Health and Healing

[kmaherali]

Cameroon will be the first country to routinely give children a new malaria vaccine as the shots are rolled out in Africa.

The campaign due to start Monday was described by officials as a milestone in the decades-long effort to curb the mosquito-spread disease on the continent, which accounts for 95% of the world’s malaria deaths.

“The vaccination will save lives. It will provide major relief to families and the country’s health system,” said Aurelia Nguyen, chief program officer at the Gavi vaccines alliance, which is helping Cameroon secure the shots.

The Central Africa nation hopes to vaccinate about 250,000 children this year and next year. Gavi said it is working with 20 other African countries to help them get the vaccine and that those countries will hopefully immunize more than 6 million children through 2025.

In Africa, there are about 250 million cases of the parasitic disease each year, including 600,000 deaths, mostly in young children.

Cameroon will use the first of two recently approved malaria vaccines, known as Mosquirix. The World Health Organization endorsed the vaccine two years ago, acknowledging that that even though it is imperfect, its use would still dramatically reduce severe infections and hospitalizations.

The GlaxoSmithKline-produced shot is only about 30% effective, requires four doses and protection begins to fade after several months. The vaccine was tested in Africa and used in pilot programs in three countries.

GSK has said it can only produce about 15 million doses of Mosquirix a year and some experts believe a second malaria vaccine developed by Oxford University and approved by WHO in October might be a more practical solution. That vaccine is cheaper, requires three doses and India’s Serum Institute said they could make up to 200 million doses a year.

Gavi’s Nguyen said they hoped there might be enough of the Oxford vaccines available to begin immunizing people later this year.

Neither of the malaria vaccines stop transmission, so other tools like bed nets and insecticidal spraying will still be critical. The malaria parasite mostly spreads to people via infected mosquitoes and can cause symptoms including fever, headaches and chills.

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.

https://apnews.com/article/malaria-vacc ... 778d3e6de3

[kmaherali]

Medical Meditation? Clinical Yoga? Alternative Therapies Go Mainstream.

More than one-third of American adults now supplement or substitute mainstream medical care with treatments long considered alternative.


Therapies such as yoga, long considered alternative, is now practiced by 22 percent of adult pain patients.Credit...Sophie Park for The New York Times

The doctor is in. So is the yogi.

A sharp shift in health care is taking place as more than one-third of American adults now supplement or substitute mainstream medical care with acupuncture, meditation, yoga and other therapies long considered alternative.

In 2022, 37 percent of adult pain patients used nontraditional medical care, a marked rise from 19 percent in 2002, according to research published this week in JAMA. The change has been propelled by growing insurance reimbursement for clinical alternatives, more scientific evidence of their effectiveness and an increasing acceptance among patients.

“It’s become part of the culture of the United States,” said Richard Nahin, the paper’s lead author and an epidemiologist at the National Center of Complementary and Integrative Health, a division of the National Institutes of Health. “We’re talking about the use for general wellness, stress management use, sleep, energy, immune health.”

And for pain management. The use of yoga to manage pain rose to 29 percent in 2022 from 11 percent in 2002, an increase that Dr. Nahin said reflected in part efforts by patients to find alternatives to opiates, and the influence of media and social media.

“It’s in the public domain so much,” he said. “People hear acupuncture, meditation, yoga. They start to learn.”

The change is impacting medical practitioners as well. Dr. Sean Mackey, chief of the pain medicine division at Stanford Medicine, said that a growing number of studies have validated alternative therapies, providing even traditional clinics like Stanford’s with more mind-body therapies and other nonpharmaceutical tools. He said the acceptance of those ideas has grown among younger people in particular, whereas patients of earlier generations may have seen these options as too out there.

“Our parents and our grandparents would look at them and they’re like, What, are you kidding me?”

At the same time, Dr. Mackey said, the growing prominence of the therapies can be a “double-edged sword” because they do not always provide the relief that is marketed.

“My advice to people when they’re pursuing this is to do these things for a trial,” he said. “But if it’s not providing long-term durable benefits, don’t just keep doing it.”

The JAMA article drew its data from the 2002, 2012 and 2022 National Health Interview Survey, which was conducted in person and by telephone. Researchers used the data to evaluate the use of seven complementary health care approaches: acupuncture, chiropractic care, guided imagery, massage therapy, meditation, naturopathy and yoga.

Meditation as a health therapy jumped sharply, to around 17 percent of American adults in 2022, from around 7.5 percent two decades earlier. Dr. Nihan said that the low cost was a factor: “How much does it cost to do meditation and yoga?” Such activities vary widely in price, depending on whether they are done at home or in classes.

For some people, the alternatives seem to prove superior. Jee Kim started down the traditional-medicine path in 2022 when he was grappling with sleeplessness and anxiety from a separation. His primary care doctor in Boulder, Colo., prescribed medications that Mr. Kim used initially but found to have intolerable side effects.

“I got serious about yoga and meditation,” he said, ultimately finding them a better solution. “I tried the pharmaceutical route, but I wanted tools I could come back to. I knew it wouldn’t be my last hard life transition.”

Mr. Kim, 49, a political consultant and a former college tennis player who still plays avidly, also credits yoga with helping stave off injury, so much so that he has become an occasional yoga instructor himself. “It’s a pillar of my physical and mental health, at work too,” he said.

Dr. Jennifer Rhodes, a psychiatrist in Boulder who specializes in treating women going through hormonal changes, said that a “majority of my patients use supplementary intervention like those for stress management,” referring to the therapies in the survey.

She said that she embraced the concept but cautioned that medications can be crucial, too.

“Do acupuncture and massage,” she said. “But it’s not fair to ask for someone who is severely depressed or anxious and not functioning to employ those until they calm their nervous system down.”

Matt Richtel is a health and science reporter for The Times, based in Boulder, Colo. More about Matt Richtel

Share free access

https://www.nytimes.com/2024/02/02/heal ... 778d3e6de3

[kmaherali]

How many STEPS should I walk per day to stay HEALTHY?

How many steps should I walk per day to stay healthy? This video will summarize the major health benefits of daily walking and how many steps you need to maximize those effects. Benefits include improved mortality, decreased cardiovascular risk, improved cognition, better immune response, and stronger mental health.

Video: https://www.youtube.com/watch?v=bs_lVqcWDB4

[kmaherali]

The man continues to improve, doctors said. Organs from genetically engineered pigs one day may make dialysis obsolete.


Surgeons performed the world’s first genetically modified pig kidney transplant into a living human at Massachusetts General Hospital on March 16.Credit...Michelle Rose/Massachusetts General Hospital, via Agence France-Presse — Getty Images

Surgeons in Boston have transplanted a kidney from a genetically engineered pig into an ailing 62-year-old man, the first procedure of its kind. If successful, the breakthrough offers hope to hundreds of thousands of Americans whose kidneys have failed.

So far, the signs are promising.

Kidneys remove waste products and excess fluid from the blood. The new kidney began producing urine shortly after the surgery last weekend and the patient’s condition continues to improve, according to physicians at Massachusetts General Hospital, known as Mass General. He is already walking the halls of the hospital and may be discharged soon.

The patient is a Black man, and the procedure may have special significance for Black patients, who suffer high rates of end-stage kidney disease.

A new source of kidneys “could solve an intractable problem in the field — the inadequate access of minority patients to kidney transplants,” said Dr. Winfred Williams, associate chief of the nephrology division at Mass General and the patient’s primary kidney doctor.

If kidneys from genetically modified animals can be transplanted on a large scale, dialysis “will become obsolete,” said Dr. Leonardo V. Riella, medical director for kidney transplantation at Mass General. The hospital’s parent organization, Mass General Brigham, developed the transplant program.

Over 800,000 Americans have kidney failure and require dialysis, a procedure that filters toxins from the blood. Over 100,000 are on a waiting list to receive a transplanted kidney from a living or dead human donor. End-stage kidney disease is three times more common among Black Americans than among white people.

In addition, tens of millions of Americans have chronic kidney disease, which can lead to organ failure.

More on Organ Transplants
Harvesting Organs: A new method for retrieving hearts from organ donors has ignited a debate over the surprisingly blurry line between life and death in a hospital. https://www.nytimes.com/2023/11/22/nyre ... nks_recirc

‘Morally Inconsistent’: Undocumented immigrants face high hurdles to receiving organ transplants themselves, even though they can donate organs, and more of them are signing up to do so. Some advocates and lawmakers are trying to change things. https://www.nytimes.com/2023/05/16/nyre ... nks_recirc

Solving the Shortage: The use of genetically engineered pigs could help solve the donor-organ shortage. But considerable hurdles remain, including concerns over the potential introduction of animal pathogens into the human population. https://www.nytimes.com/interactive/201 ... nks_recirc

Reversing Death?: A group of researchers was able to revive cells in the organs of dead pigs. They hope their findings will one day help obtain viable human organs for transplants long after death. https://www.nytimes.com/2022/08/03/scie ... nks_recirc

While dialysis keeps people alive, the gold-standard treatment is an organ transplant. Thousands of patients die annually while waiting for a kidney, however, because there is an acute shortage of organs. Just 25,000 kidney transplants are performed each year.

Xenotransplantation — the implantation of an animal’s organ into a human — has for decades been proposed as a potential solution that could make kidneys much more widely available. But the human immune system rejects foreign tissue, causing life-threatening complications, and experts note that long-term rejection can occur even when donors are well matched.

In recent years, scientific advances including gene editing and cloning have edged xenotransplants closer to reality, making it possible to modify animal genes to make the organs more compatible and less likely to be rejected by the immune system.

The kidney came from a pig engineered by the biotech company eGenesis, which removed three genes involved in potential rejection of the organ. In addition, seven human genes were inserted to enhance human compatibility. Pigs carry retroviruses that may infect humans, and the company also inactivated the pathogens.

In September 2021, surgeons at NYU Langone Health in New York attached a kidney from a genetically modified pig to a brain-dead man and watched as it began to function and make urine. Shortly afterward, scientists at the University of Alabama at Birmingham announced they had performed a similar procedure with similar results.

Surgeons at the University of Maryland have twice transplanted hearts from genetically modified pigs into patients with heart disease. While the organs functioned and the first did not appear to be rejected, both of the patients, who had advanced disease, died shortly afterward.

(Patients who agree to these cutting-edge experimental treatments are usually extremely ill and have few options available; often they are too sick to qualify for the waiting list for a precious human organ or are not eligible for other reasons.)

The transplant patient in Boston, Richard “Rick” Slayman, a state transportation department supervisor, had suffered from diabetes and hypertension for many years, and had been under treatment at Mass General for over a decade.

After his kidneys failed, Mr. Slayman was on dialysis for seven years, eventually receiving a human kidney in 2018. But the donated organ failed within five years, and he developed other complications, including congestive heart failure, Dr. Williams said.

When Mr. Slayman resumed dialysis in 2023, he experienced severe vascular complications — his blood vessels were clotting and failing — and he needed recurrent hospitalization, Dr. Williams said.

Mr. Slayman, who kept working despite his health problems, faced a long wait for another human kidney, and “he was growing despondent,” Dr. Williams said. “He said, ‘I just can’t go on like this. I can’t keep doing this.’ I started to think about extraordinary measures we could take.”

“He would have had to wait five to six years for a human kidney. He would not have been able to survive it,” Dr. Williams added.

When Dr. Williams asked Mr. Slayman about receiving a pig’s kidney, Mr. Slayman had many questions but eventually decided to proceed.

“I saw it not only as a way to help me, but a way to provide hope for thousands of people who need a transplant to survive,” he said in a statement provided by Mass General.

Mr. Slayman’s new kidney seems to be functional, so far, and he has been able to stop dialysis. The new pig kidney is making urine and filtering out creatinine, a waste product.

Other measures are also improving daily, his doctors said. Doctors will continue to monitor Mr. Slayman for signs of organ rejection.

“He looks like his own self. It’s remarkable,” Dr. Williams said.

The surgery was not without critics. Xenotransplantation raises the prospect of still greater exploitation of animals and may introduce new pathogens into human populations, said Kathy Guillermo, senior vice president at People for the Ethical Treatment of Animals.

“Using pigs as a source of spare parts is dangerous to the human patients, deadly for the animals and may bring about the next pandemic,” she said. “It’s impossible to eliminate, or even identify, all the viruses that pigs carry. Researchers need to focus on cleaning up the organ donation system and leave the animals alone.”

The four-hour operation was carried out by a team of surgeons, including Dr. Tatsuo Kawai, director of the Legorreta Center for Clinical Transplant Tolerance at Mass General, and Dr. Nahel Elias.

The procedure was performed under a Food and Drug Administration protocol known as a compassionate use provision, which is granted to patients with life-threatening illness who might benefit from an unapproved treatment. New drugs to suppress the immune system and prevent rejection of the organ were also used under the protocol.

“He’s remarkably courageous to step forward,” Dr. Williams said of Mr. Slayman. “Hats off to him. He’s making a huge contribution with this.”

A correction was made on March 21, 2024: An earlier version of this article misstated the kidney’s function regarding creatinine. The kidney removes the substance from the blood; the organ does not create creatinine.

https://www.nytimes.com/2024/03/21/heal ... 778d3e6de3

[swamidada]

Autism and SDGs
Rukhsana Shah Published April 2, 2024 Updated about 23 hours ago
The writer, a former federal secretary, is CEO, ASD Welfare Trust

THE 2024 observance of World Autism Day is aligned with the implementation status and progress on the Sustainable Development Goals. Autism is a neurodevelopmental condition representing human evolution and neurodiversity among all world populations. The SDGs are universally agreed goals adopted in 2015 by the UN to bridge economic disparities in 17 overlapping areas including access to quality health, education and safety. They promote gender equality and inclusive economic growth and employment for all.

The Sustainable Development Agenda was to be fulfilled by 2030. However, the SDG report of 2023 shows that progress on more than 50 per cent of targets is inadequate while in 30pc, it has reversed. The most important reason cited is the neoliberal fiscal and monetary policy environm­ent created by the “outdated, dysfunctional and unfair international financial architecture” of the 1940s’ Bretton Woods institutions. Inequalities within rich and poor countries are increasing, and the North-South divide is deepening. According to the report, the SDGs are in peril; their failure would sound the death knell for the planet.

Centuries of colonisation and exploitation have left developing countries with the poorest, most vulnerable people. Continu­ing injustices through institutional monetary and political instruments play a major role in the lack of progress on SDGs. The promise of increasing official development assistance by developed countries towards achieving the SDGs hasn’t been kept, and targets on climate change haven’t met with success, not least because the financial co­­m­­­­­mitment of $100 billion per year was ignored.

Poor progress on SDGs is bad news for the marginalised.

At the same time, the developing countries’ governments cannot be absolved of their responsibility of eradicating poverty and providing education, health, access and employment opportunities to their people. In the 2023 Human Development Ind­ex, Pakistan ranks below Togo and Rwanda, with only 4.4 average years of education (SDG-4), while India and Bangladesh (se­ven years) are in the Medium Development Index, and Iran and Sri Lanka (11 years) in the High Development Index. The SDG Status Report issued by the Planning Com­mission in 2021 admits Pakistan’s progress has been dismal in education and poor on economic growth and employment.

Pakistan has failed to provide literacy to 60pc of its population in the last 77 years; its primary and secondary healthcare systems are deteriorating due to low budgetary allocations and unbridled population growth; poverty is rising; its infrastructure of roads, railways and air travel is collapsing; business growth is restricted by high interest rates, chronic energy deficit, rentier capitalism and elite capture; and its position on world indices of poverty alleviation, economic opportunities, per capita productivity, human rights, safety, gender equality, inclusion of persons with disabilities and almost everything else has remained at shamefully low levels.

A critical component of development in general and achieving SDGs in particular, is good governance, oversight and accountability of governments and public institutions. Governance in Pakistan has deteriorated alarmingly, with the bureaucracy and state institutions becoming partisan, self-serving and rapacious. Two political dynasties have ruled in the name of democracy for more than 40 years, evading public accountability, weakening domestic institutions, and compromising national interest with ad hoc policy decisions. The SDGs have thus been sidelined.

The options of economic recovery are fast disappearing for Pakistan and other countries on the radar of the US and EU agenda in their war for capitalist hegemony. The re­­cent failure of UN agencies, int­ernational hum­an rights groups and Western media to stop genocide in Palestine has ex­­posed the hollowness of many slogans fed to the world in the last 80 years. This debacle has undermined the credibility of international institutions and also called into question developed countries’ respect for international law.

In 2019, Pakistan ranked 67th on the World Happiness Index, faring better than many developing countries. Cynics said it was due to our low self-esteem and lack of awareness.

In 2023, this ranking fell by 41 positions to 108 mainly because of a public awakening as to what could have been. There is widespread anger, frustration, and bitterness. People with a formal education or a degree are migrating abroad, triggering Pakistan’s biggest brain drain.

In our bleak environment of economic, sociocultural and political insolvency, achieving the SDGs seems impossible in the next seven years, particularly those relating to access, education, vocational training, employment and inclusion of persons with autism, physical dis-abilities, women, and all marginalised communities.

The writer, a former federal secretary, is CEO, ASD Welfare Trust.

Published in Dawn, April 2nd, 2024

https://www.dawn.com/news/1825180/autism-and-sdgs

[kmaherali]

Cracking the Chronic Illness Code: Ticks, Toxins & Mold



Hi Karim,

In a world where chronic illness persists as a pervasive challenge, its complexity often eludes conventional medical approaches. The intricate web of contributing factors goes beyond the specialized lens of traditional practitioners, leaving patients frustrated, sick and seeking answers.

Join us to embark on an educational exploration of complex chronic illness and embrace a new path to health.

Cracking the Chronic Illness Code: Ticks, Toxins & Mold could help you answer questions like:

- What complementary therapies or alternative treatments might support my healing journey for chronic illness?
- What strategies can help manage flare-ups or setbacks during the healing process?
- What could be my barriers to effective detox?
- What lab tests should I consider?
- What lifestyle changes can help support healing from chronic illness?
- What role does the nervous system play in healing from chronic illness?
- How can one advocate for themselves within the healthcare system to receive optimal support for healing?
- What role can mindset and attitude play in the healing journey of chronic illness?

Get answers to these and many more questions!
​​​​​​​
Find out more about this complimentary, online symposium https://fleetmaull.krtra.com/c/ZKlD5AkczPlF/ab5j9

Be sure to mark your calendar for May 6-12, 2024!

Why attend this important health event?

Drawing from over 50 years of combined clinical expertise in treating difficult-to-diagnose illnesses, Dr. Nafysa Parpia and Dr. Eric Gordon will present the crucial factors underlying and complicating chronic illness. Throughout their discussions with over 40 experts, they will share their wisdom, tools, and strategies to help guide you back to a state of health.

“One of the big reasons that chronic illness, in general, is such a massive problem today is that these types of conditions are almost always complex and multifaceted in nature. There are lots of elements working together to create the problem. There is no one root cause, and because conventional medicine has become so highly specialized, you could actually be seeing one of the best doctors in the world and completely resolve all of the issues they find and still stay sick because of things outside of their specialty that were never even looked at or considered.” - Dr. Eric Gordon

Reserve your seat at Cracking the Chronic Illness Code: Ticks, Toxins & Mold when you register now! https://fleetmaull.krtra.com/c/ZKlD5AkczPlF/ab5j9

Join them for insights that go beyond specialty medicine and conventional treatments.

REGISTER HERE FOR FREE https://fleetmaull.krtra.com/c/ZKlD5AkczPlF/ab5j9

To your health,

-Heart Mind Institute team


P.S. When you register for Cracking the Chronic Illness Code: Ticks, Toxins & Mold, you’ll also unlock early-access interviews, complimentary guides and helpful eBooks about regaining your health!

[swamidada]

Fox News
Having trouble sleeping? It could be for this surprising reason, experts say
Melissa Rudy
Thu, April 18, 2024 at 3:40 AM CDT·

Having trouble sleeping? It could be for this surprising reason, experts say
When creating an ideal sleeping environment, you might think of lighting, temperature and sound — but what about food?

What you eat during the day can have a surprising impact on how well you sleep at night, according to experts.

"Food choice is an essential consideration for ensuring good sleep quality. Some types of food promote sleep while others may cause sleep disruption," Dr. Chelsie Rohrscheib, head sleep expert at Wesper, a sleep analysis company in New York, told Fox News Digital.

Here's what to know.

If after eating you’re struggling to fall asleep, waking up often during the night or experiencing heartburn, acid reflux or indigestion, your food choices could be the culprit, according to Dr. Raj Dasgupta, chief medical adviser at Sleepopolis in California.

What you eat can have an impact on how well you sleep at night, experts say.
Other warning signs include experiencing restlessness or stomach discomfort, needing more frequent bathroom breaks at night, or waking up feeling groggy or unrested.

"Having intense dreams or nightmares or noticing changes in your usual sleep routine" are other indications that food could be interfering with sleep, Dasgupta said.

"Paying attention to these cues can help you figure out if certain foods or drinks are messing with your sleep quality, so you can make adjustments as needed for better rest," he said.

Foods that encourage better sleep include meals with a good amount of lean protein, meals that are high in fiber, and meals that are rich in complex carbohydrates, according to Rohrscheib.

"This food combination keeps us feeling full and satisfied throughout the night and prevents us from waking up from hunger," she said.

"Having intense dreams or nightmares or noticing changes in your usual sleep routine" are other indications that food choices could be interfering with sleep, an expert said.
"It also reduces the risk of indigestion and heartburn."

Foods containing dairy are especially beneficial, she said, because they contain tryptophan, an amino acid that is essential for the production of serotonin and melatonin, two chemicals needed for sleep.

Bananas can also help promote sleep, according to Dasgupta.

"They contain magnesium and tryptophan, which can help you relax and boost production of sleep-inducing hormones," he told Fox News Digital.

Almonds provide magnesium for muscle relaxation and also contain protein and healthy fats to keep blood sugar levels stable, said an expert.
Almonds also provide magnesium for muscle relaxation; they contain protein and healthy fats to keep blood sugar levels stable, he said.

"Cherries contain natural melatonin, potentially helping to regulate your sleep-wake cycles," Dasgupta said.

Oatmeal is also a sleep-friendly food.

"Its complex carbohydrates increase serotonin levels, while its melatonin content helps to regulate sleep," said Dasgupta.

Bananas can help with quality sleep because they contain magnesium and tryptophan, which can promote relaxation, an expert said.
"Kiwi is loaded with antioxidants, vitamins and serotonin, all of which support sleep pattern regulation," he said.

Dasgupta also recommends eating Greek yogurt to promote improved sleep, as its calcium content assists in the body's use of tryptophan for melatonin production, while its protein helps maintain blood sugar levels.

"Finally, warm milk, with its tryptophan content and comforting warmth, can help you relax" for a good night's sleep, he said.

Those who are lactose-intolerant can opt for warm almond milk.

Some foods are more likely to cause indigestion and heartburn, which makes it difficult to fall asleep and maintain sleep, according to Rohrscheib.

"This includes foods with high fat or acid content, foods containing caffeine, or spicy foods," she said.

Dasgupta agreed that eating heavy or spicy foods ahead of bedtime can cause stomach discomfort, heartburn and acid reflux, which can make it harder to settle down comfortably.

Eating heavy or spicy foods can cause stomach discomfort, heartburn and acid reflux, which can make it harder to settle down comfortably for the night, an expert said.
"Greasy or heavy meals take longer to digest, which can leave you feeling uncomfortable and disrupt your sleep," he advised.

Caffeine is also a common culprit in sleep disruption — experts recommend avoiding it in the hours leading up to bedtime.

"Any food containing caffeine, even small amounts, should be avoided to prevent sleep disruption," Rohrscheib said. "This includes coffee, some teas, sodas, energy drinks and some chocolates."

It’s best to abstain from alcohol as well, Dasgupta said. "While it might seem like a nightcap, it messes with your sleep cycles, leading to worse sleep quality."

Caffeine is also a common culprit in sleep disruption — experts recommend avoiding it in the hours leading up to bedtime.
Highly processed foods and foods containing high amounts of sugar cause a quick spike in glucose levels and increase the risk of a "blood sugar crash," also known as hypoglycemia, Rohrscheib warned.

"When we're hypoglycemic, our brain will attempt to wake us up to eat more food to normalize our blood glucose levels," she said. "Thus, these foods should be avoided before bedtime."

"Lastly, processed or junk foods, loaded with additives and unhealthy fats, can throw off your sleep patterns," Dasgupta added.

"Regardless of the type of meal you eat, consuming too much and making yourself over-full is likely to make you uncomfortable and cause poor sleep quality," Rohrscheib said.

https://currently.att.yahoo.com/att/cm/ ... 21622.html

[kmaherali]

Millions of Girls in Africa Will Miss HPV Shots After Merck Production Problem

The company has told countries that it can supply only 18.8 million of the 29.6 million doses it was contracted to deliver this year.



On the way to class in Freetown, Sierra Leone. The delayed vaccines means that girls in countries such as Sierra Leone, Burkina Faso and Mozambique who are now 14 will no longer be eligible for vaccination when these campaigns finally start.Credit...John Wessels/Agence France-Presse — Getty Images

Nearly 1.5 million teenage girls in some of the world’s poorest countries will miss the chance to be protected from cervical cancer because the drugmaker Merck has said it will not be able to deliver millions of promised doses of the HPV vaccine this year.

Merck has notified Gavi, the international organization that helps low- and middle-income countries deliver lifesaving immunizations, and UNICEF, which procures the vaccines, that it will deliver only 18.8 million of the 29.6 million doses it was contracted to deliver in 2024, Gavi said.

That means that more than 10 million girls will not receive their expected HPV shots this year — and 1.5 million of them most likely will never get them because they will be too old to qualify for the vaccine in subsequent years.

Patrick Ryan, a spokesman for Merck, said the company “experienced a manufacturing disruption” that required it to hold and reinspect many doses by hand. He declined to give further details about the cause of the delay.

“We are acting with urgency and rigor to deploy additional personnel and resources to resolve this matter as soon as possible,” he said.

Mr. Ryan said that Merck would deliver the delayed doses in 2025.

He also said the company would ship 30 million doses of the vaccine to Gavi-supported countries this year. However, about a third of these are doses that were supposed to have been sent in 2023, leaving Gavi with the 10.7 million dose shortfall.

The delay is a big setback for countries that had already waited years to begin vaccinating girls against HPV, the human papillomavirus, which causes an estimated 90 percent of cervical cancers.

About 350,000 women die from cervical cancer annually, according the World Health Organization. Ninety percent of them are in low-income countries, where routine screening for the disease is rare. The vaccine offers near-total protection against HPV infection, making it the lone vaccine against cancer.

“HPV is the highest impact vaccine Gavi has: If you vaccinate 1,000 girls, you prevent 17.4 future deaths,” said Dr. Aurélia Nguyen, Gavi’s chief program officer. “If there is one vaccine that you want to get out and do well on, this is it.”

The W.H.O. recommends the vaccine for girls up to age 14. The delay means that girls in countries including Sierra Leone, Burkina Faso and Mozambique who are now 14 will no longer be eligible for vaccination when these campaigns finally start.

The HPV vaccine is a complex one to deliver, since it is associated with sexual activity, a taboo topic for teenagers in many of the cultures affected by the delay, and because it is given to children who are outside the usual age for routine immunization. Both girls and their parents must be amenable to vaccination, and that requires crafting distinct messages, delivered on different media, to drum up demand. The vaccine has to be given before girls are sexually active to be effective.

Image
A close-up view of a vial of HPV vaccine.

Merck notified Gavi that it will deliver only 18.8 million of the 29.6 million doses it was contracted to deliver in sub-Saharan Africa in 2024.Credit...Joe Raedle/Getty Images

The countries affected have some of the lowest-resource health systems in the world, Dr. Nguyen said. They have invested in planning for the scrapped HPV campaign, while juggling other urgent vaccination needs such as measles or cholera, and can ill-afford the disruption, she said.

The delay will disrupt carefully laid plans to catch up on vaccinations — most of the delayed doses were bound for what’s called “multi-age cohorts,” when countries try to reach all unvaccinated girls between 9 and 14, alongside a standard immunization program for 9-year-olds, usually run in schools.

Most high-income countries routinely vaccinate both girls and boys against HPV, but the global coverage rate for the vaccine is only 20 percent.

Gavi has been trying to expand HPV vaccination for more than a decade. Many low-income countries had designed programs to begin in 2018, but Gavi could not get shots then either because it and UNICEF were competing with a global market and suppliers did not increase production to meet Gavi’s predicted demand.

The version of the Merck HPV vaccine used in the United States costs about $285. UNICEF, which typically negotiates big discounts from pharmaceutical companies, pays $3 to $5 per shot for the large volumes of vaccine it sought to procure.

“UNICEF and Gavi have struggled for years to get sufficient supply, and that was finally starting to change,” said Andrew Jones, UNICEF’s deputy director, immunization supplies.

UNICEF has contracts with other suppliers, but because the Merck product is in high demand from countries, the Gavi program is dependent on the company’s supply. That means this delay disrupts vaccination campaigns in a half-dozen countries, many of which have already had to postpone repeatedly.

“It affects countries’ confidence because for years they were told there wasn’t sufficient supply, but when finally supply opened up, they campaigned, got political buy-in, and now delivery is delayed by six or eight months,” Mr. Jones said.

Mr. Ryan of Merck said the company was committed to supporting the drive to vaccinate millions of girls in developing countries against HPV and had invested more than $2 billion in that effort.

Though Mr. Ryan said the company will deliver the delayed doses next year, Merck has yet to notify Gavi when countries can expect those deliveries, which means they cannot yet begin to plan new campaigns.

The countries that won’t get doses this year include Mozambique, Sierra Leone, Ivory Coast and Burkina Faso. They were going to do the multi-age blitz campaigns aimed at catching as many girls as possible, in addition to the routine vaccination of 9-year-olds. The routine program will continue using doses Merck has delivered.

Image
An exterior view of a Merck facility in New Jersey, with its logo and name large on a brick wall at the entrance.

A Merck campus in Rahway, N.J. A spokesman for the company said it had “experienced a manufacturing disruption” that required it to hold and reinspect many doses by hand.Credit...Brendan Mcdermid/Reuters

In addition, Burundi, and, in Asia, Tajikistan, were supposed to get supplies at the end of this year to start doing both multi-age and routine vaccinations, while Cameroon and Liberia were to take delivery of shots so they could start doing multi-age vaccination early in the new year. All of those campaigns will be postponed.

The girls who won’t get vaccinated this year are some of the least likely in the world to be screened or treated for cervical cancer, said Dr. Cathy Ndiaye, the Dakar-based director of the HPV vaccine program for the health-focused nonprofit organization PATH.

“In some countries you can say, ‘OK, you weren’t vaccinated but if you have anything later on in life you can go and get treated’, but not for these girls,” Dr. Ndiaye said.

The delay also complicates the challenge of maintaining political and community support for the HPV shot, she said.

“When you have momentum you want to take advantage of that: When you manage to create demand from the community, you want to deliver, to give them what they need,” she said. “Even at the national level you have to convince them this is important, that it should be a priority because they don’t see cervical cancer, they don’t see the disease now, they say, ‘No let’s deal with polio, let’s deal with measles, that is urgent now.’”

In Mozambique, the plan was to begin the multi-age campaign in June. “There is huge demand, people are asking for it,,” said Dr. Betuel Sigaúque, who works to support routine immunization in Mozambique through JSI, a global nonprofit focused on health and education.

Merck also failed to deliver 7.7 million doses of vaccine to Ethiopia that were scheduled to arrive late last year, and now says they will arrive in June. The country had to scrap a planned school campaign set for spring. Instead, that campaign will take place later this year and will miss girls who have aged out.

https://www.nytimes.com/2024/04/18/heal ... 778d3e6de3

[swamidada]

NBC News
Science shows how a surge of anger could raise heart attack risk
Barbara Mantel
Wed, May 1, 2024 at 6:00 AM CDT·

Previous research has suggested there’s a link between an acute episode of anger and an increased risk of heart attack. Researchers from Columbia University Irving Medical Center, Yale School of Medicine, St. John’s University in New York and other institutions wanted to tease out why.

To answer that question, they’d need to make some people angry.

The investigators recruited 280 healthy young adults and randomized them into four groups: a control group that counted out loud for eight minutes and maintained a neutral emotional state, and groups who recalled events that made them angry, sad or anxious. Before they began, and at intervals for 100 minutes afterward, the researchers took blood samples and measurements of blood flow and pressure.

The findings, published Wednesday in the Journal of the American Heart Association, show that anger may indeed affect the heart because of how it impairs blood vessel function.

The researchers found blood vessels’ ability to dilate was significantly reduced among people in the angry group compared with those in the control group. Blood vessel dilation wasn’t affected in the sadness and anxiety groups.

Dilation can be regulated by endothelial cells, which line the insides of blood vessels. By dilating and contracting, blood vessels slow down or increase the flow of blood to the parts of the body that need it.

Further tests revealed that there was no damage to the endothelial cells or to the body’s ability to repair any endothelial cell damage.

The only issue was the dilation, the study found. Impairment of how blood vessels dilate is an early marker for atherosclerosis, which is the buildup of fats and cholesterol, called plaque, on artery walls that make the arteries stiff. Atherosclerosis can lead to coronary heart disease, heart attack, stroke and kidney disorders.

“That is why endothelium-dependent vasodilation is an important mechanism to study,” said co-author Andrea Duran, an assistant professor of medical sciences at Columbia University Irving Medical Center, using the medical terminology for the impairment seen in the study.

The results of the study could help physicians persuade their patients who have heart disease and anger problems to manage their anger, through yoga, exercise, cognitive behavioral therapy or other established techniques, said Dr. Holly Middlekauff, a cardiologist and a professor of medicine and physiology at UCLA’s David Geffen School of Medicine.

“It’s not widely known or widely accepted that anger does precipitate heart attacks,” said Middlekauff, who wasn’t involved with the study. “This study offers a biological plausibility to that theory, that anger is bad for you, that it raises your blood pressure, that we’re seeing impaired vascular health.”

And that may get some patients’ attention, she added.

Duran cautioned that the laboratory study is a foundational study and that further research is needed. For example, scientists don’t know exactly how anger impairs blood vessel dilation. “That would be for a future study,” she said.

In the paper, the researchers suggested several factors could be at work, including changes caused by stress hormones, increased inflammation and activation of the autonomic nervous system, which regulates involuntary processes like heart rate, blood pressure and breathing.

In addition, the researchers intentionally selected participants who were healthy, without heart disease or other chronic conditions that could confound the results. While that is a strength of the study, it also is a limitation, because the findings may not apply to older people who are ill.

“This was just the first step,” said Rebecca Campo, a psychologist and program director at the National Heart, Lung and Blood Institute, which funded the study.

Middlekauff said the biggest limitation of the study is that it looked at one bout of provoked anger.

“I’d like to see a study of a group of chronically angry people and see what their vascular function is,” she said.

This article was originally published on NBCNews.com

https://currently.att.yahoo.com/news/sc ... 00223.html

[kmaherali]

Study Suggests Genetics as a Cause, Not Just a Risk, for Some Alzheimer’s

People with two copies of the gene variant APOE4 are almost certain to get Alzheimer’s, say researchers, who proposed a framework under which such patients could be diagnosed years before symptoms.


A C.T. scan of a patient with Alzheimer’s disease.Credit...Vsevolod Zviryk/Science Source

Scientists are proposing a new way of understanding the genetics of Alzheimer’s that would mean that up to a fifth of patients would be considered to have a genetically caused form of the disease.

Currently, the vast majority of Alzheimer’s cases do not have a clearly identified cause. The new designation, proposed in a study published Monday, could broaden the scope of efforts to develop treatments, including gene therapy, and affect the design of clinical trials.

It could also mean that hundreds of thousands of people in the United States alone could, if they chose, receive a diagnosis of Alzheimer’s before developing any symptoms of cognitive decline, although there currently are no treatments for people at that stage.

The new classification would make this type of Alzheimer’s one of the most common genetic disorders in the world, medical experts said.

“This reconceptualization that we’re proposing affects not a small minority of people,” said Dr. Juan Fortea, an author of the study and the director of the Sant Pau Memory Unit in Barcelona, Spain. “Sometimes we say that we don’t know the cause of Alzheimer’s disease,” but, he said, this would mean that about 15 to 20 percent of cases “can be tracked back to a cause, and the cause is in the genes.”

The idea involves a gene variant called APOE4. Scientists have long known that inheriting one copy of the variant increases the risk of developing Alzheimer’s, and that people with two copies, inherited from each parent, have vastly increased risk.

The new study, published in the journal Nature Medicine, analyzed data from over 500 people with two copies of APOE4, a significantly larger pool than in previous studies. The researchers found that almost all of those patients developed the biological pathology of Alzheimer’s, and the authors say that two copies of APOE4 should now be considered a cause of Alzheimer’s — not simply a risk factor.

The patients also developed Alzheimer’s pathology relatively young, the study found. By age 55, over 95 percent had biological markers associated with the disease. By 65, almost all had abnormal levels of a protein called amyloid that forms plaques in the brain, a hallmark of Alzheimer’s. And many started developing symptoms of cognitive decline at age 65, younger than most people without the APOE4 variant.

“The critical thing is that these individuals are often symptomatic 10 years earlier than other forms of Alzheimer’s disease,” said Dr. Reisa Sperling, a neurologist at Mass General Brigham in Boston and an author of the study.

She added, “By the time they are picked up and clinically diagnosed, because they’re often younger, they have more pathology.”

People with two copies, known as APOE4 homozygotes, make up 2 to 3 percent of the general population, but are an estimated 15 to 20 percent of people with Alzheimer’s dementia, experts said. People with one copy make up about 15 to 25 percent of the general population, and about 50 percent of Alzheimer’s dementia patients.

The most common variant is called APOE3, which seems to have a neutral effect on Alzheimer’s risk. About 75 percent of the general population has one copy of APOE3, and more than half of the general population has two copies.

Alzheimer’s experts not involved in the study said classifying the two-copy condition as genetically determined Alzheimer’s could have significant implications, including encouraging drug development beyond the field’s recent major focus on treatments that target and reduce amyloid.

Dr. Samuel Gandy, an Alzheimer’s researcher at Mount Sinai in New York, who was not involved in the study, said that patients with two copies of APOE4 faced much higher safety risks from anti-amyloid drugs.

When the Food and Drug Administration approved the anti-amyloid drug Leqembi last year, it required a black-box warning on the label saying that the medication can cause “serious and life-threatening events” such as swelling and bleeding in the brain, especially for people with two copies of APOE4. Some treatment centers decided not to offer Leqembi, an intravenous infusion, to such patients.

Dr. Gandy and other experts said that classifying these patients as having a distinct genetic form of Alzheimer’s would galvanize interest in developing drugs that are safe and effective for them and add urgency to current efforts to prevent cognitive decline in people who do not yet have symptoms.

“Rather than say we have nothing for you, let’s look for a trial,” Dr. Gandy said, adding that such patients should be included in trials at younger ages, given how early their pathology starts.

Besides trying to develop drugs, some researchers are exploring gene editing to transform APOE4 into a variant called APOE2, which appears to protect against Alzheimer’s. Another gene-therapy approach being studied involves injecting APOE2 into patients’ brains.

The new study had some limitations, including a lack of diversity that might make the findings less generalizable. Most patients in the study had European ancestry. While two copies of APOE4 also greatly increase Alzheimer’s risk in other ethnicities, the risk levels differ, said Dr. Michael Greicius, a neurologist at Stanford University School of Medicine who was not involved in the research.

“One important argument against their interpretation is that the risk of Alzheimer’s disease in APOE4 homozygotes varies substantially across different genetic ancestries,” said Dr. Greicius, who cowrote a study that found that white people with two copies of APOE4 had 13 times the risk of white people with two copies of APOE3, while Black people with two copies of APOE4 had 6.5 times the risk of Black people with two copies of APOE3.

“This has critical implications when counseling patients about their ancestry-informed genetic risk for Alzheimer’s disease,” he said, “and it also speaks to some yet-to-be-discovered genetics and biology that presumably drive this massive difference in risk.”

Under the current genetic understanding of Alzheimer’s, less than 2 percent of cases are considered genetically caused. Some of those patients inherited a mutation in one of three genes and can develop symptoms as early as their 30s or 40s. Others are people with Down syndrome, who have three copies of a chromosome containing a protein that often leads to what is called Down syndrome-associated Alzheimer’s disease.

Dr. Sperling said the genetic alterations in those cases are believed to fuel buildup of amyloid, while APOE4 is believed to interfere with clearing amyloid buildup.

Under the researchers’ proposal, having one copy of APOE4 would continue to be considered a risk factor, not enough to cause Alzheimer’s, Dr. Fortea said. It is unusual for diseases to follow that genetic pattern, called “semidominance,” with two copies of a variant causing the disease, but one copy only increasing risk, experts said.

The new recommendation will prompt questions about whether people should get tested to determine if they have the APOE4 variant.

Dr. Greicius said that until there were treatments for people with two copies of APOE4 or trials of therapies to prevent them from developing dementia, “My recommendation is if you don’t have symptoms, you should definitely not figure out your APOE status.”

He added, “It will only cause grief at this point.”

Finding ways to help these patients cannot come soon enough, Dr. Sperling said, adding, “These individuals are desperate, they’ve seen it in both of their parents often and really need therapies.”

https://www.nytimes.com/2024/05/06/heal ... 778d3e6de3

[kmaherali]

C.D.C. Warns of a Resurgence of Mpox

A deadlier version of the infectious disease is ravaging the Democratic Republic of Congo, while the type that caused a 2022 outbreak among gay and bisexual men is regaining strength.


A health official investigating and treating a probable case of mpox at the Yalolia health center in Tshopo, Democratic Republic of Congo, in 2022.Credit...Arlette Bashizi/Reuters

With Pride events scheduled worldwide over the coming weeks, U.S. officials are bracing for a return of mpox, the infectious disease formerly called monkeypox that struck tens of thousands of gay and bisexual men worldwide in 2022. A combination of behavioral changes and vaccination quelled that outbreak, but a majority of those at risk have not yet been immunized.

On Thursday, the Centers for Disease Control and Prevention warned of a deadlier version of mpox that is ravaging the Democratic Republic of Congo and urged people at risk to be vaccinated as soon as possible. No cases of that subtype have been identified outside Africa so far. But the escalating epidemic in Congo nevertheless poses a global threat, just as infections in Nigeria set off the 2022 outbreak, experts said.

“This is a very important example of how an infection anywhere is potentially an infection everywhere, and why we need to continue to improve disease surveillance globally,” said Anne Rimoin, an epidemiologist at the University of California, Los Angeles.

Dr. Rimoin has studied mpox in Congo for more than 20 years, and first warned of its potential for global spread in 2010.

The C.D.C. is focusing on encouraging Americans at highest risk to become vaccinated before the virus resurges. The agency’s outreach efforts include engaging with advocacy groups and social media influencers who have broad appeal among the L.G.B.T.Q. community. In December, the agency urged clinicians to remain alert for possible cases in travelers from Congo.

There are two main types of mpox: Clade I, the type that is dominant in Congo, and Clade II, a version of which caused the 2022 global outbreak. (A clade is a genetically and clinically distinct group of viruses.) Both clades have circulated in Africa for decades, sporadically erupting into outbreaks.

People with mpox may have fever, intense headache and back pain, followed by a rash. Many patients also develop painful sores, often at the site of infection. People who have weakened immune systems, including those living with H.I.V., are at highest risk of becoming severely ill and dying.

The version of mpox that caused the 2022 outbreak, called Clade IIb, led to more than 30,000 cases in the United States that year. The epidemic quieted in 2023 with only about 1,700 cases but is now showing signs of a resurgence: The number of cases in the United States this year is nearly double the tally at this time last year.

In Congo, as of April 14, the Clade I virus has led to about 20,000 cases and nearly 1,000 deaths since January 2023. Infection with Clade I has a mortality of roughly 5 percent, compared with less than 0.2 percent for Clade IIb.

More than three-quarters of deaths in Congo related to Clade I mpox have been among children under 15.

Even if the deadlier clade were to emerge in the United States, American children would be less likely to be exposed to mpox, and less vulnerable to it, than those in Congo, experts said.

Image
A microscope image showing red and white dots in a blue cell indicating an mpox infection.

A colorized transmission electron micrograph of mpox particles, in red, found within an infected cell.Credit...National Institute of Allergy and Infectious Diseases, via Associated Press

Most cases among children in Congo are thought to result from direct contact with infected animals such as monkeys, prairie dogs, squirrels and shrews, or from eating contaminated bush meat. The children may live in crowded households and be in poor health generally.

The country is troubled by armed conflicts, floods, poverty, malnutrition and multiple infectious diseases, including cholera, measles and polio.

“There’s just a difference in living in D.R.C. that probably promotes higher spread among kids,” said Dr. Jennifer McQuiston, the deputy director of the Division of High Consequence Pathogens at the C.D.C.

Adult cases in Congo have likewise been attributed to interactions with infected animals or close, sustained contact with infected people. But last year, for the first time, scientists discovered sexual transmission of Clade I mpox among male and female sex workers and their contacts.

In one outbreak in Kamituga, a mining town in Congo, heterosexual prostitution in bars appeared to be the main form of transmission. Genetic analysis showed that, sometime around September, the virus gained mutations, enabling it to spread more readily among people.

This chain of transmission appears to be a second, distinct outbreak in the country, caused by a new version of the virus called Clade Ib, with cases split about equally among young men and women, said Marion Koopmans, a virologist at Erasmus Medical Center in Rotterdam, the Netherlands.

“I do think there is more than one outbreak ongoing, and it is important to continue to evaluate what that means,” Dr. Koopmans said. “We cannot assume” all forms of mpox behave in the same way, she said.

The development has also alarmed scientists because miners and sex workers in the region are transient and may ferry the virus to the neighboring nations of Rwanda, Burundi, Uganda and Tanzania.

In many of these countries, limited access to tests, vaccines and treatments gives the virus ample opportunity to thrive and evolve. A vast majority of mpox cases are diagnosed based on symptoms alone.

Some countries rely on tests that detect only Clade I or only Clade IIb. Those tests may not pick up Clade Ib, the new version that emerged in September, according to a recent study.

That finding prompted the World Health Organization to alert nations to revisit their testing procedures “and make sure they don’t miss a diagnosis,” said Dr. Rosamund Lewis, who leads the W.H.O.’s mpox response.

Image
A line of people under a tree outside a hospital.

People waiting to take the mpox vaccine at the Zuckerberg San Francisco General Hospital and Trauma Center in 2022.Credit...Jim Wilson/The New York Times

In the United States, a test approved by the Food and Drug Administration detects all versions of mpox but cannot distinguish between them. A positive result on that test should be followed by more specific tests that can identify the clade, Dr. McQuiston said.

So far at least, the available vaccines and antiviral drugs are expected to be effective against all forms of the virus. The 2022 outbreak began in Europe in May and picked up steam in the United States during Pride Month in June and afterward.

Early in the outbreak, there was a shortage of the two-dose mpox vaccine, called Jynneos. But many gay and bisexual men, accustomed to heeding public health messaging on H.I.V., curbed their sexual activity, precipitating a decline in cases even before vaccines were broadly available.

The drop in numbers may have produced a false sense of security, however.

“A sense of complacency set in that this wasn’t really something that people needed to have an ongoing worry about, and we saw those vaccination rates rapidly decline,” said Dr. Boghuma Titanji, a virologist and infectious disease physician at Emory University.

Behavioral changes are difficult to sustain, so vaccination is important for long-term control of the virus, Dr. Titanji said.

Two doses of the vaccine are more powerful than one, with an effectiveness of up to 90 percent, according to an analysis last month of 16 studies. Even when the vaccine did not prevent infections, it tempered the severity and duration of illness.

Still, fewer than one in four Americans at risk received two doses.

“We’ve continued to saturate the space with the messaging, and uptake is not really shifting a lot,” Dr. McQuiston said, suggesting a need for more creative approaches.

In 2022, the vaccine was available only in the United States through federal agencies and plagued by problems with delivery, limiting its availability; it is now commercially available. The W.H.O., which recommends vaccines for African countries, has been slow to approve it, and has not even initiated the approval process.

Still, the W.H.O.’s advisory group on immunizations has recommended that, where available, the vaccine can be used to protect adults and children at risk of mpox, Dr. Lewis said.

In addition to preparing for mpox’s return to the United States, the C.D.C. is supporting Congo’s efforts to obtain vaccines and drugs and contain the epidemic.

“It’s much better to help them get this outbreak under control before it spills over into other areas and becomes more of a global risk,” Dr. McQuiston said. “And, ethically, it’s the right thing to do.”

https://www.nytimes.com/2024/05/16/heal ... 778d3e6de3

[kmaherali]

Hi Karim,

Is there a place for ancestral wisdom in the Psychedelic Renaissance, or will Western psychedelic therapy eclipse indigenous ways and perspectives? How could these two powerful healing modalities work together for the greater good?

Register for the open-access Plant Spirit Summit (June 23-29, 2024) and join me and 80+ experts and community leaders in a series of bold conversations on the essential role ancestral medicines play in the Psychedelic Renaissance.

Topics include:

- Ancient Medicine for Modern Times: the Essential Role of Ancestral Medicines
- Ceremony as a Service: Exploring the Landscape of Facilitated Psychedelic Experiences
- The Union of Psychedelic Therapy and Ancestral Healing
- Overcoming Racial Barriers to Participation in the Psychedelic Renaissance

Click here to register for free https://plantspiritschool.com/condor-ea ... fleetmaull

In 7 immersive days, you can access interviews with experts and Indigenous wisdom keepers, live panels discussing emerging trends in the psychedelic sector, and short films and documentaries exploring Indigenous culture and plant medicines - at no charge.

You will emerge with a profound understanding of why ancestral wisdom remains an essential guiding light for humanity in complex, modern times… and be inspired to be a part of the Condor Eagle Prophecy!

See you there!!

Fleet Maull, PhD

Heart Mind Institute

[kmaherali]

This Is Literally Your Brain on Drugs

A small new study shows reactions in the brain in people who were given psilocybin in a controlled setting.

If you had to come up with a groovy visualization of the human brain on psychedelic drugs, it might look something like this.

Video: https://vp.nyt.com/video/2024/07/16/120 ... _1080p.mp4

The image, as it happens, comes from dozens of brain scans produced by researchers at Washington University School of Medicine in St. Louis who gave psilocybin, the compound in “magic mushrooms,” to participants in a study before sending them into a functional M.R.I. scanner.

The kaleidoscopic whirl of colors they recorded is essentially a heat map of brain changes, with the red, orange and yellow hues reflecting a significant departure from normal activity patterns. The blues and greens reflect normal brain activity that occurs in the so-called functional networks, the neural communication pathways that connect different regions of the brain.

The scans, published Wednesday in the journal Nature, offer a rare glimpse into the wild neural storm associated with mind-altering drugs. Researchers say they could provide a potential road map for understanding how psychedelic compounds like psilocybin, LSD and MDMA can lead to lasting relief from depression, anxiety and other mental health disorders.

“Psilocybin, in contrast to any other drug we’ve tested, has this massive effect on the whole brain that was pretty unexpected,” said Dr. Nico Dosenbach, a professor of neurology at Washington University and a senior author of the study. “It was quite shocking when we saw the effect size.”

The study included seven healthy adults who were given either a single dose of psilocybin or a placebo in the form of methylphenidate, the generic version of the amphetamine Ritalin. Each participant underwent a total of 18 brain scans, taken before, during and after the initial dosing.

Four participants returned six months later for an additional psilocybin session.

Although the scans of those given methylphenidate showed acute changes in brain activity patterns, the neural disruption among those who took psilocybin was three times greater, the study found.

Much of that disruption occurred in parts of the brain involved in introspective thinking, like daydreaming and remembering. Those areas help individuals define their sense of self.

Perhaps more surprising were the scans taken days and weeks later. They showed that the brains of those who took psilocybin had largely returned to normal, but there remained a small and significant change suggesting that the drug’s effects remained long after psilocybin had left the individual’s body.

Dr. Jan Ramaekers, a professor of psychopharmacology at Maastricht University in the Netherlands who was not involved in the study, said the scans showing that the drug had lingering effects correlated with anecdotal evidence suggesting that the benefits of some psychedelic therapies were not permanent. “Treatments with psilocybin, even though they are effective, don’t last forever,” he said. “At some point, they need to be done again.”

Dr. Joshua Siegel, a neuroscientist and lead author of the study, said psilocybin appeared to disrupt the brain’s default mode network, an interconnected set of areas ordinarily active when the brain is not focused on anything in particular. By contrast, the default mode network remained stable in the participants who received the methylphenidate.

“The activity in these networks became much more disorganized, and boundaries between the networks essentially evaporated,” Dr. Siegel said.

He used the analogy of the synchronized stadium wave to explain the phenomenon. In normal day-to-day activity, millions of neurons work in synchrony but when a psychedelic like psilocybin washes over the brain, those neurons start firing off in a chaotic fusillade. “It’s like having thousands of stadium fans randomly raise their hands,” he said.

Ceyda Sayali, a cognitive neuroscientist at the Center for Psychedelic and Consciousness Research at Johns Hopkins University who was not involved with the study, said she was struck by the images that showed a marked change when participants on psilocybin were asked to answer simple questions that forced them to focus on what was happening around them. The requests, known in the field as grounding, can briefly draw participants out of their psychedelic reverie.

In this case, the sudden jolt of reality was reflected in scans that showed a brief calming of brain activity. “This is something that has never been shown before,” she said.

Dr. Siegel said the scrambled brain activity was most likely a driver of neuroplasticity, the brain’s ability to form new ways of thinking and a hallmark of how psychedelic medicine can help patients break destructive thought patterns. “It almost makes you a different person, so to speak,” he said.

The study, he and others say, lends weight to the notion that the psychedelic experience — the intense visualizations, the distortions of time and space, and the detachment from self — is an essential part of the therapeutic process. While such a hypothesis might seem self-evident, it is not universally accepted among psychedelic researchers, some of whom are working to develop new compounds that provide the benefits of psychedelic drugs without the disorienting effects.

Dr. Siegel said he thought the results might also serve to counter a theory promoted by some researchers that places an outsize role on the placebo effect, given that a significant percentage of participants in psychedelic studies traditionally report improvements to their mental health despite the fact that they did not receive a psychoactive drug.

“Being able to show a neurobiological mechanism that says, hey, this is actually affecting the brain, gives more meat to the argument that this not just placebo effect,” he said. “It shows that these drugs are creating lasting change to the brain.”

Andrew Jacobs is a Times reporter focused on how healthcare policy, politics and corporate interests affect people’s lives. More about Andrew Jacobs

https://www.nytimes.com/2024/07/17/heal ... 778d3e6de3

[kmaherali]

The World Health Organization declared a global health emergency over an outbreak that has spread to more than a dozen African countries.


A Congolese health worker speaking with relatives and discharged patients about hygienic measures to follow after recovering from mpox last month near Goma, North Kivu Province.Credit...Arlette Bashizi/Reuters

Mpox was declared a global health emergency on Wednesday for the second time in three years, as the World Health Organization urged action on a virus spreading rapidly through more than a dozen African countries.

The outbreak is most severe in the Democratic Republic of Congo, which has reported 15,600 mpox cases and 537 deaths, according to the U.N. agency. The mpox epidemic there has already proved more deadly than one in 2022, the last time an emergency was announced.

Here is what to know about mpox, which was known as monkeypox before health officials, responding to complaints about the word, recommended its current name in 2022.

What is mpox and how is it spread?

The mpox virus is endemic to Central and Western Africa. The disease is similar to smallpox but less contagious, and the virus is spread primarily through close contact with infected animals or people, and the consumption of contaminated meat.

Mpox can also be spread through sexual contact, and there is a risk of transmission to a fetus.

Who is currently being affected?

Ninety-six percent of the mpox deaths reported in June were in Congo, a country already assailed by an internal conflict and humanitarian crisis. But the disease has now been identified in 13 countries, including for the first time in the East African nations of Burundi, Kenya, Rwanda and Uganda.

There are differences between the outbreaks in various regions and countries, depending on the circumstances in each community, according to Dr. Sylvie Jonckheere, an adviser on emerging infectious diseases for Doctors Without Borders. But they share a common feature, she said: “We do not know how to control this outbreak.”

Facing the threat of global spread, the Centers for Disease Control and Prevention in the United States has warned medical professionals and people in the country to remain on high alert.

What are the symptoms?

Fever, headache, muscle aches and a blistering rash that progresses to pustules and eventually scabs over can be signs of the disease. Symptoms can last two to four weeks, and treatment in many cases relies heavily on supportive care and alleviating symptoms.

Historically, the disease is more lethal to young children, people who are immunocompromised and those with comorbidities, such as H.I.V.

How is it being treated?

Though vaccines were used in 2022 during that epidemic, they are insufficient to curb the current crisis, experts say. “There are not enough vaccines in the world to do that,” said Dr. Jonckheere, who has recently assisted health care workers in Congo and Burundi.

Though not a comprehensive solution to slowing the disease, social distancing can help reduce its spread, Dr. Jonckheere said.

In 2022 in the United States, for example, as people received vaccinations and changed their behavior, the toll dropped to about 1,700 cases last year from more than 30,000 in 2022.

But in some places in Congo, such as camps for internally displaced people near the city of Goma in the North Kivu Province, the crowded conditions make isolation impossible. Congo has approved two mpox vaccines but has yet to carry out an immunization plan.

What is the history of the disease?

The disease was discovered in 1958, after outbreaks occurred in monkeys used for research. The first infection in a human was confirmed in 1970 in Congo.

The W.H.O. declared the mpox epidemic a global health emergency in July 2022, and the disease was detected in over 70 countries that had never previously reported mpox. Since then, it has affected nearly 100,000 people in 116 countries.

Though the outbreak has largely subsided in Europe, Asia and the Americas, it has worsened in parts of Africa. The Africa Centers for Disease Control and Prevention reported a 160 percent increase in the number of cases reported from the start of 2024 to July 28 compared with the same period last year.

Who is most at risk?

The strain of mpox that has been spreading in Congo has a death rate of 3 percent, much higher than the 0.2 percent death rate observed in the 2022 outbreak.

Women and children are most affected, according to Save the Children, an international charity, which said newborns as young as 2 weeks old are contracting the disease because of overcrowded hospitals.

In the affected areas, health care workers are treating patients of all ages, including families.

“It’s really heartbreaking when you see entire families end up in your treatment center,” Dr. Jonckheere said. “It’s the mom, it’s all the kids, including the very, very young ones.”

https://www.nytimes.com/2024/08/14/worl ... 778d3e6de3

[kmaherali]

New mpox virus: Why is it spreading so quickly? | DW News

Video: https://www.youtube.com/watch?v=EfvNgwLs56g

How Did Mpox Become a Global Emergency? What’s Next?

The virus is evolving, and the newest version spreads more often through heterosexual populations. Sweden reported the first case outside Africa.


Dr. Tresor Wakilongo examines the skin lesions of a child with mpox at a treatment center in Munigi, Democratic Republic of Congo. Credit...Arlette Bashizi/Reuters

Apoorva Mandavilli
By Apoorva Mandavilli
Apoorva Mandavilli covered the 2022 mpox outbreak and the Covid-19 pandemic.

Aug. 15, 2024
Leer en español
Faced once again with a rapidly spreading epidemic of mpox, the World Health Organization on Wednesday declared a global health emergency. The last time the W.H.O. made that call was in 2022, when the disease was still called monkeypox.

Ultimately the outbreak affected nearly 100,000 people worldwide, primarily gay and bisexual men, including more than 32,000 in the United States.

The W.H.O.’s decision this time was prompted by an escalating crisis of mpox concentrated in the Democratic Republic of Congo. It recently spread to a dozen other African countries. If it is not contained, the virus again may rampage all over the world, experts warned.

On Thursday, Sweden reported the first case of a deadlier form of mpox outside Africa, in a person who had traveled to the continent. “Occasional imported cases like the current one may continue to occur,” the country’s public health agency warned.

“There’s a need for concerted effort by all stakeholders, not only in Africa, but everywhere else,” Dr. Dimie Ogoina, a Nigerian scientist and chair of the W.H.O.’s mpox emergency committee, said on Wednesday.

Congo alone has reported 15,600 mpox cases and 537 deaths, most of them among children under 15, indicating that the nature of the disease and its mode of spread may have changed.

Here’s what to know.

Is this the virus we saw in 2022?

This is a different version of the mpox virus.

Mpox is a close relative of the smallpox virus. There are two main types: Clade I, the version that is dominant in Congo, and Clade II, a form of which caused the 2022 global outbreak. (A clade is a genetically and clinically distinct group of viruses.)

Clade I mpox is generally thought to cause more severe illness and to have a much higher mortality rate, which is one reason the W.H.O. is sounding the alarm now. Officials hope to contain this outbreak before it spreads to other continents.

The infection may resemble an ordinary respiratory illness at first but later blooms into a raised rash in the mouth, hands, feet or genitals. The virus spreads mainly through close contact — directly with the skin or fluids of an infected person, or with contaminated bed linens and other items.

Scientists learned during the 2022 outbreak that mpox can spread even in the absence of symptoms. And the rash may be mistaken for other diseases such as measles or chickenpox, particularly in young children.

Who is getting infected this time?

In the 2022 outbreak, mpox spread globally mainly among gay and bisexual men. Behavioral changes in that community helped to contain the virus, and vaccination at the time, or now, will help protect them.

Until recently, most cases in Congo resulted from consumption of contaminated meat or close contact with infected animals and people. But last year, scientists discovered a new subtype of mpox, Clade Ib, which appears to spread from person to person primarily through heterosexual transmission.

Most cases have been observed in prostitutes, truckers and other transient workers.

“Sex is probably the primary driver, and then the secondary driver is close contact and households,” said Dr. Jay Varma, the chief medical officer at SIGA Technologies, which manufactures tecovirimat, a drug used to treat mpox infection.

As with many other infections, most people with healthy immune systems are unlikely to become severely ill with mpox. Those who have weakened immune systems, including those living with H.I.V., are at highest risk of severe illness and death.

Older adults, who are typically more susceptible to infections, may be at least somewhat protected by their childhood vaccinations for smallpox, which ended in the United States in 1972.

Most of the deaths in Congo have been in children under 15, perhaps because their health may already be compromised by poor medical care, malnutrition and the many other pathogens they face.

Has the outbreak spread to the United States or Europe?

Many countries worldwide, including the United States, have continued to see patients with Clade IIb mpox, the version that caused the 2022 outbreak.

So far this year, there have been about 740 cases of mpox in the United States, more than double the number at this time last year, according to the Centers for Disease Control and Prevention.

Just one case of the more severe Clade I infection has been reported in Europe — in Sweden, in a person who had traveled to Africa. Other so-called “imported” cases seem likely. But experts tend to worry more about community transmission.

“I don’t think the risk right now for Americans is high at all, but what this is telling us is that we have to be vigilant,” said Dr. Trish Perl, an infectious disease physician at UT Southwestern Medical Center.

But previous epidemics, including of mpox, illustrate that an uncontrolled outbreak anywhere in the world may eventually turn up everywhere, Dr. Varma said. Since December, the C.D.C. has twice warned clinicians and the general public to remain alert for signs of mpox.

“I really think it’s only a matter of time before North America, Europe, etc., start to see cases,” he said, referring to the deadlier viral subtype. “Unless we invest in disease control everywhere, we’re going to remain always at risk.”

Will the vaccine still protect against mpox?

Two doses of the mpox vaccine Jynneos should protect against all versions of the virus, experts said.

Jynneos, made by Bavarian Nordic, was used in 2022 in the United States and Europe. The vaccine, initially developed against smallpox, should protect against mpox and all other members of that virus family, said Dr. Boghuma Titanji, an infectious diseases physician at Emory University in Atlanta.

Several studies have shown that antibodies prompted by the Jynneos vaccine wane and may be undetectable within a year. But other research has found that two doses effectively prevent severe illness, Dr. Titanji said.

In the United States, however, fewer than one in four people for whom vaccination was recommended got two doses.

“People were less interested in coming back and getting that second dose, or even starting the course of their vaccination,” Dr. Titanji said. “Maybe we will see an increase in uptick in vaccination, and this will serve as a reminder for people to come in and get vaccinated.”

In 2022, the federal government provided the shots at no cost. Jynneos is now commercially available, and some insurance companies may cover the cost.

For some patients, the shots may prove too expensive, Dr. Perl said. If mpox cases were to escalate, the U.S. government may again make the shots available free of charge, according to a federal official with knowledge of the situation.

Is the U.S. prepared for another bout with mpox?

Yes and no.

Scientists learned a lot about the virus in 2022 and have identified vaccines and treatments. But they do not fully understand how the deadlier virus is spreading in Africa, especially among children, or who is most at risk.

“This is very, very crucial when you think about designing a response strategy,” Dr. Titanji said.

There are few resources allocated to fighting sexually transmitted infections in the United States, said David Harvey, the executive director of the National Coalition of STD Directors.

Officials have not solved the problems that hobbled the response in 2022, including poor uptake of the vaccine and “a shockingly underfunded S.T.I. public health system,” Mr. Harvey said.

“Today, we worry about an mpox outbreak,” he added. “We’re already dealing with syphilis, and tomorrow there will be another outbreak of an S.T.I.”

https://www.nytimes.com/2024/08/15/heal ... 778d3e6de3

[kmaherali]

Philippines Reports First Mpox Case Since W.H.O. Declared Global Emergency

It was not clear if the patient had contracted the new, potentially more deadly strain of the disease, which first appeared outside of Africa in Sweden last week.


The Geneva-based World Health Organization declared mpox a global health emergency, last week.Credit...Denis Balibouse/Reuters

The Philippines reported its first case this year of mpox, previously known as monkeypox, on Monday, just days after the World Health Organization declared the disease a global health emergency.

The Philippines Department of Health, in a statement announcing the case, did not say whether the patient was infected with Clade Ib, the newer and potentially more deadly version of the mpox virus that is dominant now in the Democratic Republic of Congo, driving a rise in cases there.

It was an older strain, Clade IIb, that caused a worldwide outbreak of mpox in 2022.

Last Thursday — a day after the W.H.O. declaration of a global emergency — officials in Sweden revealed that a patient there was the first person outside of Africa to be diagnosed with the new strain, setting off fears of a much wider spread. Also on Thursday, Pakistan announced a case of mpox but said it was not yet clear which strain of the disease was involved.

Here is what we know.

The case in the Philippines

The patient is a 33-year-old Filipino man with no travel history outside of the country, whose mpox infection was confirmed and reported on Sunday to the Department of Health, the department said.

The man became sick more than a week ago, first with a fever, “followed four days later by findings of a distinct rash on the face, back, nape, trunk, groin, as well as palms and soles,” the department said. The patient was seen in a government hospital, where samples of his skin lesions were taken to test for genetic evidence of the virus.

The Philippines’ secretary of health, Dr. Teodoro J. Herbosa, discouraged public panic by emphasizing that officials were working to make testing convenient. “Our health system is working,” he said in a statement, “we can handle the situation and will keep the public well-informed.”

The latest case is only the 10th ever confirmed infection with mpox in the country, and all previous cases were isolated and patients have since recovered, the department said.

Mpox and its spread

Mpox is a virus endemic to Central and Western Africa. It is similar to smallpox but less contagious, and spreads primarily through close contact with infected animals or people, or the consumption of contaminated meat. It can also be spread through sexual contact or transmitted in utero to a fetus.

The disease’s rapid spread in 2022 led the World Health Organization to declare the mpox epidemic a global health emergency in July of that year, and infections were detected in over 70 countries that had never previously reported the disease. Since then, it has affected nearly 100,000 people in 116 countries.

Image
Three medical workers wearing blue protective gowns and masks walk between temporary structures.

Most cases of a new, more dangerous strain of mpox have been in the Democratic Republic of Congo, where health workers cared for mpox patients at Nyiragongo General Referral Hospital, north of Goma, on Saturday.Credit...Guerchom Ndebo/Agence France-Presse — Getty Images

The outbreak has largely subsided in Europe, Asia and the Americas, but it has not been eradicated — there have been hundreds of cases in the United States this year. At the same time, it has worsened in parts of Africa this year, leading the W.H.O. to declare once again that mpox is a global health emergency.

Smallpox vaccination, which was nearly universal half a century ago, gives a high degree of resistance to mpox infection. But smallpox was declared eradicated in 1980, and since then few people have received the vaccine.

Fever, headache, muscle aches and a blistering rash that progresses to pustules, which eventually scab over, are common signs of the disease. Symptoms can last two to four weeks, and treatment relies heavily on supportive care and alleviating symptoms.

How is this outbreak different?

The 2022 outbreak was primarily a version of mpox spread through sexual contact, and men who had sex with men were deemed most at risk. The spread was curbed through a combination of vaccinations and behavioral change, though health agencies like the W.H.O. and the U.S. Centers for Disease Control and Prevention have reported that new infections were still occurring this year.

In 2022 and 2023, there was a push to inoculate people who were at risk, particularly men who had sex with men, but the C.D.C. reported that most people in that group were not vaccinated.

The newer mpox strain that has been spreading in Congo has a death rate of 3 percent, much higher than the 0.2 percent death rate observed in the 2022 outbreak, and the populations most at risk appear to be different.

Women and children are most affected this time, according to Save the Children, an international charity, and doctors have reported treating entire families.

https://www.nytimes.com/2024/08/19/worl ... 778d3e6de3

[kmaherali]

Why Mpox Vaccines Aren’t Flowing to Africans in Desperate Need

Drugmakers have supplies ready to ship that are necessary to stop a potential pandemic. But W.H.O. regulations have slowed access.


A health worker prepared a dose of the mpox vaccine at a medical center in Paris last month. The vaccine is widely available in the West but not in Africa.Credit...Pool photo by Alain Jocard

There are no vaccines for mpox available in the Democratic Republic of Congo, the epicenter of a global health emergency declared last week, even though the country first asked for the shots two years ago and the manufacturers say they have supplies.

“The most important thing we need right now are the vaccines,” said Dr. Samuel-Roger Kamba, health minister of Congo.

So where are the shots? They are trapped in a byzantine drug regulatory process at the World Health Organization.

Three years after the last worldwide mpox outbreak, the W.H.O. still has neither officially approved the vaccines — although the United States and Europe have — nor has it issued an emergency use license that would speed access.

One of these two approvals is necessary for UNICEF and Gavi, the organization that helps facilitate immunizations in developing nations, to buy and distribute mpox vaccines in low-income countries like Congo.

While high-income nations rely on their own drug regulators, such as the Food and Drug Administration in the United States, many low- and middle-income countries depend on the W.H.O. to judge what vaccines and treatments are safe and effective, a process called prequalification.

But the organization is painfully risk-averse, concerned with a need to protect its trustworthiness and ill-prepared to act swiftly in emergencies, said Blair Hanewall, a global health consultant who managed the W.H.O. approvals portfolio as a deputy director of the Bill & Melinda Gates Foundation, a key funder, for more than a decade.

“They don’t have flexibility to use alternative approaches,” she said.

There have been more than 15,000 cases of mpox in Congo this year, and at least 550 deaths, although many cases are not diagnosed or treated. Most of those deaths have occurred among children, some of whom starve because agonizing lesions in their mouths and throats have prevented them from eating.

A new variant of the virus, spread by close intimate contact, has now crossed Congo’s eastern border into 13 countries, prompting the W.H.O. to declare a global health emergency on Aug. 14.

Paul Chaplin, chief executive of Bavarian Nordic, which makes the Jynneos vaccine that was widely used in North America and Europe during the mpox outbreak in 2022, said the company has 350,000 shots it could sell immediately.

The company can produce 10 million more doses by the end of 2025, he said — but there are no orders. This week, under pressure from member states, the W.H.O. signaled to Gavi to start a purchase negotiation with Bavarian Nordic even though vaccine approval is still pending.

The W.H.O. says that, until this extraordinary measure, it had been bound by the rules: It has not had the data it requires to do a full review for approval of Jynneos, and the emergency license process can be carried out only after a public health emergency of international concern (known as a P.H.E.I.C.) has been declared, which just occurred.

But Bavarian Nordic first met with the W.H.O. in August 2022 to discuss Jynneos, and submitted a dossier of information on the vaccine in May 2023, according to Mr. Chaplin.

That dossier contained the research that led to approval years ago from the European Medicines Agency, as well as data from studies carried out once the vaccine was deployed during the 2022 mpox outbreak.

More than 1.2 million people in the United States received at least one dose of the vaccine at that time, and studies showed it provided a high level of protection against mpox.

Yet the W.H.O. did not open formal consideration of that research until last week.

Deusdedit Mubangizi, the W.H.O.’s director of health product policy and standards, said that the organization’s group of experts would meet the week of Sept. 16 to consider the submitted data, and could issue a license as early as that week if they were satisfied.

In recent weeks, key players in the epidemic response have grown increasingly critical of the W.H.O. for unnecessarily slowing the effort to get vaccines to Africa. It’s a “broken system” that “is not built for emergencies,” said one U.S. scientist who sits on W.H.O. advisory panels but was not authorized to speak publicly.

Critics question why the W.H.O. did not act sooner to approve an mpox vaccine, since the virus has never stopped circulating in Congo. And they ask why it has not been possible to give the shots an emergency license based on the U.S. and European authorizations of the Jynneos vaccine.

The vaccine was originally created to prevent smallpox and had been kept in biosecurity stockpiles after the eradication of the disease. Because mpox, like smallpox, is part of the orthopoxvirus family, researchers thought smallpox vaccines might work to block mpox. There were small studies in animals that showed it was effective.

Although there were no human trials, drug regulators in high-income countries moved quickly to allow emergency use as mpox began to spread in Europe, North America and South America in 2022.

But Mr. Mubangizi said it was not possible for W.H.O. to approve the vaccines at that time. “We could not prequalify them, because there was no data to support” their effectiveness against mpox, he said.

And the W.H.O. decided not to issue an emergency license back then because it wanted to ensure that research data was generated, he said. Authorizing widespread use would have cost researchers that essential opportunity.

Then, spread of the virus slowed or ended everywhere outside of Congo, and attention to the vaccine dissipated.

This year, as case numbers grew in Congo, the W.H.O. decided to trigger the emergency license process even as it declared a global emergency. “We immediately got in touch with manufacturers and told them to submit a formal application,” Mr. Mubangizi said.

KM Biologics, a Japanese pharmaceutical company that makes an mpox vaccine called LC16, submitted its dossier on Friday. Bavarian Nordic offered additional information regarding what the W.H.O. calls “programmatic suitability for use,” he said.

This refers to aspects of the vaccine that may influence how it can be used in different settings. The Jynneos vaccine, for example, needs to be stored at minus 20 degrees Celsius, but not all health centers in a country such as Congo will be able to keep vials of it that cold. Regulators in high-income countries do not typically evaluate a vaccine with these kinds of considerations.

Most of the data collected on the Jynneos vaccine evaluated it for use on the Clade 2 mpox virus, a less lethal version that caused the 2022 global outbreak. But the Clade 1 virus is circulating in Congo and across East Africa, and the vaccine has not been tested against it.

“We are not sure the efficacy on Clade 2 is transferable to Clade 1 — nobody has that information,” Mr. Mubangizi said.

Congo’s own drug regulator approved Jynneos and the LC16 vaccine on June 27 — long after Nigeria, which had many mpox cases in the 2022 outbreak, did an approval of its own.

The lengthy delay raised eyebrows in health agencies supporting Congo, but Dr. Kamba, the health minister, said the country has limited resources and a host of crises.

“We have a lot of emergencies on our hands,” Dr. Kamba said.

Congo currently has outbreaks of measles and cholera, as well as a severe malaria problem that threatens small children. Hundreds of thousands of people live in camps because they have been displaced by ongoing armed conflicts.

Because Congo has approved the vaccines, the country can receive donations — 215,000 Jynneos doses are set to be shipped to Congo in the coming weeks, Dr. Kamba said.

There are 175,000 doses donated by the European Union, and 40,000 more by Bavarian Nordic. The U.S. government has pledged to donate 50,000 Jynneos doses from its national stockpile.

Congo could simply buy mpox vaccines. But the Japanese vaccine is complicated to deliver — requiring a rare specialized needle — and the Danish vaccine is expensive. In 2022, Bavarian Nordic was selling it for about $110 a dose. Full vaccination requires two doses.

As a low-income nation, Congo qualifies for support from Gavi, which has a $500 million pandemic emergency response fund earmarked for situations such as this.

Mr. Chaplin would not say what price Bavarian Nordic planned to offer Gavi. “There is room to maneuver, but it’s based on volume and commitment,” he said.

“If the international community were to say, ‘OK, we’re going to buy X doses a year because we want to start vaccinating children in Africa’ — that changes everything,” he added.

With that sort of commitment it would be worthwhile for the company to work with a contract manufacturer based in Africa, Mr. Chaplin said. That firm would produce the vaccine at a much lower price while paying a royalty to Bavarian Nordic.

But Gavi has been waiting for the W.H.O.’s emergency authorization to begin the process.

“The first priority needs to be getting donated vaccines that we know are available into countries,” said Dr. Derrick Sim, Gavi’s managing director for vaccine markets and health security.

“When it comes to procuring vaccines directly, since a P.H.E.I.C. was announced last week, we have intensified our efforts, with near-daily contact with manufacturers,” he said, referring to the global health emergency. “We are ready to go as soon as we get a clear picture on demand.”

Some experts now wonder why Gavi should wait for W.H.O. approval of vaccines at all.

“That would not be a complicated thing for the Gavi board to change, if they wanted to move faster in an emergency,” said a U.S. global health official who was not authorized to speak publicly about the matter.

A process for the W.H.O. to prequalify drugs without a full review of the research already exists. The organization has approved more than 100 medications, mostly antivirals to treat H.I.V., based on F.D.A. review, for their use in Pepfar, the U.S. government’s program to treat that virus in African countries.

There is reason for caution. Dr. Placide Mbala, director of the clinical research center at the National Institute of Biomedical Research in Kinshasa, said he had hopes for the vaccines, but it was an open question how well they will work with the variant of the virus now circulating in Congo.

Dr. Mbala was a co-principal investigator on a large U.S.-funded trial in Congo of the antiviral tecovirimat, which was used to treat mpox in high-income countries in 2022. Last week, the National Institute of Allergy and Infectious Diseases announced that the drug had not improved mpox resolution in Congolese patients with Clade 1 infections.

“As we see with tecovirimat, in different contexts the drug or the vaccine can act differently,” Dr. Mbala said. “We can’t be sure until we are able to test them.”

https://www.nytimes.com/2024/08/23/heal ... 778d3e6de3

[kmaherali]

How Does Mpox Spread, and Who Is Most at Risk?

Here’s what scientists have learned about the virus, which was recently declared a global health emergency.


Mpox can lead to painful rashes.Credit...Glody Murhabazi/Agence France-Presse — Getty Images

This month, the World Health Organization declared mpox a global health emergency. The virus, formerly known as monkeypox, is spreading quickly in parts of Africa, particularly the Democratic Republic of Congo. The outbreak there has been fueled by a new version of the virus that has also been discovered in Sweden and Thailand.

The fast-evolving situation has led to anxiety and confusion about who is at risk of infection, and how the virus spreads. “I can understand why there’s concern,” said Dr. Taimur Khan, associate medical research director at Fenway Health, a medical center in Boston. But, he added, “it’s not like we’re being caught off guard in the same way that we were with Covid-19. It’s a virus that we are familiar with, to a certain extent, and we have tools already.”

We asked Dr. Khan and other experts to answer common questions about the virus.

What are we learning about how mpox spreads?

As the virus has evolved, so has our understanding about how it circulates, said Dr. Rosamund Lewis, technical lead of the World Health Organization’s global mpox response team.

In the 2022 outbreak, many cases were caused by sexual contact. The newer version of the virus continues to spread through sex, but experts said it is also circulating in other ways. Those could potentially include skin-to-skin interactions, contact with infected animals and touching contaminated surfaces, objects or fabrics, like bedding and clothes. Researchers are working to understand how the virus may spread through respiratory droplets and prolonged face-to-face interactions.

“We don’t always know exactly what was the mode of transmission in any given situation,” Dr. Lewis said.

Scientists are continuing to investigate when people are contagious. Some people can spread mpox days before they feel ill. No evidence to date indicates that people who never develop symptoms can spread the virus, according to the Centers for Disease Control and Prevention.

Who is at most at risk?

The risk is greatest in countries in central and eastern Africa, especially the Democratic Republic of Congo and bordering nations.

“The reality right now is the risk for Americans is exceedingly small,” said Dr. Carlos del Rio, an infectious disease specialist at Emory University.

Health care workers and people in the same household as someone with mpox are susceptible to infection. Because the virus spreads so efficiently through intimate contact, people with multiple sexual partners are at higher risk for contracting the virus.

Why do some people get more severe cases than others?

Mpox can cause painful rashes, fevers, head and muscle aches, swollen lymph nodes and other symptoms. Most people recover from mpox within a month, but the virus can be fatal. The version currently spreading in Africa appears to cause more severe illness, and be deadlier, than the version that spread in 2022.

Infants and children are at higher risk for getting seriously sick, in part because their immune systems are still developing. “Children become much more ill, much more quickly,” Dr. Lewis said. A majority of deaths in the Democratic Republic of Congo have been among children under 15.

People who are immunocompromised, particularly those with untreated H.I.V., are also more likely to become seriously ill because their immune systems can’t fight off the virus effectively. Contracting the virus during pregnancy can lead to complications, including pregnancy loss.

What’s the situation in the United States?

The newer version of mpox spreading in Africa has not been detected yet in the United States. But people are still getting infected with the version that spread widely in 2022. While American cases are currently lower than they were during that outbreak, there have still been over 1,700 cases nationwide this year — more than double the count at this time last year.

“People are still getting sick, and people are actually coming forward less to talk about their experience of getting sick, because it’s sort of fallen out of the public perception,” said Joseph Osmundson, a clinical associate professor of biology at New York University.

Who should get vaccinated? How long does the vaccine protect you for?

Global health officials have raised concerns about gaps in vaccine access: Even though the Democratic Republic of Congo is the epicenter of the current outbreak, for example, no vaccines are available there. The shots are more accessible in wealthy, Western countries.

“Our major role right now is honestly to try to keep the outbreak contained to Africa and send vaccines over there,” Dr. del Rio said.

But the renewed attention on mpox may also encourage eligible people in the United States to get vaccinated. The Centers for Disease Control and Prevention recommends that some men who have sex with men, transgender people and nonbinary individuals get vaccinated, including those with multiple sexual partners or who have had sexually transmitted infections. People who know or suspect they were exposed to someone with mpox should also get vaccinated.

Experts said that some other groups may also want to get the shots, including women who have sex with bisexual men. “If you are in queer sexual networks, regardless of your identity, you are able to get vaccinated,” Dr. Osmundson said.

The C.D.C. has an online directory people can use to find mpox vaccines near them. People should get two doses, at least 28 days apart; if someone has received only one shot, it is never too late for a second. Studies have shown that two doses of the vaccine can reduce the risk of infection between 66 percent to 88 percent.

Scientists are now studying how long that protection lasts. “We can’t promise that the vaccine will be effective forever,” said Dr. Kelly Johnson, an infectious disease specialist at the University of California, San Francisco. People can get mpox even if they’ve been vaccinated, she said, but those cases tend to be less severe. She compared mpox vaccines to Covid shots.

“There’s a good chance that if you do get Covid and you’re vaccinated, you’re not going to be one of those people who gets super sick,” she said. “I think it’s a very similar message with mpox.”


Dani Blum is a health reporter for The Times. More about Dani Blum

https://www.nytimes.com/2024/08/29/well ... 778d3e6de3

[kmaherali]

The decision is a crucial step in getting shots to the Democratic Republic of Congo, the center of the outbreak.


The Jynneos vaccine, made by Bavarian Nordic, has been approved in Europe as well as the United States and other high-income countries since a global mpox outbreak in 2022.Credit...Rungroj Yongrit/EPA, via Shutterstock

The World Health Organization has given its authorization to a first vaccine to protect against mpox, a decision announced in such haste on Friday that it caught even the head of the company that makes the vaccine by surprise.

The vaccine, made by the Danish company Bavarian Nordic, has been approved by the regulatory authorities in Europe as well as the United States and other high-income countries since a global mpox outbreak in 2022. But low- and middle-income countries rely on the W.H.O., through a process called prequalification, to determine which drugs, vaccines and health technologies are safe and efficient uses of limited health funding, and the organization had declined to act until now.

The W.H.O. had come under increasing criticism for declaring a global public health emergency for mpox last month without giving a vaccine that prequalification stamp of approval, or a more provisional form of approval called emergency use authorization. Bavarian Nordic first submitted its safety and effectiveness data on the vaccine, called Jynneos, to the W.H.O. in 2023. The W.H.O. had defended its slow pace of review, saying that it needed to subject the vaccine to careful study because it, and two others that have been used to protect against mpox, were originally designed as smallpox immunizations, and because delivering it in low-resource settings such as Central Africa would involve factors different from those relating to its use in high-income countries.

But on Friday morning, the W.H.O. suddenly said it was authorizing the shot.

“This first prequalification of a vaccine against mpox is an important step in our fight against the disease, both in the context of the current outbreaks in Africa, and in future,” Dr. Tedros Adhanom Ghebreyesus, the W.H.O. director general, said in a statement.

Paul Chaplin, Bavarian Nordic’s chief executive, said he was among the many who had been caught off guard.

“We’ve got there eventually — I don’t know quite how,” he said. “But it’s good news. It’s going to make the regulatory pathway much easier.”

Mpox was first identified more than 50 years ago in the Democratic Republic of Congo and has been endemic there ever since. While the global spread that started in 2022 waned in 2023, people in Congo have continued to become infected. A new version of the virus, one that is sexually transmissible, was identified there in 2023, and there have been more than 21,000 suspected mpox cases, and 700 deaths, this year.

However, no vaccines have yet been publicly administered in Congo.

About 245,000 donated shots, from the European Union, the United States and Bavarian Nordic, began to arrive in the capital, Kinshasa, last week. The Congolese government has said it hoped to begin to distribute them by Oct. 2.

The Jynneos prequalification decision vaulted over a planned meeting next week of a W.H.O. committee that is set to evaluate the vaccine for emergency use.

Prashant Yadav, an expert on health technology supply chains and a professor of technology and operations management at the French business school INSEAD, said the W.H.O. decision to authorize the vaccine now was both surprising and admirable.

“It’s not routine for them to do such an expedited approval, and I commend them for doing this,” he said.

The Africa Centres for Disease Control and Prevention declared its own public health emergency for mpox, before the W.H.O. did so, and African health ministers have expressed frustration at the pace of response from the global organization.

Image
A police officer and an airport worker talk on an airport runway as they gesture toward the giant crate on a wheeled pallet next to them.

A shipment of mpox vaccines arriving at N’Djili International Airport in Kinshasa, Democratic Republic of Congo, on Sept. 5.Credit...Justin Makangara/Reuters

In its announcement on Friday, the W.H.O. said that it was authorizing the vaccine for adults but that it could be used at the discretion of health care providers for children and adolescents under age 18. More than half of the mpox cases in Congo this year have been in children, according to UNICEF. The W.H.O.’s expert committee on vaccination said in August that the benefits of using the vaccine for children at high risk of exposure outweighed the risk.

In late August, the W.H.O. instructed Gavi, an international organization that funds vaccines for low-income countries, and UNICEF, which procures the shots, to issue a tender for mpox vaccines even before the emergency use license had been considered by its experts.

Bavarian Nordic submitted a bid, Mr. Chaplin said, and could supply two million doses of the vaccine this year and an additional 11 million in 2025. The Africa C.D.C. says that as many as 10 million doses of the vaccine could be required to respond to an outbreak that now involves more than a dozen African countries, including Burundi and Uganda, which have never before reported mpox.

The vaccine must be given in two shots for strongest protection, although the W.H.O. said use of a single shot should be considered in emergency situations where supply is constrained. Bavarian Nordic charged about $115 per shot to higher-income countries in 2022; Mr. Chaplin, the chief executive, said the price charged to Gavi would depend on the volumes ordered.

Gavi has a dedicated “first response fund” of money meant for purchasing vaccines in emergencies such as this one and will face pressure to make an order large enough that African countries will have sufficient supply of the vaccine.

Getting supplies to the countries is only one challenge. These vaccines require complex logistics of transport, temperature control, staff training and community education, and the production of the shots is only the first piece of trying to protect against the virus.

“While we remain in a supply-constrained environment, an important focus now is to translate deliveries of vaccines into countries into vaccinations,” said Derrick Sim, Gavi’s director of vaccine markets and health security. “One of the lessons from the Covid-19 pandemic is that vaccine supply needs to be matched with the timing of countries’ vaccination programs.”

Indemnity will be a separate challenge. Bavarian Nordic has liability insurance for the use of the vaccine in adults, but that insurance will not cover off-label pediatric use.

“Use in children would need to be included in the emergency use authorization for the individual countries,” Mr. Chaplin said. “Or the organization using the product off label would have to take the responsibility.”

https://www.nytimes.com/2024/09/13/heal ... ation.html

[kmaherali]

2 Million People Know This... Do you?

Hi Karim,

What if I told you that 60 minutes could change your life?

No, I'm not talking about some miracle cure or snake oil remedy.

I'm talking about a simple, scientifically-backed method that's already helped over 2 million people sharpen their minds and boost their memory.

And it all starts with something as small as... well, let me explain.

Over the last decade, I've spent every single day immersed in what makes a healthy brain, what causes memory problems, and how to stack the odds of not getting horrible brain diseases in your favor.

And in all that time, I've found there are some very simple things you can do that will dramatically improve your recollection, and your overall brain health.

The key to a razor-sharp memory isn't some complex regimen or expensive treatment.

It's about simple, almost effortless changes in your daily routine.

Skeptical?

I don't blame you.

But here's the kicker:

Over 2 MILLION people have already used these simple techniques to:

Remember names and faces with ease
Recall important dates without a second thought
Focus like a laser, even in distracting environments
Feel more confident and mentally agile

And the best part? I can show you everything in just one hour.

Want to know what this "Brain Boost" trick is?

I'm revealing all in my upcoming workshop: "How to Improve Your Memory in 30 Days or Less"

Click here to save your spot https://www.simplesmartscience.com/lp/h ... 91724-am-B

In just 1 hour, you'll learn:

The 3 everyday habits secretly draining your brain power (and how to fix them)
Why expensive "brain training" apps might be doing more harm than good
The 2-minute daily routine that can dramatically improve your memory

If you're tired of:

Worrying about Alzheimer's or dementia
Feeling like your mind isn't as sharp as it used to be
Relying on pills or prescriptions to think clearly

Then this workshop is for you.

Claim your spot now before they're gone https://www.simplesmartscience.com/lp/h ... 91724-am-B

Remember, over 2 million people have already discovered these life-changing techniques. Don't let this opportunity slip away (like that thing you were supposed to remember this morning).

To your brighter, sharper future,
Julia

Julia Lundstrom, Neuroscience and Brain Health Educator
Simple Smart Science

Making a Measurable Improvement in Your Brain Health

[kmaherali]

Boost Your Memory Transcript

Hi Karim

I get it. In this day and age, it's incredibly difficult to find the time for an hour-long workshop.

So...

For those that prefer to read, we've taken a recording from last week's workshop on the "How to Improve Your Memory in 30 Days or Less Workshop" and made a transcript out of it.

This is so important, I don't want you to miss this.

If you'd like to continue where you left off, just click here to read the transcript. https://www.simplesmartscience.com/lp/m ... T4X6iA348K


To your better memory,

Julia

Julia Lundstrom, Neuroscience and Brain Health Educator
Simple Smart Science

Making a Measurable Improvement In Your Memory

[kmaherali]

Greetings all,

New discoveries and breakthroughs in the field of psychedelic-assisted therapies and Medicine are providing a ray of hope for millions of people suffering from the effects of trauma, addiction, anxiety, and depression. As this field rapidly evolves, staying informed about the latest advancements is crucial to accessing cutting-edge developments that transform lives and reshape therapeutic practices.

There is such enormous potential for this psychedelic renaissance and the emergence of evidence-based psychedelic-assisted therapies and medicine… not only for individuals suffering from difficult-to-treat mental health challenges, but for all of us and for human society altogether.

This 7-day online event is for EVERYONE interested in the psychedelic renaissance and the emerging field of Psychedelic-Assisted Therapies and Medicine, including the General Public, Clinicians, Researchers, Clients, Policymakers, and Entrepreneurs.

We are so happy to invite you to the 3rd annual 2024 Psychedelic-Assisted Therapy Global Summit taking place online October 8-14. It’s a brand new 7-day summit produced by our friends at Heart Mind Institute.


Claim Your Free Ticket Now https://www.psychedelicassistedtherapys ... nganddoing

Summit sessions will address many important topics, including:

- Learning about new advances that are providing hope for people suffering from trauma, addiction, anxiety, and depression

- How psychedelic experiences impact our evolving understanding of mind and consciousness within the larger matrix of interconnectedness and interbeing

- How the field is progressing with research, clinical trials, and efforts to reschedule psychedelic medicines for clinical use

- How to facilitate the ideal set & setting for session facilitation with cultural competency and the latest developments in dosing and protocols with different psychedelic medicines

- How to implement best practices for pre-session preparation & post-session integration

- How to ensure standards, ethics, and best practices for P.A.T. delivery and therapist and/or facilitator training

- Strategies for creating an accessible treatment infrastructure and business models that assure diversity, equity, and inclusion

This is going to be a powerful event, and I hope you will not miss it...

See you there,


The Being & Doing Team

[kmaherali]

Hi Karim,

Dr. Dean Ornish says: “If Lifestyle Medicine was a drug, every doctor would prescribe it.”

Over the last 30 years, Dr. Ornish has proven that diet and lifestyle improvements have the potential to not just prevent but also to reverse:

- Heart Disease
- Diabetes and Pre-diabetes
- Weight Gain
- Prostate Cancer
- High Blood Pressure
- Depression
- And now, with his latest research, early-stage Alzheimer’s disease, too!

And he’s not alone.

At the upcoming 2024 Lifestyle Medicine Summit https://www.lifestylemedicine.ai/?sa=sa ... 241&jb=313, Dr. Ornish is joining 50 of the world’s top lifestyle medicine experts and researchers to reveal how to reverse the majority of chronic diseases.

You’ll find out about the latest breakthroughs in the lifestyle medicine revolution and how you can use this emerging field to prevent chronic illness, enjoy more abundant energy, and improve the health of your family and community.

The presentations will be streamed live.

>> Find out all about it and join in right here. https://www.lifestylemedicine.ai/?sa=sa ... 241&jb=313

Yours for solutions,

Ocean Robbins

P.S. Don’t miss out on brand-new live presentations from amazing experts like Dean Ornish MD, Joel Furhman MD, Beth Frates MD (ACLM), Bruce Lipton PhD, Leigh-Ann Webster (NBHWC), David Katz MD, Johannes R. Fisslinger MA, Susan Pierce Thompson PhD, Bernie Siegel MD, Wayne Dysinger MD (ACLM), Joel Fuhrman MD, and some guy named Ocean Robbins (yup, I’m honored to be part of this, too).

As in almost any series featuring dozens of experts, I don’t necessarily agree with every speaker about every detail. So keep your brain turned on — and I think you’ll learn a lot.

Click here to register. https://www.lifestylemedicine.ai/?sa=sa ... 241&jb=313

[kmaherali]

Hello, Karim!

Most doctors won’t talk about this…

But there are crucial factors contributing to cancer that often get brushed aside.

We'll spare you the conspiracy theories...

But just imagine if you could understand these little-known factors and take immediate action to lower your risk.

This eBook by our friend and award-winning cancer researcher Nathan Crane discusses in-depth the science and gives you actionable insights to protect yourself and your loved ones.



What Actually Causes Cancer? https://go.conqueringcancer.com/missing ... 28eBook%29

(And Why Doctors Refuse To Talk About It)
Nathan is a certified holistic cancer coach, a certified professional nutrition coach, a 20x award-winning documentary filmmaker and a CA senate-recognized cancer researcher.

And when it comes to understanding what causes cancer and how to beat it, he’s one of the most trusted voices in the natural health space today.

What’s inside his eBook will help you understand one thing...

You don’t have to be afraid if you have the so-called "cancer gene."

Ready to uncover the truth?

--->>Here’s what most doctors won’t tell you about cancer! https://go.conqueringcancer.com/missing ... 28eBook%29

So thankful that you’re making an investment in your health, your life and yourself.

Because health means everything,

[swamidada]

CNN
Don’t sit on the toilet for more than 10 minutes, doctors warn
Jocelyn Solis-Moreira, CNN
Tue, November 12, 2024 at 7:08 AM CST·

Leave your devices behind when you head to the bathroom, doctors say, warning too much time spent on the toilet can cause possible health problems.

Let’s be honest — people have a habit of bringing their phones to the bathroom. I’ve been guilty of it myself, and chances are that someone is on the toilet reading this article right now. A three-minute trip to the loo can easily turn into 15 minutes of reading, scrolling and posting.

It might seem a harmless way to pass the time when you’re going number two. However, experts warn that what they call prolonged sitting on the toilet can harm your health. It’s even been connected to an increased risk of hemorrhoids and weakened pelvic muscles, said Dr. Lai Xue, a colorectal surgeon at the University of Texas Southwestern Medical Center in Dallas.

“When patients present to me with complaints, one of the main areas we have to delve deeply into is spending a lot of time on the toilet,” Xue said.

Here’s what is going on when you overstay your toilet time.

Potty problems from sitting too long
People should spend an average of five to 10 minutes on the john, according to Dr. Farah Monzur, an assistant professor of medicine and director of the Inflammatory Bowel Disease Center at Stony Brook Medicine on Long Island, New York.

Why is it a problem if you stay longer? First, here’s a short physics lesson. Gravity keeps us grounded on Earth, but that same gravity also forces the body to work harder to pump blood back up to the heart, Xue said.

The open oval-shaped toilet seat compresses the buttocks, keeping the rectum in a lower position than if you were sitting on the couch. With gravity pulling the lower half of the body down, the increased pressure affects your blood circulation.

“It becomes a one-way value where blood enters, but blood really can’t go back,” Xue said.

As a result, the veins and blood vessels surrounding the anus and lower rectum become enlarged and engorged with blood, increasing the risk of hemorrhoids.

Don’t force it either
Forced straining can also increase the pressure to allow hemorrhoids to build. People scrolling on their phones on the toilet tend to lose track of time, Monzur said, sitting and straining their muscles to get a bowel movement out.

And guess what? Your doctors can tell. “Nowadays, we’re seeing an increase in people passing more time on the toilet, and that is very much unhealthy for the anorectal organs and the pelvic floor,” Xue added.

In addition to weakened anal muscles and forced straining, Monzur said sitting on the toilet bowl for too long can also increase the risk of rectal prolapse. A rectal prolapse is when the rectum, part of the large intestine, slips down and bulges out of the anus.

The pelvic floor muscles are another type of muscle weakened from prolonged toilet sitting. Xue explained that pelvic floor muscles coordinate a significant amount of bowel movement and work with the rest of the body to ensure stool comes out smoothly. The gravitational pressure on the pelvic floor strains the muscles when constantly sitting for long periods.

Be more mindful of bathroom time
To avoid spending too much time on the porcelain throne, Dr. Lance Uradomo, an interventional gastroenterologist at City of Hope Orange County in Irvine, California, advised keeping phones, magazines and books out of the bathroom.

“You don’t want to go with the mindset that you will be there for a long time. Because then you’ll want to bring something to keep the mind occupied,” Monzur said. “Make sitting on the toilet bowl as uninteresting as possible.”

If you’re having trouble relieving yourself, Xue advised quitting after 10 minutes. Instead, walk around a bit — since the motion can stimulate gut muscles to produce a bowel movement. Xue also recommended getting hydrated and eating high-fiber foods such as oats and beans to produce regular bowel movements and avoid straining.

Need to know how much? The National Academy of Medicine recommends 2.7 to 3.7 liters of water daily. Additionally, the US Department of Agriculture recommends 14 grams of fiber for every 1,000 calories of food. Xue said that fiber and water soften the stool, making it easier to pass.

Long bathroom times and colorectal cancer
There are situations, however, in which people have to spend an unusual amount of time on the toilet. Constant difficulty or discomfort when passing stool can be a symptom of gastrointestinal issues, such as irritable bowel syndrome and Crohn’s disease.

Worsening constipation or a need to sit on the toilet for a long time may also be a sign of cancer. “If a growth inside the colon grows big enough, it can block the flow of your stool, which can cause constipation and bleeding,” Uradomo said.

The American Cancer Society recently reported an increase in colorectal cancer rates among people under age 55 since the mid-1990s, and the nonprofit estimated there would be 106,590 new cases of colon cancer and 46,220 new cases of rectal cancer this year.

In Uradomo’s career, he’s recalled more young people talking to him about hemorrhoids and constipation and later being diagnosed with rectal cancer.

If you’ve had these symptoms of constipation or sitting on the toilet for a long time for more than three weeks, Monzur said it might be time to bring your concerns to your doctor. Depending on the severity of the symptoms, your primary care doctor can refer you to a gastroenterologist or a colorectal surgeon for a closer look.

Jocelyn Solis-Moreira is a New York-based freelance health and science journalist.

https://currently.att.yahoo.com/att/cm/ ... 55102.html