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A new study from North Carolina State University and Duke University offers insights into the ways that education, work and motherhood shape the lives of women in the United States. In a longitudinal study of more than 8,100 women, the researchers found seven “pathways” that illustrate the way major life events can have long-term ripple effects.
“Our goal here was to examine how family, work and education influence each other in the lives of women, rather than viewing education as a separate process from work and family,” says Anna Manzoni, co-author of a paper on the study and an associate professor of sociology at NC State. “Our approach highlights the fluidity of education in many women’s lives, and challenges the idea that completing one’s education and transitioning from school to a full-time job are essential elements of how we define adulthood.”
For the study, researchers examined data from 8,101 women who participated in the National Longitudinal Study of Adolescent to Adult Health, which is a nationally representative panel study that followed people in the United States from youth through adulthood.
The researchers then conducted analyses of these data to find patterns and subgroups among study participants, which helped them identify distinct pathways or commonalities among subgroups. The researchers also assessed the extent to which these pathways related to the race and socioeconomic class of the study participants.
“We found that women’s lives tend to take one of seven pathways, with six of those pathways broadly defined by when or if women become parents,” Manzoni says. “These pathways really underscore the extent to which specific life events, opportunities or constraints can shape later patterns in women’s lives. However, it’s important to recognize that there are notable nuances in the way women’s lives end up unfolding in more ways than one.”
The first three pathways all include women who became parents between the ages of 18 and 25: Early Mothers with High School Interrupted (making up 13.29% of participants); Early Mothers with Limited Education (13.01%), which refers to women who obtained a high school diploma or GED; Early Mothers with Continuing Education (19.31%).The second three pathways include women who got college degrees by the time they were 25: College then Work Focused (11.95%); College then Family Focused (8.97%); and Graduate Degree Professionals (13.31%).The seventh pathway was Independents with Continuing Education (20.17%), which is largely made up of women who pursue education at community colleges and vocational schools into adulthood and are unlikely to marry or have children until they are in their 30s and 40s.

Thousands of people could be spared from a hip fracture each year if a new method to identify the risk of osteoporotic fractures were to be introduced in healthcare. This is the view of the researchers at Lund University in Sweden who are behind a new 3D-simulation method. The results were recently published in the Journal of Bone and Mineral Research.
Osteoporosis causes 120,000 bone fractures in Sweden every year — including 18,000 hip fractures — and half of all those affected will sustain more fractures. The condition entails a reduction in bone density, a weakening of bone structure and an increased risk of fractures. Osteoporosis mainly affects the elderly.
Current method misses around half of those at high risk
The current diagnosis technique for osteoporosis is a bone density measurement — a 2D X-ray examination that in general is first used once the patient has already sustained a fracture.
However, measurement of the skeleton’s bone density does not detect all those with a high risk of a fracture and around half of the people in the risk zone are missed, points out Hanna Isaksson, professor of biomedical engineering at Lund University’s Faculty of Engineering (LTH).
“Up to now there have been no reliable methods for identifying the condition at an early stage, importantly before the first fracture occurs,” she says.
A greater percentage of those with a high risk of sustaining a hip fracture could be identified using a new calculation and simulation method that Hanna Isaksson and her research colleagues have developed. This was shown in the results of a study that evaluated the method based on patient data from 2,000 people — the results were recently published in the Journal of Bone and Mineral Research.
“Using the new model, we could identify around 1,000 more people per year with a high risk of hip fracture. The results suggest that the method can also be used to identify osteoporosis before the first fracture occurs,” says Hanna Isaksson.

HIV anti-retroviral therapy is considered a treatment and not a cure because patients usually carry a reservoir of HIV-infected cells that can re-emerge if treatment stops. These reservoirs have long been thought to be dormant, but two independent groups of researchers report in the journal Cell Host & Microbe on September 13th that a subset of these cells spontaneously produce HIV RNA and proteins that may impact patients’ HIV-specific immune responses.
“It’s a deceptively dormant virus,” says immunovirologist Daniel Kaufmann of the University Hospital of Lausanne, the University of Lausanne, and l’Université de Montréal, who is senior author on one of the papers . “Even in people who are treated, HIV continues to have some activity, and it continues to interact with the immune system. We have to understand if these ongoing interactions have clinically relevant consequences.”
Previous studies have shown that when “dormant” HIV reservoir cells are reactivated in the lab, they produce viral RNA and proteins, but it wasn’t clear whether this phenomenon was happening inside the bodies of people with HIV. “We wanted to understand if this phenomenon is real and, if it is, what parts of the virus are being expressed and do they have an impact on the immune system,” says Kaufmann.
To do this, the researchers took blood samples from 18 people with HIV who had all had been on anti-retrovirals — drugs that block HIV growth without actually killing the virus — for more than 3 years. Then, they used a lab method called RNA flow cytometry to sort CD4+ or “helper” T cells (the type of cell that HIV selectively infects) based on whether they were infected with HIV and, then further, whether they were actively producing HIV RNA or proteins. The researchers also characterized the T cells by role — e.g., whether they were the type of T helper cell that combats intracellular viruses or the type that combats extracellular bacteria — to determine whether any subtypes of CD4+ T cells were more likely to host HIV reservoirs.
“Our technique allows us to look at the individual cells to see if they contain the virus and which parts of the virus they are expressing,” says Mathieu Dubé, an immunovirologist at l’Université de Montréal and first author on the paper led by Kaufmann. “For each patient, we could estimate how many of these cells are still active, and we could also look for associations between viral characteristics and cell characteristics.”
The researchers found that 14 of the 18 patients had HIV reservoirs that spontaneously produced viral RNA. For 7 of the 18 patients, the viral reservoirs also produced viral proteins including p24, a component of HIV’s shell.
“Most of the virus that remains in the body is defective or junk virus that cannot really multiply, but we found these defective viruses can still produce virus RNA and sometimes proteins,” says Kaufmann.

The agency now must decide whether products containing the ingredient, like some Sudafed and NyQuil products, should no longer be sold or perhaps give companies lead time to substitute other ingredients.An advisory panel to the Food and Drug Administration agreed unanimously on Tuesday that a common decongestant ingredient used in many over-the-counter cold medicines is ineffective.The panel’s vote tees up a likely decision by the agency on whether to essentially ban the ingredient, phenylephrine, which would result in pulling hundreds of products containing it from store shelves.If the F.D.A. ordered their removal, a trade group warned that numerous popular products — including Tylenol, Mucinex and Benadryl cold and flu remedies — might become unavailable as companies race to reformulate them.Agency officials generally follow the recommendations of the advisory panels, though not always, and it could take some months before a final decision is made. And the findings could be contested, prolonging any move toward product substitutions or removing certain stock at stores.In the meantime, experts advised consumers not to panic or toss out all the drugs in their medicine cabinet. Even though the agency’s advisers have decided the ingredient, phenylephrine, doesn’t work to relieve nasal congestion when taken orally, it is not dangerous, and the products do contain other ingredients that will work to ease cold symptoms.The panel’s vote followed its review on Monday and Tuesday of several existing studies, with the advisers largely concluding that the research settled the question that the ingredient was useless and no better than a placebo.Several advisers noted that patients taking the drug were merely delaying their journey to a useful remedy.“I think we clearly have better options in the over-the-counter space to help our patients, and the studies do not support that this is an effective drug,” said Maria Coyle, the chairwoman of the panel and an associate professor of pharmacy at Ohio State University.“If you have a stuffy nose and you take this medicine, you will still have a stuffy nose,” said Dr. Leslie Hendeles, a pharmacist from the University of Florida in Gainesville who, along with colleagues, first petitioned the F.D.A. in 2007 to remove the drug from the market.Every cold and flu season, millions of Americans reach for these products, some over decades. The decongestant is in at least 250 products that were worth nearly $1.8 billion in sales last year, according to an agency presentation. Among the products: Sudafed Sinus Congestion, Tylenol Cold & Flu Severe, NyQuil Severe Cold & Flu, Theraflu Severe Cold Relief, Mucinex Sinus Max and others.There are two main oral decongestants in products on store shelves — phenylephrine and pseudoephedrine.Under old, outdated agency standards, phenylephrine, which constricts blood vessels in the nasal passages, had long been considered safe and effective, and the F.D.A. still says that it is safe.Nasal sprays that contain the ingredient are still considered effective, as well as when it is used in surgery or to dilate the eyes. Nasal sprays containing another ingredient, oxymetazoline, are also effective for a stuffy nose.Other medicines to ease congestion for the common cold include those containing oral pseudoephedrine, and for hay fever or allergic rhinitis, nasal steroids, such as Flonase, as well as nasal antihistamines and oral pseudoephedrine.Many popular cold and flu products that don’t specifically target congestion do not include the ingredient.If the agency decides the decongestant should be eliminated from products, it could significantly disrupt the market for the makers of cold medicines if they do not have enough time to replace it in popular items.What’s more: It could possibly renew widespread use of an alternative, pseudoephedrine, whose sales are restricted — placed behind store counters or in locked cabinets because it was often used in illicit meth labs.As a result, buying pseudoephedrine products can be a clunky, time-consuming process. Even though they don’t require a prescription, they are kept out of customers’ reach, the number of tablets that can be purchased at one time is capped, and consumers must be 18 or over and show identification.There are also side effects associated with pseudoephedrine, which can raise blood pressure, and cause jitters and wakefulness, Dr. Hendeles said.This issue has been simmering at the F.D.A. for decades.Now an emeritus professor, Dr. Hendeles said in an interview on Tuesday that he had been evaluating the ingredient since 1993.“The bottom line is quality research has told the true story about phenylephrine,” he said.For consumers, the potential benefits of ending use of the ingredient, the agency suggested, would include avoiding unnecessary costs or delays in care by “taking a drug that has no benefit.”Although there is no known health risk associated with taking a combination cold medicine that contains phenylephrine, consumers unable to get relief from a single dose should not take additional doses in a short span of time to feel better. Higher levels of the other ingredients may be dangerous when taken in excess, experts cautioned.The Consumer Healthcare Products Association, which represents companies that make over-the-counter drugs, took issue with the panel’s recommendation on Tuesday, issuing a statement that the ingredient was both safe and effective. The organization said pulling the ingredient would have the “negative unintended consequences” of sending patients to doctors and pharmacists for problems they might otherwise treat themselves — or of getting no treatment at all.“Simply put, the burdens created from decreased choice and availability of these products would be placed directly onto consumers and an already-strained U.S. health care system,” according to the statement from Marcia D. Howard, the group’s vice president of regulatory and scientific affairs.It could be a while before any changes are announced.But the agency has already shown its hand, by declaring the ingredient ineffective. But now, F.D.A. officials will mull the comments and opinions of its panel experts before preparing a final decision.As often happens whenever the F.D.A. is poised to impose a regulatory move that will affect the bottom line of major corporations, efforts to delay a decision, including lawsuits and lobbying Congress and the White House, will probably occur. The agency also may give the drug companies a grace period to swap ingredients in products, if required.

The human microbiome includes the genetic material of more than 100 trillion tiny microorganisms — fungi, yeast, bacteria, and even viruses, most of which hang out in our gastrointestinal tract to serve as guardians of our health. But when a healthy microbiome gives way to an imbalance — a “pathobiome” — any number of health problems can occur — from rheumatoid arthritis, to bacterial vaginosis. New data published this month in the journal Frontiers in Cellular and Infection Microbiology, from researchers at Drexel’s College of Medicine, gives more evidence to the possibility that developing a pathobiome in the brain could cause some forms of Alzheimer’s and related dementias.
When biomes turn unhealthy, either by invasion of outside pathogens, or a major change in the relative numbers of the microbial species present, a dysbiosis, or imbalance in the microbiota, occurs. This dysbiosis can alter human metabolism and cause inflammation, which has been linked to the tissue damage seen in ulcerative colitis, rheumatoid arthritis and many other chronic inflammatory diseases.
Studying 130 samples from the donated brains of 32 people — 16 with Alzheimer’s and 16 age-matched controls without the disease, the Drexel researchers found bacterial flora in all the brains — but the Alzheimer’s brains showed profoundly different bacterial profiles compared to their age-matched controls.
The group used full-length 16s ribosomal RNA gene sequencing, a technique that can detect any and all bacterial species present in a sample. In this process, the researchers pinpointed disease-specific sets of bacteria in almost all of the Alzheimer’s-affected brains, suggesting these groups of bacteria are strong predictors of the disease.
The authors detected five brain microbiomes, four that are hypothesized to be present at different times in the evolution of the Alzheimer’s-afflicted brains. The authors said it is likely that the observed Alzheimer’s microbiomes evolve to become more pathogenic as the disease progresses with the later stages characterized as a pathobiome. The authors hypothesize that the brain begins with a healthy biome, but as the disease develops, the healthy biome is supplanted as a new set of microbes replace the original healthy ones with the eventual emergence of the Alzheimer’s pathobiome.
Samples from both sets of brain samples were drawn from the frontal and temporal lobes and entorhinal cortex. Based on the random distribution of microbiomes requiring delivery all over the brain, the results were consistent with failure in one or more of the brain’s networks; however it too soon to tell if the observed distribution patterns result from a leaky blood-brain barrier, the brain’s glymphatic system, or synaptonemal transmission that allowed bacteria, including Cutibacterium acnes (formerly called Proprionibacterium acnes), Methylobacterium, Bacillus, Caulobacter, Delftia, and Variovora to enter the brain. In Alzheimer’s brain samples, the researchers noted, these pathogenic bacteria appeared to have overpowered and replaced Comamonas sp. bacteria, which are associated with a dementia-free brain.
“Perhaps destruction of the Comamonas bacteria, part of a healthy brain microbiome, is the first sign of impending dementia,” said Garth D. Ehrlich, PhD, a professor in the College of Medicine, who was a senior author of the paper. “We’re now coming up with the questions to guide future studies, but the hypotheses are many. The culprit could be bacteria or something else — like fungi, parasites, or viruses — at the same time.”
When a patient has Alzheimer’s, they experience inflammation in the brain characterized by deposits of amyloid beta which are formed by an increase in the production of the A? peptide (an antimicrobial peptide, which is part of the innate immune response) resulting in amyloid plaques in the brain. Similarly, Alzheimer’s is characterized by tau protein tangles found with the cells which are characterized by abnormal phosphorylation which ultimately lead to the destruction of synapses and neurons, but which have also been demonstrated to help stop the spread of pathogens in the brain.

An infectious diseases surveillance system created by University of Pittsburgh School of Medicine scientists and deployed at a UPMC hospital successfully flagged cases of a drug-resistant infection spread by eye drops months before national public health officials announced an outbreak.
The findings, published today in The Journal of Infectious Diseases, were obtained through a hospital-based program called Enhanced Detection System for Healthcare-Associated Transmission (EDS-HAT). They demonstrate the potential of this technology to detect and stop nationwide outbreaks sooner.
“Our study really showcases the utility of whole genome sequencing surveillance,” said senior author Daria Van Tyne, Ph.D., assistant professor in Pitt Medicine’s Division of Infectious Diseases. “If more hospitals were to use EDS-HAT or a similar increasingly accessible technology, they could head off outbreaks within their walls much faster. And if multiple hospitals share this data with each other and public health authorities, then national outbreaks could be stopped in their tracks.”
Whole genome sequencing allows scientists to see the unique DNA “fingerprints” of pathogens in a sample from a patient with an infection. When the genetic code from two different patient samples is very closely matched, it means either one patient somehow gave the infection to the other or they both got it from the same source, indicating an outbreak.
UPMC, a nonprofit health care provider with hospitals in Pennsylvania, New York and Maryland, is the only U.S. hospital system that Van Tyne is aware of using whole genome sequencing in this way.
On February 1, 2023, the U.S. Centers for Disease Control and Prevention issued an advisory warning of an outbreak of a drug resistant strain of the bacteria Pseudomonas aeruginosa that was linked to use of artificial tears. Dozens of cases in 13 states had been found, with at least one death and multiple cases of permanent vision loss. In April 2023, CDC released the genetic code for the outbreak strain.
At that point, Alexander Sundermann, Dr.P.H., lead author of the study and assistant professor in Pitt Medicine’s Division of Infectious Diseases, compared the CDC’s newly released code with whole genome sequencing results kept on file from UPMC’s surveillance. He got a match.

Published46 minutes agoShareclose panelShare pageCopy linkAbout sharingImage source, Getty ImagesBy James Gallagher and Michelle RobertsBBC HealthMPs will investigate the sexual harassment and sexual assault of female surgeons taking place within the NHS. BBC News reported women being sexually assaulted even in the operating theatre, while surgery took place.And the first major report into the problem found female trainees being abused by senior male surgeons.The Health and Social Care Committee said it would look into the issue and its chair, Steve Brine, said the revelations were “shocking”.”The NHS has a duty to ensure that hospitals are safe spaces for all staff to work in and to hold managers to account to ensure that action is taken against those responsible,” Mr Brine said.”We expect to look into this when we consider leadership in the NHS in our future work.”Warning – this story contains some graphic detail. There is support for anyone affected here.Female surgeons have been fondled inside their scrubs, had male surgeons wipe their brow on their breasts and had men rubbing erections against them. Some have been offered career opportunities for sex or even been raped.The British Medical Association (BMA), the doctors’ union, called the treatment of women surgeons “atrocious” and the Royal College of Surgeons of England said it was clear the problem was “common” and this was a “source of great embarrassment” to the profession.Dr Latifa Patel, from the BMA, said: “It is appalling that women in surgery are being subjected to sexual assault and sexual misconduct from their colleagues, at work and often whilst they are trying to care for patients. “The impact this will have on their wellbeing for years to come as well as their careers is profound.”‘Ground against me’Image source, BBC NewsRetired surgeon Dr Liz O’Riordan says she experienced years of sexual harassment during her career: “That ranged from being in an operating theatre where the consultant asked me who I was having sex with and then propositioned me, to being at a Christmas party and a married consultant from another hospital came up to me, ground his erection against me and said ‘it’s not cheating if I kiss you on a dance floor’.”Afterwards, so many times I wanted to speak up but as a trainee surgeon your career depends on that man or woman harassing you, letting you operate, giving you operating time, saying you’ve reached all the competencies.”Former surgeon wants NHS MeToo movementHer experiences chime with the findings of a large survey of over 1,400 surgical staff – half of them women – published in the British Journal of Surgery and commissioned by the independent Working Party on Sexual Misconduct in Surgery.Nearly two-thirds of women surgeons who responded to the researchers said they had been the target of sexual harassment and a third had been sexually assaulted by colleagues in the past five years.Women said they feared reporting incidents would damage their careers and they lacked confidence the NHS would take action.’Why is his face in my cleavage?’Judith asked that we use only her first name. She is now an experienced and talented consultant surgeon.Image source, Credit: Jonathan SumbergShe was sexually assaulted early in her career when she was the person with the least power in the operating theatre – and a senior male surgeon was sweating.”[He] just turned round and buried his head right into my breasts and I realised he was wiping his brow on me.”You just freeze right, ‘why is his face in my cleavage?'”When he did it for a second time Judith offered to get him a towel. The reply came back “no, this is much more fun”, she says, “and it was the smirk – I felt dirty, I felt humiliated”.Another theme that emerged in the data was a lack of faith in bodies – such as NHS Trusts, the General Medical Council (which manages the UK’s register of doctors allowed to practice) and the Royal Colleges (which represent specialities in medicine) – to tackle the problem.Dr Binta Sultan, from NHS England, said the report made “incredibly difficult reading” and presented “clear evidence” that more action was needed to make hospitals “safe for all”.The Department of Health issued a statement making clear that sexual violence was “unacceptable” and had “no place in the NHS”.More on this storyFemale surgeons sexually assaulted while operatingPublished9 hours agoNHS needs MeToo moment, says former surgeonPublished11 JulyRelated Internet LinksBritish Journal of SurgeryThe BBC is not responsible for the content of external sites.

Published47 minutes agoShareclose panelShare pageCopy linkAbout sharingBy Alastair Fee & Ben MooreBBC NewsA high-profile government climbdown which legalised a type of cannabis medicine on the NHS five years ago misled patients, campaigners say.It was thought the law change would mean the unlicensed drug, which treats a range of conditions, could be freely prescribed by specialist doctors.But fewer than five NHS patients have been given the medicine, leaving others to either pay privately or miss out.The government says safety needs to be proven before a wider rollout. Legalisation of whole-cannabis medicine was hailed as a breakthrough for patients – giving either NHS or private specialist doctors the option to prescribe it if they believed their patients would benefit.Medical whole cannabis uses the entire cannabis plant – which includes the compound THC, the part which can make people feel high.But patients are being turned away, say campaigners, because doctors often do not know about the medicine, which is not on NHS trusts’ approved lists. Some specialists who do know about it say there is insufficient evidence of the drug’s safety and benefits to support prescribing. The drug would need to undergo medical trials before it could be officially licensed – but these are costly and complicated because of the many chemical compounds within the cannabis plant. Campaigners say trials of medicines containing whole plant cannabis, particularly with the aim of helping children, would be unethical as some patients would have to come off essential medication to take a placebo.Cannabis: Prescription Pot Luck?Five years after medical cannabis was legalised, why is it so hard to get a prescription?Watch now on BBC iPlayer (UK Only) The BBC has been told that when specialist doctors do want to prescribe the unlicensed products, there is no simple way to get funding.They have to ask NHS England to make an exception to pay for individual cases, but they are almost always turned down. It is known that fewer than five have been approved.Licensed cannabis drugs do exist for specific conditions – but they do not use the whole plant. For example one called Epidiolex contains another cannabis compound – CBD. It can be prescribed for epilepsy but does not benefit patients across the spectrum of epilepsy disorders. ‘I felt like I changed history’The first patient to receive an NHS prescription for medical cannabis was 11-year-old Alfie Dingley, who has severe epilepsy. His mother, Hannah Deacon, from Kenilworth in Warwickshire, successfully spearheaded the high-profile campaign which led to the 2018 legislation change.Before then, Alfie travelled to the Netherlands where whole-plant cannabis oil is legal under prescription for medical purposes. Following Hannah’s campaign, Alfie’s GP was granted a licence to prescribe it under direction by a specialist doctor, in a process called a shared care agreement.Alfie’s mother believes the treatment has been life-changing – he has not had a seizure for three years. He gets 13 bottles of Bedrolite on an NHS prescription each month. The cost would otherwise be £225 per bottle.Hannah says back in 2018, she felt like she had changed history, opening up the treatment to people with a wide range of debilitating conditions including chronic pain, insomnia and neurological conditions like Tourettes.But now, she feels she only got the drug on the NHS because she made a huge fuss in the media.”I think they changed the law to take the wind out of my sails because the campaign was very effective,” she says. ‘Parents clamouring’Senior paediatric consultant Dr David McCormick, from King’s College Hospital in London, says it was “disingenuous” of the government to suggest in 2018 that NHS prescribing was ready to take place. Ministers “shifted the heat” to practitioners like him, he says.”Parents were clamouring at our door, or phoning all the time, as they believed we were able to prescribe and that was not the case.”The message went out, ‘doctors can now prescribe cannabis products’ and that put us in a difficult position, because in truth we need to apply for that to be approved by NHS England.” £1,600 for a six-week supplyPre-2018, the only way patients could get hold of cannabis products and use them medicinally was to buy them illegally in the UK, or to travel abroad to get them. Now, if the NHS will not pay, they can legally pay for private prescriptions from specialist clinics.There are now 31 private prescribing centres across the UK. These clinics issued more than 140,000 prescriptions between November 2018 and 2022. It is estimated that the medical cannabis market will be worth £1bn in 2024. One private patient is 13-year-old Jasper Salisbury-Jones, from Brixton in south London, who – like Alfie Dingley – has a rare form of epilepsy. “By the time he was 11, he was having about 800 seizures a day, which sounds ridiculous but that was where we got to,” says Jasper’s mum, Alice Jones. “The doctors did say we were out of options, so the expectation was that eventually a seizure would kill him.”Jasper had tried nine different other medicines, had brain surgery, and an electrical implant was put in his chest – but nothing would stop his fits. Then he tried medical cannabis oil and his mother says his seizures, which once dominated his life, now only occur every few days. “It’s just jaw-dropping,” Alice says. “For this medication to do this is incredible.”Jasper has been unable to get medical cannabis on the NHS. His parents now pay a private clinic £1,600 for a six-week supply. That cost is likely to increase as Jasper gets older and bigger.The couple are using their savings to pay for the medication and Alice no longer pays into her private pension. While they say it is financially very difficult, she knows they are lucky. “We’re not choosing between this and another medication or a form of treatment, we’re choosing between this and watching my son slowly slip into mental disability and then probably paralysis and death,” she explains.’Esme’s being denied’But one parent who cannot get an NHS prescription – or afford to pay for one privately – is Carly Ashton, an ex-social worker from Christchurch in Dorset.Her two-and-a-half-year-old daughter Esme has an extremely rare form of epilepsy that affects one in 600 children worldwide. Esme has been treated with 15 different drugs and currently spends much of her life sedated.Carly has been warned that if her condition is not brought under control, Esme could die suddenly from a seizure.”Ultimately they could become more violent, they could cause broken bones, multiple hospital admissions, it could cause her to die in her sleep,” she explains. She finds the situation very unfair, knowing there are children with the same condition who say they are benefitting from taking a form of medical whole cannabis. “They are almost seizure-free or [entirely] seizure-free. It’s given their life back. Esme’s being denied that opportunity,” she says.Hannah Deacon says she is heartbroken that legislation she fought for has not led to the hoped-for change. “I find it shocking that the government has literally just washed their hands of this problem,” she says. The Department of Health and Social Care (DHSC) said in a statement: “Licensed cannabis-based medicines can be funded by the NHS where there is clear evidence of their quality, safety and effectiveness.”It is important to carefully review evidence on unlicensed cannabis-based treatments to ensure they are proved safe and effective before they can be considered for roll out on the NHS more widely.”The government also adds that if a funding request for this medicine is not approved by an independent panel of experts, it cannot intervene in that decision.The BBC contacted NHS England but it declined to comment, stating only that the DHSC response was “robust”. In Scotland, health boards would make the decision on whether to fund a specialist’s request for a prescription. NHS Wales said: “Where an NHS healthcare professional wishes to prescribe these products arrangements are in place for the NHS to consider, and where appropriate, meet their cost.” Northern Ireland offers advice for NHS patients. The National Institute for Health and Care Excellence’s (NICE) guidelines state it recommended research into the use of unlicensed cannabis-based medicines for severe treatment-resistant epilepsy. The body, which is responsible for deciding which drugs and treatments should be available to patients on the NHS, said there was insufficient evidence of the medicines’ safety and effectiveness to recommend it for the whole population of people with the condition. But it added that this should not be interpreted by doctors as meaning they were prevented from considering the medicines where clinically appropriate. It says they can be prescribed on advice of a specialist, in consultation with the patient. Edited by Sarah BellMore on this storyCannabis products available on prescriptionPublished1 November 2018Plea for more families to get cannabis treatmentPublished2 November 2021

A standard chemotherapy drug injures surrounding non-cancer cells, which can then awakens dormant cancer cells and promotes cancer growth, according to a new study publishing September 12 in the open access journal PLOS Biology by Ramya Ganesan of Emory University, US, and colleagues. The finding is important for understanding cancer recurrence and may point to important new targets to prevent it.
Advances in cancer treatment, including chemotherapy, have dramatically reduced mortality for many types of cancer, including breast cancer. Nonetheless, up to 23% of breast cancer patients experience recurrence within the first five years. Treatment is meant to kill all cancer cells, but often, some cells enter a state of dormancy, in which they stop dividing and become unresponsive to chemotherapeutic agents. Recurrence occurs when dormant cells re-awaken and start dividing again.
Some studies have indicated that chemotherapy itself may promote escape from dormancy, but the mechanism of this effect has not been clear. To explore that question, the authors worked with both a cell model and a mouse model of breast cancer. Importantly, the cell model contained both cancer cells and non-cancer stromal cells, connective tissue cells that are found in breast and other tissue. They administered the chemotherapy drug docetaxel at physiologically relevant concentrations, and found that even at very low doses, stromal cells were injured, while cancer cells were not, and that treatment induced cell-cycle reentry in cancer cells.
The driver of this reawakening of dormant cells, the authors showed, was release of two key cell signaling molecules, granulocyte colony stimulating factor (G-CSF) and interleukin-6 (IL-6) by the injured stromal cells, which acted on the dormant cells to promote their growth, both in vitro and in vivo. That provided the team with potential anti-cancer targets, and they showed that antibodies that neutralized either G-CSF or IL-6, or a drug that blocked the mediator of those signals within cancer cells, inhibited awakening from dormancy due to docetaxel treatment.
These findings have several important implications. First, they highlight the importance of surrounding cells, not just the cancer cells themselves, in determining the response to chemotherapy. Second, they provide a possible mechanistic foundation for the observation that high serum levels of IL-6 are associated with early recurrence in breast cancer patients receiving chemotherapy, potentially strengthening the utility of that biomarker in planning treatment. Third, they provide new targets for preventing recurrence.
Dr. Ganesan and Dr.Sukhatme add, “Our paper highlights a deleterious effect of cancer chemotherapy: release of stromal IL-6 and G-CSF by taxane chemotherapy awakened dormant breast cancer cells, a postulated mechanism for tumor relapse. Transient blockade of cytokine signaling during chemotherapy administration may prevent tumor recurrence.”

While life expectancy rates for older Americans are rising, nearly 40% of adults report living with a digestive disease of some kind.
“Many people don’t realize that these conditions are very common in ambulatory care,” said Michigan Medicine gastroenterologist Shirley Ann Cohen-Mekelburg, M.D., who specializes in conditions like inflammatory bowel disease, Crohn’s disease and ulcerative colitis.
“Ultimately, this creates an excess in health care spending in the United States. Not only are these conditions debilitating for the millions of people living with them, but they’re also very expensive to treat.”
Cohen-Mekelburg says that in recent years, there has been a greater emphasis among providers in detecting why so many Americans are developing digestive diseases.
However, she notes that current approaches often fail to consider how things like psychosocial factors contribute to these conditions.
“As physicians, it’s important for us to pay attention to psychosocial factors involved in the lives of our patients, but they often go overlooked,” she said.
“These factors have the potential to significantly impact gastrointestinal health, and they also play a crucial role in the overall wellbeing of our patients.”
This notion inspired Cohen-Mekelburg and a team of fellow gastroenterologists and hepatologists to examine the rates of loneliness, depression and social isolation in older adults both with and without digestive diseases.