Type 2 diabetes: Jackfruit proven to benefit blood sugar levels

A healthy and balanced diet with regular meals, three times a day, is a way to control blood sugar.

As part of a healthy diet, Bupa advises: "Include in each meal carbohydrates, such as whole wheat pasta or potatoes, and it is a good idea to eat fatty fish weekly whenever possible.

"Your family doctor can refer you to a dietitian, who can advise you on how to keep your blood sugar under control."

Over the past two years, there has been a movement toward increased consumption of plant-based foods, and more and more research has focused on their benefits.

READ MORE: Type 2 Diabetes: Best Supplement for Lowering Blood Glucose – Natural Remedies

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Homeless with HIV: A lack of housing makes a preventable disease deadly in Oregon

Tim Menza receives monthly reports on new HIV diagnoses and compares them to previous years. As a physician and data analyst for the Oregon Health Authority's HIV and Sexually Transmitted Diseases program, he knows how the HIV epidemic has grown.

In Oregon, the four-year program funded by the federal government aims to stop HIV transmission by testing vulnerable Oregoners, alerting them to their HIV status, and providing them with treatment and preventative medications. Menza had been optimistic. Oregon was on track to eliminate future HIV transmissions.

But a year ago, he noticed a disturbing trend to which Oregon was ill-prepared – an HIV epidemic exacerbated by the harsh living conditions of the street.

Although the increase in new cases is due to drug use, it is difficult to contain because of homelessness.

In Multnomah County, where the number of cases of HIV infection has more than tripled, 71 countries have seen the same wave of HIV cases over the past two years. In that year alone, 37 people were diagnosed, which equates to almost the total for 2016 and 2017.

The virus has always targeted marginalized communities, devastating an entire generation of gay men in the United States in the 1980s and 1990s and then settling into communities of color. But in recent years, the epidemic has surged among intravenous drug users who are – or will soon become – homeless and their sexual partners.

Public health officials have had to start considering their work as being linked to the homeless service system, actively seeking out camps to look for those who are sick. While health care providers have become homeless service providers, they are meeting the needs of patients beyond medication.

People who have a home can easily survive HIV, a pill taken once a day allowing them to live almost without symptoms. Yet, this remains a potential death sentence for homeless people, who are stealing their medicines, who do not have access to safe shelters, who lack food and sleep poorly, leaving their immune system unprotected. the deadly virus.

A compound factor

When Menza reviewed the data a year ago, he found that across the state, in both rural and urban areas, new HIV cases were occurring among drug users. injectable and did not have access to stable housing.

It was not necessarily a surprise. He had seen cases of syphilis and hepatitis C increase in these populations – often precursors of HIV infection.

He knew that the state needed to take immediate action, but the traditional way would not work this time.

The number of HIV cases among people who use heroin and methamphetamines has risen to 30% in the last two years, more than double the percentage of previous years, according to data from the US. State.

Drug users generally separate into social and sexual networks based on the drug of their choice. But recently, these circles seemed to overlap more than ever. Officials said cheap, high-quality methamphetamine had invaded the state in recent years, a popular drug for people who live outside and wish to stay awake all night to avoid being exposed. assaulted or stolen. The increase in methamphetamine use coincides with an existing opioid crisis, and many people have started using both the depressant and the stimulant.

On top of that, Menza said there was more and more evidence that homelessness was an aggravating factor.

Whenever a campsite or group of people who use drugs are scattered during sweeps or cleanings, people move and form new networks. Unisex shelters divide heterosexual couples, making it difficult to stay with one partner in the long run.

This slowly increases the number of people able to spread the disease geographically and demographically.

A public health worker trying to contain an epidemic in a small group of people must now navigate in constantly expanding networks.

"If you try to do an intervention in a camp," said Menza, "you have to work fast."

Take health care in the camps

In Multnomah County, many people who are homeless or on the verge of treatment receive HIV care from the publicly funded HIV clinic in the new headquarters of the Health Department near Union Station .

From this outpost, public health officials tailor their mobilization around the HIV epidemic almost on the fly.

Jaxon Mitchell leads the investigation team on the disease and field activities in the field. He usually hounds people. He can usually search for a person's mobile number or send him a message on social networks. But that does not work with this epidemic.

To locate people, Mitchell and his team have to search for camps, search social network profiles for clues, and search for leads from hospitals and friends. This is made even more difficult by the strict privacy laws that forbid Mitchell from telling fellow campers why he is looking for a particular person.

The rise of HIV – and associated diseases such as syphilis, shigella, hepatitis A and hepatitis C – means that Mitchell often receives the results of screening tests for homeless people who went to emergency for short-term treatment but were returned to the street before the results were released. return.

When he finds the person he is looking for, he must often quickly identify anyone else likely to be infected – sexual partners or people sharing needles – and have them tested or followed by treatment.

In a van designed for this type of field work, the county offers on-site medical assistance, tests and provides other necessities, such as clean socks, snacks and tampons.

The public health service has already faced smaller epidemics. For example, Mitchell's team is sent following a diagnosis of tuberculosis in a homeless person and must ensure that the patient takes several months of pills to contain it.

But it's a much bigger business than ever before.

"It's all about finding people," said Jennifer Vines, deputy director of county health. "Now we are suddenly faced with a new situation, which forces us to understand how to use our tools when people are hard to find – or not wanting to be found."

Train the front lines

In his role in the county, Chris Hamel must train service providers on how to talk to their clients and patients about being tested for HIV.

It looks for homelessness service agencies, primary care physicians, detox centers, parole and probation officers – anyone who can interact with people at risk of contracting HIV – so to facilitate this step.

County officials have found that if they are able to treat a newly diagnosed person within 30 days, they will be more likely to stay in the long term. Field workers therefore try to stay in touch during first appointments.

"We are doing our best now to see people," Hamel said. "But I would like us to continue to put in place a public health system where people feel comfortable enough to come and see us."

Public health workers face the challenge of focusing as much on those who have not yet contracted HIV as on those who have tested positive.

Pre-exposure prophylaxis, or PrEP, is an extremely effective daily medication to prevent the transmission of the disease. Mitchell and his team are also looking for anyone likely to be on a person living with HIV to make sure they have access to medication.

This is a new sale to many. The pill has been largely targeted at homosexual men because it works even without a condom. But state data shows a 600% increase in the number of women with syphilis – a sure sign that HIV will parallel this increase.

In this epidemic, those most at risk are women, sex workers and intravenous drug users, who are usually heterosexual men – people who have probably never considered using preventive medicine.

"It's the art of public health," said Vines. "We think about the individual, but we must also think about the social circle of the person."

Difficult to help

In 2014, Indiana had more than 200 cases among injecting drug users in a county. Last year, West Virginia recorded 80 new HIV cases related to intravenous drug use.

Officials are witnessing the resurgence of HIV across the country, but the west coast is unique in that it is sorely lacking affordable housing for people who are sick or addicted.

In 2018, a group of HIV cases in Seattle attracted the attention of the federal government. The epidemic occurred within a distinct group of people who had not previously been a driving force among new cases: heterosexual people who were homeless and who took intravenous drugs.

In Seattle, 21 homeless people circulated around HIV, needle sharing and sex. This group reduced the HIV rate among homeless heterosexuals who inject drugs in King County by 286%. A few months after cluster identification, seven of the 21 people still did not receive HIV care.

"King County's epidemic shows how difficult it is to get the most socially marginalized people treated," says a report released by the US Center for Disease Control and Prevention.

San Francisco has seen a steady increase in mortality among this growing population. An HIV-positive person with HIV is 27 times more likely to die than an HIV-positive person housed, said Elizabeth Imbert, the physician who oversees a new private clinic at Zuckerberg San Francisco General Hospital.

Homeless people in the city account for 14% of all new HIV diagnoses, while they account for only 1% of the city's population, according to the local public health department.

Service 86 at the hospital was at the forefront of the AIDS crisis in the 1970s. Now, it has launched the POP-UP Clinic, a program designed to allow homeless people to come forward. to follow a treatment.

According to local data, Imbert has learned that only one-third of San Francisco's homeless infected have been able to reduce the amount of HIV in their blood to the point of no longer being able to transmit it – this that health officials call "viral suppression". This rate is well below the average rate of 74% observed in San Francisco for all HIV-positive people.

The hospital launched its own investigation to discover that, out of 1,200 patients, the amount of virus in their bodies increased as their housing situation became more unstable. And as the amount of virus in their bodies increased, they missed appointments for primary care and ended up in the emergency room and received emergency care.

The leaders of Room 86 have created a new way to treat these patients. They had to find a way to attract patients to patients who do not trust institutions like hospitals.

The 86 service employs people who focus on non-medical needs in the hope of helping patients stabilize enough to continue taking their medications. They also work with housing specialists from the state health department and community organizations to put patients in touch with services – and ask these workers to visit the clinic to do so.

The clinic is open four hours a day from Monday to Friday and patients do not need an appointment to see a doctor. Currently, about 180 patients are eligible for the program, which targets people who have missed an appointment in the past year.

Once they have walked through the door, they are offered financial incentives to keep coming. The hospital offers a $ 10 gift card for each week in the program, a $ 10 gift card for blood tests and $ 25 if the patient achieves viral suppression.

Nearly a year later, 60 people are registered. Most started taking medication and Imbert stated that she had already seen it in the program whose virus had become undetectable. About half of patients come regularly, while a quarter goes several times a week.

"We use essentially all the resources of the city," said Imbert, "to place them indoors, hosted, on a waiting list."

– Molly Harbarger

mharbarger@oregonian.com | 503-294-5923 | @MollyHarbarger

Visit subscription.oregonlive.com/newsletters get the Oregonian / OregonLive journalism in your inbox.

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I Thought Being a Health Care Reporter Would Make Cancer Easier. I Was Wrong.

The other night, like most nights, I woke up several times, soaked in sweat. I'm getting up. I pee and take off all my clothes and put on new ones. I drink what's in the glass on my bedside table, I'm so dehydrated.

I go to the washbasin in the bathroom and throw water on my face to try to cool down before taking care of my soaked sheets.

History continues below

I am 32 years old and I am postmenopausal. It's temporary and I chose to endure it when I was diagnosed with life-threatening breast cancer a year ago. But it's much worse than expected.

Early menopause is one of the many decisions I made about my treatment program in the last 12 months. At present, I am a consequence of these decisions. In five years, I will have another choice to make: decide to stop menopause and have children. Becoming pregnant would pump my body of estrogen and possibly stimulate the micro-tumors that float in my blood, which are undetectable of course. I'm not looking forward to making that decision.

When I wrote my first try about breast cancer for POLITICO magazine after diagnosis of my diagnosis last year, I was struck by the number of cancer survivors and other patients who contacted me to welcome me to cancer club ". At first, I did not want the club. First of all, it was full of "sick" and I was not ready to join the ranks. On the other hand, I did not think I needed it.

Oh, how wrong I was. Now, I realize what really is the cancer club. His a real network of patients who advise each other – in my experience, through social media – on how to choose treatment programs and manage their side effects. (My favorite cancer club's recommendation is to take Claritin to relieve bone pain caused by a medicine to keep my white blood count so that I can continue to receive chemotherapy, as well as gingerbread.)

If I've learned anything in the past year, it's nothing – not being a health journalist, not even having a scientist as a father and a doctor as a sister – can not prepare you for the immense number of complicated, sometimes fatal situations. -or-death decisions that the disease and the system require you to take on your own treatment, all by yourself.

Here's what I mean: There is a standard cancer treatment protocol that involves chemotherapy, hormone therapy, surgery and radiation therapy. These treatment programs are best practices based on the most reliable data available for my type of cancer. What most people do not realize is that patients must decide for themselves whether or not they follow their usual regimen and then they should follow a treatment other than that- This, including clinical trials or experimental drug programs not approved by the federal government has yet to adopt less well-studied holistic approaches such as diets and supplements. Although doctors can guide you in your decisions, few will take them for breast cancer treatment.

This is because many of the choices that women are forced to make are truly personal: for example, whether you want to have children or the amount of life pleasures you are willing to give up to overcome the disease. By the way, different doctors also give contradictory guidelines. That's where the cancer club comes in.

In all, I can think of six major decisions that I took during the year, with the consequences with which I live now.

The first three (after deciding to continue chemotherapy and surgery) – where to seek treatment, whether to participate in a clinical trial and which one – related to life. The next three steps – trying to preserve my hair, what operation to undergo and how much I wanted to have the opportunity to have children later – largely concerned life. Even though menopause has not been fun, Fighting these decisions has also changed me positively by forcing me to decide what is most important in my life. This has been the main asset for catching cancer.

But making so many decisions about my treatment program has also made me realize how disparate and overwhelming the health care system is and how intimidating it is for patients. I am one of the best equipped people to navigate there: I am a health journalist and my father works in the system as a scientist. Between us, we have a lot of access to people and information, which is a privilege. Most patients are not so lucky.

And yet, I feel totally buried in the system a lot of the time.


Let's go back to the beginning. It is August 2018 and I have just been diagnosed with breast cancer. I'm only 31 years old. When writing my last essay, I'm still waiting to find out what kind of cancer I have and what is the threat.

It seems to last forever until my surgeon, Dr. Brian Czerniecki – Breast Cancer Service Manager for the Moffitt Cancer Center in Tampa – calls the results of my last tests.

I have stage II cancer in the left breast, he tells me. It eats estrogen, which is good for the treatment, painful for my personal life. At that time, medical tests revealed six tumors in my left breast and three in my left lymph nodes under my armpit. Because cancer has Czerniecki has suggested to do a clinical trial in combination with chemotherapy before undergoing surgery and radiation therapy.

What I hear from this phone call is that I am going to live. I know as soon as he speaks of "stage II", that the cancer has not progressed enough throughout my body to put his life in danger. I breathe for the first time in weeks and listen to his technical speech. I agree to go down for a meeting.

That Monday, Lawrence, my new boyfriend at the time (now engaged), and I get up in the middle of the night to drive to Tampa for four hours to pick up my father, who comes from Boston, to the airport. In the morning, we meet all three Czerniecki and my oncologist, Dr. Heather Han. The goal is to find out what clinical trials the Moffitt Cancer Center has to offer.

If I participate in a clinical trial according to the recommendations of Czerniecki, I will be treated at Moffitt because the cancer center offers – the tests do not exist in all hospitals. If I do not do it, I can get treatment in Tallahassee, where I live and work, Han explains. There is no guarantee that one or the other of the two trials will give better results than chemotherapy alone.

The first trial at Moffitt focuses on some of the newer immunotherapy drugs and the second one gave good preliminary results for patients with cancer such as mine caused by estrogen. Han then explain the essays in details I can not remember. She wants me to make a decision on Wednesday, in two days. Han and I are eager to start treatment and I still have to qualify for the test I choose, which also takes time, which we do not have much.

The end of our meeting of about an hour starts the 48 most stressful hours of my life.

That night, my dad and Lawrence and I have a drink in the lobby of our hotel before dinner. We bring our documents describing the different tests with us, we study them and discuss their advantages and disadvantages. In my belly, I lean towards the one who has good preliminary results. It is a much simpler process and it would force me to go to Moffitt less often.

My dad says it's not a bad logic, but he wants more opinions. He calls his colleagues and asks them to help us understand the nuances. My father is a geneticist who associates a lot with cancer research, but he has not lost his depth.

Lawrence gets up to ask us for a second round.

"That's the one," my father tells me, hating all the little friends of my life. "A person who stays with you against cancer and with you all your life." (One of my doctors tells me later that the marriage of his patients ends in a divorce.)

Getting to know Lawrence and our relationship through this terrible situation is another major asset for cancer. When your life is at stake, it is important to stack these silver liners until they shine.

Tuesday, Lawrence and I drive to Orlando to cover for our respective media organs what was supposed to be the main party of the victory of Democratic presidential candidate Gwen Graham. Graham loses a lot against Tallahassee Mayor Andrew Gillum. I spend the night chatting at the historic moment – Gillum is the first candidate for the black governorship in Florida for a general election – for POLITICO and I paced in random hallways on my cell phone to listen to my friend's advice , Dr. Michael Lotze, oncologist. at the University of Pittsburgh.

Lotze, blessed by him and his wonderful scientific spirit, intends to explain the term "equilibrium" to me. This basically means that choosing a clinical trial is only part of luck, because no one really knows what's best and that's why it's a trial. It's experimental and I'm a test subject. But I participate in the trial because it could improve my response to chemotherapy, he tells me.

This is the essence of both tests, but they are otherwise very different. He tries to warn me to have too many opinions. I do not consider his advice.

I get out of the women's washroom where I finally end up in my conversation with him and spend part of the night complaining to Pati Mazzei, the Florida correspondent for New York Times, about my situation.

"How am I going to report on this?", I said as we look at The Social's bar in downtown Orlando at the Graham event. "I have not even started treatment yet, and I am already so overwhelmed."

"You will learn," says Mazzei.

On Wednesday, I spend most of the day in a messaging chain with my dad's friends and colleagues trying to help him.

The team is torn.

When immunotherapy drugs work, they work really well. And it's appealing because I'm decades younger than most women with breast cancer and I want the most effective drugs I can get. (This treatment targets the immune system rather than the cells and can keep the cancer away longer.)

But it is possible that these medications are not working, and this test involves a lot more testing and a lot more driving towards Moffitt. It would also delay some of my chemotherapy. I finally choose the other trial, which contains an additional experimental drug, that seems to work well in women with estrogen-induced breast cancer such as mine. I tease my father that I could have gone with my instinct 48 hours ago and have finished all the ordeal.

Instead of understanding, my father is keen to want to test me for specific genes that he thinks related to the experience drug. Czerniecki finally rejected it for reasons that I still do not understand.

So, I choose my clinical trial. Now, am I going to be treated entirely at Moffitt? Yes I decide I could choose a local oncologist in Tallahassee, where I live, but I do not want to disrupt the continuity of my care. I fear that more doctors equate to more administration, which equates to a higher risk of errors. (I do not realize at the time that I will eventually have an oncologist in my hometown, anyway.)

My decisions mean that Lawrence and I drive 10 hours a week at Moffitt for the first three months of treatment so that I can receive my clinical trial medication and the first cycle of my chemotherapy every Friday. After that, we go down every two weeks for two months so that I can receive the second cycle of chemotherapy. (Fortunately, 160 hours later, Lawrence and I are still together.)

The next important decision I make is just as important as choosing a clinical trial, but probably less discussed and less understood. That's because there are not many breast cancer patients who, like me, have not had children yet. It is possible that chemotherapy makes me sterile. The risks vary depending on the age of the woman and the medications she takes, but a doctor tells me that my risk of infertility is about 1 in 10.

I do not like these chances. Han therefore offers to help me make an appointment at the University of South Florida in Tampa, where I will be able to freeze my eggs. But another oncologist, Dr. Ann Partridge, discourages me from the idea.

Partridge is studying breast cancer in young women at Harvard and tells me that she has reservations about freezing my eggs because the process would require me to produce a lot of estrogen, which could potentially speed up the growth of my tumors. Partridge says that it does not usually discourage patients from freezing their eggs, but my risk could be greater since my tumors are still in my body.

"How much do you want to have children?" She asks. If it's the most important thing in the world for you, then freeze your eggs, she says. But the procedure could put my life even more at risk than today.

I want children but I do not want to die before I can have them. And also, freezing your eggs costs thousands of dollars, and my the insurance will not cover. So, this decision turns out easier than I think.

Instead, I choose to have my ovaries lulled once a month to reduce the amount of estrogen in my body. This will help protect my ovaries and my finished number of eggs from chemotherapy. It's also a good idea since my cancer is eating estrogen.

In In short, these blows will send my body into temporary menopause, Partridge tells me. It will last as long as I receive the vaccines. This will also exacerbate some of the side effects of chemotherapy: hot flashes, vaginal dryness, decreased sexual desire and some kind of loss of sexual identity … but I do not know it yet.

"Sex does not work, as physically," I say to a nurse practitioner who I like a lot in the winter. She tells me it's normal.

Lawrence takes my hand. I start crying, explaining how I feel more like a ship for an ongoing war in my body than for a woman.

"You're still hot," Lawrence tells me.

Then, to the question of surgery. I tell my fears to the nurse practitioner, which, I am embarrassed to admit, is centered on vanity.

Czerniecki, my surgeon, just wants to remove the tumors through a procedure called lumpectomy, instead of taking all the breast by mastectomy, I say to the nurse. The choice is finally mine, but I trust Czerniecki's judgment.

Still, I have my reservations. "But the left breast is already smaller than the right breast," I tell him. "I know that they have to take a wide margin. I mean that there are six tumors in there. I can not imagine that there will be no more breast.

She nods. I have the impression that she really listens to me and notices how strange it is to feel so much heat towards a person in such a sterile room.

You will just have to balance your body image with what is safest for you, she says. Mastectomy and reconstructive surgery are both much more extensive procedures than a lumpectomy.

Lawrence tells me later that the mastectomy seems too dangerous and unnecessary. I know he's right. I just do not want to walk around with a half-breast. And I feel ashamed to want implants if my breasts are not fully removed.

"Honey, do not worry about that," Lawrence tells me. "Take your breasts if you want them. You have won them. "

The final decision I need to make before I can begin treatment is to try to preserve my hair, buy a wig or go completely bald.

Patients can preserve their hair through a "cold treatment" process in which they apply a refreshing gel and wrap their head during chemotherapy. It works but it's expensive and my insurance does not cover it. My insurance does not reimburse me either the purchase of a wig, which is very irritating.

So, I'm bald. (Until it is very cold, and then, I wear a hat.)

A woman who lives in Tallahassee and who has also had breast cancer – a member of the cancer club – has sent me a message on Twitter. "To see you bald and proud made me smile," she writes. "I've never had the courage to do without my hat. Hang in there.

I tell him that the message has returned all my week, but really, it makes every day a little sunnier.

"We stay bald together," I replied.

I felt so positive that day. But then, I came back to what I wonder every day: do my treatment decisions mean that I will never be able to have children?

It's hard to imagine surviving cancer without them.

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Vaping illness spurs calls for federal marijuana changes

Marijuana advocates are seizing the recent outbreak of vaping-related illnesses to renew their calls for clear federal cannabis rules.

Federal health officials have indicated that the THC-based products sold on the black market were probably at the origin of a mysterious vaping disease. has sickened more than 2,000 people across the country and caused at least 39 deaths.

Human rights advocates argue that federal regulation of marijuana, including changing the rules to allow for better and better research, will make people safer.

"The black market can only be addressed by a regulated legal viable market that can guarantee the safety of consumers," said Terry Holt, spokesperson for the National Round Table on Cannabis.

According to the latest update of the Centers for Disease Control and Prevention (CDC), products containing THC, especially from "informal sources" such as friends, family members, or online or offline resellers. line, are related to most cases and play an important role. major role in the epidemic.

Friday, CDC officials refined on an electronic cigarette cutting agent called vitamin E acetate. According to experts, vitamin E has been used in unregulated and illegal vaping products in order to dilute THC oil to maximize profits.

The CDC said that vitamin E acetate was a "very powerful culprit" of the potential cause of vapor-related injury, but officials pointed out that there could also be other causes.

Anne Schuchat, Deputy Chief Director of the CDC, said that while most diseases are linked to illicit THC vexation, the agency does not rule out any "infiltration" of contaminated products into state-approved clinics.

Marijuana is illegal at the federal level, so companies are forced to go through a patchwork of state laws for their own markets. Eleven states have legalized marijuana for recreational purposes and 33 authorize marijuana for medical purposes.

"States that have dispensaries set their own regulatory measures" in terms of documentation and testing of ingredients, said Schuchat, which makes it difficult for the federal government to track them.

At least one death would have been linked to oil legally purchased at a dispensary in Oregon. Although Schuchat has stated that there is anecdotal evidence about patients who have purchased vaping products exclusively from dispensaries, many unknown factors remain.

"Data to date indicates a much greater risk associated with THC-containing products from informal sources than accredited clinics," said Schuchat, adding, "I do not think we know enough to completely eliminate dispensaries. "

Colton Grace, spokesperson for the anti-legalization group Smart Approaches to Marijuana, said the death of Oregon showed that it was not just a black and white problem .

"By insisting that legal products are safe, we will put more people at risk," said Grace. All vaping products should be banned until researchers discover the main cause of the diseases, he added.

"The answer is not to regulate and test. Some states already are, and these products are hurting and killing people, "said Grace. "Use permission (from the Food and Drug Administration) to remove these products from tablets."

Holt said the government needed to take action to better control state laws or intervene to regulate cannabis at the federal level.

"It is becoming increasingly clear that, regardless of the inequities and unsafe practices in the illicit market, sunlight would be a marvel to clean up the industry," said Holt.

Some states that have already legalized marijuana are taking steps to try to protect the public from vaping.

Massachusetts has recently begun to require manufacturers of spray cartridges, marijuana extracts and concentrates that they publish a list of all ingredients and chemicals.

Massachusetts Governor Charlie Baker (R) has also instituted a state-wide ban on all vaping products, including marijuana. A state judge later ruled that the marijuana prohibition portion was not enforceable, but this remedy may be short-lived due to pending court challenges and future regulation by regulators marijuana from the state.

In Colorado, authorities are on the verge of banning certain additives, including vitamin E acetate. The state is also studying changes to be made to labeling in order to give consumers more specific information.

At the federal level, marijuana is a controlled substance in Schedule I, which means that it is classified in the same category as heroin and LSD. The lawyers say the restrictions make it difficult to study the safety of cannabis and even harder to regulate.

The National Cannabis Industry Association has been arguing for months that steam diseases are an excellent example of why marijuana needs to be reprogrammed and better regulated.

"The current patchwork of state regulations underlines the need for uniformity. And consistency comes with timing and federal regulation, "wrote the group in a letter to the Speaker of the House in October Nancy PelosiNancy PelosiTrump calls Pelosi, Schiff, Biden and others to testify as part of a dismissal investigation Will Pelosi save Trump by defeating the impeachment procedure in the Senate? A GOP senator defends himself by calling him "idiotic" Pelosi: "What I said was right" MORE (D-calif.) And leader of the minority Kevin McCarthyKevin Owen McCarthyHouse Republicans Add Jordan to Intel Panel for Impeachment Investigation Bipartite leadership will reduce emissions faster than the Paris agreement The launcher in Ukraine under fire – Where are the first responders? MORE (R-Calif.).

"It is confirmed that Americans are harmed by illegal cannabis-based products sold on the illicit market, this is one more reason for a truly comprehensive federal cannabis reform that will allow for Cannabis industry regulated and tested to substitute for illegal market players, "the statement added. .

. (tagsToTranslate) vaping (e) cigarettes (t) Cannabis (t) marijuana (t) Marijuana (t) Kevin McCarthy (t) Nancy Pelosi (t) Centers for Disease Control and Prevention (t) CDC (t) National Round Table on Cannabis (t) National Association of the Cannabis Industry

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10 Best Episodes Of Chicago Med (According To IMDb) | ScreenRant – Screen Rant

Top 10 episodes of Chicago Med (according to IMDb) | ScreenRant Rant screen

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Measles case confirmed in metro Atlanta; it’s the 8th case this year in Georgia

COBB COUNTY, Ga. – Public health officials have confirmed a case of measles in the Atlanta subway. The Georgia Department of Public Health said Saturday that the case was an unvaccinated person in Cobb County.

Authorities inform people who may have been exposed to the virus between 31 October and 6 November.

People with measles symptoms should immediately contact their health care provider.

"DO NOT visit a doctor, hospital, or public health clinic without the FIRST call to inform them of your symptoms." Health care providers who suspect measles in a patient should immediately report it. public health, "said the department in a statement. .


The virus usually starts with a fever followed by a cough, a runny nose and red eyes. A rash of tiny red spots starts in the head and spreads to the rest of the body.

This is the eighth confirmed case in Georgia this year. Atlanta Centers for Disease Control and Prevention has more information on measles here.

Measles in Georgia

• 2019 – 8 (to date)
• 2018 – 0
• 2017 – 0
• 2016 – 0
• 2015 – 1
• 2014 – 0
• 2013 – 0
• 2012 – 2
• 2011 – 0
• 2010 – 1
• 2009 – 1

. (tagsToTranslate) Cobb County (t) Local

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Beating cancer without chemo – Israel National News

The results of an Israeli study published in the prestigious international journal Nature Breast Cancer indicate that chemotherapy can be avoided in women with early breast cancer discovered.

According to a report in Yediot Aharonot, for a decade, researchers followed 1,365 women in Israel with the two most common types of cancer (ER positive and HER2 negative). In all cases, the cancer was discovered early.

As part of the study, women underwent an oncotype test in which they were evaluated on a scale of 0 to 100 based on the level of risk of cancer recurrence. Each patient with a score of 25 and under was asked to give up chemotherapy. In almost 100% of women, the disease has not recurred even though they have not received chemotherapy.

The journal explained that a breast oncotype is a unique molecular test performed on a tumor tissue taken from a patient during the biopsy or at the time of the initial surgery. The test measures the biological profile of the tumor by measuring the expression of 21 different genes in the tumor cells.

The study results indicate that in 97.4% of women who discontinued chemotherapy as a result of the test, the disease did not recur. The mortality rate in the patient group was only 0.7%.

This is great news since chemotherapy often has serious health consequences over the years. One of the high risks it poses is to cause serious damage to the immune system, which can be life threatening.

The study was conducted by experienced oncologists, including Dr. Shulamit Rizel from Assuta Hospital, Dr. Noa Ben Baruch from Kaplan Hospital, and Dr. Lior Shoshan-Gutman, CEO of "Oncotest".

Professor Solomon Stettmer, director of the research unit of the Beilinson Institute of Oncology and among the researchers, said in Yediot Aharonot that "research proves beyond a doubt that chemotherapy can be denied to most women who have breast cancer detected early".

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DR ELLIE CANNON: Can you inherit dementia – and will any foods help to stop it advancing?

When we think of dementia, we think of memory loss, but that simplifies a lot. For starters, most people have heard of Alzheimer's disease, but there are also other types of dementia.

They can affect reading and writing, movement and even the ability to follow a conversation.

There may also be changes in behavior, mood and attitude. As Lynne Wallis's story about her mother's story in this week's Mail section on Sunday Health shows, dementia can completely transform a person. Doctors have trouble diagnosing, especially early.

There is no cure, and very few ways to reliably slow down the inevitable progression of these diseases.

All of these things combined can leave patients and their families even more confused.

But that does not mean that modern medicine can not help, on the contrary. With this in mind, I am trying to answer some of your vital questions about dementia.

When we think of dementia, we think of memory loss, but that simplifies a lot. For starters, most people have heard of Alzheimer's disease, but there are also other types of dementia. (Image of the file)

I'm worried about my 68-year-old mother for a while because she did not seem to be herself. She was even caught in the act of stealing from the window. We are concerned about dementia, but the results of a memory test are normal and the doctor says there is nothing wrong. But I know that there are some.

Memory loss is only one aspect of dementia. These diseases can also cause personality changes.

For the most common types of dementia such as Alzheimer's disease, memory loss often comes first, then behavioral changes occur later. But about five percent of people with dementia will have frontotemporal dementia. The most important characteristics are behavior: loss of inhibitions, change of likes and dislikes, inappropriate social behavior and unusual rituals. The loss of memory comes later.

Symptoms such as those described here should be discussed with your GP, as well as any history of depression or mini-stroke. Other tests and a brain scan – an MRI – will probably be needed.

My husband has dementia. Often, I feel completely overwhelmed by everything and feel sad. I feel bad talking about myself, because he's the one who's sick. But on bad days, I can not seem to cope and, I hate to admit, I want to run to the hills. Is this normal?

Absolutely. If you do not feel like that, it would be abnormal. Any caregiver role is incredibly stressful no matter what situation you are in.

You are mourning for your partner, a fear for the future and the daily fatigue of care. It's a huge burden to wear.

I urge anyone who feels this way to register with your GP and explore the available help. In many areas, there are counseling services for you to talk about how you feel.

There may also be social support or support for caregivers. Carers UK charity (carersuk.org) also offers excellent advice.

More Dr. Ellie Cannon for The Mail on Sunday …

My 67 year old woman was diagnosedsed two years ago with dementia. She was relatively active, but now rarely leave the house. After reading that this exercise is good for dementia, I tried to suggest walks but she refused. What would you suggest?

Exercise is really important: it reduces isolation, builds confidence and strength of bones and can even improve memory and slow down the decline. It is worth exploring what is available in your area – for example, tai chi or specific courses for the elderly.

Your local authority will be able to tell you what is available, and there may be a local budget for "social prescription" that deserves to be questioned by your attending physician. This would allow him to go to a proper session at no cost.

Gardening is an option as it involves exercise and safe movements. And the exercise can be done without leaving home – use her favorite music to make her dance a little each day.

The Alzheimer Society (alzheimers.org.uk) has great ideas for sitting exercises.

My father is seen at something called a clinic of memory. Nobody said the word "dementia", but I think that's what he has. Would I have been informed if that was the case?

We refer patients to memory clinics for the diagnosis of dementia, as well as treatment. If dementia is not suspected, staff usually discharge patients. Some patients have memory impairments caused by treatable diseases such as vitamin B12 deficiency.

That said, dementia is not an easy diagnosis to establish. Determining which dementia has a patient (there are six main types) can take time as the results of the analysis come back.

As long as the staff does not have all the information, they will not ask the diagnosis and will not use the word "dementia". This should be told to you, but if you are not, you have to ask if you have any information.

Dementia is not an easy diagnosis to make. Determining which dementia has a patient (there are six main types) can take time as the results of the analysis come back. (Image of the file)

Dementia is not an easy diagnosis to make. Determining which dementia has a patient (there are six main types) can take time as the results of the analysis come back. (Image of the file)

We have just diagnosed Alzheimer's disease and a friend told me to participate in a clinical trial to benefit from new treatments. How can I do that – and are there risks?

The safest way to do this is to join Join Dementia Research (join dementiaresearch.nihr.ac.uk). It's like a matchmaking service: you sign up by registering online, then they will inform you of appropriate studies being recruited.

These may involve drug trials, scans or even genetic testing. But it is important that your expectations are realistic: this is certainly not a guaranteed way of getting new treatments.

Trials may involve the use of existing drugs, for example.

Reduce the risk

Untreated, hearing loss is thought to increase the risk of developing dementia.

My father died earlier this year with dementia. Having myself realized how difficult the situation can be, I am afraid to reach it too when I grow up. Can we inherit dementia and can I test to see if I will have it?

Genetics has only a minor role to play in dementia. Most people who develop Alzheimer's disease do not have a known genetic mutation. There is a small group of people who develop Alzheimer's disease at a younger age, which can be genetic and family-related. But for most of us, it's not just about genes but about a combination of risk factors.

Diabetes and smoking seem to increase risks, as does lack of exercise and loneliness.

Dementia was diagnosed in my husband earlier this year and I am too scared to ask his specialist how much time he has left.

This is a very difficult question to answer. On average, people with dementia live between three and nine years after diagnosis. The range is very large because there are many types of dementia and, of course, it depends on the background health.

During this survival period, it is also difficult to estimate the course of the disease. We speak of early, moderate or severe dementia stages, and each of these stages lasts about two years before progressing.

In the beginning, planning is important: finances, care and health. This would include the registration of a power of attorney (gov.uk/power-of-attorney) and an advanced care directive – a living will.

Visit compassionindying.org.uk for more details.

My mother was diagnosed with dementia a few months ago. Is there a special diet that will help keep your brain healthy?

It is important that people with dementia consume enough calories. Affected individuals tend to lose weight due to changes in appetite and behavior. They are also very susceptible to dehydration if they forget to drink. The priority is to eat regularly.


Send an email to DrEllie@mailonsunday.co.uk or write to Health, The Mail on Sunday, 2 Derry Street, London, W8 5TT.

Dr. Ellie can only answer in a general context and can not answer individual cases or give personal answers.

If you have a health problem, always consult your own doctor.

My wife has been suffering from type 2 diabetes for a long time and last year she was diagnosed with Alzheimer's disease. His memory is gradually deteriorating and it becomes more and more difficult to manage these two conditions. What should we do?

It's tricky but actually quite common. Type 2 diabetes in middle age or later increases the risk of vascular dementia and Alzheimer's disease by 50%. The help of a GP to handle this is crucial.

The medication regimen must be simple but sufficient to control diabetes: a pod box with compartments indicating which pills to take at what time of day will be essential.

A referral to a dietitian is also helpful – it would help you establish a diet for your woman that is beneficial for her diabetes but can benefit her despite her dementia.

How a song brings a smile back to Barbara Windsor's face

Last month, Scott Mitchell, Barbara Windsor's husband, said her memories "come back" when she sings

Last month, Scott Mitchell, Barbara Windsor's husband, said her memories "come back" when she sings

Music plays an important role in many life events.

Almost everyone has a song or two that reminds them of a special moment – and this can often be associated with powerful emotions.

Last month, Scott Mitchell, Barbara Windsor's husband, said her memories "come back" when she sings.

The old actress was diagnosed with Alzheimer's five years ago, but Scott says that music evokes happiness among 82-year-olds.

It's so important.

Management of dementia is not just about care and pills, it's also fun and gives patients and caregivers time to have fun – this is clearly therapeutic for Barbara.

And it's also essential that she and Scott are having fun together, which is all too often dismissed with dementia.

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CDC says a toxic compound may be responsible for vaping illnesses

The samples contained other ingredients, although they did not appear so evenly. THC appeared in 23 samples and nicotine in 16.

The CDC was quick to warn that vitamin E acetate was not confirmed as a cause and that multiple factors could be involved in sometimes fatal diseases. However, he reiterated a recommendation to avoid the use of electronic cigarettes and videos containing THC, especially "informal sources" such as friends or street vendors. The CDC also pointed out that companies should not add the compound to their products until its effects on the lungs are better understood. The answers might well arrive – it's just that officials do not want to take any chances.

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Wisconsinites use cannabis as a medicine, but research and the law are not yet on their side

The national illegality of marijuana makes studying difficult and the Wisconsin study banning it is hard to get for people who depend on it for treatment.

After four decades of using powerful prescription medications to treat Crohn's disease, a chronic digestive disorder, Patty has developed an aggressive form of skin cancer.

"It's because my body has been removed for so long, it can not fight cancer," said the Wisconsin resident.

Patty, who has been working at her father's restaurant for 27 years, is now struggling to take on full-time jobs.

"I'm trying to get a disability, but I've already been denied once.I do not plan to stop working.I just need help.J & # 39; I need help because I can not work full time, "Patty said.

In March 2017, a friend who lives in New Mexico, where medical marijuana is legal, posted her Buddha Tears, a cannabis oil product containing cannabidiol (CBD), and THC, the component psychotropic cannabis. After consuming a tiny amount of oil each day, as well as smoked marijuana, Patty said that she had found a noticeable improvement in her condition.

"Unfortunately, I have to smoke every day, because if I do not do it, I'll be in the bathroom all the time," said Patty, who asked that her last name not be published because she uses an illegal substance.

But these days, Patty is again struggling with symptoms.

"My connection (for CBD and marijuana) has been cut off," she said. "I am very angry."

While Patty and others have successfully treated their medical problems with cannabis, the drug remains illegal in Wisconsin.

And because of its Schedule I drug status – the most restrictive classification – little research has been conducted in the United States on its effectiveness as a drug. The US Food and Drug Administration has authorized a cannabis component to treat serious and rare convulsions, as well as three drugs containing synthetic cannabis-based substances; no other use has been approved.

Although it remains illegal at the federal level, 33 states and the District of Columbia authorized the medical use of cannabis. A bipartisan group of legislators proposed to legalize it for medical purposes in Wisconsinand another group of Democratic legislators introduced a bill in October to decriminalize possession of less than 28 grams. But Senate Majority Leader Scott Fitzgerald, R-Juneau, remains opposed.

A survey conducted in April by the Marquette Law School Poll revealed that 83% of registered voters surveyed were in favor of using marijuana for medical purposes with a doctor's prescription.

"When registered voters in Wisconsin support more than 70 percent of the problems, the legislature must listen and act," said Rep. David Bowen, D-Milwaukee.

Marijuana misclassified?

According to Dr. Angela Janis, Director of Psychiatry for University of Wisconsin-Madison Health ServicesSchedule I drugs, including marijuana, are considered to have no currently accepted medical use and have a high potential for abuse, while for Schedule II drugs, the potential for abuse is less and there is a therapeutic benefit.

Janis knows this distinction very well. In addition to her academic work, Janis is Chief Medical Officer at LeafLine Labs, a medical marijuana company based in Minnesota.

"To give you an idea: Methamphetamine is listed in Schedule II because it is approved for obesity." Cocaine is listed in Schedule II because it is approved for nasal surgery because it can tighten the blood vessels during nose surgery.Therefore is the bar for what is medical benefit, "said Janis.

According to Janis, cannabis has a lower potential for abuse than any of these substances.

"Cannabis is not programmed properly, and it's one of the obstacles, but not the only one, to research," Janis said.

Janis recommends reprogramming the drug so that researchers can deepen its properties. same Smart approaches to marijuana (SAM), who opposes the legalization of marijuana, supports "totally" cannabis drugs that have been approved by the FDA, said Colton Grace, a spokesman for the group.

How marijuana works in the body

According to National Institute for Combating Drug AbuseCannabinoids are substances found in cannabis plants that act on specific receptors in the human brain and body. These are the main active ingredients in medical products derived from cannabis.

These receptors affect many essential functions, including memory, thinking, concentration and coordination. Interfering with it can have profound effects, both positive and negative.

Delta-9-tetrahydrocannabinol (THC) and CBD are two of the most studied cannabinoids. However, there are dozens of cannabinoids that can also have medical uses.

"Many cannabis strains can contain 60, 70, 80 cannabinoids that interact in different ways," Janis said.

The National Institutes of Health announced that it has spent $ 191 million on cannabinoid research for medical use in 2017-18.

Some effects are already known. For example, THC can affect the central nervous system, producing benefits such as decreased vomiting and nausea, increased appetite, reduced pain and anti-inflammatory effects. CBD also acts as an anti-inflammatory, increasing immune function, reducing pain and preventing certain cells from proliferating.

Cannabinoid receptors are not found in areas that control breathing, which explains the absence of fatal overdose of marijuana, Janis said. CBD actually blocks the psychotropic effects of THC, said Janis.

In addition to all these cannabinoids, the sativa cannabis plant has a lot of other chemicals. For example, terpenes, which give each variety its particular smell, such as lemon or pine, "would have a lot of effects, but we do not know what they actually do in the body," Janis said.

An effective treatment against pain

In 2017, the National Academies of Science, Engineering and Medicine have published one of the most comprehensive reviews of scientific research on what we know of health effects of cannabis and derived products. The committee reviewed over 10,000 scientific abstracts. It resulted in nearly 100 findings and found substantial evidence for only a few indications, the most important being pain.

According to the report, there is substantial evidence that cannabis is an effective treatment for chronic pain in adults, particularly nerve pain, Janis said.

The group also found conclusive evidence of cannabis treatment of nausea and vomiting associated with chemotherapy and muscle spasm associated with MS.

The report also showed moderate evidence that cannabis or cannabinoids are effective at improving sleep in people with sleep apnea, fibromyalgia, chronic pain and multiple sclerosis.

He also found limited evidence that cannabis was effective in increasing appetite and decreasing weight loss associated with HIV / AIDS, muscle relaxation and pain related to MS, symptoms of Tourette, anxiety and post-traumatic stress disorder (PTSD).

Anecdotal evidence has also proven the effectiveness of cannabinoids in the treatment of Rett syndrome.

Norah Lowe, 10, began to feel relief after a rare neurological disease a year ago, when she started using CBD to treat her symptoms. Rett syndrome affects almost every part of a child's life, including his ability to speak, walk, eat and breathe. A distinct characteristic of the condition is the almost constant repetition of the movements of the hand.

Norah, who uses a wheelchair, experienced "increased flexibility, decreased pain and muscle cramps, increased communication, cognitive abilities, reduced seizures, better mood control, and so on. "said his father, Josh Lowe.

At a press conference organized by state representative Melissa Sargent, D-Madison, to present her latest bill aimed at legalizing marijuana for medical and recreational purposes, Lowe said that He was frustrated that state law prohibited Norah from trying marijuana for medical purposes, which helped other people with this disease. .

A 2017 study published in the Cochrane systematic reviews database analyzed several studies, concluding that cannabis-based drugs were better than placebos for pain relief – and that these drugs also improved sleep and psychological distress – he concluded their adverse effects may be greater than their adverse effects.

According to the Marijuana Policy Project, the most common conditions Accepted by states that allow cannabis for medical purposes are the relief of symptoms of cancer, glaucoma, HIV / AIDS and MS. Other common indicators include Alzheimer's disease, inflammatory bowel disease, Crohn's disease, Parkinson's disease and PTSD, according to the group, which advocates the legalization of marijuana.

In addition, the University of Michigan published a study in the February issue of Health Affairs understand why people use cannabis for medical purposes and whether these purposes are based on evidence.

The authors found that 85.5% of medical cannabis uses were for conditions for which there was substantial or conclusive evidence of therapeutic efficacy. Even more, they found that chronic pain is currently the most common qualifying condition reported by patients treated with medical cannabis. It was used by 64.9% of these patients in 2016.

"It's a good sign," says Janis. "Even though a doctor can write it (a cannabis prescription) for a variety of things, it seems to be used for what it's intended for."

Barriers to research continue

As cannabis is an Annex I drug, it is "very difficult to study at any institutional level" because, to do this, researchers need the approval of the US Drug Enforcement Agency, which "has not always wanted to provide them," said David Abernathy, vice president of data and government affairs for the United States. Arcview Group, a company that advises investors in the cannabis industry.

For this reason, "things like placebo-controlled, double-blind clinical trials were not happening in the United States," said Abernathy. But there has been a lot of research over the past decade in other countries, including Israel, Canada, China, and Italy, and "we are now starting to see more research in the United States. Unis", a-t-il déclaré.

L'examen de la recherche sur le cannabis mené par les académies nationales en 2017 a confirmé que le statut de la drogue en tant que substance de l'annexe I rendait son étude difficile. "Les chercheurs ont également souvent du mal à accéder à la quantité, à la qualité et au type de produit à base de cannabis nécessaires pour traiter des questions de recherche spécifiques", a révélé la revue.

Patty, la patiente de Crohn, pense que son traitement au cannabis a non seulement atténué les symptômes de son Crohn, mais elle lui attribue également le maintien de son cancer agressif de la peau.

According to one Article de 2018 publiées dans Biochemical Pharmacology, des études ont montré le potentiel des cannabinoïdes pour réduire la progression du cancer de la peau. Cependant, il y a un manque significatif d'études cliniques suffisamment prometteuses pour faire des déclarations concluantes pour le moment.

"Je n'ai pas eu l'huile de cannabis depuis mars 2018, et une fois que je ne pouvais plus en obtenir, je veux dire, je viens de terminer ma 12e opération (pour un cancer)", a déclaré Patty. "Alors, tu me dis, qu'est-ce que tu en penses?"

Cette histoire a été produite dans le cadre d'une classe de reportage d'investigation à l'école de journalisme et de communication de masse de l'Université du Wisconsin-Madison, sous la direction de Dee J. Hall, rédacteur en chef de Wisconsin Watch. Les collaborations de Wisconsin Watch avec des étudiants en journalisme sont financées en partie par Ira et Ineva Reilly Baldwin Wisconsin Idea Endowment à UW-Madison. L'association à but non lucratif Wisconsin Watch (www.WisconsinWatch.org) collabore avec la radio publique du Wisconsin, la télévision publique du Wisconsin, d'autres médias et l'école de journalisme et de communication de masse UW-Madison. Toutes les œuvres créées, publiées, postées ou diffusées par Wisconsin Watch ne reflètent pas nécessairement les vues ou opinions de UW-Madison ou de ses sociétés affiliées.

La liste des médicaments à base de marijuana approuvés par le gouvernement fédéral aux États-Unis est courte

La Food and Drug Administration des États-Unis n’a approuvé que quatre médicaments contenant des produits liés au cannabis; d'autres pays ont approuvé plus.

Le débat sur les effets du cannabis sur la santé se polarise depuis de nombreuses années. Ce n’est qu’au cours des deux dernières décennies que la substance a été légalement utilisée à des fins médicales. Il existe actuellement quatre produits médicamenteux liés au cannabis approuvés par la US Food and Drug Administration.

Ce sont Marinol, Syndros et Cesamet, qui contiennent des cannabinoïdes synthétiques; et Epidiolex, le premier médicament contenant du cannabis approuvé par la FDA.

Marinol a d'abord été approuvé pour traiter les nausées et les vomissements provoqués par la chimiothérapie anticancéreuse, mais comprend désormais le traitement de la perte de poids et de l'anorexie chez les personnes séropositives. Par conséquent, le médicament est un médicament de l'annexe III, ce qui signifie qu'il a un usage médicinal accepté. Syndros a été approuvé pour les mêmes indications que Marinol.

Cesamet imite les effets du THC, l’ingrédient psychotrope du cannabis. Il a été approuvé pour le traitement des nausées et des vomissements associés à la chimiothérapie. Il s'agit donc d'un médicament de l'annexe II.

Epidiolex est approuvé par la FDA pour le traitement des convulsions associées au syndrome de Lennox-Gastaut et au syndrome de Dravet, deux formes d'épilepsie sévères et difficiles à traiter. Epidiolex est un médicament de l'annexe V, la classification la moins restrictive de la Loi sur les substances contrôlées.

Certaines drogues dérivées du cannabis ne sont pas encore approuvées aux États-Unis, notamment le Sativex, une combinaison de THC et de cannabidiol.

Sativex combine des quantités égales de THC et de CBD provenant de deux extraits de cannabis. This product, which is sprayed inside the cheek or under the tongue, has been approved to alleviate the symptoms associated with multiple sclerosis, including muscle spasms and neuropathic pain. Sativex has been approved in 25 countries outside of the United States, including Canada and the United Kingdom.

The Cannabis Question is a series exploring questions about proposals to legalize marijuana in Wisconsin.

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Use Frozen Banana Instead of Sugar For Natural Sweetener

I have a tooth so sweet that it has happened to put some maple syrup on my hash browns. But two years ago, I started not feeling so good when I ate sugar: it really destroyed my stomach. At one point, I had to cut it completely – even the fruits! Instead of feeling sad about not being able to eat ice cream, chocolate or vegan dairy-free pastries, I thought I could get a sweet taste with banana once I could get it back into my diet without any problem of digestion.

Banana puree is an excellent alternative to sugar! I use extra to soften banana muffins and chocolate chips, add it to the oatmealand use it to make sugar-free cookies.

To make sure I always have enough bananas on hand, I crushed them and then frozen them in ice cube trays, making them easier to use than frozen pieces of whole bananas. I just crush two normal size bananas with a fork and spread them evenly in an ice cube tray. Then, I know that six cubes equals a banana. I put the cubes in a glass container in the freezer.

If I want to add half a banana to soften my oatmeal, I can put three microwavable cubes in a bowl or add them to the pan if I cook oats on the stove. If I prepare oats for the night, I just add the frozen cubes to the jar and thaw them in the refrigerator all night long. This is a simple way to add natural sweetness and a great way to use a large amount of ripe bananas.

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How Did a Virus From the Atlantic Infect Mammals in the Pacific?

Sea otters and seals from the Pacific Ocean, off the coast of Alaska, are infected with a virus that we previously only saw in animals from the Atlantic .

A new study suggests that ice melting in the Arctic may be to blame – and that climate change may help spread the disease to new areas and new animals.

Tracey Goldstein, a biologist at the University of California at Davis, became curious when Pacific Sea otters were tested positive for the Parkinson's disease virus by phocine – a cousin of Canine distemper virus – in 2004, two years after a major outbreak among harbor seals.

Genetic analysis showed that infections in both groups were related. Dr. Goldstein asked how a virus typically transmitted through direct contact with a sick animal had managed to pass from one ocean to another.

Until 2002, the seas around the Arctic Circle remained largely frozen, even at the end of the summer. That year however, the Atlantic Ocean and the Pacific Ocean were passable in late summer, discovered with his colleagues.

Although sea otters do not venture far from home, seals would probably have been carrying the virus from the Atlantic to the Pacific, Dr. Goldstein said.

Melting sea ice is a viable explanation for the spread of viruses – but not the only one, said Charles Innis, veterinarian and director of animal health at Boston's New England Aquarium.

"A skeptic might explain that this virus could perhaps be transmitted by an intermediate host, such as a bird capable of flying long distances," said Dr. Innis, who did not participate in the new study. "Or maybe this is transmitted in the ballast water of ships or something like that."

Even the illegal trade of pets or wild animals or contaminated meat shipped from one coast to the other could spread a virus, he added.

Dr. Goldstein and her team also examined the anti-virus antibodies in animals. There was no evidence of antibodies in tests performed before the year 2000.

In 2002, however, the new study revealed "a significant difference" in antibody levels in Steller sea lions, said Dr. Goldstein, suggesting that the animals had active infections or had healed them.

The virus of Carré phocine's disease is quite lethal in Atlantic harbor seals. Hundreds of harbor seals and gray seals were found dead in 2018 along the New England coast, from Massachusetts to Maine, due to infections with distemper and influenza.

But harp seals seem to be better able to survive the phosphaine, says Dr. Goldstein, and could serve as a reservoir – the ecological niche in which the infection persists. Epidemics can begin when a sick Greenland seal comes into contact with a gray seal.

Epidemics seem to happen in cycles, said Dr. Goldstein, because animals develop immunity to infection. Every five to ten years, as new seals and otters are born and immunity decreases, the population becomes vulnerable again and another outbreak occurs.

The new study identified a second wave of viral antibodies in 2009 in several seal species, including ice seals, fur seals and Steller sea lions. The current study ended in 2016 and it is therefore unclear whether the virus has spread since then, said Dr. Goldstein.

But she fears that another cycle of infection is not far off. "These channels in the ice seem to be open every year, so these rare events could become more frequent," she said.

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