Whether surgical or nonsurgical, these back beautifiers can remove excess fat, tighten loose skin, and restore uneven tone and texture.

Light + Energy Devices

According to Louisville, KY plastic surgeon Chet Mays, MD, depending upon the degree of skin laxity present, light and laser treatments can be effective to smooth skin and improve pigmentation concerns. “BroadBand Light (BBL) allows us to treat sun-damaged skin all over the body. Intense Pulsed Light (IPL) can help eliminate discoloration and improve skin clarity.”

Microneedling

To promote healthy, glowing skin, New York plastic surgeon Roman Rayham, MD says he is a fan of radio-frequency microneedling. “I recommend this to my patients because the microinjuries in the skin allow topical treatments, like hydroquinone cream for hyperpigmentation, to penetrate deeper. I also combine it with liposuction treatments so the skin is also addressed while we are sculpting the back.”

Radio Frequency

For those with excess fat around the bra line, first make sure that your bra fits properly, as an ill-fitting bra can create the appearance of back fat. For very moderate skin laxity or small pockets of fat, Houston plastic surgeon Christopher Patronella, MD says radio-frequency treatments like BodyTite are a good option. “I like to combine BodyTite with liposuction to achieve the best result,” he adds. “With radio-frequency heat to reduce fat, we also see some tightening of the skin by stimulating collagen and elastin production,” explains Dr. Mays. “We get the best results in my practice when we ‘stack’ these therapies, like TruSculpt 3D and ThermiSmooth, which both use heat technology.”

CoolSculpting

“CoolSculpting plays a definite role in back contouring,” says Chicago plastic surgeon Peter Geldner, MD. “The results of surgical treatment are always more impressive than any nonsurgical method, but if you’re adverse to surgery and only have a small amount of fat to target, it will give a slimming result.” Dr. Mays utilizes the fat-freezing treatment as well. “Combining CoolSculpting and ThermiSmooth can help achieve better fat reduction and skin tightening. And as with all nonsurgical treatments, it can take three to six months to see the results, and many modalities require multiple treatments to see full results.”

Liposuction

The gold standard for fat reduction is also the gold standard for back contouring. “Most back sculpting procedures begin with liposuction,” says Dr. Geldner. “Skin excision can also be performed in some cases if needed. The exact location of the excision depends on where the excess fat exists: the bra line, flanks or a component of the posterior.”

“Liposuction is by far the most common procedure I perform on the back,” says Concord, CA plastic surgeon Eric Mariotti, MD. “If it is the lower back or hips, then standard liposuction is often sufficient. However, for the lower bra roll area and the upper back, the fat is oftentimes more fibrous and can be harder to remove. The addition of energy-based liposuction devices such as laser or ultrasound-assisted liposuction can also be utilized to remove more fat and have better skin retraction.”

To sculpt a new shape, Dr. Mays prefers power-assisted liposuction. “Once the fat has been separated and aspirated, I use my hands to smooth the fat in areas where contouring was performed. Sometimes, instead of discarding the aspirated fat, I will inject it back into the buttock region for a Brazilian Butt Lift to provide even more reshaping of the back.”

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KUALA LUMPUR • A Malaysian woman who wanted to lose weight to look good at her wedding ended up losing her life instead when she underwent liposuction at a beauty salon that was not licensed to perform the procedure.

Malaysian police have detained the owners of the beauty salon in Cheras, Kuala Lumpur, and are investigating the matter after the death last Saturday of 23-year-old Coco Siew Zhi Shing, whose hanyu pinyin name is Xiao Zhixin.

Ms Siew had been preparing for her wedding and wanted to look her best for the once-in-a-lifetime event, her brother Xiao Mingan told Sin Chew Daily.

She had found the beauty salon online while scouring the Internet for liposuction-related treatments, and signed up for a RM2,500 (S$820) procedure to extract fat from her arms, according to Mr Xiao.

Last Saturday, Ms Siew visited the salon for the first time, accompanied by a friend. She received an injection for anaesthesia upon arrival, local media reported.

About half an hour later, she started to feel unwell, and about an hour later, her heartbeat stopped, according to the reports.

Ms Siew was rushed to hospital but efforts to resuscitate her failed and she was certified dead at around 5pm.

Mr Xiao said his family members were especially grieved that they did not arrive at the hospital in time to see his sister before she died.

The owner of the beauty salon was not present during the procedure and did not appear at the hospital until 8pm, he said.

“After our repeated questioning, the person in charge of the salon finally revealed that they were not licensed to conduct such medical procedures, but were licensed only for normal beauty treatments,” Mr Xiao told Sin Chew Daily.

“The beautician who performed the procedure for my sister did not have a professional licence.”

The two owners of the beauty salon, a woman and her daughter, have been detained to assist in investigations into Ms Siew’s death, The Star newspaper reported.

“We are still ascertaining the cause of death,” Kuala Lumpur police chief Saiful Azly Kamaruddin told a press conference at the Sentul police headquarters yesterday.

Liposuction packages at the salon were being advertised for between RM1,500 and RM3,800, and it had performed the procedure for at least 10 customers, according to local media reports.

Mr Xiao said his sister led a healthy and fit lifestyle and cared greatly about her looks. She had come in first in an Asian modelling competition in 2014, he added.

“I hope my sister’s experience will serve as a warning to many young women,” Mr Xiao said.

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When you and your partner are planning to start, or add to, your family, it should be a joyous, exciting time – with hours spent poring over lists of baby names, and picking out new decor for the nursery. But if you’re having trouble conceiving, it can feel as if your happy future has been put on hold. Many couples struggle with a range of emotions – sadness, anger, frustration, guilt, jealousy – and this can put a strain on the relationship. Those who are experiencing fertility problems often feel isolated as well, as they may be reluctant to share with others the very personal struggles they’ve been going through.

The good news is that fertility is, at heart, a science. Infertility is treatable and need not be taboo. There are experienced and skilled physicians who can help.

While many families have had success with in vitro fertilization (IVF), the treatment is widely perceived as prohibitively expensive – one that is simply out of reach for many Canadians. Though the provincial government does provide some financial assistance through the Ontario Fertility Program, in many cases it isn’t nearly enough.

To start, every single patient has their own distinct fertility journey. While the government program states that it will cover one full IVF cycle per patient per lifetime, the services that can make up a single cycle vary greatly from person to person. After that cycle is complete, the patient is not eligible for further funded IVF services. 

Not only is each treatment plan unique, but often more than one cycle is required. The majority of patients who seek fertility treatments, therefore, are in need of it being covered by OHIP insurance to help cover the costs. Without it, IVF treatment isn’t even an option they are able to consider.  

Cost is often the biggest factor in determining who can access fertility treatments, but one clinic is committed to changing all of this. By providing affordable fertility treatment to every patient it serves, NewLife Fertility Centre opens the door to everyone. The clinic’s fertility team wants to open up the market and make treatment more accessible and affordable.

The clinic offers IVF treatment at the guaranteed lowest cost available in the GTA. To see the current packages please visit the clinic’s website. 

NewLife Fertility Centre has seven locations across the GTA and offers a range of helpful services, including ovulation induction, intrauterine insemination, in vitro fertilization, fertility preservation, genetic testing and egg freezing. All you need to see them is a referral from your doctor. Your first visit is covered by OHIP. Contact the fertility clinic today.

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MADISON, Wisconsin, December 13, 2019 (LifeSiteNews) – Attorneys for several gender-confused Medicaid patients announced a settlement with the state of Wisconsin on Tuesday, clearing the way for gender-reassignment treatments to begin being offered at taxpayers’ expense.

Under the settlement, the Wisconsin Department of Health Services must establish a new “inclusive” policy on Medicaid coverage for transgender treatments and notify recipients that had previously been denied of their newfound eligibility, the Milwaukee Journal-Sentinel reported. Plaintiffs Cody Flack, Sara Ann Makenzie, Courtney Sherwin, and Marie Kelly will also split $840,000 in damages, and their law firms will receive $1.35 million in legal fees from the state.

The agreement settles a case brought by four gender-confused Medicaid patients against a 1997 state administrative provision that excluded “transsexual surgery” from Medicaid, which U.S. District Judge William Conley found in August constituted “sex discrimination” under the federal Affordable Care Act (Obamacare).

“We applaud the Wisconsin Department of Health Services for accepting the Court’s rulings and the medical consensus that gender-confirming health care saves lives,” said lead attorney Joseph Wardenski. “We are delighted that the Court’s decision invalidating Wisconsin’s legally and medically indefensible coverage exclusion is now permanent.”

Wisconsin’s Medicaid system has an estimated $9.7 billion budget and 1.2 million enrollees, approximately 5,000 of whom are believed to have some form of gender confusion. The state argued that covering surgery for all of them could cost taxpayers as much as $2.1 million, which Conley rejected on the grounds that the estimates were well below one percent of the $3.9 billion share of Wisconsin Medicaid’s $9.7 billion annual budget.

The state also argued that transgender surgery has no proven medical benefit. A variety of scientific literature indicates that reinforcing a patient’s gender confusion rather than helping him or her overcome it fails to prevent significant emotional harm up to and including attempted suicide, with or without surgery. There is also a growing movement of former transgenders who have “de-transitioned” back to their real sex after experiencing “sex change regret.”

The case follows the Wisconsin Group Insurance Board 5-4 vote in August 2018 to cover hormone therapy and sex-reassignment surgery deemed “medically necessary” for public-sector employees.

The post Wisconsin Medicaid to begin funding sex-reassignment surgery after settlement appeared first on MyMedicPlus.

For the estimated 11 percent of American women between1 5 and 44 living with endometriosis, symptoms like severe pain, fatigue, and nausea can profoundly disrupt their lives. Yet endometriosis remains under-diagnosed, with a lack of effective treatments.

That’s why many women are taking symptom relief into their own hands by using cannabis, according to a recent survey published this November in the Journal of Obstetrics and Gynaecology Canada. Other women are turning to cannabidiol (CBD) for pain relief, hoping to address the symptoms without the high. 

“Pain relief in endometriosis is an important topic, as it can impact women on so many levels, including work, relationships, academic studies, and of course their mental health,” says study co-author Mike Armour, PhD, a post-doctoral research fellow in women’s health at Western Sydney University’s NICM Health Research Institute, a government-funded group that focuses on integrative and complementary medicine research and policy in Australia.

Dr. Armour’s team surveyed nearly 500 Australian women between the ages of 17 and 45 and found that 13 percent say they use cannabis to self-treat endometriosis symptoms. The authors estimate that their findings suggest approximately 10 percent of Australian women with endometriosis use cannabis for symptom and pain management.

Why are patients self-managing their symptoms?

Women frequently report that they can’t get endometriosis symptoms under control with recommended medications or surgery; there’s little evidence to show current treatments relieve endometriosis pain. NSAIDS like ibuprofen, for one, don’t appear to be effective, and there’s a strong potential for addiction and abuse with opioid painkillers. Although research suggests hormonal birth control can reduce symptoms, many women stop or avoid using it due to perceived side effects like mood swings and depression. 

“Women with endometriosis often report that despite various medications, they have pain that is difficult to deal with,” Dr. Armour tells Florence Health. That’s why it’s not surprising they’re turning to cannabis and CBD, he adds, since limited studies suggest these drugs may (or may not) relieve pain.

The difference between cannabis and CBD

Cannabis is the most popular illicit drug in the United States; there has been a steady rise in use every year since 2007, with 7.7 percent of American adults reporting using it within the past month as of 2017. That may be in part because it’s well on its way to becoming a legal medical therapy. A total of 33 states and the District of Columbia have legalized medical marijuana to date; 11 states and D.C. also permit marijuana for recreational use, with another 16 states having decriminalized the possession of small amounts of the drug.

“Prescribing” CBD and Cannabis

Marijuana remains illegal at the federal level, so the act of prescribing it is still illegal, even in states that have legalized it. Physicians and some APPs can, however, write a recommendation for and discuss the benefits of the plant if the patient suffers from a qualifying condition covered by their local law (usually severe conditions like cancer, HIV/AIDS, glaucoma, or multiple sclerosis).

Because the Drug Enforcement Agency classifies cannabis as a schedule 1 drug — with more restrictions than even fentanyl or methadone — officially, there are “no currently accepted medical use and high potential for addiction.” It requires a rigorous approval process to study, so to-date there’s little peer-reviewed research. That leaves providers hesitant to recommend a drug that’s hasn’t been rigorously studied and whose contents and dosage aren’t regulated by the FDA.

Meanwhile, interest in cannabidiol, or CBD, has skyrocketed in recent years. While CBD is an essential component of marijuana, it doesn’t contain tetrahydrocannabinol (THC) and therefore doesn’t cause a “high.” A full 14 percent of American adults say they use CBD, according to an August 2019 Gallup poll, most often for pain (40 percent), anxiety (20 percent), and insomnia (11 percent).

Only one CBD-derived drug, which treats seizures in children, has been approved by the Food & Drug Administration (FDA). All 50 states have legalized CBD in some form, and retailers have added it to pretty much any product you can imagine — from cheeseburgers to toothpicks to mouth wash.

How can cannabis and CBD affect endometriosis?

Cannabis mimics endocannabinoids, natural molecules that act on the endocannabinoid system (ECS), which maintains homeostasis in the body. ECS receptors, in turn, are found throughout the human body. The ECS participates in a wide variety of processes, including pain, stress, sleep, metabolism, immune function and reproduction. 

While research is lacking, Dr. Armour says there’s another reason to believe cannabis could have a particularly powerful effect on endometriosis pain. Both the uterus and ovaries have highly expressed cannabinoid receptors, he explains. Some researchers even think cannabis could slow the growth of endometrial tissue.

“The endocannabinoid system has been found recently to interact with specific mechanisms associated with pain,” explains Dr. Armour. “It also appears to play an important role in cellular proliferation and apoptosis, which may explain why cannabis is being used by women with endometriosis. However, little has been done clinically to investigate this currently.”

What the research says

While there’s little research into cannabis for pain, one recently published paper found it may can effectively reduce pelvic pain and opioid use. In Dr. Armour’s study, on average, respondents rated the effectiveness of cannabis a 7.6 out of 10, with 55 percent reporting they were able to reduce the need for pharmaceuticals by at least half. Women reported the greatest improvements in sleep and nausea/vomiting, with only 10 percent saying they experienced adverse side effects, like anxiety, drowsiness, and rapid heart rate. 

CBD, meanwhile, appears to have analgesic, anti-inflammatory, and immunomodulatory properties — but “the jury is out at the moment as to whether it can provide as much potential pain relief in endometriosis as THC does,” says Dr. Armour. 

What should you tell patients with endometriosis about using CBD or cannabis? 

For now, researchers agree that there’s not enough research to make a conclusion about the benefits or risks of cannabis. People who are at risk of developing addiction or schizophrenia should avoid it altogether, while patients with lung disease should avoid smoking it since it causes airway inflammation, wheezing and chest tightness.

Understanding the risks

For patients interested in using cannabis, “talking with a physician who understands the ECS and has experience in prescribing cannabis is an important first step,” says Dr. Armour. “Like all medications, it still comes with certain risks.” 

CBD, on the other hand, may seem less risky to recommend, as it doesn’t have the psychoactive effect of THC and no known risk of abuse or dependence, notes Dr. Armour. But there still are dangers.

Because CBD isn’t regulated by the FDA, it’s impossible to confirm the exact ingredients or concentration in any given supplement. The FDA has found some CBD products contain contaminants like pesticides and heavy metals. 

What’s more, CBD can raise levels of certain medications. “[It’s] been shown in preclinical and case studies to change the way certain medications are metabolized. It appears to be of more concern than THC in this particular regard,” notes Dr. Armour. Providers should ask patients taking CBD about any other medications they’re on and closely monitor for adverse side effects, he adds.

Safer alternatives

Dr. Armour also calls out the other, nonpharmacological treatments that can address endometriosis symptoms. Some women find relief from heat packs, hot baths, and hot water bottles. Research suggests that acupuncture twice a week for several months may reduce pelvic pain, although it’s unclear whether the effect lasts after patients complete treatment. And a low-FODMAP diet may help improve any IBS-like symptoms. Just remind patients that this eating plan is for short periods of time.

The post More Women are Self-Treating Endometriosis with Cannabis and CBD — But is it Safe? appeared first on MyMedicPlus.

LONDON (Thomson Reuters Foundation) – U.S. legislators would do better relying on medical evidence, not opinion, as they consider a spate of new proposals that would ban transgender children from treatments such as puberty blockers and cross-sex hormones, expert doctors say.

A measure newly introduced in South Carolina would revoke licenses of doctors who treat trans children, while other lawmakers proposed banning gender reassignment for minors after a Texas father tried to stop his ex-wife from raising their child as a girl instead of a boy.

“These legal efforts could not be more archaic,” said Scott Leibowitz, associate professor of psychiatry at the Ohio State University College of Medicine who works with trans youth.

“The absence of access to beneficial, evidence-based care, which does exist, is very harmful and quite frankly puts youth in the middle of political battles when lives are at stake,” said Leibowitz.

Trans issues are politically contentious in the United States, where the administration of President Donald Trump has banned most trans people from serving in the military. State-level battles have been waged over whether they can use restrooms of their choice.

Leibowitz recently co-wrote a statement condemning “efforts to ban evidence-based care” issued by the American Academy of Child & Adolescent Psychiatry, with nearly 10,000 members.

“This is no place for a legislators to lay in on what their opinion is,” he said.

An estimated 150,000 U.S. teens are trans, according to The Williams Institute, a research group at the University of California, Los Angeles, School of Law.

No public data was readily available on the numbers of younger trans children nor on patients at the nation’s nearly 50 clinics that treat trans youth.

Clinics in other countries have reported increases in referrals, which along with the greater visibility of trans people in the media, has prompted fierce debate over whether children who identify as trans may change their minds.

In the United States, Republican legislators in Texas, Georgia and Kentucky proposed banning gender reassignment treatment for minors following the court battle of a Texas father over how he and his ex-wife raise their 7-year-old child.

The parents disagree over whether the child can have long hair, wear girl’s clothes and go by a female name and pronouns.

Conservative politicians and commentators have sided with the father, and the Texas attorney general has asked for an investigation into possible child abuse.

Legislation to ban gender reassignment “would essentially be going against what is thought in the medical community to be best practice,” said Jennifer Abbott, a family doctor in North Carolina, who has treated trans youth.

“The evidence shows decreases in depression and anxiety in people who receive gender-affirming care,” she said.

Stewart Jones, the lawmaker behind the South Carolina bill, acknowledged that mental illness issues need to be addressed.

“However, to have a person under 18 go forth with that kind of life-altering decision while they’re still developing is a dangerous thing,” he said.

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Wound healing events in mucous tissues — part of the body’s defense against germs — during early infection by Simian Immunodeficiency Virus (SIV) guard some primate species against developing AIDS, a study has found.

Aspects of this wound-healing immune response could become targets for developing new therapies to prevent AIDS in people with HIV infections, according to the researchers from the University of Washington School of Medicine in the US. The research, published in the journal Nature Communications, looked at why certain species can carry the virus throughout their lives, and still avoid disease progression.

SIV is closely related to the Human Immunodeficiency Virus and is used as a laboratory model for many studies seeking AIDS and HIV cures and preventions.

Despite effective treatments to manage HIV, the virus remains a major global health threat, the researchers said.

Nearly 37.9 million people in the world are living with an HIV infection. Each year about 770,000 people die of AIDS, they said.

There are no clinically available vaccines against HIV, or cures for the infection, till now.

New study

In the latest study, scientists sought to uncover, in natural hosts, successful virus-fighting tactics that could inform the design of better antiviral drugs to treat HIV in people.

They found that the biological events involved in wound healing of mucosal tissues create an environment inside the body that protects against the destructive consequences of SIV infection.

The researchers compared virus-host interactions and immune response to SIV, including gene expression profiles, from the African green monkey — a natural host for HIV — with those from an AIDS-susceptible species, the rhesus macaque.

Similar data from human HIV infections was also evaluated.

“The use of public datasets were a key component of this research and highlights the importance of the scientific community sharing their data in public forums,” said Fredrik Barrenas from the University of Uppsala, Sweden.

The researchers explained that both HIV and SIV infect immune cells called T helper cells. These cells are abundant in the intestine and in specialised tissues elsewhere in the body.

The HIV infection provokes an immune response that injures tissues surrounding the intestine, the researchers said.

This injury allows the bacteria that normally reside in the gut to penetrate the tissue and invade other sites in the body, they said.

This causes further inflammation and damage. The situation attracts more immune cells, some of which get infected with HIV, according to the researchers.

Others undergo a programme of spontaneous cell death. Deterioration of the immune system and further decline of infection-fighting T cells can follow, they said.

If the infection progresses to AIDS, the syndrome lowers the ability to resist opportunistic pathogens and fend off cancer.

The researchers found that, in contrast, African green monkeys in the early stages of SIV infection quickly activate and maintain regenerative wound healing mechanism in their mucosal tissue.

For example, in the monkeys, a white-cell mediated remodelling of tissue occurs.

Some of the repair mechanisms, the researchers said, are evolutionarily conserved.

The green monkey’s ability to activate mucous tissue wound healing, the research team found, interrupts the course of the disease such that the onset of AIDS is avoided.

“We think the regenerative wound healing process likely preserves the tissue integrity, and could prevent the inflammatory insults that underlie immune exhaustion, cell death and AIDS that happen due to SIV or HIV infection,” said Michael Gale, a professor at the University of Washington School of Medicine.

“This maintenance of tissue integrity would be a valuable therapeutic strategy to avoid systemic immune activation and progression to AIDS.

“Our findings indicate that the use of therapies that stimulate the wound healing response during early infection could have a protective effect against disease from HIV infection,” he said.

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Fact: We’re all getting old everyday. But even though aging is a completely natural and normal life experience we all go through, what it looks like in terms of changes to your skin can be dramatically different for you than it was for your mom, older sister, or favorite aunt. This air of mystery is why aging continues to be such a hot topic — especially in skincare.

If you’re someone who is concerned with how your skin may evolve as the years go on, you’re not alone. When InStyle surveyed a group of 1,800 racially diverse women, from ages 17 to 74, across the U.S. on their biggest skin concerns, 59% were focused on fine lines and wrinkles.

So if you’re part of the 59% who wants to turn back the hands of time, or maybe just hit pause, the good news is that there are a number of treatment options available, like over-the-counter and prescription creams, to injectibles like Botox, which all promise major results. But, can these popular anti-aging treatments actually prevent and erase the inevitable?

We turned to four top skin experts to find out what they wish they could tell you about how anti-aging treatments really work, as well as what your expectations should be.
Don’t Expect to See Results Overnight

“Nothing will solve anything overnight, it’s all about consistency,” says Dr. Howard Sobel cosmetic dermatologist and director of Sobel Skin. “Look for products that contain preventative ingredients such as ceramides to maintain skin’s hydration, and peptides which are rich in antioxidants that act like a shield to protect your skin.”

It’s also important not to give up if you don’t see quick results. “These products take time to kick in, sometimes you need to play around with various brands and formulas to find the right regimen for your specific needs,” explains Dr. Sobel.

RELATED: The 14 Best Retinol Products You Can Buy Right Now
Ceramides Are an Anti-Aging Ingredient That are Just as Effective as Retinol

“Ceramides are lipids abundantly present in the skin. It is responsible for effective skin function, retaining moisture, and creating a natural protective barrier,” says Dr. Gretchen Frieling, a Boston-based board-certified dermapathologist. “However, after age 20, our ceramide production decreases by one percent each year. While the results of this decrease in production won’t be noticeable until you hit your thirties, using ceramide infused moisturizers would be a way of combating this aging process.”
That Being Said, Yes, Retinol and Other Retinoids Can Be Transformative

“If there’s one ingredient that could be considered the fountain of youth, it’s a retinoid,” says Dr. Sobel. They work to promote skin cell turnover and even out the skin.”

“Retinol is a preform of vitamin A, and it is extremely popular in beauty today because it helps stimulate cell turnover, collagen production, and directly addresses uneven skin tones, sun spots, and fine lines,” explains Dr. Frieling. “You can consult your doctor about a prescription-strength retinol treatment or opt for a less-active but a more sustainable formula that you can find over-the-counter.”
Sun Damage Can Cause the Earliest Signs of Aging, So Wearing SPF Is a Must

“Sunscreen is vital for people of all ages and skin colors. It is suggested that one in five Americans will have skin cancer at some point in their lives, so everyone should try to include sunscreen as part of their skincare regimen,” says Dr. Frieling. “Sunscreen has many significant benefits, one of which is to protect the skin from the sun’s harmful UV rays. These harmful beams not only increase your chances of getting skin cancer, but also cause wrinkles, age spots, and fine lines.”

Along with UVA/UV rays, free radicals in the air can also contribute to pre-mature aging. But sunscreen can provide protection. “Preventing the loss of collagen is best achieved through minimizing the effects of free radicals,” explains Dr. Ted Lain, board-certified dermatologist and chief medical officer at Sanova Dermatology. “Our current understanding is that a healthy lifestyle and diet are effective, but daily, consistent sun protection, along with topical anti-oxidants, are also essential for anti-aging.”

“Most people wrinkle on their face more than they do on their buttock because of sun — the number one cause of wrinkles,” says Dr. Paul Jarrod Frank, cosmetic dermatologist, chief medical officer, and founder of PFRANKMD.
Botox Will Not Freeze Your Face

“A common misconception that patients have is if they will get that frozen expressionless face, but that is not the case.” says Dr. Sobel. “A licensed, certified doctor should be able to moderately and properly administer Botox and filler correctly for a more natural look.”
Preventative Botox Can Help Stop Shallow Lines from Becoming Full-Fledged Wrinkles, But Won’t Entirely Prevent Them

“It’s always inevitable that some wrinkling will occur – no one grows old wrinkle-less. I always tell people to start using Botox or other neuromodulators when you start seeing the wrinkles,” says Dr. Frank. “I don’t recommend doing it prophylactically if you don’t have any wrinkles, but certainly it’s easier to clean your room before it gets too dirty. So, don’t use age as a gauge, use whether or not you are starting to see the lines.”

VIDEO: Beauty Now: Face Yoga

Botox Isn’t a Perment Fix

“If you are considering preventative Botox, you should make the commitment to continue to get Botox throughout the year, whenever it wears off,” says Dr. Sobel. “If you don’t, you will start seeing etched fine lines in the skin that will not go away even with Botox. So, remember preventative means being consistent and you won’t be saying, ‘How come I had Botox, but I still see fine lines?'”

The post What Dermatologists Wish You Knew About Anti-Aging Treatments appeared first on MyMedicPlus.

When we celebrate World AIDS Day less than a month from now, Americans will have something to celebrate. Innovative treatments have transformed a disease that a few decades ago would have been a death sentence into a diagnosis that, with support, is manageable. 

While lawmakers should acknowledge this progress, they should not consider this crisis solved. People living with HIV and AIDS often live on the edge of poverty and homelessness. For these individuals, access to local, state, and federal support will determine whether or not they survive.   

Keeping individuals with HIV and AIDS alive not only requires access to quality health care, it requires that individuals are stably housed. I have been working with people living with HIV and AIDS for more than two decades. I know that without the Housing Opportunities for People with AIDS (HOPWA) program, U.S. efforts to address this disease would not have been as successful.

This program remains as important as it was when it was implemented in 1990, which is why federal lawmakers must reject potential cuts to it. 

The Senate has approved just $330 million for HOPWA for fiscal year 2020, a figure that represents a 21 percent cut from the FY 2019 enacted level of $393 million. The Senate’s allocation is $100 million lower than what the U.S. House of Representatives approved this summer, and it would reduce funding back to levels not seen in a decade.

These cuts would come at a moment when social services agencies like CAMBA are trying to serve more people. 

The 1.1 million Americans currently diagnosed with HIV and AIDS are living longer, and the country continues to see thousands of new cases each year. According to the Centers for Disease Control (CDC) about 40,000 Americans receive an HIV diagnosis every year. Demand for HOPWA is growing.

While it might be easy for some federal lawmakers to dismiss this issue as one that only affects urban centers like New York City or Los Angeles, current data reveal that assumption is false. According to the CDC, HIV diagnoses are not evenly distributed across the country. In fact, of the 38,739 new HIV diagnoses in the United States in 2017, more than half (19,968) were made in the southern part of the United States.

No matter where these men and women live, they are more likely than their fellow Americans to face poverty and housing instability. 

According to the National Alliance to End Homelessness, individuals living with HIV and AIDS are three to six times more likely than members of the general population to be homeless. Or, as the Congressional Research Service found, studies of the relationship between HIV and homelessness have found the disease’s prevalence among homeless populations that range from two percent to 22 percent. That correlation translates into to the fact that, according to U.S. Department of Housing and Urban Development data, on any given night in the United States there are 10,000 individuals living with HIV and AIDS who are homeless. 

Even if people living with HIV and AIDS have a roof over their head, according to the National Low-Income Housing Coalition, it is estimated that as many as half will need housing assistance at some point during their illness.

The HOPWA program is a homelessness prevention program that provides housing assistance and supportive services for low income people living with HIV/AIDS and their families. It is the only federal program dedicated to this mission. According to data from fiscal year 2015, about 10 percent of HOPWA beneficiaries once served the United States in uniform.

HOPWA also provides support to communities across the country that are developing housing strategies to prevent people living with HIV and AIDS from becoming homeless or unstably housed. The program helps my organization provide case management and housing assistance to approximately 100 New Yorkers annually. This assistance allows these individuals to stay out of our shelter system and off the streets. For them, that is the difference between health and death.

Sharon R. Browne is executive vice president of CAMBA for Health, Housing Services and Development. CAMBA is a New York-based non-profit that provides services that connect people with opportunities to enhance their quality of life.

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ADDIS ABABA, Oct. 30 (Xinhua) — China has been making direct and indirect contribution to Africa’s efforts in the fight against HIV/AIDS, tuberculosis, and malaria on the continent, an official of the African Union (AU) said.

Speaking to Xinhua exclusively on Wednesday, Benjamin Djoudalbaye, AU Acting Head of HIV/AIDS, TB, Malaria, noted that China’s contribution to the Global Fund, which is to fight against the major deadly diseases, is one of the indirect support areas in the fight against HIV/AIDS on the African continent.

The World Health Organizations (WHO) says HIV continues to be a major global public health issue. In 2018, some 770, 000 people died from HIV-related causes globally.

There were approximately 37.9 million people living with HIV at the end of 2018, with 1.7 million people becoming newly infected in 2018 globally. And 62 percent of adults and 52 percent of children living with HIV were receiving lifelong antiretroviral therapy (ART) in 2018.

Africa is the most affected region, with about 25.7 million people living with HIV in 2018; and the continent accounts for almost two thirds of the global total of new HIV infections, according to WHO.

Reiterating that Africa is one of the most affected regions by HIV/AIDS in the world, the AU Acting Head of HIV/AIDS, TB, Malaria said the continent has achieved remarkable results in the past two years, despite the success stories are with disparities.

“For the last couple of years, I think we are on the (trajectory) in controlling HIV today on the continent, ” the official said, adding people have access to treatments and efforts were made to reduce maternal mortality and mother to child transmission of HIV.

“The new infections are going down in parts of the continent but despite all these efforts the disparities exist,” he said.

In addition to the indirect contribution through the Global Fund, China forged a very good partnership with the 55-member pan-African bloc, whereby it provides supports, including among others training for experts who have indispensable role in the fight against the HIV/AIDS.

“For us, as the African Union, we have a very good collaboration with China. And recently two of my two members went to China and were trained on HIV control. So, this type of action programs do exist between China and the African Union Commission,” he said.

Reiterating that Africa has achieved remarkable results in the anti-HIV/AIDS interventions, the acting head mentioned Botswana and Rwanda as two success stories on the continent.

“I can tell you two success stories; a country like Botswana has virtually eliminated mother to child transmission of HIV; that is a success story; and the second success story is that a country like Rwanda will control HIV, as a program of Public Health, before 2030,” Djoudalbaye has noted.

Speaking of the challenges, Djoudalbaye says funding and resistance to the drug are among the two major challenges in Africa, while the health system is also there as far as the fight against HIV/AIDS is concerned.

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New Delhi: In a relief to patients with some mental illnesses, speech disorders, drug-related issues and those who are in need of artificial life support, the Insurance Regulatory and Development Authority of India (IRDAI) has come up with new guidelines that say that many of these issues can no longer be excluded from health insurance contracts.

However, people with HIV/AIDS, epilepsy, heart disease and a number of other common health ailments are to be “permanently excluded” from health insurance coverage.

This attempt at standardisation by IRDAI follows years of arbitrariness and variance across insurance contracts from different companies, which claim to cover some illness and not others. In order to streamline this, the IRDAI put together a working group in July 2018, and now has come up with the guidelines. The new guidelines standardise what kind of conditions can be excluded from health insurance contracts.

The new guidelines do four things: They list a number of health issues that cannot be excluded by insurance policies, and includes the standard language that should be used if there is an exclusion. They also list some existing diseases that can be excluded, and modern medical treatments that should be covered under insurance.

Health insurance policies can now no longer exclude the following:

• Treatment of mental illness, stress or psychological disorders and neurodegenerative disorders,
• Treatment of speech and language disorders such as stammering, dyslexia and any other behavioural and neurodevelopmental disorders, including in adults,
• Treatment that arises due a patient failing to follow medical advice,
• Injuries and illness associated with any hazardous activities (adventure sports will not be covered),
• Impairment of a person’s intellect due to drugs, stimulants or depressants, which are prescribed by a doctor,
• Artificial life support even if the treatment won’t result in the recovery of the patient to her previous state of health,
• Treatment for things related to puberty or menopause for women, and
• Treatments of age-related macular degeneration.

However there is still a substantial number of health conditions that are to be “permanently excluded” from health insurance policies, many of which are common:

• Epilepsy,
• HIV/AIDS,
• Hepatitis B,
• Heart ailment, congenital heart disease and valvular heart disease,
• Parkinson’s disease,
• Hearing loss, and
• Chronic liver disease and chronic kidney disease, pancreatic disease and inflammatory bowel disease.

Mental illness coverage is being delayed, HIV/AIDS is excluded

Although the guidelines say that mental illness is going to be covered by all health insurance policies, it is only for policies that are filed on or after October 1, 2019. Existing insurance policies will have to include mental illness only from October 1, 2020.

The Mental Healthcare Act was passed in 2017 and was enforced in 2018. So the IRDAI is delaying the implementation of this Act in insurance policies by at least three years.

Also on HIV/AIDS, parliament passed the HIV/AIDS Prevention and Control Act in 2017 and Section 3 of this Act says that “no person shall discriminate against the protected person on any ground including the denial of, or unfair treatment in the provision of insurance unless supported by actuarial studies”.

The Act clearly says that patients with HIV/AIDS are not supposed to be denied insurance coverage.

But on this, the IRDAI says that insurance companies are still bound by Section 3 of the Act and if they have actuarial studies that support the claim of denial of health insurance coverage to people with HIV/AIDS, then they can consider extending health insurance coverage to policy holders with HIV/AIDS.

In effect, this leaves people with HIV/AIDS at the mercy of insurance companies who can take a decision to allow or deny their medical coverage.

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Two major U.S. biomedical research funders plan to each put at least $100 million over 4 years toward bringing cutting-edge, gene-based treatments to a part of the world that often struggles to provide access to even basic medicines: sub-Saharan Africa. The National Institutes of Health (NIH) and the Bill & Melinda Gates Foundation today announced the unusual collaboration to launch clinical trials for gene-based cures for HIV and sickle cell disease within the region in the coming decade.

The ambitious goal is to steer clear of expensive, logistically impractical strategies that require stem cell transplantation, and instead develop simpler, affordable ways of delivering genes or gene-editing drugs that can cure these diseases. “Yes, this is audacious,” NIH Director Francis Collins said during a press teleconference this morning on the project. “But if we don’t put our best minds, resources, and visions together right now, we would not live up to our mandate to bring the best science to those who are suffering.”

After decades of work and setbacks, the traditional gene therapy approach of delivering DNA into the body to replace a defective gene or boost a protein’s production is now reaching the clinic for several diseases, including inherited blindness, neuromuscular disease, and leukemia. Animal studies and some clinical trials have suggested that two diseases prevalent in Africa, HIV and sickle cell disease, can be treated by gene therapies or newer genome-editing tools such as CRISPR.

But in most cases, introducing those therapeutic genes or the components of a genome editor involves removing stem cells from the body, adding or modifying genes, then reinfusing the cells back into the body. That is essentially a stem cell transplant with one’s own cells, an expensive procedure that is also typically risky because physicians wipe out a patient’s existing stem cells with chemotherapy so the corrected cells can engraft and grow. It remains out of reach for most people in sub-Saharan Africa, where few places have the medical infrastructure to support such intensive interventions.

Yet sub-Saharan Africa is home to about two-thirds of the 20 million people with sickle cell disease and the 38 million living with HIV. The NIH-Gates partnership “is an incredible opportunity to find new therapies and possible cures for two diseases that affect millions of Africans and to make them available at affordable costs,” said Matshidiso Moeti, who heads the Regional Office for Africa at the World Health Organization.

Anthony Fauci, director of NIH’s National Institute of Allergy and Infectious Diseases, noted that if this collaboration pans out, it could also lead to enormous cost savings. “If we do successfully achieve an HIV cure, it will ultimately be important not only for millions of individuals with HIV, but also will save hundreds of billions of dollars in health care costs,” said Fauci, whose institute already funds a major HIV cure initiative.

In sickle cell disease, which involves a defect in the oxygen-carrying hemoglobin in red blood cells, several ongoing gene therapy and gene-editing clinical trials in the United States and Europe are either adding a new hemoglobin gene to cells or turning on the gene for a fetal form of the protein. Other clinical trials for HIV have used CRISPR or other genome editors in stem cells to cripple a receptor, CCR5, that the virus depends on to establish infection.

Instead of modifying a person’s stem cells and transplanting them back, the new collaboration will seek to ferry a therapeutic gene or gene-editing tools directly into the body (in vivo) with “vectors” such as harmless viruses or nanoparticles, Collins said. The treatment itself would be similar to a simple blood transfusion. Although studies are already underway with viral vectors that deliver new genes to certain tissues in people, in vivo gene therapy has only been used to modify blood stem cells in animal models of certain diseases. Figuring out how to home in on and modify those cells in people “is a big part” of the collaboration’s plan, Collins said.

Hematologist Alexis Thompson of the Northwestern University Feinberg School of Medicine in Chicago, Illinois, who is involved with some sickle cell gene therapy trials, calls the NIH-Gates collaboration “phenomenal.” But, she says, a more urgent need is to expand efforts to screen newborns in Africa for sickle cell disease and treat them with antibiotics; at the moment, the majority die before age 5 from bacterial infections because the sickled cells impair the spleen’s ability to filter bacteria and make antibodies. Unless more children with sickle cell disease mutations survive longer, there will be few to be cured with the new gene-based treatments, Thompson says. “It’s almost being able to crawl or walk before you sprint.” (Gates and NIH say they plan to support screening efforts outside of the new collaboration.)

For HIV, a big impetus for the cure push builds on two people infected with the AIDS virus who were cured with stem cell transplants. These two men each had blood cancers that required the transplants, which intentionally used blood from donors who had white blood cells with crippled CCR5 receptors. After the transplants, whatever HIV remained in these men could not enter new host cells, and their infections petered out. This new initiative hopes to speed development of direct injections of gene editor components that can target the CCR5 gene in blood cells and cripple it. “The potential beauty of in vivo gene editing is that it might be given ultimately as a single shot, curing everyone in a scalable manner,” says Steven Deeks, a leading HIV cure researcher at the University of California, San Francisco.

The collaboration will also try to speed development of more experimental interventions that directly excise HIV’s genetic material from a patient’s cells or allow people to artificially make superpotent antibodies against the virus. “This might be science fiction now, but one day may be a real possibility,” Deeks says.

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HIV/AIDS has gone from a mysterious deadly illness to a manageable chronic disease. But a lot happened in the roughly four decades it took to get there. And, according to the American activist David Barr, there’s much that needs to be done to ensure the gains are not reversed.

Barr has seen almost everything in his 35 years of fighting the epidemic, from the early gatherings in the 1980s of the pioneering activist group ACT UP to the roll-out of treatments that saved millions of lives, including his own.

Looking back at his life’s work, and the seminal efforts in the United States that helped launch a global movement, Barr broke down the six stages of the battle against HIV/AIDS.

Fear 

To be gay in the 1980s was to be scared. There was a disease infecting your friends, and someday it might come for you, too — if it hadn’t already.

Lawyers around the U.S. were calling the Lambda Legal Defense Fund, where Barr was working, asking what they could do for clients who had been kicked out of doctor’s offices, thrown out of apartments, or fired.

There wasn’t much they could do. By 1985, the U.S. government had just licensed an antibody test that screened for HIV, the precursor to AIDS, which had already claimed thousands of lives in the U.S.

Lambda was advising the gay community not to take the test because there was nothing protecting people should they test positive. Texas had tried, after all, to pass a law forcing those who tested positive to be quarantined.

And what were you supposed to do if you tested positive anyway? That just meant you were afflicted by an illness for which there was no cure.

“And in the midst of all of it, our government wasn’t responding at all,” Barr said.

So the gay community developed their own legal responses, introduced education about how to keep from catching the disease, and put in place social work services. And they began to fight back.

Fight

In New York City in the late 1980s, Monday nights at the newly established AIDS Coalition to Unleash Power (ACT UP) meetings were the place to be. By the summer of 1987, hundreds of gay people made their way to take part.

“People were sick and dying all around us, constantly,” Barr said. “It felt like we were in a war zone.”

In a politically charged time, ACT UP was the angry activist group. Their first action was to protest the high price for the antiretroviral azidothymidine (AZT), the only treatment on the market for people living with HIV.

In October 1988, ACT UP took the fight to the U.S. Food and Drug Administration in suburban Maryland, donning lab coats with their hands painted red with fake blood, demanding a government response. They wanted more studies on HIV/AIDS, and they wanted quicker access to possible treatments.

“That was really the demonstration where the national AIDS movement was born,” Barr said.

Drugs

As the camaraderie of the early years began to fray, Barr and other members of ACT UP broke off in 1991 to form their own group, Treatment Action Group (TAG), to begin a new phase of activism. Rather than fight the power, they’d try to harness it. “I didn’t need to take over the FDA,” Barr explained. “I needed to get into the room with FDA.”

In 1993, AIDS claimed around 40,000 lives in the U.S. alone.

That year, Barr and four other members of TAG protested a conference in Berlin, where a doctor planned to say that taking AZT and two other analogs, ddI or ddC, was effective for a particular group of people. Barr and his fellow activists stormed in to tell the crowd that her results were skewed, and the drugs were actually not effective at all. The group of five marched out to applause and the feeling of triumph.

“We had made our point,” he said.

But later, as they sat in a park, the reality of what that meant hit them: They were left without a cure. “We were the ones who were going to suffer from this,” he explained.

Turning point

The mid-1990s were a time of guarded optimism. Patients who had signed up for clinical trials and an expanded access program were taking what was informally known as the AIDS cocktail, and it seemed to be working: “People getting up from their deathbeds — literally,” Barr said.

The pills were difficult to take. Patients couldn’t miss a dose. The side effects could be harsh. But they were working. By 1996, antiretrovirals were available on the market for anyone with the virus — not just those in the expanded trials. The FDA, having recognized the urgency, was flagging new treatments for approval, with less data than was needed for any other group of drugs before it. That was the first year that death rates began to decline.

“There was certainly some elation,” Barr said. “But there was also this odd guilt, because why am I alive, and my friends aren’t? How did I get lucky, and they didn’t? There was no rhyme or reason to any of it.”

Global battle

The fight against HIV/AIDS went worldwide in the 2000s.

The momentum began at the XIII International AIDS Conference in Durban, South Africa in 2000, when activists in the country took their national fight to the global stage.

The Global Fund and the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), the two main revenue streams for HIV/AIDS funding, were put in place. The World Health Organization set a goal of getting 3 million people into treatment by 2005 — “a very ambitious target at the time.”

HIV/AIDS activists teamed up around the world. Some faced “much greater challenges” than in New York, and their collaborative work built momentum and help rake in money.

“We were making the right argument at the right time,” Barr said.

Fragile success

Barr says the fight has only gotten more difficult. Funding for HIV/AIDS has remained relatively flat. A 2019 report from the Kaiser Family Foundation and UNAIDS found that donor governments’ spending hasn’t changed much in the last year. Donors are also less inclined to give money for HIV-specific work.

Meanwhile, the number of people living with HIV continues to rise. “Every year you have a flat budget it’s like a cut,” Barr said.

U.N. member states signed up to 90-90-90 targets in 2014, pledging to ensure that by 2020, 90 percent of people with HIV will know their status, 90 percent of those diagnosed will be on antiretroviral therapies, and 90 percent of those receiving therapy will have succeeded in repressing the virus. But they have not come up with the money to make that happen.

Barr objects to how UNAIDS and PEPFAR frame their messaging. They claim “we’ll meet the targets, and we’ll end AIDS,” he said. “That’s not true.” Those starting treatment now will have to maintain it for decades. “Those bills are going to keep coming in,” he said.

Then there’s sex and drugs — as the fear subsides, a whole new generation is growing up now who has not learned the lessons from the 1980s and 1990s.

“The success we have made is remarkable,” Barr said, “but it’s incredibly fragile.”

“If the response is not sustained and maintained, we’re going to lose the tools we’ve miraculously been able to develop [over the decades],” Barr warned. “And then we’re back to 1986.”

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Aging is going to happen no matter what we do. However, focusing on good skin care can make a difference in how well we age. At SLUCare Medical Spa, we work with patients – young and older – to understand their skin care concerns and needs and recommend the best treatments (in-office and at-home) to help reverse any skin damage and prevent further damage.

SLUCare clinical esthetician Paige Gardner offers the same services you expect to find at most MedSpas, but she performs services under a doctor’s supervision.  “If there was ever a question by skin type, skin concern, we can always take that to the doctor together with the patient. They always feel more comfortable when the doctor has addressed it as well.”

Together, they recommend the best treatment options and explain the procedure to manage expectations.

For anyone looking to improve their skin and slow down the aging process without undergoing the more invasive, surgical treatments, there are a number of options available, including:

Injectables and Fillers such as Botox, Restylane and Juvaderm, which are used to smooth facial creases and wrinkles, minimize the appearance of scars, enhance facial contours, plump lips, and improve under-eye appearance. While these treatments can help combat signs of aging, they are not a permanent solution and will require ongoing treatments to maintain results.

Cosmetic Laser Treatments such as the:

1) MicroLaser Peel, which decreases fine lines and wrinkles in the face, neck and chest. Nicknamed the “weekend peel,” the procedure allows patients treated on Thursday to return to work on Monday;

2) Broad Band Light (BBL) treats brown pigment, red pigment, rosacea, acne, secondary hair removal and can rejuvenate the skin overall. This non-invasive, gentle procedure requires virtually no downtime. I

3) HALO is the first hybrid laser to deliver ablative and non-ablative results with minimal to no downtime. It dramatically boosts skin’s collagen and elastin production, smooths fine lines and improves texture and skin discoloration.

Chemical Peels help to exfoliate the dead skin cells both on the surface of the skin as well as within the cell layers. There are a variety of peels that can improve concerns such as hyperpigmentation, acne, rosacea, sun damage, texture, and aging. Chemical peels are a great add-on to most facials. There are light, medium and deep chemical peels as well as pigment balancing peels and medical microdermabrasion.

Non-Laser Skin Rejuvenation and Facials including dermabrasion, microdermabrasion, microneedling, facials, and dermaplaning. These all are non-invasive, exfoliating treatments that improve fine lines, wrinkles, acne scars, skin discoloration and/or other aging conditions. Regular facials are often recommended to keep your skin healthy and beautiful.

No matter what your skincare goals are, our SLUCare clinical estheticians can help you achieve long term results that will keep your skin healthier and looking more youthful.  To learn more, click here.

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