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Elvie: $42M Raise in Female Care Space


Pregnancy often causes a weakness of pelvic muscles  



The female-led startup called ELVIE, developed two main products. The first helps strengthen pelvic muscles, and the second, is to  help during pregnancy.

“Whether it’s menstruation, pregnancy or menopause, women’s bodies have been shrouded in taboo for centuries. We know so many issues of womanhood can be improved by technology, and there is so much potential in this space,” Tania Boler, CEO of Elvie, said in a statement.



It’s an Elvie Trainer,app-connected pelvic trainer women wear while doing Kegel exercises.


The Elvie Trainer app lets users visualize their pelvic floor movements with biofeedback, while the user performs the exercise. Each session is designed to be fun and lasts 5- min.

The small pebbled-shaped pod, is inserted into the vagina like a tampon, connects to a phone app that guides you through the 5-min. workouts to strengthen and tone your pelvic floor. It now has more than 1,000 health professionals around the world recommending it.



The exercises are often recommended for people with incontience, which most times are women who have gone through childbirth, but obesity or constant coughing may also weaken pelvic floor muscles.

See Pregnancy, childbirth, obesity, and constant coughing weaken pelvic floor muscles.


Kegel exercises are linked to better core strength, improved back & abdominal strength.





The second product is the Elvie Pump, a smart breast pump to help women who breast feed post-pregnancy.  It’s silent and worn inside of a standard nursing bra.


It comes with a connected app, which lets moms monitor the volume of their milk in real time. It tracks the pumping history on each breast, and is designed to switch from stimulation to expression mode when it detects let down. It will also stop when the bottle is full.


Femtech has become a growing piece of the digital health market, and connected breast pumps are becoming more plentiful on the market.

A number of breast pumps launched at last year’s CES. This included Willow, a handsfree breast pump that connects to the user’s phone so they can see what is happening while they pump, and Sonata Smart Breast Pump, which lets users track their sessions as well as gives educational information about breast feeding.

There’s also one other pelvic floor coach on the market.  In 2015a smartphone-connected device called PeriCoach, that helps women with pelvic floor exercises was approved by the FDA.


The latest round of Series B funding was led by IPGL with participation from Octopus Ventures and Impact Ventures UK.

The raise will be put towards research and development for the two products in the Americas, Europe and Asia.
We are delighted to have the support of Michael Spencer on our journey to create extraordinary products that improve women’s lives. This financing will enable us to continue innovating, while driving global scalability to meet customer needs.” –
Tania Boler, CEO, Elvie
Questions/Comments? Let us know.
NewsMD: What’s Hot in Health is a division of Healthy Within Network
contact: maria.dorfner@yahoo.com

Safe Cooking Temps Prevent Infections

In March, more than 100 people fell ill from an E. coli outbreak that federal health officials now say is linked to ground beef. Here’s information your can use year round to keep you safe from E-coli, Trichinosis, and Salmonella.


Before cooking any type of meat, you must find out what internal temperature must be reached for the meat to be safely eaten. This is important for several reasons.

plate chicken food salad
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The first, and most important, is that you don’t want to give anyone food poisoning or a food-borne illness by undercooking the meat, or leaving the meat in the ‘Danger Zone.’

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The second is because you want to ensure that you are cooking your meat to your desired doneness (i.e. rare, medium-rare, medium, etc.) and not overcooking it.

Safe Internal Meat Temperatures

  • Beef roasts 145 F
  • Leg of lamb 145 F
  • Whole chicken 165 F
  • Chicken pieces (breasts or thighs)165 F
  • Duck or goose 165 F
  • Turkey 165 F
  • Veal 145 F
  • Pork roast or tenderloin 145 F
  • Ground pork 160 F
  • Fresh ham 160 F
  • Fully cooked ham 140 F
  • Fish 145 F

Food Danger Zone

So, what is the ‘Danger Zone?’ According to foodsafety.gov, the ‘Danger Zone’ is when foods are held between 40 F and 140 F for two or more hours.

Food should never be held at these temperatures because most bacteria will quite happily reproduce in that range.

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These bacteria can cause food poisoning and food-borne illnesses, which in turn can make you very sick.

These bacteria reproduce very slowly, if at all, below 40 F and above 140 F. But note that the temperatures at which bacteria are killed vary according to the microbe.

For example, salmonella is killed by heating it to 131 F for one hour, 140 F for a half-hour, or by heating it to 167 F for 10 minutes. When it comes to killing microorganisms, both heat level and time affect the equation.

E-coli, Trichinosis, and Salmonella

There’s also the issue of where the contamination is found. E-coli lives in the intestinal tract of animals, not the flesh.

animal chicken cockerel countryside
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The danger is that in the process of butchering a cow or chicken, some of the contents of the intestinal tract may contaminate the exposed flesh.

That’s why it’s relatively safe to sear a steak over high heat and still eat it rare or medium rare (125 to 135 F).

That’s also why all ground meat should be cooked to 160 F because the external flesh and internal flesh are mixed together during grinding.

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Trichinosis, which is a multi-celled parasite and not a bacterium, lives in the muscles and so searing the outside of, say, a pork chop won’t kill any organisms in the meat, though it will taste better.

Trichinosis is killed at 135 F, so it’s safe to eat pork if it’s cooked to at least 140 or 145 F. Though do remember, if the pork is ground, it should be cooked to 160 F.

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Salmonella can sometimes inhabit the meat of poultry, so cooking chicken and turkey to at least 160 F is wise.

Salmonella can also inhabit eggs and so there is a risk with soft-boiled eggs, omelets, and scrambled eggs if any part of the egg is left undone, like the yolk. Hence why pregnant women are advised not to eat these types of eggs.

bowl of fried food and fried egg
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Cooking Meat at Low Temperatures

It’s safe to cook meat and vegetables at low temperatures for longer periods or higher temperatures for shorter periods. And it’s almost always safer to sear meat over high heat before cooking it at lower temps.

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For low-temperature cooking both for roasts and braises, it’s a good idea to brown the meat first over medium-high heat (about 350 F) and then follow the recipe for cooking at a low temperature for a longer period of time.

Toxicity Factor

Heat alone isn’t the only element in preventing food poisoning. There’s also a toxicity factor. Some bacteria are simply more toxic than others, and some toxins hang around after the bacteria is dead.

Most people with healthy immune systems can ingest a bit of salmonella or listeria and their systems will kill it off without them even noticing.

Botulism toxins, though, are highly potent and dangerous, and even a small dose of the bacteria can have significant effects.

steaks and skewered sausages on grill
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Botulism occurs mostly in improperly canned goods, but can also appear in homemade sausage. Never take a chance on something that might contain botulism.

USDA Food Safety Guidelines

If you want to be exceptionally safe, follow the USDA food safety guidelines and cook everything to at least 160 F.

Again, never hold hot food below 140 F, and make sure to cool food you’re going to refrigerate quickly to at least 40 F, so that you aren’t flirting with the Danger Zone.



Wash hands well before and after preparing food.

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Digital Instant Read Meat Thermometers are available on Amazon. Here’s one of their Bestsellers:



More Information:



Centers for Disease Control (CDC) Current Warnings and Travel Advisories:



April 13, 2019 – Ground Beef Warning – USA Today

More than 100 people have fallen ill from an E. coli outbreak that the federal health officials now say is linked to ground beef.

A total of 109 people in six states have been infected with the strain of Escherichia coli O103. No deaths or cases of kidney failure have been reported, but 17 have been hospitalized, the U.S. Centers for Disease Control and Prevention said Friday.

The infections date back to March, but the common cause of the illnesses was previously unknown. The CDC said health officials are working to determine a common supplier, distributor or brand of the ground beef.

Kentucky and Tennessee have seen the highest number of cases, with 54 and 28, respectively. Other states affected are Indiana, Georgia, Ohio and Virginia, the CDC says.

For More On This Story Visit: 


CDC Current Outbreak List | CDC

Travel Health Notices | Travelers’ Health | CDC



Recent Outbreaks and Incidents | CDC – CDC Emergency Preparedness



Health Alert Network (HAN) | CDC – CDC Emergency Preparedness

OR you can become Vegan. Vegans (total vegetarians)  do not eat meat, poultry, fish, or any products derived from animals, including eggs, dairy products, and gelatin.

close up of salad in plate
Photo by Pixabay on Pexels.com


basil leaves and avocado on sliced bread on white ceramic plate
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Lacto-ovo vegetarians: Do not eat meat, poultry, or fish, but do eat eggs and dairy products.


15 of the Most Vegan-Friendly Cities in the World
Enjoy vegan schnitzel at this restaurant in Tel Aviv | image/Goodness
Senior Editor, UK | Contactable via charlotte@livekindly.co

Are you planning a trip? You might be inspired to after checking out the 15 best cities in the world for vegan food.

15 Of The Most Vegan-Friendly Cities In The World

1. New York City

Vegan BBQ Crayfish Burger at Seasoned Vegan in Harlem | Image/Seasoned Vegan

The Big Apple is one of the most vegan-friendly cities in the world. Not only is it packed with meat-free and plant-based restaurants, but many of its non-vegan restaurant menus are also plating up plant-based options. If you’re self-catering, many supermarkets – like Lifethyme, Whole Foods, and Trader Joe’s- throughout the city have shelves brimming with vegan food.

If you’re visiting the “City That Never Sleeps,” be sure to check out one of these five vegan-friendly restaurants:

1. By Chloe – a vegan fast-casual restaurant with six locations in West Village, Flatiron, Soho, Rock Center, Williamsburg, and Seaport District.

2. Seasoned Vegan – a soul food restaurant based in Harlem.

3. Champs Diner – classic diner food with a vegan twist, based in Brooklyn’s Bushwick Neighbourhood.

4. Avant Garden – an upscale vegan restaurant with two locations in Manhattan and Brooklyn.

5. Beyond Sushi – a vegan sushi chain with locations across Manhattan.

2. Bristol

Spiced cauliflower and potato cakes at Suncraft | image/Suncraft

Bristol has a vegan scene to rival any capital city around the world. Located in the southwest of the UK, the maritime city has landed in the top 10 of many lists of the world’s best vegan-friendly destinations. Most recently, Chef’s Pencil named it as the number one destination for plant-based food in the world, edging out major European capitals like Berlin and London.

The popular destination is even home to vegan vending machines. Earlier this year, Vegan Vend launched Violet and Daisy — two purely plant-based vending machines — in the Galleries shopping center and studio complex the Island.

According to restaurant app Happy Cow, Bristol is home to a whopping 167 vegan restaurants. Here are five top picks:

1. Suncraft – healthy vegan cafe on Gloucester Road.
2. Oowee – a vegan junk food diner on Baldwin Street.
3. Vx – vegan fast food cafe on East Street.
4. Eat Your Greens – vegan cafe serving Sunday Roasts on Wells Road.
5. Earthcake – vegan bakery serving cake, tea, and sandwiches on North Street.

3. London

Vegan fried chicken at Temple of Seitan | image/Temple of Seitan

Alongside Bristol, London is one of the UK’s most vegan-friendly cities. In the capital, you can find vegan food at countless restaurants, independent grocery stores, supermarket chains, markets, and pop-ups. If you’re a party animal, head into Vegan Nights. Brick Lane’s monthly festival night celebrates everything plant-based, with live music, DJs, and lots and lots of indulgent, creative, tasty vegan food. If you prefer to keep things a bit more quiet and relaxed, you could take a trip up the OXO tower for a spot of vegan afternoon tea.

Whatever you fancy, London should be able to deliver. If you’re planning a meal out, here are five top vegan restaurant picks:

1. Temple of Seitan – a vegan fried chicken fast food-style restaurant with locations in Camden and Hackney.
2. Vantra Loungevity –  lounge bar serving steamed and raw vegan food on Wardour Street.
3. Itadaki Zen – vegan sushi restaurant at King’s Cross.
4. By Chloe – vegan fast-casual restaurant in Covent Garden and Tower Bridge.
5. Club Mexicana – a vegan Mexican restaurant in Dinerama.

4. Berlin

Voner specialises in vegan doner kebabs | image/Voner

Germany’s capital city has so much to offer; from art to history to culture, it doesn’t disappoint and neither does its vegan food scene. If you’re looking for junk food, raw food, smoothies, donuts, or snacks, this city has you covered. If you prefer to cook for yourself, Berlin is also brimming with organic supermarkets where you can buy whole food produce. Try Veganz, Basic Bio, or Alnatura, for example. If it’s a sit-down meal you want, try one of these top five restaurants:

1. Bamerang – a rock and metal bar serving vegan cakes and snacks.
2. Kopps – one of the best vegan fine-dining restaurants in the world.
3. Viasko – a vegan restaurant known for its freshly baked cakes.
4. Vöner – a vegan Doner kebab joint.
5. Cafe Vux – a cafe serving sweet indulgent vegan desserts.

5. Los Angeles

Mushroom crostini at Moby’s Little Pine Restaurant | image/Little Pine

Los Angeles is arguably one of the easiest places on the planet to be vegan. Among a plethora of plant-based restaurants, cafes, supermarkets, and independent grocery stores, the southern city even has its own vegan milkman, a Jewish delicatessen that makes pastrami out of mushrooms, and an In-n-Out style vegan burger joint. Every year it also plays host to Eat Drink Vegan, which is basically a plant-based foodie version of Coachella. If it’s a regular restaurant experience you’re after, here are top five restaurant picks:

1. Little Pine – a vegan restaurant owned by animal activist and musician Moby.
2. Crossroads Kitchen – an upmarket vegan eatery offering wine, cocktails, and fine food.
3. Cruzer Pizza & Pasta – a pizza restaurant serving a variety of creative recipes with vegan meats and cheeses.
4. Gracias Madre – a Mexican restaurant serving vegan versions of traditional recipes.
5. SunCafe – vegan cafe serving a variety of light cooked dishes as well as raw recipes.

6. Chiang Mai

Fresh spring rolls at Reform Kafe | image/Reform Kafe

Chiang Mai, a backpacking hotspot and one of the most relaxed destinations in South East Asia, is also a vegan haven. According to Happy Cow, the northern Thai city has much to offer in terms of cuisine, with plant-based Thai, Burmese, Indian, Chinese, and Western on offer.

Here are five of the top restaurants to check out if you’re visiting the laidback northern jewel of Thailand any time soon.

1. Reform Kafe – located in the Green Tiger Guesthouse, the restaurant serves vegan versions of Thai classics.
2.  Bee Vegan – a restaurant offering plant-based Thai dishes and Western cuisine, too.
3. Munchies – a vegan fast food joint serving comfort food like vegan hot dogs and fish and chips.
4. Dtrairatanrap – a restaurant serving Chinese and Thai vegan dishes, including plant-based meats and fish.
5. Hearts Choices – a vegan cafe serving traditional Thai-style dishes.

7. Tel Aviv

Dosa Bar in Tel Aviv offers a wide variety of vegan dishes | image/Dosa Bar

Tel Aviv in Israel has long been at the forefront of the vegan movement. Last year, at Tel Aviv Pride, a vegan LGBTQIA+ float joined the parade to send a message of compassion to all, and in March 2018, the city held its fifth annual “Vegan Congress,” which has doubled in size since the first event was held in 2014. “We will continue to carry the banner of veganism in Israel and lead the field with great pride,” said Omri Paz of Vegan-Friendly, which sponsored the event.

As is to be expected from a city often dubbed the “vegan capital of the world,” Tel Aviv is also home to a number of vegan restaurants. Here are our five top picks:

1. Dosa Bar – an Indian restaurant that serves a variety of vegan street food.
2. Anastasia – one of the city’s first vegan restaurants. It serves healthy raw and gluten-free food, as well as sandwiches and vegan cheese platters.
3. Goodness – a vegan diner serving schnitzel and tofu among other comfort food options.
4. Nature Boys – a vegan fast food joint with a twist; there is no frying of any food involved.
5. Meshek Barzilay – a fully vegan and organic restaurant that serves a variety of dishes, including breakfast, pancakes, and Indian Thali.

8. Melbourne

Hot dogs at Lord of the Fries | image/Lord of the Fries

Melbourne, the Australian capital of Victoria, is one of the most visited destinations in the country thanks to its location on the coast. It’s packed with things to do, including museums and nightlife, and is home to some beautiful beaches. When you tire of the sand, Melbourne is also a vegan travelers paradise, with plenty of choice to please even the fussiest of eaters. Here are our five top restaurant choices:

1. Lord of the Fries – the meat-free fast food joint is one of Australia’s most popular vegan destinations, and there are six located in Melbourne.
2. Smoothme Superfood Bar – a vegan bar that serves açaí bowls and smoothies as well as cheesecake and savory bagels.
3. Crossways – a vegetarian restaurant that serves an all-vegan buffet for lunch.
4. Saravana Bhavan – an International vegetarian chain that sells South Indian meat-free cuisine.
5. Realfoods Organic Cafe – serves a variety of raw vegan and gluten-free meals.

9. Chennai

Chennai is the most vegan-friendly city in India

Chennai, located on the eastern coast of India, was recently crowned India’s most vegan-friendly city – no mean feat for a city in a country that prides itself on vegetarian cuisine. Animal rights organization PETA (People for the Ethical Treatment of Animals) awarded the city its title. CEO of PETA India Dr. Manilal Valliyate said at the time, “global interest in the vegan lifestyle has never been higher, and Chennai is leading the country in responding to it.” As you would expect, many restaurants in Chennai offer vegan options, but these are our top five:

1. Raw Routine – serves sugar cane blends, cold-pressed juices, smoothies, and salads.
2. Wild Garden Cafe at Amethyst – offers continental cuisine with a variety of vegan options, including tofu scramble.
3. Ananda Bhavan – a veggie restaurant serving Southern Indian-inspired vegan food.
4. Annalakshmi – another high-quality veggie restaurant serving Southern Indian-inspired vegan food.
5. Flower Drum – a vegetarian restaurant serving Indian, Chinese, and Thai food with plenty of vegan food on offer.

10. Portland

Vegan steak and burrito at Portland’s Homegrown Smoker | image/Homegrown Smoker

Portland in Oregon really is the place to be if you’re after lots of vegan food choice. The city is packed with options and is frequently acknowledged as one of the most vegan-friendly destinations in the U.S. The city is so cruelty-free, it’s even home to an all-vegan strip club. If it’s just food you’re after, here are our five top restaurant picks:

1. Homegrown Smoker – a cafe offering vegan versions of BBQ and Soul dishes.
2. Virtuous Pie – a restaurant offering vegan pizza and dairy-free ice cream.
3. Aviv – an Israeli vegan restaurant serving a variety of dishes, including falafel bowls.
4. Blossoming Lotus – an organic cafe serving freshly made healthy vegan food.
5. Veggie Grill – a plant-based fast-casual chain.

11. Budapest

Vegan stuffed omelettes at Foodiez | image/Slow Foodiez

The capital of Hungary is super popular among backpackers, thanks to its cheap bars, rich history, and pretty architecture. It’s also a hot spot for vegan food, with plenty of variety on offer. See below for our top five Budapest vegan restaurant picks:

1. Madal Food – a vegan pasta bar with creamy fresh pasta options.
2. Slow Foodiez – vegan restaurant serving Hungarian dishes among options like Spanish omelette and sushi.
3. Vegazzi – a vegan Neopolitan pizza parlour.
4. Napfenyes Restaurant – a vegan restaurant serving Hungarian specialties.
5. Szabad Bisztro – a new vegan pub serving a variety of sandwiches, bagels, and of course, beer.

12. Ho Chi Minh City

Veggie Saigon serves a variety of vegan meals | image/Jamiie.vo

Ho Chi Minh City is a Vietnamese jewel; it’s busy, it’s bustling, it’s full of history, and you guessed it, its vegan scene isn’t half bad either. There aren’t many things to keep you away from Ho Chi Minh City, so if you do decide to visit, try one of these five top restaurants:

1. The Organick House – a veggie restaurant serving a number of vegan dishes and a variety of smoothies and juices.
2. Hum Vegetarian – the veggie chain has a few locations across the city. It offers healthy plant-based dishes and raw vegan options.
3.Veggie Saigon – a restaurant serving vegan and vegetarian traditional Vietnamese dishes, including seaweed spring rolls.
4. A Di Da Phat – a vegan Vietnamese restaurant with plant-based meats on the menu.
5. Prem Bistro and Cafe – stop at this vegan-friendly cafe for a spot of scrambled tofu or a quinoa stir fry.

13. Prague

Vegan notdog at Forky’s in Prague | image/Forky’s

There isn’t much not to love about Prague, the capital of the Czech Republic. The medieval city is the largest in the country and as you may already be aware, is steeped in fascinating history and architecture. If you’re visiting the capital and need to rest your weary feet after all that sightseeing, try one of these five restaurants:

1. Prasad – a veggie restaurant offering a daytime buffet packed with plant-based treats.
2. Bubu’s Pub & Kitchen – stop by this vegan pub for a plant-based snack and an indulgent locally brewed beer.
3. Country Life Restaurant – a vegan restaurant serving a buffet and a selection of burgers, salads, and juices.
4. Forky’s – a vegan fast food joint offering hot dogs, burgers, and kebabs.
5. Herbivore – a vegan bistro serving soups, salads, and a selection of cakes.

14. Ubud

Earth Cafe’s Planet Platter | image/Earth Cafe

Fancy sunning yourself in beautiful Bali? In between beach stops, head inland to busy Ubud, where you can visit temples, markets, and lots of vegan-friendly restaurants. See below for our top picks:

1. Clear Cafe – a vegan-friendly cafe with a focus on serving international cuisine made with locally-sourced produce.
2. Sage – a vegan restaurant serving burgers and burritos, as well as indulgent cakes, like banana bread.
3. Earth Cafe – a vegan cafe serving a variety of healthy plant-based dishes.
4. Kafe – stop by this plant-based cafe for a healthy organic brunch.
5. Warung Sopa – a traditional Indonesian buffet-style warung with plenty of plant-based food options.

15. Edinburgh

Holy Cow uses sustainable local produce | image/Holy Cow

Scotland’s capital, Edinburgh, is popular for a number of reasons; it’s home to a castle, a diverse music and art scene, and plenty of beautiful architecture. It’s also home to a growing vegan scene and has plenty of plant-based restaurants for hungry travelers to fuel their busy sightseeing schedule. See below for a list of five top picks:

1. NovaPizza Vegetarian Kitchen – this veggie pizza and pasta restaurant has an extensive vegan menu filled with dairy-free cheese and plant-based meats.
2. Holy Cow – a vegan cafe with a focus on using sustainably sourced local produce.
3. Naked Bakery – a vegan bakery serving a variety of sweet treats and savoury options, including toasties and soups.
4. Karma Kebab – a vegan cafe offering vegan versions of the traditional Doner kebab.
5. Beetroot Sauvage – a vegan cafe serving smoothies and juices; it also hosts yoga classes and a weekly vegan market.





Dogs Sniff Out Cancer 97% Of Time

According to a study presented this week at the 2019 Experimental Biology meeting, researchers may have figured a way to use the keen sense of smell of dogs to detect deadly cancers, a new study says. 
Heather Junqueira, lead researcher at BioScentDx, a pharmaceutical lab in Florida is the author of the study. The experiment, conducted by researchers BioScentDx, trained the beagles to differentiate between blood samples from lung cancer patients and normal blood samples.
Smell receptors of all dogs are 10,000 times more sensitive than in humans.

dog sitting on rug overlooking green leafed plants
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Researchers trained beagles to differentiate between malignant lung cancer tissue and normal blood serum. One of the dogs, named Snuggles, didn’t perform, but the other three were able to correctly identify blood samples with lung cancer 96.7 percent of the time as well as normal blood samples 97.5 percent of the time.

brown white short coated dog
Photo by Flickr on Pexels.com
The dogs identified cancerous tissue 96.7% of the time. They identified normal tissue 97.5% of the time.  Three beagles detected lung cancer nearly 97% of the time,  

“Although there is currently no cure for cancer, early detection offers the best hope of survival, a highly sensitive test for detecting cancer could potentially save thousands of lives and change the way the disease is treated.” -Heather Junqueira, study author

The researchers now hope to use this sense to develop inexpensive, noninvasive ways of cancer detection.

Junqueira says, “This work is very exciting because it paves the way for further research along two paths, both of which could lead to new cancer-detection tools.”

The company plans to use the dog-sniffing technique in a recently launched breast cancer study, it says in a news release.

Heather with dog
Heather Junqueira, lead researcher, BioScentDx


‘None of the oncologists I met was skeptical about Mia’s role in diagnosing my cancer – they have heard it before’ -Emilie Clark, patient

The insider’s guide to cancer prevention

experience: Emilie Clark with dog Mia

Photograph: Mark Chilvers for the Guardian“She fixed her eyes on mine and stared intently. She seemed certain there was a problem.’ -Emilie Clark with her dog Mia

met my miniature dachshund, Mia, at a rescue centre five years ago. She was one of a litter of 12-week-old puppies confiscated from a puppy farm. I hoped she would be my assistance dog for my health problems.

Since birth, I have suffered with a type of heart arrhythmia called ventricular tachycardia. My heart races and, if I don’t take medication immediately to slow it, I lose consciousness.

I’ve had to be rushed to hospital to have it restarted. Unrelated to that, at 19 I started to lose my hearing and now struggle with high-pitched sounds such as the phone or doorbell ringing.

I was studying to be a vet, so the idea of having an assistance dog appealed to me – I love animals. The theory was that Mia would alert me when the phone was ringing or when my heart rate was speeding up and I had to take emergency medication.

When she was 16 weeks old, she was assessed by a charity that trains pets to become assistance dogs. I hoped the immediate and instinctive bond Mia and I shared when we met meant she’d be suitable.

She qualified as my assistance dog just before her second birthday. Mia learned to alert me just before my arrhythmia starts by making a horrible screeching noise and jumping up at me. She ferrets in my handbag and brings me my heart medicine.

She puts her paw on my leg to inform me when the phone’s ringing. Once we were in B&Q when the fire alarm sounded and, executing her training perfectly, she lay on the floor and stared at me, hard, to tell me a siren was blaring.

One evening in November 2011, I was at my computer when Mia leapt on to my lap and nuzzled into the flesh at the top of my left breast. She closed her eyes and licked furiously. That frightened me because it’s what she does when I have a bruise or cut.

I pushed her gently away but she fixed her eyes on mine and stared at me intently, as she does when she’s alerting me to something. I was uneasy now.

Mia seemed certain there was a problem with the area at the top of my breast. I couldn’t distinguish anything – my breasts are naturally lumpy – so it was difficult.

All evening Mia attempted to leap on to my lap and tend to the area of skin where she perceived a problem. The following morning, I visited my GP with a sense of dread.

I asked for an ultrasound or a mammogram. I didn’t start the consultation by telling him that my dog had alerted me to the possible abnormality – I was aware it might sound far-fetched, but when he was dismissive, saying it was unlikely I had breast cancer because I was only 24, I explained.

“I know dogs detect cancer and my dog is determined there’s something wrong with my breast,” I said firmly. Then I informed him that, as I trusted my dog, I wasn’t leaving his surgery until he’d made me a hospital appointment.

My faith in Mia’s diagnostic abilities wasn’t misplaced. I had an ultrasound within a week and, sure enough, there was a lump that a biopsy later confirmed was grade 2a breast cancer.

Two days later, I was in surgery having the lump removed. Then I started radiotherapy – five days a week for three weeks. I was angry. I was only 24 and I’d already suffered so many health problems.


It made everything else harder. Training to be a vet requires 100% dedication and, with fighting cancer and having intense and exhausting radiotherapy, I couldn’t give that, so I had to drop out of university. They were really hard times. My relationship broke up and I had to move back home with my parents. Mia was by my side through it all. Cuddling her after bad news or a gruelling session of treatment alleviated some of the pain.

None of the oncologists I met during my ordeal was sceptical about Mia’s role in diagnosing my cancer – they had heard it before. There’s a charity called Medical Detection Dogs that trains dogs to sniff out cancer, and its work is endorsed by Cancer Research UK. Scientists are researching how dogs possess this diagnostic ability so that humans can harness it.

Fortunately, my cancer hadn’t spread but it will be another 16 months of scans before doctors grant me the all clear. Meanwhile, I’m rebuilding my life. No matter what life serves up, the bond between Mia and me will always be incredibly strong.

As told to Jane Common, The Guardian



 Have a story you want to share? Contact: Maria.Dorfner@yahoo.com


Secrets to Aging Well Naturally

Genetics and environmental factors aside, you actually have a lot of control over how well you age and how long you live. It’s good news because every day you have an opportunity to make better, healthier choices.

man kissing woman on neck near swimming pool
Photo by Natthanon Kongyam on Pexels.com

In 2012, U.S. News and World Reports published the How to Live to 100 Project.


Lindsay Lyon, staff writer and senior editor for the Consumer Advice section, compiled research findings by different age groups. She found there are over 20 basic lifestyle choices you can control to age well naturally. Many seem like basic things you should already know, but they’re worth repeating.


man and woman walks beside green sea
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All ages:



Cut your chances of being mowed down prematurely by major scourges like heart disease and cancer by exercising regularly. Get your heart rate up for 150 minutes each week through moderately intense aerobic activities, such as brisk walking, or for 75 weekly minutes through more intense activities, such as jogging.

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Strength training at least twice a week is also important, according to the CDC.

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Extra pounds can set the stage for arthritis and mobility problems.

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Fruit, vegetables, and fish are staples of a healthy diet.

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Limit red meat to no more than 18 (cooked weight) ounces per week, suggests the American Institute for Cancer Research.

Harvard School of Public Health researchers recently linked daily consumption of red meat—particularly processed varieties—with increased risk of premature death, especially from cancer and heart disease.



Limit alcohol: no more than two daily drinks for men and one for women.


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Floss daily to prevent the buildup of gum-disease-causing bacteria, which are increasingly being implicated in heart disease.

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Too little sleep can  lower your immunity and invite obesity to accidents. One sleepless night can be the equivalent of being drunk, so you don’t want to drive. Consistently getting at least 9 hours of sleep is best. 10 hours for teenagers.

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Even at older ages, quitting smoking may still add years to your life. Here’s a research-tested trick: When the urge to light up strikes, imagine, say, having to breathe through a tracheotomy tube as opposed to the feel-good sensation of taking a drag. Evoking smoking’s serious potential consequences helps quell cravings.

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Flex your mental muscle by writing, reading, or playing games, such as crossword puzzles. Despite there being no proven way to cut the chances of Alzheimer’s, some research suggests that keeping the brain active from childhood on may somewhat armor against the disease.

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Apply and reapply sunscreen and sport a brimmed hat and UV-blocking shades whenever it’s sunny to avoid skin cancer and cataracts.

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Excessive testing—even preventive screenings—and over-reliance on medications, such as antibiotics, can actually be harmful. Before taking any medication or agreeing to any procedure, discuss with your doctor the pros and cons. If you’re uncertain, don’t hesitate to get a second opinion.


Watch out for anti-aging treatments: Nothing can turn back the clock and some therapies can be dangerous. Your money and health are on the line.

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You can get a ballpark idea of how long you can expect to live with centenarian researcher Thomas Perls’ Life Expectancy Calculator. The roughly 10-minute, 40-question test helps reveal the affect your health-related behaviors could have on your longevity, and suggests ways to adjust your lifestyle to add years.

20s and 30s:



Your lifestyle now can affect how well (or poorly) you age.

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Develop “positive coping skills,” or healthy ways to manage life’s stressors. Deadline looming? Rather than shoveling chips into your mouth, go on a run or bike ride. Meditate. Now’s the time to lay down a lifelong foundation for healthy living.

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Cultivate a positive outlook on aging. No one wants to grow old, but evidence
suggests a link between harboring a negative view and heart attack and stroke susceptibility.

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Safeguard your hearing. Noises over 85 decibels, roughly the volume of a hair dryer, can inflict permanent damage.

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Maintain a healthy weight.

40s and 50s:


Limit processed foods that combine sugar and fat; research suggests this combo is highly addictive.

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Keep up with weekly strength-training sessions to maintain lean muscle mass.

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Don’t skimp on calcium and vitamin D—both promote bone health. This chart, from the Institute of Medicine (IOM), outlines recommended daily intake by age and gender.

Men and women ages 51 to 70 are generally advised to get 1,000 milligrams and 1,200 mg of calcium, respectively, and 600 international units (IU) of vitamin D each day.

(Read labels. Don’t overdo any supplement –or you can damage liver and kidneys)

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60s and up:


Once you turn 65, make sure to get an annual eye exam. Age-related vision problems can arise slowly, often unnoticed.

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Take care to avoid falls—the No. 1 cause of injury-related death for the 65-plus set. Potential preventives include balance-building activities such as tai chi, and making practical changes around the house, like installing “grab bars” near the shower.


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Maintain your fitness to prolong good health and ability to live independently. If 150 minutes of physical activity per week seems daunting, try dividing it into three 10-minute blocks, five days per week.

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Stay up to date on recommended cancer screening tests, such as colonoscopies, and immunizations, such as flu and pneumonia shots, especially ages 50 plus.

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Know the warning signs of top killers, such as stroke. Call 911 immediately if you notice symptoms. For stroke, they include numbness in your face and limbs, sudden difficulty seeing or speaking, dizziness, and/or a sudden severe headache.

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CHECK out How to Live 100 ebook now available.


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Fun Fact:

Healthy, positive, supportive relationships are a big part of aging well. Turns out, married men are healthier, wealthier and live longer. The longest-running study of longevity ever conducted is the Terman Life-Cycle Study, begun in 1921. 1,528 men and women, were 11-years old when the study started, were followed for their lifetime. The group who lived the longest were those who got married and stayed married. The study revealed consistency made a positive difference in their lives. You’re more likely to stick to healthy habits when your partner is like-minded.

U.S. News How to Live to 100 project,

Saturday, April 13, tune into Dr. Sanjay Gupta on CHASING LIFE. He travels the world to find not so common secrets to living well longer. 9pmET/PT on CNN



Be sure to click Follow on this blog for the best in Health

Maria Dorfner

Maria Dorfner is a health journalist and producer, who began her career at NBC in 1983 working behind-the-scenes on the Today Show. Three years after commuting from Brooklyn, New York, she moved to New York City. In 1989, she purchased her first car, which she needed to drive from New York City to Ft. Lee, New Jersey with fellow producers to help launch CNBC. She then worked as a reporter for Top Cops, syndicated by CBS and as a producer for The Rush Limbaugh Show and Profiles with Liz Smith pilots, nationally syndicated. In 1993, she created and produced Healthy Living, Lifestyles and Longevity, Healthcare Consumers and more. The shows generated more revenue and profits for the production company than any others in their history. She covered health for NBC Miami and  produced the weekly JAMA Report airing on all networks, co-founded and launched Cleveland Clinic News Service. While based in North Carolina for two years, she field produced and directed  21st Century Medicine for Discovery. She traveled extensively for the documentary series, conducting interviews with pioneers in medicine.

She is the recipient a Medical Reporting Scholarship from the American Medical Association, Freddie Award for Excellence in Medical Reporting,  Media Recognition Award from the American Heart Association for her series, Heart Smart airing on NBC, nominated for an Alfred I. DuPont Award for best new talk show, Outstanding Leadership Abilities Award from Pace University and National Association of Female Executives, an Advanced Writing Scholarship from NBC, Commitment to the Advancement of Women in Media Award, and a 2019 Albert Nelson Lifetime Achievement Award for Excellence in her field.  Maria mentors journalism and marketing students at her alma mater, Pace University, where she was a member of the National English Honor Society and won Miss Pace University and an Outstanding Achievement Award from Pace and March of Dimes. She was awarded an Advanced Writing scholarship for graduate work at Columbia University from NBC NEWS and wrote The Ivy League Roundup covering health.

She is the author of Healthy Within and PRESSure: Break Into Broadcasting and an Italian cookbook based on her grandmother’s recipes. Health Heart and Humor in an Italian-American Kitchen.

You can follow her on Twitter at @Maria_Dorfner | maria.dorfner@yahoo.com

She is the founder of NewsMD.

This is her blog.


Actress Shares Experience with Brain Aneurysm

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A brain aneurysm (AN-yoo-riz-um) is a bulge or ballooning in a blood vessel in the brain.

It can leak or rupture, causing bleeding into the brain (hemorrhagic stroke).


Aneurysms have a variety of causes. Most often a ruptured brain aneurysm occurs in the space between the brain and the thin tissues covering the brain.

Causes include high blood pressure and atherosclerosis, trauma, heredity, and abnormal blood flow at the junction where arteries come together.

There are other rare causes of aneurysms. Mycotic aneurysms are caused by infections of the artery wall.

Although the exact cause is unclear, certain factors contribute to it, like damaged tissue in arteries.


The arteries can be harmed by blockages, such as fatty deposits.

This stress can damage the arteries because of the increased pressure.


You can‘t always prevent brain aneurysms, but you can lower your risk by not smoking and reducing high blood pressure.

10 Ways to Reduce High Blood Pressure Naturally: https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/in-depth/high-blood-pressure/art-20046974

Game of Thrones Daenerys actress Emilia Clarke

Emilia Clarke

(Credit: ANGELA WEISS/AFP/Getty Images

Emilia Clarke Talks Further About Health

Emilia Clarke shares never-before-seen photos from her traumatic hospitalisation.

The Game of Thrones actor reveals in a personal essay published in The New Yorker that she has survived two brain aneurysms during the early years of making the fantasy show.

Over the weekend, Clarke made an appearance on CBS News and spoke of her experience with these brain bleeds, or as they’re formally known, as subarachnoid haemorrhages.

“With the second one, there was a bit of my brain that actually died,” Clarke said. “If a part of your brain doesn’t get blood to it for a minute, it will just no longer work. It’s like you short circuit. So, I had that. And they didn’t know what it was.

Emilia Clarke shares hospital photo (Credit: Emilia Clarke/CBS News

“They literally were looking at the brain and being like, ‘Well, we think it could be her concentration, it could be her peripheral vision [affected].’”

For Clarke, though, she found the humour: “I always say it’s my taste in men that’s no longer there! That’s the part of my brain, yeah, my decent taste in men.”


The actress says her recovery was helped by being able to lose herself in such an empowering character like Daenerys.

Emilia Clarke shares hospital photos (Credit: Emilia Clarke/CBS News

“You go on the set, and you play a badass character, and you walk through fire, and you speak to hundreds of people, and you’re being asked to be – to work as hard as you possibly can,” Clarke said.

“And that became the thing that just saved me from considering my own mortality.”

Clarke details the symptoms she suffered that first suggested she was not well in her New Yorker essay:

“My trainer had me get into the plank position, and I immediately felt as though an elastic band were squeezing my brain. I tried to ignore the pain and push through it, but I just couldn’t. I told my trainer I had to take a break. Somehow, almost crawling, I made it to the locker room. I reached the toilet, sank to my knees, and proceeded to be violently, voluminously ill. Meanwhile, the pain—shooting, stabbing, constricting pain—was getting worse. At some level, I knew what was happening: my brain was damaged.”

Game of Thrones’ eighth and final season will begin its broadcast with episode one on April 15, on Sky Atlantic at 2am and 9pm.

For more visit:

CBS News: Emilia Clarke on “Game of Thrones” and her near-death experience

http://www.cbsnews.com or click video links below


As Danerys Taergaryn on “Game of Thrones,” Emilia Clarke plays a character who can walk through fire. And the actress has found that, in some ways, she can, too. She tells correspondent Tracy Smith that portraying a strong woman on TV helped her to be one in life, when she suffered a subarachnoid hemorrhage, twice, and nearly died. Having completed ten years’ production on the hit HBO series, Clarke has started a charity, SameYou, for brain injury survivors.





Improve the health of your brain by including these foods on a regular basis:

Research shows the best brain foods are the same ones that protect your heart:

  • Green, leafy vegetables. Leafy greens such as kale, spinach, collards, and broccoli are rich in brain-healthy nutrients like vitamin K, lutein, folate, and beta carotene. Research suggests these plant-based foods may help slow cognitive decline.

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  • Fatty fish. Fatty fish are abundant sources of omega-3 fatty acids, healthy unsaturated fats that have been linked to lower blood levels of beta-amyloid—the protein that forms damaging clumps in the brains of people with Alzheimer’s disease.
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    Try to eat fish at least twice a week, but choose varieties that are low in mercury, such as salmon, cod, canned light tuna, and pollack.

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    If you’re not a fan of fish, ask your doctor about taking an omega-3 supplement, or choose terrestrial omega-3 sources such as flaxseeds, avocados, and walnuts.

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  • Berries. Flavonoids, the natural plant pigments that give berries their brilliant hues, also help improve memory, research shows.In a 2012 study published in Annals of Neurology, researchers at Harvard’s Brigham and Women’s Hospital found that women who consumed two or more servings of strawberries and blueberries each week delayed memory decline by up to two-and-a-half years.
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  • adult beard black jacket cup
    Photo by Burst on Pexels.comTea and coffee. The caffeine in your morning cup of coffee or tea might offer more than just a short-term concentration boost.

    In a 2014 study published in The Journal of Nutrition, participants with higher caffeine consumption scored better on tests of mental function.

    Caffeine might also help solidify new memories, according to other research. Investigators at Johns Hopkins University asked participants to study a series of images and then take either a placebo or a 200-milligram caffeine tablet. More members of the caffeine group were able to correctly identify the images on the following day.

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  • Walnuts. Nuts are excellent sources of protein and healthy fats, and one type of nut in particular might also improve memory. A 2015 study from UCLA linked higher walnut consumption to improved cognitive test scores.Walnuts are high in a type of omega-3 fatty acid called alpha-linolenic acid (ALA), which helps lower blood pressure and protects arteries.

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  • That’s good for both the heart and brain.heart

    For more on staying sharp as you age, read Cognitive Fitness a Special Health Report from Harvard Medical School.

How To Spot A Thyroid Nodule

Thyroid RFA 101: Radiofrequency ablation for the management of thyroid nodules: A critical appraisal of the literature

RFA stands for Radiofrequency Ablation for the management of thyroid nodules.

A TV viewer of “Inside Edition” spotted a lump (a thyroid nodule) on host, Deborah Norville’s neck and commented on it.

“A long time ago an “Inside Edition” viewer reached out to say she’d seen something on my neck. It was a lump,” she said. “I’d never noticed the thing, but I did have it checked out and the doctor said it was nothing, a thyroid nodule. And for years, it was nothing. Until recently, it was something.”-Deborah Norville, Anchor, “Inside Edition”

She went to a doctor, had it checked and was told it was fine. Years later, she learns it wasn’t fine. It was cancerous.

Norville says:

“The doctor says it’s a very localized form of cancer, which tomorrow I’ll have surgery to have removed. There’ll be no chemo, I’m told no radiation, but I will have surgery and I’ll be away for a bit,” Norville said on “Inside Edition.” “If you believe in prayer, please say one for me and for my surgeon and I thank you very much.” -Deborah Norville

She had surgery to have it removed and it went well.

“Thank you again for all your kind words of encouragement. The world truly is filled with good people 😊 in case you missed the end of @insideedition yesterday, here’s the message that explains my brief absence from the show.”

-Deborah Norville


It’s important for people to know the majority of benign thryoid nodules are asymptomatic, remain stable in size and do not require treatment. A lump as seen in photos above may not cause pain or other symptoms.

A minority of patients experience pain in their jaw, ear or neck or have difficulty swallowing. Patients say it feels there’s a constant tickle in their throat.


Thyroid nodule is a lump that can develop in your thyroid gland. It can be solid or filled with fluid.

Image result for THYROID GLAND


Thyroid nodules are relatively common and rarely cancerous.


Your thyroid is a small butterfly-shaped gland located near your larynx (voice box) and in front of the trachea (windpipe). See photo above.


If your doctor thinks a biopsy is needed, the simplest way to find out if a thyroid lump or nodule is cancerous is with a fine needle aspiration (FNA) of the thyroid nodule. This type of biopsy can sometimes be done in your doctor’s office or clinic.


Again, most people have no symptoms at all, but can visually see the thyroid nodule on their neck (see photos at top). If it’s cosmetically an issue, it can be removed. You should always have a doctor check any lumps. Some people do experience symptoms, such as trouble swallowing, pain in neck, ear or jaw, hoarseness of voice (a concern for cancer)

FOR MORE INFORMATION: https://www.cancer.gov/types/thyroid

More From https://www.cancer.org

Signs and Symptoms of Thyroid Cancer

Thyroid cancer can cause any of the following signs or symptoms:

  • A lump in the neck, sometimes growing quickly
  • Swelling in the neck
  • Pain in the front of the neck, sometimes going up to the ears
  • Hoarseness or other voice changes that do not go away
  • Trouble swallowing
  • Trouble breathing
  • A constant cough that is not due to a cold

If you have any of these signs or symptoms, talk to your doctor right away. Many of these symptoms can also be caused by non-cancerous conditions or even other cancers of the neck area.

Again. lumps in the thyroid are common and are usually benign. Still, if you have any of these symptoms, it’s important to see your doctor so the cause can be found and treated, if needed.



The cause is unknown, but some say it may be from too much exposure to radiation. It’s important to ask for a THYROID GUARD whenever you have a mammogram or are at dentist getting x-rays. Dr. Oz did an episode on it this week as there has been a rise in thyroid cancer in women. Please share that information.

TREATMENTS for Benign (harmless) Thyroid Nodule:

The timely use of ultrasound-guided, minimally invasive thermal therapies has changed the natural history of benign, enlarging thyroid nodules (TNs).

These procedures produce persistent shrinkage of TNs and an improvement of local symptoms.

RFA is performed in outpatient clinics and has a lower risk of complications compared to surgery.

For more visit: https://www.thyroidsurgery.com


For information on Treatments for Thyroid Cancer visit:



Recap of Deborah Norville’s story:


“Inside Edition” anchor Deborah Norville revealed to viewers on Monday that she will undergo surgery to remove a cancerous nodule on her thyroid.

“The doctor says it’s a very localized form of cancer, which tomorrow I’ll have surgery to have removed. There’ll be no chemo, I’m told no radiation, but I will have surgery and I’ll be away for a bit,” Norville said on “Inside Edition.” “If you believe in prayer, please say one for me and for my surgeon and I thank you very much.” -Deborah Norville

Deborah’s surgery went well, She is recovering. Sending prayers and well wishes.

Thank you to the viewer who saw something and said something.

If you ever notice something unusual, don’t be shy. One time, a friend of mine shared a post from this blog on unusual symptoms of breast cancer. She shared it on Facebook. Her friend read it, recognized one of the signs in herself, got it checked and sure enough they caught breast cancer early.




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Easter Egg Strawberries Are Way Tastier Than Dyed Eggs

Maria Dorfner is an award-winning TV producer and health journalist and owner of NewsMD, providing health content and PR services for the best in medical | health. Maria has produced and directed “21st Century Medicine” on DISCOVERY, created and co-anchored Healthcare Consumers, Healthy Living, Lifestyles and Longevity and Green Magazine on CNBC. She also co-founded and launched The Cleveland Clinic News Service, helped launch MedPage TODAY and CNBC.

Maria has received a Freddie Award for Excellence in Medical Reporting, Medical Reporting Scholarship from the American Medical Association and Upjohn Pharmacia, Media Recognition Award for her “Heart Smart” series from the American Heart Association, an Outstanding Achievement Award from the March of Dimes, an Outstanding Leadership Abilities Award from her alma mater, Pace University, where she was an honors English and Political Science student.

She interned at NBC in New York and launched her own company after relocating to North Carolina. She studied illustration and design at Pratt Institute and Advanced Writing at Columbia University through a scholarship from NBC News.

She currently divides her time on the east and west coast and donates her time to good causes and mentoring. She speaks to Investors and start-ups about “The Power of Storytelling.” Most recently, at The Core Club in New York City.
She is an avid reader, traveller, explorer and lifelong health enthusiast and advocate.  Her books include: Healthy Within, Health Heart and Humor in an Italian-American Kitchen and PRESSure: Break Into Broadcasting. Her next health book due is out in 2020.
This is her blog. Be sure to follow this blog for more on What’s Hot in Health.
Follow on Twitter: @Maria_Dorfner | Email: Maria.Dorfner@yahoo.com


NewsMD: What's Hot in Health


Do you have a Healthy Millionaire Mind?  Dr. Thomas J. Stanley extensively interviewed and surveyed 733 Millionaires asking what factors were most vital to their success.

Top 10 factors they attribute to their success:

1.  Being honest with all people

2.  Being well-disciplined

3.  Getting along with people

4.  Having a supportive spouse

5. Working harder than most people

6. Loving my career/business

7.  Having strong leadership qualities

8.  Having a very competitive spirit/personality

9.  Being very well-organized

10.  Having an ability to sell my ideas/products


Integrity, someone who doesn’t cheat is high on the list, as well as having extraordinary energy and being physically fit.  Integrity and physical fitness are within your control. Anyone can cheat. Anyone can be lazy and not exercise.  Wise people make better choices, and reap the long-term rewards from it.


Here are remaining factors Millionaires attribute to their success:

11.  Make wise investments

12. …

View original post 203 more words

Psychiatrist Explains How Newly Approved Ketamine Works for Depression


The Food and Drug Administration on Tuesday approved esketamine, the first major depression treatment to hit the U.S. market in decades and a new option for patients who haven’t responded to existing therapies.

Esketamine—delivered as a nasal spray—was tested in combination with oral antidepressants in patients with treatment-resistant depression. The drug is related to ketamine, a common anesthetic sometimes misused recreationally.

Many experts hail esketamine as a critical option for patients in dire need of new treatment.

Janssen, the subsidiary of Johnson & Johnson developed the drug, called Spravato.


Zoe Biehl spoke with an experienced psychiatrist (who wished to remain anonymous) to dive deeper and learn more about how exactly prescribing ketamine for depression works.

Some psychiatrists have been prescribing ketamine off-label for depression. What does off-label mean exactly?

Off-label refers to using an FDA-approved medication for a purpose other than the indication that it is FDA approved for.

Off-label use of medications is common.

It is entirely legal to prescribe for symptoms other than the FDA-approved indication, as long as the drug is FDA approved for distribution in the US.

In order to for a drug to be approved by the FDA, it has to be proven both safe and effective for its proposed indication.

All drugs have potential for adverse effects, so for a medication to be considered safe it has to have a low incidence of severe adverse effects compared to the benefits derived from treating the indicated condition.

A medication may be effective for conditions other than the FDA approved indication. It’s just that it has not undergone the extensive and expensive process of FDA approval.

As long as the medication is proven safe, physicians can legally prescribe a medication for off-label use. An approved drug has a well known safety profile, so it is generally safe to consider a medication for other conditions.

What are some examples of other medications that are prescribed off-label?

Some antidepressants that have passed FDA approval for treatment of depression have been used for neuropathic pain or chronic pain syndromes for over 30 years, but most of them are not FDA approved for pain.

Another example is trazodone—an older medication that has FDA approval for treatment of depression, but it is also very sedating to the point of making it difficult to reach the full dose for the anti-depressant effect. So, because of its sedating side effects, it has become commonly used for insomnia at lower doses. One can assume it is safe enough at lower doses to use for simple insomnia because it has been studied in higher doses in depression.

So how do doctors give the ketamine to patients once they prescribe it to them off-label?

Ketamine is given via IV in a supervised setting, using 1/10 the anesthetic dose, which is 0.5 mg / kg body weight. The effect tends to be delayed to the next day, at which time some sort of reset and release of habitual thoughts and emotions occurs, leaving an opportunity to engage in therapy to help solidify the results.

The antidepressant effect of ketamine tends to wear off within a few days.

Dextromethorphan (DXM) in the usual over-the-counter doses for cough is given twice a day to help maintain the antidepressant effect of ketamine. DXM affects similar receptors and neural pathways as ketamine at a much more mild and attenuated level. Some practitioners have been prescribing DXM in the hopes that it might augment and maintain the effects of the ketamine treatment.

A doctor in San Diego is giving oral ketamine at the same dose of 0.5 mg / kg body weight for situational depression in hospice patients with good results. He has the pharmacy compound the IV ketamine into a syrup that is administered every night for the remainder of their life (which is only a few weeks for the population that he has been treating). It is a small number of patients, but so far he has found it to be generally well tolerated and effective.

Ketamine only comes in IV formulation—there is no commercially available oral formulation. So you have to use a compounding pharmacy, where personalized medications in specific doses are created to fit the unique needs of a patient.

Ketamine for depression is experimental. There is not enough evidence of safety and efficacy to justify wide-spread off-label use at this point. For outpatients, the treatment protocols involve oral or IV administration in a supervised office setting. It is not dispensed as a prescription to be taken at home.

What are some concerns/risks in prescribing ketamine off-label for depression?

The important issue with ketamine is the fact that the use of it for depression is still highly experimental. It would not be as serious a concern if it were a simple medication like ibuprofen being used for treatment of cough—which can work when the cough is related to inflammation in the trachea.

Ibuprofen is a fairly safe medication. Ketamine is not. It can be used at anesthetic doses to induce a dissociative state in which pain is not felt. Any medication that is used for anesthesia can be lethal if overused. And ketamine has a street value as it is used as a party drug. This can result in people seeking treatment for reasons other than depression, or for people who are looking to access drugs simply to get high.

Ketamine has been studied by the FDA for one-time single use as an anesthetic. There is no data of the safety of repeated doses over time.

Use of ketamine for depression is being closely monitored and studied. The protocols stress the importance of screening out people with a history of substance abuse. There is concern that such patients might be more prone to respond to low-dose ketamine by developing addictive responses to the use of the medication.

The use of ketamine for depression is also limited to just a few treatments a week for a limited number of weeks. The problem is that the antidepressant effect wears off, so the idea is to use these days when the mood is improved to work on psychological issues and shift one’s perspective and break cycles of habitual negative thoughts.

How does that work exactly? What does the ketamine do?

The use of ketamine for depression is analogous to the use of plant medicine in shamanism.

Ayahuasca, for example, limited to a single session (or a limited series of 2-4), each time focusing on a specific desired goal of the ceremony—purging, cleansing, insight, teaching, and/or healing of a specific illness or concern. The idea is to use the insights gained from the expanded awareness and consciousness and incorporate the ideas and insights into daily life.

The goal of repeated ceremonial use of ayahuasca is to be able to access and retain the insights and expanded level of consciousness without the need for the plant. By remembering the state of expanded insight and re-entering that level of awareness consciously, you can incorporate the effects of the plant into your daily life.

So, likewise with ketamine, the idea is to enter a state of release of depression, feel what it feels like to have the burden of depression lifted, and learn to maintain that state of mind by conscious intent and practice.

Some researchers have noted that ketamine seems to break the ruts of chronic negative thoughts and negative emotional states that self-perpetuate when depressed, and by breaking the patterns for a few hours or days, you have an opportunity to move forward without continuing the patterns of negative thoughts and feelings. It’s like a reboot of a computer. A momentary shutting down, setting the dials back to zero, and then starting again. Like turning your computer off and on again to resolve a persistent and baffling problem on your computer.

A British physician from England who has been researching ketamine has suggested that ketamine is somehow addressing the “ruts” in our thoughts and emotions.

When certain negative thoughts and feelings are repeated over and over, you tend to fall back into the same ruts over and over. He feels ketamine clears out the ruts, like repaving a street, providing a smooth surface to respond and move forward in a different direction instead of following the same old paths.

Ketamine is a drug that was approved by the FDA in the 1970’s to be used by doctors and veterinarians as an anesthetic.

It’s also a fairly popular recreational drug that provides out-of-body experiences.

However, even though ketamine has been legal for around 50 years, it was only in the last few years that psychiatrists began to realize this drug is actually quite effective at treating depression. According to one clinical study, around 70-85% of patients with severe depression reported that their ketamine treatment was effective.




FDA Approves Esketamine Nasal Spray For Hard-To-Treat Depression

Editor’s note, March 6, 9:30 a.m.: This story was updated to include information about the price of Spravato.

The Food and Drug Administration approved the first drug that can relieve depression in hours instead of weeks.

Esketamine, a chemical cousin of the anesthetic and party drug ketamine, represents the first truly new kind of depression drug since Prozac hit the market in 1988.

The FDA’s decision came Tuesday, less than a month after a panel of experts advising the agency voted overwhelmingly in favor of approval.

“There has been a long-standing need for additional effective treatments for treatment-resistant depression, a serious and life-threatening condition,” said Dr. Tiffany Farchione, acting director of the Division of Psychiatry Products in the FDA’s Center for Drug Evaluation and Research, in a press release about the decision.

“This is potentially a game changer for millions of people,” said Dr. Dennis Charney, dean of the Icahn School of Medicine at Mount Sinai in New York. “It offers a lot of hope.”

Esketamine works through a mechanism different from those of drugs like Prozac, Charney said. And that is probably why studies show it can often help people with major depressive disorder who haven’t been helped by other drugs.

“Many of them are suicidal,” Charney said. “So it’s essentially a deadly disease when you haven’t responded to available treatments and you’ve been suffering for years if not decades.”

Charney was part of the team that first showed two decades ago that ketamine could treat depression. He also is named as co-inventor on patents filed by the Icahn School of Medicine relating to the treatment for treatment-resistant depression, suicidal ideation and other disorders.

Esketamine, developed by Johnson & Johnson, will be administered as a nasal spray and be used in conjunction with an oral antidepressant. It will be marketed under the brand name Spravato. The FDA has approved it for patients who have failed to respond adequately to at least two other drugs.

That means about 5 million of the 16 million people in the U.S. with major depression might benefit from esketamine, said Courtney Billington, president of Janssen Neuroscience, a unit of Johnson & Johnson.

But esketamine presents some challenges because of its similarities to ketamine. In high doses, both drugs can cause sedation and out-of-body experiences. And ketamine, often called Special K in its illicit form, has become a popular party drug.

So Johnson & Johnson is taking steps to make sure esketamine will be used only as intended, Billington said.

“Spravato will not be dispensed directly to a patient to take at home,” he said. “It will only be available in approved and certified treatment centers.”

Patients will inhale the drug under supervision at these centers once or twice a week. And they will receive a dose that is unlikely to produce side effects such as hallucinations.

“The amount of active ingredient that’s in this product, it’s at a very, very low dose,” Billington said.

Even so, the FDA, according to its press release, is requiring a warning label that says patients “are at risk for sedation and difficulty with attention, judgment and thinking (dissociation), abuse and misuse, and suicidal thoughts and behaviors after administration of the drug,”

Esketamine’s approval comes as more and more doctors have begun administering a generic version of ketamine for depression. Generic ketamine is approved as an anesthetic, not as an antidepressant. Even so, doctors can legally prescribe it for off-label medical uses.

And as a growing number of studies have shown ketamine’s effectiveness against depression, ketamine clinics have sprung up around the United States. These clinics often administer the drug in an intravenous infusion that can cost more than $500 per treatment.

Many doctors who have become comfortable offering ketamine for depression probably won’t switch to esketamine, said Dr. Demitri Papolos, director of research for the Juvenile Bipolar Research Foundation and a clinical associate professor at Albert Einstein College of Medicine.

For the past 10 years, Papolos has been prescribing an intranasal form of ketamine for children and adolescents who have a disorder that includes symptoms of depression.

“I’m very pleased that finally the FDA has approved a form of ketamine for treatment-resistant mood disorders,” Papolos said. He said the approval legitimizes the approach he and other doctors have been taking.

But he hopes that doctors who are currently using ketamine continue to do so. “It’ll be a lot less expensive and a lot easier for their patients [than esketamine],” he said.

And animal studies show it’s possible that old-fashioned ketamine is a more potent antidepressant than esketamine, Papolos said.

Esketamine “may not be as effective as a generic that any psychiatrist or physician can prescribe without restrictions,” Papolos said.

Johnson & Johnson said the wholesale cost of each treatment with ketamine will range from $590 to $885, depending on the dose. That means twice-weekly treatments during the first month will cost centers that offer the drug at least $4,720 to $6,785. Subsequent weekly treatments will cost about half as much.

The drugmaker says those figures don’t include administration and observation costs.



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