factors like exposure to loud noise."Dr.

Hertzano first became interested in GFI1 while completing her M.D., Ph.D. At Tel Aviv propecia cost University. As part of her dissertation, she discovered that the hearing loss resulting from mutations in another protein called POU4F3 appeared to largely result from a loss of GFI1 in the hair cells. Since then, she has propecia cost been conducting studies to discover the role of GFI1 and other proteins in hearing.

Other research groups in the field are now testing these proteins to determine whether they can be used as a "cocktail" to regenerate lost hair cells propecia cost and restore hearing."Hearing research has been going through a Renaissance period, not only from advances in genomics and methodology, but also thanks to its uniquely collaborative nature among researchers," said Dr. Herzano.The new study was funded by the National Institute on Deafness and Other Communication Disorders (NIDCD) which is part of the National Institutes of Health (NIH). It was also funded by the Binational propecia cost Scientific Foundation (BSF)."This is an exciting new finding that underscores the importance of basic research to lay the foundation for future clinical innovations," said E. Albert Reece, MD, PhD, MBA, Executive Vice President for Medical Affairs, UM Baltimore, and the John Z.

And Akiko propecia cost K. Bowers Distinguished Professor propecia cost and Dean, University of Maryland School of Medicine. "Identifying the complex pathways that lead to normal hearing could prove to be the key for reversing hearing loss in millions of Americans." Story Source. Materials provided by University of propecia cost Maryland School of Medicine.

Note. Content may be edited for propecia cost style and length.Researchers at Indiana University School of Medicine are learning more about how a person's genes play a role in the possibility they'll suffer from alcoholic cirrhosis with the discovery of a gene that could make the disease less likely.Alcoholic cirrhosis can happen after years of drinking too much alcohol. According to the researchers, discovering more about this illness couldn't propecia cost come at a more important time."Based on U.S. Data, alcohol-associated liver disease is on the rise in terms of the prevalence and incidents and it is happening more often in younger patients," said Suthat Liangpunsakul, MD, professor of medicine, dean's scholar in medical research for the Department of Medicine Division of Gastroenterology and Hepatology, and one of the principal investigators of the study.

"There's a real public health problem involving the consumption of alcohol and people starting to drink at a younger age."The team describes their findings in a propecia cost new paper published in Hepatology. The GenomALC Consortium was funded by the National Institutes on Alcohol Abuse and Alcoholism (NIAAA), part of the National Institute of Health (NIH). This genome-wide association study propecia cost began several years ago and is one of the largest studies related to alcoholic cirrhosis ever performed. DNA samples were taken from over 1,700 patients from sites in the United States, several countries in Europe and Australia and sent to IU School of Medicine where the team performed the DNA isolation for propecia cost genome analysis.

The patients were divided into two groups -- one made up of heavy drinkers that never had a history of alcohol-induced liver injury or liver disease and a second group of heavy drinkers who did have alcoholic cirrhosis."Our key finding is a gene called Fas Associated Factor Family Member 2, or FAF2," said Tae-Hwi Schwantes-An, PhD, assistant research professor of medical and molecular genetics and the lead author of the study. "There's this convergence of findings now that are pointing to the genes involved in lipid droplet organization pathway, and that seems to be one of the biological reasonings of why certain people propecia cost get liver disease and why certain people do not."The researchers are anticipating to study this gene more closely and looking at its relationship to other, previously-discovered genes that can make a person more likely to develop alcoholic cirrhosis."We know for a fact those genes are linked together in a biological process, so the logical next step is to study how the changes in these genes alter the function of that process, whether it's less efficient in one group of people, or maybe it's inhibited in some way," Schwantes-An said. "We don't know exactly what the biological underpinning of that is, but now we have a pretty well-defined target where we can look at these variants and see how they relate to alcoholic cirrhosis."As their research continues, the team hopes to eventually find a way to identify this genetic factor in patients with the goal of helping them prevent alcoholic cirrhosis in the future or developing targeted therapies that can help individuals in a more personalized way. Story Source propecia cost.

Materials provided by Indiana University School of Medicine propecia cost. Original written by Christina Griffiths. Note. Content may be edited for style and length.Penn Medicine researchers have found that middle-aged individuals -- those born in the late 1960s and the 1970s -- may be in a perpetual state of H3N2 influenza propecia susceptibility because their antibodies bind to H3N2 propeciaes but fail to prevent s, according to a new study led by Scott Hensley, PhD, an associate professor of Microbiology at the Perelman School of Medicine at the University of Pennsylvania.

The paper was published today in Nature Communications."We found that different aged individuals have different H3N2 flu propecia antibody specificities," Hensley said. "Our studies show that early childhood s can leave lifelong immunological imprints that affect how individuals respond to antigenically distinct viral strains later in life."Most humans are infected with influenza propeciaes by three to four years of age, and these initial childhood s can elicit strong, long lasting memory immune responses. H3N2 influenza propeciaes began circulating in humans in 1968 and have evolved substantially over the past 51 years. Therefore, an individual's birth year largely predicts which specific type of H3N2 propecia they first encountered in childhood.Researchers completed a serological survey -- a blood test that measures antibody levels -- using serum samples collected in the summer months prior to the 2017-2018 season from 140 children (ages one to 17) and 212 adults (ages 18 to 90).

They first measured the differences in antibody reactivity to various strains of H3N2, and then measured for neutralizing and non-neutralizing antibodies. Neutralizing antibodies can prevent viral s, whereas non-neutralizing antibodies can only help after an takes place. Samples from children aged three to ten years old had the highest levels of neutralizing antibodies against contemporary H3N2 propeciaes, while most middle-aged samples had antibodies that could bind to these propeciaes but these antibodies could not prevent viral s.Hensley said his team's findings are consistent with a concept known as "original antigenic sin" (OAS), originally proposed by Tom Francis, Jr. In 1960.

"Most individuals born in the late 1960s and 1970s were immunologically imprinted with H3N2 propeciaes that are very different compared to contemporary H3N2 propeciaes. Upon with recent H3N2 propeciaes, these individuals tend to produce antibodies against regions that are conserved with older H3N2 strains and these types of antibodies typically do not prevent viral s."According to the research team, it is possible that the presence of high levels of non-neutralizing antibodies in middle-aged adults has contributed to the continued persistence of H3N2 propeciaes in the human population. Their findings might also relate to the unusual age distribution of H3N2 s during the 2017-2018 season, in which H3N2 activity in middle-aged and older adults peaked earlier compared to children and young adults.The researchers say that it will be important to continually complete large serological surveys in different aged individuals, including donors from populations with different vaccination rates. A better understanding of immunity within the population and within individuals will likely lead to improved models that are better able to predict the evolutionary trajectories of different influenza propecia strains."Large serological studies can shed light on why the effectiveness of flu treatments varies in individuals with different immune histories, while also identifying barriers that need to be overcome in order to design better treatments that are able to elicit protective responses in all age groups," said Sigrid Gouma, PhD, a postdoctoral researcher of Microbiology and first author on the paper.Other Penn authors include Madison Weirick and Megan E.

Gumina. Additional authors include Angela Branche, David J. Topham, Emily T. Martin, Arnold S.

Monto, and Sarah Cobey.This work was supported by the National Institute of Allergy and Infectious Diseases (1R01AI113047, S.E.H.. 1R01AI108686, S.E.H.. 1R01AI097150, A.S.M.. CEIRS HHSN272201400005C, S.E.H., S.C., E.T.M., A.S.M.

A.B., D.J.T.) and Center for Disease Control (U01IP000474, A.S.M.). Scott E. Hensley holds an Investigators in the Pathogenesis of Infectious Disease Awards from the Burroughs Wellcome Fund.Males and females share the vast majority of their genomes. Only a sprinkling of genes, located on the so-called X and Y sex chromosomes, differ between the sexes.

Nevertheless, the activities of our genes -- their expression in cells and tissues -- generate profound distinctions between males and females.Not only do the sexes differ in outward appearance, their differentially expressed genes strongly affect the risk, incidence, prevalence, severity and age-of-onset of many diseases, including cancer, autoimmune disorders, cardiovascular disease and neurological afflictions.Researchers have observed sex-associated differences in gene expression across a range of tissues including liver, heart, and brain. Nevertheless, such tissue-specific sex differences remain poorly understood. Most traits that display variance between males and females appear to result from differences in the expression of autosomal genes common to both sexes, rather than through expression of sex chromosome genes or sex hormones.A better understanding of these sex-associated disparities in the behavior of our genes could lead to improved diagnoses and treatments for a range of human illnesses.In a new paper in the PERSPECTIVES section of the journal Science, Melissa Wilson reviews current research into patterns of sex differences in gene expression across the genome, and highlights sampling biases in the human populations included in such studies."One of the most striking things about this comprehensive study of sex differences," Wilson said, "is that while aggregate differences span the genome and contribute to biases in human health, each individual gene varies tremendously between people."Wilson is a researcher in the Biodesign Center for Mechanisms in Evolution, the Center for Evolution and Medicine, and ASU's School of Life Sciences. advertisement A decade ago, an ambitious undertaking, known as the Genotype-Tissue Expression (GTEx) consortium began to investigate the effects DNA variation on gene expression across the range of human tissues.

Recent findings, appearing in the Science issue under review, indicate that sex-linked disparities in gene expression are far more pervasive than once assumed, with more than a third of all genes displaying sex-biased expression in at least one tissue. (The new research highlighted in Wilson's PERSPECTIVES piece describes gene regulatory differences between the sexes in every tissue under study.)Sex-linked differences in gene expression are shared across mammals, though their relative roles in disease susceptibility remain speculative. Natural selection likely guided the development of many of these attributes. For example, the rise of placental mammals some 90 million years ago may have led to differences in immune function between males and females.Such sex-based distinctions arising in the distant past have left their imprint on current mammals, including humans, expressed in higher rates of autoimmune disorders in females and increased cancer rates in males.Despite their critical importance for understanding disease prevalence and severity, sex differences in gene expression have only recently received serious attention in the research community.

Wilson and others suggest that much historical genetic research, using primarily white male subjects in mid-life, have yielded an incomplete picture.Such studies often fail to account for sex differences in the design and analysis of experiments, rendering a distorted view of sex-based disease variance, often leading to one-size-fits-all approaches to diagnosis and treatment. The authors therefore advise researchers to be more careful about generalizations based on existing databases of genetic information, including GTEx.A more holistic approach is emerging, as researchers investigate the full panoply of effects related to male and female gene expression across a broader range of human variation. Story Source. Materials provided by Arizona State University.

Original written by Richard Harth. Note. Content may be edited for style and length.Researchers at Yale have identified a possible treatment for Duchenne muscular dystrophy (DMD), a rare genetic disease for which there is currently no cure or treatment, by targeting an enzyme that had been considered "undruggable." The finding appears in the Aug. 25 edition of Science Signaling.DMD is the most common form of muscular dystrophy, a disease that leads to progressive weakness and eventual loss of the skeletal and heart muscles.

It occurs in 16 of 100,000 male births in the U.S. People with the disease exhibit clumsiness and weakness in early childhood and typically need wheelchairs by the time they reach their teens. The average life expectancy is 26.While earlier research had revealed the crucial role played by an enzyme called MKP5 in the development of DMD, making it a promising target for possible treatment, scientists for decades had been unable to disrupt this family of enzymes, known as protein tyrosine phosphatases, at the enzymes' "active" site where chemical reactions occur.In the new study, Anton Bennett, the Dorys McConnell Duberg Professor of Pharmacology and professor of comparative medicine, and his team screened over 162,000 compounds. They identified one molecular compound that blocked the enzyme's activity by binding to a previously undiscovered allosteric site -- a spot near the enzyme's active site."There have been many attempts to design inhibitors for this family of enzymes, but those compounds have failed to produce the right properties," Bennett said.

"Until now, the family of enzymes has been considered 'undruggable.'"By targeting the allosteric site of MKP5 instead, he said, "We discovered an excellent starting point for drug development that circumvented the earlier problems."The researchers tested their compound in muscle cells and found that it successfully inhibited MKP5 activity, suggesting a promising new therapeutic strategy for treating DMD.The research was supported by a National Institutes of Health grant through the National Institute of Arthritis and Musculoskeletal and Skin Diseases, as well as by the Blavatnik Fund for Innovation at Yale, which annually presents awards to support the most promising life science discoveries from Yale faculty.Bennett said that the Blavatnik funding, which is administered by the Yale Office of Cooperative Research, was critical in moving the research forward. "It resulted in a license with a major pharmaceutical company," he said, "and we hope they will rapidly move forward with the development of the new treatment."The finding has implications well beyond muscular dystrophy, he added. The researchers have demonstrated that the MKP5 enzyme is broadly implicated in fibrosis, or the buildup of scar tissue, a condition that contributes to nearly one-third of natural deaths worldwide."Fibrosis is involved in the end-stage death of many tissues, including liver, lung, and muscle," Bennett said. "We believe this enzyme could be a target more broadly for fibrotic tissue disease."The research team from Yale included Naftali Kaminski, the Boehringer-Ingelheim Professor of Internal Medicine and chief of pulmonary, critical care and sleep medicine.

Jonathan Ellman, the Eugene Higgins Professor of Chemistry and professor of pharmacology. Karen Anderson, professor of pharmacology and of molecular biophysics and biochemistry. Elias Lolis, professor of pharmacology. Zachary Gannam, a graduate student in pharmacology.

Kisuk Min, a postdoctoral fellow. Shanelle Shillingford, a graduate student in chemistry. Lei Zhang, a research associate in pharmacology. And the Yale Center for Molecular Discovery.

Story Source. Materials provided by Yale University. Original written by Brita Belli. Note.

Content may be edited for style and length.This story is part of a partnership that includes NPR and Kaiser Health News. This story can be republished for free (details). After shutting down in the spring, America’s empty gyms are beckoning a cautious public back for a workout. To reassure wary customers, owners have put in place — and now advertise — a variety of hair loss control measures. At the same time, the fitness industry is trying to rehabilitate itself by pushing back against what it sees as a misleading narrative that gyms have no place during a propecia.In the first months of the hair loss outbreak, most public health leaders advised closing gyms, erring on the side of caution.

As s exploded across the country, states ordered gyms and fitness centers closed, along with restaurants, movie theaters and bars. State and local officials consistently branded gyms as high-risk venues for , akin to bars and nightclubs. In early August, New York Gov. Andrew Cuomo called gym-going a “dangerous activity,” saying he would keep them shut — only to announce later in the month that most gyms could reopen in September at a third of the capacity and under tight regulations.New York, New Jersey and North Carolina were among the last state holdouts — only recently allowing fitness facilities to reopen.

Many states continue to limit capacity and have instituted new requirements.The benefits of gyms are clear. Regular exercise staves off depression and improves sleep, and staying fit may be a way to avoid a serious case of hair loss treatment. But there are clear risks, too. Lots of people moving around indoors, sharing equipment and air, and breathing heavily could be a recipe for easy viral spread.

There are scattered reports of hair loss cases traced back to specific gyms. But gym owners say those are outliers and argue the dominant portrayal overemphasizes potential dangers and ignores their brief but successful track record of safety during the propecia. Email Sign-Up Subscribe to KHN’s free Morning Briefing. A Seattle gym struggles to comply with new rules and surviveAt NW Fitness in Seattle, everything from a set of squats to a run on the treadmill requires a mask.

Every other cardio machine is off-limits. The owners have marked up the floor with blue tape to show where each person can work out.Esmery Corniel, a member, has resumed his workout routine with the punching bag.“I was honestly just losing my mind,” said Corniel, 27. He said he feels comfortable in the gym with its new safety protocols.“Everybody wears their mask, everybody socially distances, so it’s no problem here at all,” Corniel said.There’s no longer the usual morning “rush” of people working out before heading to their jobs.Under Washington state’s hair loss rules, only about 10 to 12 people at a time are permitted in this 4,000-square-foot gym.“It’s drastically reduced our ability to serve our community,” said John Carrico. He and his wife, Jessica, purchased NW Fitness at the end of last year.John and Jessica Carrico run NW Fitness, a small gym in Seattle that has struggled to stay afloat during the propecia.

Their membership has plummeted in recent months, in part because the gym has been closed and subject to strict hair loss requirements.(Will Stone)Meanwhile, the cost of running the businesses has gone up dramatically. The gym now needs to be staffed round-the-clock to keep up with the frequent cleaning requirements, and to ensure people are wearing masks and following the rules.Keeping the gym open 24/7 — previously a big selling point for members — is no longer feasible. In the past three months, they’ve lost more than a third of their membership.“If the trend continues, we won’t be able to stay open,” said Jessica Carrico, who also works as a nurse at a homeless shelter run by Harborview Medical Center.Given her medical background, Jessica Carrico was initially inclined to trust the public health authorities who ordered all gyms to shut down, but gradually her feelings changed.“Driving around the city, I’d still see lines outside of pot shops and Baskin-Robbins,” she said. €œThe arbitrary decision that had been made was very clear, and it became really frustrating.”Even after gyms in the Seattle area were allowed to reopen, their frustrations continued — especially with the strict cap on operating capacity.

The Carricos believe that falls hardest on smaller gyms that don’t have much square footage.“People want this space to be safe, and will self-regulate,” said John Carrico. He believes he could responsibly operate with twice as many people inside as currently allowed. Public health officials have mischaracterized gyms, he added, and underestimated their potential to operate safely.“There’s this fear-based propaganda that gyms are a cesspool of hair loss, which is just super not true,” Carrico said.Gyms seem less risky than bars. But there’s very little research either wayThe fitness industry has begun to push back at the propecia-driven perceptions and prohibitions.

€œWe should not be lumped with bars and restaurants,” said Helen Durkin, an executive vice president for the International Health, Racquet &. Sportsclub Association (IHRSA).John Carrico called the comparison with bars particularly unfair. €œIt’s almost laughable. I mean, it’s almost the exact opposite.

€¦ People here are investing in their health. They’re coming in, they’re focusing on what they’re trying to do as far as their workout. They’re not socializing, they’re not sitting at a table and laughing and drinking.”Since the propecia began, many gyms have overhauled operations and now look very different. Locker rooms are often closed and group classes halted.

Many gyms check everyone for symptoms upon arrival. They’ve spaced out equipment and begun intensive cleaning regimes.Gyms have a big advantage over other retail and entertainment venues, Durkin said, because the membership model means those who may have been exposed in an outbreak can be easily contacted.A company that sells member databases and software to gyms has been compiling data during the propecia. (The data, drawn from 2,877 gyms, is by no means comprehensive because it relies on gym owners to self-report incidents in which a positive hair loss case was detected at the gym, or was somehow connected to the gym.) The resultant report said that the overall “visits to propecia” ratio of 0.002% is “statistically irrelevant” because only 1,155 cases of hair loss were reported among more than 49 million gym visits. Similarly, data collected from gyms in the United Kingdom found only 17 cases out of more than 8 million visits in the weeks after gyms reopened there.Only a few U.S.

States have publicly available information on outbreaks linked to the fitness sector, and those states report very few cases. In Louisiana, for example, the state has identified five clusters originating in “gym/fitness settings,” with a total of 31 cases. None of the people died. By contrast, 15 clusters were traced to “religious services/events,” sickening 78, and killing five of them.“The whole idea that it’s a risky place to be … around the world, we just aren’t seeing those numbers anywhere,” said IHRSA’s Durkin.A study from South Korea published by the Centers for Disease Control and Prevention is often cited as evidence of the inherent hazards of group fitness activities.The study traced 112 hair loss s to a Feb.

15 training workshop for fitness dance instructors. Those instructors went on to teach classes at 12 sports facilities in February and March, transmitting the propecia to students in the dance classes, but also to co-workers and family members.But defenders of the fitness industry point out that the outbreak began before South Korea instituted social distancing measures.The study authors note that the classes were crowded and the pace of the dance workouts was fast, and conclude that “intense physical exercise in densely populated sports facilities could increase the risk for ” and “should be minimized during outbreaks.” They also found that no transmission occurred in classes with fewer than five people, or when an infected instructor taught “lower-intensity” classes such as yoga and Pilates.Linda Rackner with PRO Club in Bellevue, Washington, says the enormous, upscale gym has adapted relatively easily to the new hair loss rules. The fitness club’s physical size, extensive budget and technology have helped staffers maintain a fairly normal experience for their members.(Will Stone)Public health experts continue to urge gym members to be cautiousIt’s clear that there are many things gym owners — and gym members — can do to lower the risk of at a gym, but that doesn’t mean the risk is gone. Infectious disease doctors and public health experts caution that gyms should not downplay their potential for spreading disease, especially if the hair loss is widespread in the surrounding community.“There are very few [gyms] that can actually implement all the control measures,” said Saskia Popescu, an infectious disease epidemiologist in Phoenix.

€œThat’s really the challenge with gyms. There is so much variety that it makes it hard to put them into a single box.”Popescu and two colleagues developed a hair loss treatment risk chart for various activities. Gyms were classified as “medium high,” on par with eating indoors at a restaurant or getting a haircut, but less risky than going to a bar or riding public transit.Popescu acknowledges there’s not much recent evidence that gyms are major sources of , but that should not give people a false sense of assurance.“The mistake would be to assume that there is no risk,” she said. €œIt’s just that a lot of the prevention strategies have been working, and when we start to loosen those, though, is where you’re more likely to see clusters occur.”Any location that brings people together indoors increases the risk of contracting the hair loss, and breathing heavily adds another element of risk.

Interventions such as increasing the distance between cardio machines might help, but tiny infectious airborne particles can travel farther than 6 feet, Popescu said.The mechanics of exercising also make it hard to ensure people comply with crucial preventive measures like wearing a mask.“How effective are masks in that setting?. Can they really be effectively worn?. € asked Dr. Deverick Anderson, director of the Duke Center for Antimicrobial Stewardship and Prevention.

€œThe combination of sweat and exertion is one unique thing about the gym setting.”“I do think that, in the big picture, gyms would be riskier than restaurants because of the type of activity and potential for interaction there,” Anderson said.The primary way people could catch the propecia at a gym would be coming close to someone who is releasing respiratory droplets and smaller airborne particles, called “aerosols,” when they breathe, talk or cough, said Dr. Dean Blumberg, chief of pediatric infectious diseases at UC Davis Health.He’s less worried about people catching the propecia from touching a barbell or riding a stationary bike that someone else used. That’s because scientists now think “surface” transmission isn’t driving as much as airborne droplets and particles.“I’m not really worried about transmission that way,” Blumberg said. €œThere’s too much attention being paid to disinfecting surfaces and ‘deep cleaning,’ spraying things in the air.

I think a lot of that’s just for show.”Blumberg said he believes gyms can manage the risks better than many social settings like bars or informal gatherings.“A gym where you can adequately social distance and you can limit the number of people there and force mask-wearing, that’s one of the safer activities,” he said.Adapting to the propecia’s prohibitions doesn’t come cheapIn Bellevue, Washington, PRO Club is an enormous, upscale gym with spacious workout rooms — and an array of medical services such as physical therapy, hormone treatments, skin care and counseling. PRO Club has managed to keep the gym experience relatively normal for members since reopening, according to employee Linda Rackner. €œThere is plenty of space for everyone. We are seeing about 1,000 people a day and have capacity for almost 3,000,” Rackner said.

€œWe’d love to have more people in the club.”The gym uses the same air-cleaning units as hospital ICUs, deploys ultraviolet robots to sanitize the rooms and requires temperature checks to enter. €œI feel like we have good compliance,” said Dean Rogers, one of the personal trainers. €œFor the most part, people who come to a gym are in it for their own health, fitness and wellness.”But Rogers knows this isn’t the norm everywhere. In fact, his own mother back in Oklahoma believes she contracted the hair loss at her gym.“I was upset to find out that her gym had no guidelines they were following, no safety precautions,” he said.

€œThere are always going to be some bad actors.”This story is part of a partnership that includes NPR and Kaiser Health News. Carrie Feibel, an editor for the NPR-KHN reporting partnership, contributed to this story. Related Topics Multimedia Public Health States Audio hair loss treatment WashingtonThis story also ran on CNN. This story can be republished for free (details). CLEVELAND — Families skipping or delaying pediatric appointments for their young children because of the propecia are missing out on more than treatments. Critical testing for lead poisoning has plummeted in many parts of the country.In the Upper Midwest, Northeast and parts of the West Coast — areas with historically high rates of lead poisoning — the slide has been the most dramatic, according to the Centers for Disease Control and Prevention.

In states such as Michigan, Ohio and Minnesota, testing for the brain-damaging heavy metal fell by 50% or more this spring compared with 2019, health officials report.“The drop-off in April was massive,” said Thomas Largo, section manager of environmental health surveillance at the Michigan Department of Health and Human Services, noting a 76% decrease in testing compared with the year before. €œWe weren’t quite prepared for that.” Don't Miss A Story Subscribe to KHN’s free Weekly Edition newsletter. Blood tests for lead, the only way to tell if a child has been exposed, are typically performed by pricking a finger or heel or tapping a vein at 1- and 2-year-old well-child visits. A blood test with elevated lead levels triggers the next critical steps in accessing early intervention for the behavioral, learning and health effects of lead poisoning and also identifying the source of the lead to prevent further harm.Because of the propecia, though, the drop in blood tests means referrals for critical home inspections plus medical and educational services are falling, too.

And that means help isn’t reaching poisoned kids, a one-two punch, particularly in communities of color, said Yvonka Hall, a lead poisoning prevention advocate and co-founder of the Cleveland Lead Safe Network. And this all comes amid hair loss treatment-related school and child care closures, meaning kids who are at risk are spending more time than ever in the place where most exposure happens. The home.“Inside is dangerous,” Hall said.The CDC estimates about 500,000 U.S. Children between ages 1 and 5 have been poisoned by lead, probably an underestimate due to the lack of widespread testing in many communities and states.

In 2017, more than 40,000 children had elevated blood lead levels, defined as higher than 5 micrograms per deciliter of blood, in the 23 states that reported data.While preliminary June and July data in some states indicates lead testing is picking up, it’s nowhere near as high as it would need to be to catch up on the kids who missed appointments in the spring at the height of lockdown orders, experts say. And that may mean some kids will never be tested.“What I’m most worried about is that the kids who are not getting tested now are the most vulnerable — those are the kids I’m worried might not have a makeup visit,” said Stephanie Yendell, senior epidemiology supervisor in the health risk intervention unit at the Minnesota Department of Health.Lifelong ConsequencesThere’s a critical window for conducting lead poisoning blood tests, timed to when children are crawling or toddling and tend to put their hands on floors, windowsills and door frames and possibly transfer tiny particles of lead-laden dust to their mouths.Children at this age are more likely to be harmed because their rapidly growing brains and bodies absorb the element more readily. Lead poisoning can’t be reversed. Children with lead poisoning are more likely to fall behind in school, end up in jail or suffer lifelong health problems such as kidney and heart disease.That’s why lead tests are required at ages 1 and 2 for children receiving federal Medicaid benefits, the population most likely to be poisoned because of low-quality housing options.

Tests are also recommended for all children living in high-risk ZIP codes with older housing stock and historically high levels of lead exposure.Testing fell far short of recommendations in many parts of the country even before the propecia, though, with one recent study estimating that in some states 80% of poisoned children are never identified. And when tests are required, there has been little enforcement of the rule.Early in the propecia, officials in New York’s Erie County bumped up the threshold for sending a public health worker into a family’s home to investigate the source of lead exposure from 5 micrograms per deciliter to 45 micrograms per deciliter (a blood lead level that usually requires hospitalization), said Dr. Gale Burstein, that county’s health commissioner. For all other cases during that period, officials inspected only the outside of the child’s home for potential hazards.About 700 fewer children were tested for lead in Erie County in April than in the same month last year, a drop of about 35%.Ohio, which has among the highest levels of lead poisoning in the country, recently expanded automatic eligibility for its Early Intervention program to any child with an elevated blood lead test, providing the opportunity for occupational, physical and speech therapy.

Learning supports for school. And developmental assessments. If kids with lead poisoning don’t get tested, though, they won’t be referred for help.In early April, there were only three referrals for elevated lead levels in the state, which had been fielding nine times as many on average in the months before the propecia, said Karen Mintzer, director of Bright Beginnings, which manages them for Ohio’s Department of Developmental Disabilities. €œIt basically was a complete stop,” she said.

Since mid-June, referrals have recovered and are now above pre-propecia levels.“We should treat every child with lead poisoning as a medical emergency,” said John Belt, principal investigator for the Ohio Department of Health’s lead poisoning program. €œNot identifying them is going to delay the available services, and in some cases lead to a cognitive deficit.”propecia Compounds WorriesOne of the big worries about the drop in lead testing is that it’s happening at a time when exposure to lead-laden paint chips, soil and dust in homes may be spiking because of stay-at-home orders during the propecia.Exposure to lead dust from deteriorating paint, particularly in high-friction areas such as doors and windows, is the most common cause of lead exposure for children in the U.S.“I worry about kids in unsafe housing, more so during the propecia, because they’re stuck there during the quarantine,” said Dr. Aparna Bole, a pediatrician at Cleveland’s University Hospitals Rainbow Babies &. Children’s Hospital.The propecia may also compound exposure to lead, experts fear, as both landlords and homeowners try to tackle renovation projects without proper safety precautions while everyone is at home.

Or the economic fallout of the crisis could mean some people can no longer afford to clean up known lead hazards at all.“If you’ve lost your job, it’s going to make it difficult to get new windows, or even repaint,” said Yendell.The CDC says it plans to help state and local health departments track down children who missed lead tests. Minnesota plans to identify pediatric clinics with particularly steep drops in lead testing to figure out why, said Yendell.But, Yendell said, that will likely have to wait until the propecia is over. €œRight now I’m spending 10-20% of my time on lead, and the rest is hair loss treatment.”The propecia has stretched already thinly staffed local health departments to the brink, health officials say, and it may take years to know the full impact of the missed testing. For the kids who’ve been poisoned and had no intervention, the effects may not be obvious until they enter school and struggle to keep up.

Brie Zeltner. @BrieZeltner Related Topics Public Health CDC Children's Health hair loss treatment Michigan Minnesota New York Ohio StudyCan’t see the audio player?. Click here to listen on SoundCloud. The headlines from this week will be about how President Donald Trump knew early on how serious the hair loss propecia was likely to become but purposely played it down.

Potentially more important during the past few weeks, though, are reports of how White House officials have pushed scientists at the federal government’s leading health agencies to put politics above science.Meanwhile, Republicans appear to have given up on using the Affordable Care Act as an electoral cudgel, judging, at least, from its scarce mention during the GOP convention. Democrats, on the other hand, particularly those running for the U.S. House and Senate, are doubling down on their criticism of Republicans for failing to adequately protect people with preexisting health conditions. That issue was key to the party winning back the House in 2018.This week’s panelists are Julie Rovner of Kaiser Health News, Joanne Kenen of Politico, Mary Ellen McIntire of CQ Roll Call and Sarah Karlin-Smith of the Pink Sheet.Among the takeaways from this week’s podcast:The Affordable Care Act has become a political vulnerability for Republican officials, who have no interest in reopening the debate on it during this campaign.

Trump vowed before his 2016 election to repeal the law immediately after taking office and members of Congress had berated it for years. But they could not gain the political capital to overturn Obamacare.Trump’s comments to journalist-author Bob Woodward about holding back information on the risks of the hair loss propecia from the public may not have a major effect on the election since so many voters’ minds are already set on their choices. For many, the president’s statements are seen by partisans as identifying what they already believe. For Trump’s supporters, that he is protecting the public.

For his critics, that he is a liar.The number of hair loss treatment cases appears to have hit another plateau, but it’s still twice as high as the count last spring. Officials are waiting to see if end-of-the-summer activities over the Labor Day holiday will create another surge.The stalemate on Capitol Hill over hair loss relief funding shows no sign of easing soon. Republicans in the Senate are resisting Democrats’ insistence on a massive package, but it’s not exactly clear what the GOP can agree on.The treatment being developed by AstraZeneca ran into difficulty this week as experts seek to determine whether a neurological problem that developed in one volunteer was caused by the treatment. Some public health officials, such as NIH Director Francis Collins, said this helps show that even with the compressed testing timeline, safeguards are working.Nonetheless, another treatment maker, Pfizer, said it might still have its treatment ready before the election.The recent controversy at the FDA over the emergency authorization of plasma to treat hair loss treatment patients and the awkward decision at the Centers for Disease Control and Prevention to change guidelines for testing asymptomatic people have created a credibility gap among some Americans and played into concerns that the administration is undercutting science.Also this week, Rovner interviews KHN’s Elizabeth Lawrence, who reported the August NPR-KHN “Bill of the Month” installment, about an appendectomy gone wrong, and the very big bill that followed.

If you have an outrageous medical bill you would like to share with us, you can do that here.Plus, for extra credit, the panelists recommend their favorite health policy stories of the week they think you should read too:Julie Rovner. ProPublica’s “A Doctor Went to His Own Employer for a hair loss treatment Antibody Test. It Cost $10,984,” by Marshall AllenJoanne Kenen. The Atlantic’s “America Is Trapped in a propecia Spiral,” by Ed YongSarah Karlin-Smith.

Politico’s “Emails Show HHS Official Trying to Muzzle Fauci,” by Sarah OwermohleMary Ellen McIntire. The Atlantic’s “What Young, Healthy People Have to Fear From hair loss treatment,” by Derek ThompsonTo hear all our podcasts, click here.And subscribe to What the Health?. on iTunes, Stitcher, Google Play, Spotify, or Pocket Casts. Related Topics Elections Multimedia Public Health The Health Law hair loss treatment FDA KHN's 'What The Health?.

' NIH Podcasts Trump Administration U.S. Congress treatmentsSOBRE NOTICIAS EN ESPAÑOLNoticias en español es una sección de Kaiser Health News que contiene traducciones de artículos de gran interés para la comunidad hispanohablante, y contenido original enfocado en la población hispana que vive en los Estados Unidos. Use Nuestro Contenido Este contenido puede usarse de manera gratuita (detalles). El gobernador de Florida, Ron DeSantis, trató de aliviar el temor a volar durante la pandemia en un evento con ejecutivos de aerolíneas y compañías de alquiler de autos.“Los aviones simplemente no han sido vectores cuando se observa la propagación del hair loss”, dijo DeSantis en el encuentro en el Aeropuerto Internacional Fort Lauderdale-Hollywood el 28 de agosto.

“La evidencia es la evidencia. Y creo que es algo que la gente puede hacer con seguridad “, agregó.¿La evidencia es realmente tan clara?. La afirmación de DeSantis de que los aviones no han sido “vectores” de la propagación del hair loss es falsa, según expertos. Un “vector” disemina el propecia de un lugar a otro, y los aviones han transportado a pasajeros infectados a través de distintas regiones, lo que hace que los brotes de hair loss treatment sean más difíciles de contener.Joseph Allen, profesor asociado en la Universidad de Harvard y experto en exposiciones a propecia, calificó a los aviones como “excelentes vectores para la propagación viral” en una llamada de prensa.En contexto, DeSantis parecía estar haciendo hincapié en la seguridad de volar en avión en lugar del papel que desempeñaron los aviones en la propagación del propecia de un lugar a otro.Cuando se le consultó a la oficina del gobernador sobre datos que respaldaran los comentarios de DeSantis, el secretario de prensa Cody McCloud no presentó ningún estudio ni estadística.

En cambio, citó el programa de rastreo de contactos del Departamento de Salud de Florida y escribió que “no ha proporcionado ninguna información que sugiera que algún paciente se haya infectado mientras viajaba en un vuelo comercial”.El programa de rastreo de contactos de Florida se ha visto envuelto en una controversia sobre informes que denuncian que no tiene suficiente personal y que es ineficaz. CNN llamó a 27 residentes del estado que dieron positivo para hair loss treatment y descubrió que solo cinco habían sido contactados por las autoridades de salud. (El Departamento de Salud de Florida no respondió a las solicitudes de entrevista).Expertos aseguran que, en general, los aviones brindan ambientes seguros en lo que respecta a la calidad del aire, pero agregaron que el riesgo de infección depende en gran medida de las políticas que las aerolíneas puedan tener sobre los asientos de los pasajeros, el uso de máscaras y el tiempo de embarque.Según indicaron, el riesgo de contraer el hair loss en un avión es relativamente bajo si la aerolínea sigue los procedimientos de salud pública. Hacer cumplir la regla de usar máscara, espaciar los asientos disponibles y examinar a los pasajeros enfermos.“Si observas otras enfermedades, ves pocos brotes en aviones”, dijo Allen.

€œNo son los semilleros de infección que la gente cree que son”.Las aerolíneas señalan con frecuencia que los aviones comerciales están equipados con filtros de aire HEPA, recomendados por los Centros para el Control y Prevención de Enfermedades (CDC), que se utilizan en las salas de aislamiento de los hospitales.Los filtros HEPA capturan el 99,97% de las partículas en el aire y reducen sustancialmente el riesgo de propagación viral. Además, el aire en las cabinas se renueva por completo entre 10 y 12 veces por hora, elevando la calidad del aire por encima de la de un edificio normal.Debido a la alta tasa de renovación del aire, es poco probable que se contraiga el hair loss de alguien sentado a varias filas de distancia. Sin embargo, sí podría ocurrir el contagio de alguien cercano.“El mayor riesgo durante el vuelo sería si el pasajero se sienta cerca de alguien que pueda infectar”, dijo Richard Corsi, quien estudia la contaminación del aire en interiores y es decano de Ingeniería en Universidad Estatal de Portland.También es importante señalar que los sistemas de filtración de alta potencia de los aviones no son suficientes por sí solos para prevenir brotes. Si una aerolínea no mantiene libres los asientos del medio ni hace cumplir rigurosamente el uso de máscaras, volar puede ser bastante peligroso.

Actualmente, las aerolíneas nacionales que mantienen abiertos los asientos intermedios incluyen Delta, Hawaiian, Southwest y JetBlue.La razón de esto es que las personas infectadas envían partículas virales al aire a un ritmo más rápido que el que los aviones las expulsan fuera de la cabina. €œSiempre que tose, habla o respira, está enviando gotitas”, dijo Qingyan Chen, profesor de ingeniería mecánica en la Universidad Purdue. €œEstas gotas están en la cabina todo el tiempo”.Esto hace que las medidas de protección adicionales, como el uso de máscaras, sean aún más necesarias.Chen citó dos vuelos internacionales anteriores a la pandemia donde las tasas de infección variaron según el uso de mascarillas. En el primer vuelo, ningún pasajero llevaba máscaras y un solo pasajero infectó a 14 personas mientras el avión viajaba de Londres a Hanoi, Vietnam.

En el segundo vuelo, de Singapur a Hangzhou, en China, todos los pasajeros llevaban máscaras faciales.Aunque 15 pasajeros eran residentes de Wuhan con casos sospechosos o confirmados de hair loss treatment, el único hombre infectado en el recorrido se había aflojado la máscara en pleno vuelo y había estado sentado cerca de cuatro residentes de Wuhan que luego dieron positivo para el propecia.Pero, aunque volar es una actividad de riesgo relativamente bajo, se debe evitar viajar a menos que sea absolutamente necesario.“Cualquier cosa que te ponga en contacto con más personas aumentará el riesgo”, dijo Cindy Prins, profesora clínica asociada de Epidemiología en la Escuela de Salud Pública y Profesiones de la Salud de la Universidad de Florida.El verdadero peligro de viajar no es el vuelo en sí. Sin embargo, pasar por el control de seguridad y esperar en la puerta de embarque es probable que ponga a la persona en contacto cercano con otros y aumente sus posibilidades de contraer el propecia.Además, abordar, cuando el sistema de ventilación del avión no está funcionando y las personas no pueden mantenerse alejadas entre sí, es una de las partes más riesgosas. €œReducir este tiempo es importante para bajar la exposición”, escribió Corsi. €œHay que llegar al asiento con la máscara y sentarse lo más rápido posible”.Con todo, es demasiado pronto para determinar cuánta transmisión de persona a persona ha ocurrido en vuelos.Julian Tang, profesor asociado honorario en el Departamento de Ciencias Respiratorias de la Universidad de Leicester, en Inglaterra, dijo que está al tanto de varios grupos de infecciones relacionadas con los viajes aéreos.

Sin embargo, es un desafío demostrar que las personas contrajeron el propecia en un vuelo.“Alguien que presenta síntomas de hair loss treatment varios días después de llegar a su destino podría haberse infectado en casa antes de llegar al aeropuerto, mientras estaba en el aeropuerto o en el vuelo, o incluso al llegar al aeropuerto de destino, porque todo el mundo tiene un período de incubación variable”, dijo Tang.Katherine Estep, vocera de Airlines for America, un grupo comercial de la industria centrado en Estados Unidos, dijo que los CDC no han confirmado ningún caso de transmisión a bordo de una aerolínea estadounidense.La ausencia de transmisión confirmada no es necesariamente una prueba de que los viajeros estén seguros. En cambio, la falta de datos refleja el hecho de que Estados Unidos tiene una tasa de infección más alta en comparación con otros países, dijo Chen. Dado que tiene tantos casos confirmados, es más difícil determinar exactamente dónde alguien contrajo el propecia. Related Topics Noticias En Español Public Health hair loss treatment KHN &.

PolitiFact HealthCheckThis story also ran on NPR. This story can be republished for free (details). Nurses at Alta Bates Summit Medical Center were on edge as early as March when patients with hair loss treatment began to show up in areas of the hospital that were not set aside to care for them. Explore Our Database KHN and The Guardian are tracking health care workers who died from hair loss treatment and writing about their lives and what happened in their final days. The Centers for Disease Control and Prevention had advised hospitals to isolate hair loss treatment patients to limit staff exposure and help conserve high-level personal protective equipment that’s been in short supply.Yet hair loss treatment patients continued to be scattered through the Oakland hospital, according to complaints to California’s Division of Occupational Safety and Health. The concerns included the sixth-floor medical unit where veteran nurse Janine Paiste-Ponder worked.hair loss treatment patients on that floor were not staying in their rooms, either confused or uninterested in the rules.

Staff was not provided highly protective N95 respirators, said Mike Hill, a nurse in the hospital intensive care unit and the hospital’s chief representative for the California Nurses Association, which filed complaints to Cal/OSHA, the state’s workplace safety regulator. “It was just a matter of time before one of the nurses died on one of these floors,” Hill said.Two nurses fell ill, including Paiste-Ponder, 59, who died of complications from the propecia on July 17.The concerns raised in Oakland also have swept across the U.S., according to interviews, a review of government workplace safety complaints and health facility inspection reports. A KHN investigation found that dozens of nursing homes and hospitals ignored official guidelines to separate hair loss treatment patients from those without the hair loss, in some places fueling its spread and leaving staff unprepared and infected or, in some cases, dead.As recently as July, a National Nurses United survey of more than 21,000 nurses found that 32% work in a facility that does not have a dedicated hair loss treatment unit. At that time, the hair loss had reached all but 17 U.S.

Counties, data collected by Johns Hopkins University shows.California Nurses Association members had complained to Cal/OSHA about hair loss treatment patients being spread throughout Alta Bates Summit Medical Center and say the practice was a factor in Janine Paiste-Ponder’s illness and death.(National Nurses United)KHN discovered that hair loss treatment victims have been commingled with uninfected patients in health care facilities in states including California, Florida, New Jersey, Iowa, Ohio, Maryland and New York.A hair loss treatment outbreak was in full swing at the New Jersey Veterans Home at Paramus in late April when health inspectors observed residents with dementia mingling in a day room — hair loss treatment-positive patients as well as others awaiting test results. At the time, the center had already reported hair loss treatment s among 119 residents and 46 propecia-related deaths, according to a Medicare inspection report.The assistant director of nursing at an Iowa nursing home insisted April 28 that they did “not have any hair loss treatment in the building” and overrode the orders of a community doctor to isolate several patients with fevers and falling oxygen levels, an inspection report shows.By mid-May, the facility’s hair loss treatment log showed 61 patients with the propecia and nine dead.Federal work-safety officials have closed at least 30 complaints about patient mixing in hospitals nationwide without issuing a citation. They include a claim that a Michigan hospital kept patients who tested negative for the propecia in the hair loss treatment unit in May. An upstate New York hospital also had hair loss treatment patients in the same unit as those with no , according to a closed complaint to the federal Occupational Safety and Health Administration.

Email Sign-Up Subscribe to KHN’s free Morning Briefing. Federal Health and Human Services officials have called on hospitals to tell them each day if they have a patient who came in without hair loss treatment but had an apparent or confirmed case of the hair loss 14 days later. Hospitals filed 48,000 reports from June 21 through Aug. 28, though the number reflects some double or additional counting of individual patients.hair loss treatment patients have been mixed in with others for a variety of reasons.

Some hospitals report having limited tests, so patients carrying the propecia are identified only after they had already exposed others. In other cases, they had false-negative test results or their facility was dismissive of federal guidelines, which carry no force of law.And while federal Medicare officials have inspected nearly every U.S. Nursing home in recent months and states have occasionally levied fines and cut off new admissions for isolation lapses, hospitals have seen less scrutiny.The Scene Inside SutterAt Alta Bates in Oakland, part of the Sutter Health network, hospital staff made it clear in official complaints to Cal/OSHA that they wanted administrators to follow the state’s unique law on aerosol-transmitted diseases. From the start, some staffers wanted all the state-required protections for a propecia that has been increasingly shown to be transmitted by tiny particles that float through the air.The regulations call for patients with a propecia like hair loss treatment to be moved to a specialized unit within five hours of identification — or to a specialized facility.

The rules say those patients should be in a room with a HEPA filter or with negative air pressure, meaning that air is circulated out a window or exhaust fan instead of drifting into the hallway.Initially, in March, the hospital outfitted a 40-bed hair loss treatment unit, according to Hill. But when a surge of patients failed to materialize, that unit was pared to 12 beds.Since then, a steady stream of propecia patients have been admitted, he said, many testing positive only days after admission — and after they’d been in regular rooms in the facility.From March 10 through July 30, Hill’s union and others filed eight complaints to Cal/OSHA, including allegations that the hospital failed to follow isolation rules for hair loss treatment patients, some on the cancer floor.So far, regulators have done little. Gov. Gavin Newsom had ordered workplace safety officials to “focus on … supporting compliance” instead of enforcement except on the “most serious violations.”State officials responded to complaints by reaching out by mail and phone to “ensure the proper propecia prevention measures are in place,” according to Frank Polizzi, a spokesperson for Cal/OSHA.A third investigation related to transport workers not wearing N95 respirators while moving hair loss treatment-positive or possible hair loss patients at a Sutter facility near the hospital resulted in a $6,750 fine, Cal/OSHA records show.The string of complaints also says the hospital did not give staff the necessary personal protective equipment (PPE) under state law — an N95 respirator or something more protective — for caring for propecia patients.Nurse Janine Paiste-Ponder died July 17 of hair loss treatment.

Her colleagues held a vigil for her on July 21.(National Nurses United)Instead, Hill said, staff on floors with hair loss treatment patients were provided lower-quality surgical masks, a concern reflected in complaints filed with Cal/OSHA.Hill believes that Paiste-Ponder and another nurse on her floor caught the propecia from hair loss treatment patients who did not remain in their rooms.“It is sad, because it didn’t really need to happen,” Hill said.Polizzi said investigations into the July 17 death and another staff hospitalization are ongoing.A Sutter Health spokesperson said the hospital takes allegations, including Cal/OSHA complaints, seriously and its highest priority is keeping patients and staff safe.The statement also said “cohorting,” or the practice of grouping propecia patients together, is a tool that “must be considered in a greater context, including patient acuity, hospital census and other environmental factors.”Concerns at Other HospitalsCDC guidelines are not strict on the topic of keeping hair loss treatment patients sectioned off, noting that “facilities could consider designating entire units within the facility, with dedicated [staff],” to care for hair loss treatment patients.That approach succeeded at the University of Nebraska Medical Center in Omaha. A recent study reported “extensive” viral contamination around hair loss treatment patients there, but noted that with “standard” control techniques in place, staffers who cared for hair loss treatment patients did not get the propecia.The hospital set up an isolation unit with air pumped away from the halls, restricted access to the unit and trained staff to use well-developed protocols and N95 respirators — at a minimum. What worked in Nebraska, though, is far from standard elsewhere.Cynthia Butler, a nurse and National Nurses United member at Fawcett Memorial Hospital in Port Charlotte, on Florida’s west coast, said she actually felt safer working in the hair loss treatment unit — where she knew what she was dealing with and had full PPE — than on a general medical floor.She believes she caught the propecia from a patient who had hair loss treatment but was housed on a general floor in May. A similar situation occurred in July, when another patient had an unexpected case of hair loss treatment — and Butler said she got another positive test herself.She said both patients did not meet the hospital’s criteria for testing admitted patients, and the lapses leave her on edge, concerns she relayed to an OSHA inspector who reached out to her about a complaint her union filed about the facility.“Every time I go into work it’s like playing Russian roulette,” Butler said.A spokesperson for HCA Healthcare, which owns the hospital, said it tests patients coming from long-term care, those going into surgery and those with propecia symptoms.

She said staffers have access to PPE and practice vigilant sanitation, universal masking and social distancing.The latter is not an option for Butler, though, who said she cleans, feeds and starts IVs for patients and offers reassurance when they are isolated from family.“I’m giving them the only comfort or kind word they can get,” said Butler, who has since gone on unpaid leave over safety concerns. €œI’m in there doing that and I’m not being protected.”Given research showing that up to 45% of hair loss treatment patients are asymptomatic, UCSF Medical Center is testing everyone who’s admitted, said Dr. Robert Harrison, a University of California-San Francisco School of Medicine professor who consults on occupational health at the hospital.It’s done for the safety of staff and to reduce spread within the hospital, he said. Those who test positive are separated into a hair loss treatment-only unit.And staff who spent more than 15 minutes within 6 feet of a not-yet-identified hair loss treatment patient in a less-protective surgical mask are typically sent home for two weeks, he said.Outside of academic medicine, though, front-line staff have turned to union leaders to push for such protections.In Southern California, leaders of the National Union of Healthcare Workers filed an official complaint with state hospital inspectors about the risks posed by intermingled hair loss treatment patients at Fountain Valley Regional Hospital in Orange County, part of for-profit Tenet Health.

There, the complaint said, patients were not routinely tested for hair loss treatment upon admission.One nursing assistant spent two successive 12-hour shifts caring for a patient on a general medical floor who required monitoring. At the conclusion of the second shift, she was told the patient had just been found to be hair loss treatment-positive.The worker had worn only a surgical mask — not an N95 respirator or any form of eye protection, according to the complaint to the California Department of Public Health. The nursing assistant was not offered a hair loss treatment test or quarantined before her next two shifts, the complaint said.The public health department said it could not comment on a pending inspection.Barbara Lewis, Southern California hospital division director with the union, said hair loss treatment patients were on the same floor as cancer patients and post-surgical patients who were walking the halls to speed their recovery.She said managers took steps to separate the patients only after the union held a protest, spoke to local media and complained to state health officials.Hospital spokesperson Jessica Chen said the hospital “quickly implemented” changes directed by state health authorities and does place some hair loss treatment patients on the same nursing unit as non-hair loss treatment patients during surges. She said they are placed in single rooms with closed doors.

hair loss treatment tests are given by physician order, she added, and employees can access them at other places in the community.It’s in contrast, Lewis said, to high-profile examples of the precautions that might be taken.“Now we’re seeing what’s happening with baseball and basketball — they’re tested every day and treated with a high level of caution,” Lewis said. €œYet we have thousands and thousands of health care workers going to work in a very scary environment.”Nursing Homes Face Penalties More than 40% of the people who’ve died of hair loss treatment lived in nursing homes or assisted living facilities, researchers have found.Patient mixing has been a scattered concern at nursing homes, which Medicare officials discovered when they reviewed control practices at more than 15,000 facilities.News reports have highlighted the problem at an Ohio nursing home and at a Maryland home where the state levied a $70,000 fine for failing to keep infected patients away from those who weren’t sick — yet.Another facing penalties was Fair Havens Center, a Miami Springs, Florida, nursing home where inspectors discovered that 11 roommates of patients who tested positive for hair loss treatment were put in rooms with other residents — putting them at heightened risk.Florida regulators cut off admissions to the home and Medicare authorities levied a $235,000 civil monetary penalty, records show.The vice president of operations at the facility told inspectors that isolating exposed patients would mean isolating the entire facility. Everyone had been exposed to the 32 staff members who tested positive for the propecia, the report says.Fair Havens Center did not respond to a request for comment.In Iowa, Medicare officials declared a state of “immediate jeopardy” at Pearl Valley Rehabilitation and Care Center in Muscatine. There, they discovered that staffers were in denial over an outbreak in their midst, with a nursing director overriding a community doctor’s orders to isolate or send residents to the emergency room.

Instead, officials found, in late April, the assistant nursing director kept hair loss treatment patients in the facility, citing a general order by their medical director to avoid sending patients to the ER “if you can help it.”Meanwhile, several patients were documented by facility staff to have fevers and falling oxygen levels, the Medicare inspection report shows. Within two weeks, the facility discovered it had an outbreak, with 61 residents infected and nine dead, according to the report.Medicare officials are investigating Menlo Park Veterans Memorial Home in New Jersey, state Sen. Joseph Vitale said during a recent legislative hearing. Resident council president Glenn Osborne testified during the hearing that the home’s residents were returned to the same shared rooms after hospitalizations.Osborne, an honorably discharged Marine, said he saw more residents of the home die than fellow service members during his military service.

The Menlo Park and Paramus veterans homes — where inspectors saw dementia patients with and without the propecia commingling in a day room — both reported more than 180 hair loss treatment cases among residents, 90 among staff and at least 60 deaths.A spokesperson for the homes said he could not comment due to pending litigation.“These deaths should not have happened,” Osborne said. €œMany of these deaths were absolutely avoidable, in my humble opinion.” Christina Jewett. ChristinaJ@kff.org, @by_cjewett Related Topics California Health Industry Public Health States hair loss treatment Hospitals Lost On The Frontline Nursing Homes.