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Feeding Your Infant

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Feeding Your Infant There are several different options and questions that parents have regarding baby feeding. The most common question, that parents will hear from doctors and pediatricians, is whether they plan to bottle feed formula, or to breast feed their infant. While some parents choose to go solely with breast feeding, and others only bottle feed, some parents use a mixture of both styles. If the mother does not work outside the home, only breast feeding may be a possible option.

However, for those that do work, breast feeding can be tricky. Many mothers use a breast pump while at work to maintain their milk supply, and to provide their infant with breast milk from a bottle while they are away. Other mothers of infants breast feed until the time arrives for them to return to work, and then switch their infant gradually to a formula. For those mothers that choose breast feeding, fewer options exist. However, there are many choices and concerns when it comes to choosing a formula for an infant. There are numerous brands of formulas on the market. Within each brand, there are several different types.

Some formulas claim to reduce spit up and gas, while others are soy based.Some formulas for baby feeding are even designed to imitate the breast milk from the mother. In most cases, breast fed babies eat more often than formula fed babies. Most newborn infants breast feed every 1.5 to 3 hours. Bottle fed babies may go 3 or 4 hours before appearing hungry. For the first four months of life, it is suggested that infants only consume formula or breast milk. After four months of age, most babies are ready to begin a rice or other grain cereal in addition to their formula or breast milk.

The consistency of the cereal should be thin, and then thickened gradually as the infant becomes accustomed to the texture. Near six months of age, many recommend beginning to add fruits and veggies to a baby's diet. You should always begin with one type at a time, for two or three days, and watch for signs of allergies. Always begin with the first baby foods that are much thinner. These are also in smaller jars, due to the smaller amounts that infant's eat at this age. Bananas, pears, carrots, sweet potatoes, and applesauce are popular for first foods.

By eight to ten months, most babies are ready to begin trying foods with more texture, and even finger foods, designed for older infants to pick up themselves. Table foods usually begin around ten months of age, but breast milk or formula is also continued at this time. Whether you chose breast feeding or formula feeding for your infant, it is important to gain information pertaining to your type of baby feeding. Storage, amounts, and sterile methods are all important factors to consider.

The surgeon who treats your ankle fracture is more important than previously recognized

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Short-term complications after ankle fracture surgeries could lead to poor, long-term patient outcomes

ROSEMONT, Ill., Aug. 15, 2019 /PRNewswire/ — A wrong twist, rotation or roll could cause a broken ankle, also known as an ankle fracture, among people of all ages. One or more broken bones in an ankle joint can lead to instability and an active, older population of “baby boomers” have been seeing an increase in the number and severity of broken ankles. Among Medicare patients, ankle fractures are the third most common extremity fracture, costing more than half a billion dollars per year. Yet, according to new research published in the August 15 issue of the Journal of the American Academy of Orthopaedic Surgeons, the surgeon who treats your fracture may be more important to the healing process than previously recognized. The study authors at Stanford Health Care’s Department of Orthopaedic Surgery reviewed 11,745 records from an insurance claims database of patients between the ages of 20-80 treated for ankle fractures by orthopaedic surgeonsi,ii and podiatristsiii between 2007 and 2015.

The study specifically looked at several short-term complications after ankle fracture surgery:

  • the rate of fractures healing in a poor or incorrect position (malunion) within a year;
  • the rate of fractures that did not heal (nonunion) within a year; and,
  • the rate of infection, blood clots or repeat surgery for removal of unhealthy wound tissue within 90 days.

The study authors found a large difference in the rates of malunion and nonunion after comparing ankle fracture surgery outcomes by different surgeon types. Review of the insurance claims database revealed that “patients who had ankle fracture surgeries performed by podiatrists had a 50 percent increase in the rate of malunion or nonunion compared to surgery done by orthopaedic surgeons,” says lead researcher and orthopaedic surgeon Jeremy Chan, MD. “These differences were even higher in more complex ankle fracture patterns.”

Even though this study analyzed all types of orthopaedic surgeons, including those with subspecialized training in the foot and ankle trauma care as well as general orthopaedic surgeons, it was not designed to look at the causes for the differences, or long-term complications. Dr. Chan indicated that a range of factors could potentially influence the rates of fracture healing, which may include some surgeon-related factors (e.g., differences in surgical training between orthopaedic surgeons and podiatrists; volume of ankle fracture surgeries performed by individual surgeons). “This is important because ankle fractures that heal in a poor position or do not heal lead to future problems for patients such as continued pain, as well as the development of ankle arthritis long-term.”

Study highlights

  • There were no statistical differences in complications observed in patients with unimalleolar fractures—a fracture in one of the three components (i.e., medial, lateral, and posterior malleolus — the bony components on each side of the ankle) that make up an ankle joint.
  • In patients with fractures in bimalleolar or trimalleolar fractures—two or three ankle joint components, respectively—treatment by a podiatrist was associated with higher malunion/nonunion rates.
  • Patients treated by orthopaedic surgeons versus podiatrists had similar comorbidity profiles (long-term or chronic conditions).
  • Despite higher malunion/nonunion rates, there is an increasing number of ankle fracture surgeries being performed by podiatrists over the past decade, whereas the number of ankle fracture surgeries being performed by orthopaedic surgeons is decreasing. However, over 90 percent of ankle fractures in this study sample were still treated by orthopaedic surgeons.

Given the potential risks associated with a poorly treated ankle fracture, “patients with ankle fractures undergoing surgery should consider choosing a physician with lower complication rates, and someone who routinely treats ankle fractures for the best outcome,” says Dr. Chan.

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Disclosure
Dr. Michael J. Gardner or an immediate family member has received IP royalties from Synthes; is a member of a speakers’ bureau or has made paid presentations on behalf of KCI; serves as a paid consultant to Biocomposites, BoneSupport AB, Conventus, Globus Medical, KCI, Pacira Pharmaceuticals, SI-Bone, StabilizOrtho, and Synthes; has stock or stock options held in Conventus, Imagen Technologies; has received research or institutional support from Medtronic, SmartDevices, SMV Medical, Synthes, and Zimmer Biomet; and serves as a board member, owner, officer, or committee member of the American Orthopaedic Association, Orthopaedic Research Society, and Orthopaedic Trauma Association. Dr. Julius A. Bishop or an immediate family member has received IP royalties from Globus Medical and Innomed; serves as a paid consultant to DePuy, Globus Medical, and KCI; has received research or institutional support from Conventus; and serves as a board member, owner, officer, or committee member of the Western Orthopaedic Association. Neither of the following authors nor any immediate family member has received anything of value from or has stock or stock options held in a commercial company or institution related directly or indirectly to the subject of this article: Dr. Jeremy Y. Chan and Dr. Jeremy N. Truntzer.

i Orthopaedic surgeons are medical doctors who have completed a total of approximately 14 years of formal education, with extensive training in the proper diagnosis and both non-surgical and surgical treatment of injuries and disease of the musculoskeletal system. Board-certified orthopaedic surgeons must maintain their certification with continuous, life-long learning and demonstrating their expertise on a regular basis via an oral or written examination. Orthopaedics. (June 2017). Retrieved from OrthoInfo: https://orthoinfo.org/en/treatment/orthopaedics/

ii Foot and ankle orthopaedic surgeons additionally complete a one- or two-year fellowship focused on foot and ankle care. About Us. (n.d.). Retrieved from American Orthopaedic Foot & Ankle Society: https://www.aofas.org/about-us

iii A podiatrist is a Doctor of Podiatric Medicine (DPM), known also as a podiatric physician or surgeon, qualified by their education and training to diagnose and treat conditions affecting the foot, ankle and related structures of the leg. Becoming a Podiatric Physician. (n.d.). Retrieved from American Association o f Colleges of Podiatric Medicine: https://www.aacpm.org/becoming-a-podiatric-physician/

Cision View original content:http://www.prnewswire.com/news-releases/the-surgeon-who-treats-your-ankle-fracture-is-more-important-than-previously-recognized-300895719.html

SOURCE American Academy of Orthopaedic Surgeons

The History of the Babydoll

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A babydoll is a piece of lingerie that is quite popular with the younger generation. It is a short nightgown or negligee that is usually worn to bed. Babybolls are decorated in many different decorations was, including but not limited to lace, faux fur, ruffles, bows and ribbons. Most babydolls hang off of the shoulder by spaghetti straps. The babydoll mainly comes in chiffon, silk or nylon and is usually sheer or see-through. The babydoll got it’s name from the length of the hemline, which comes about six inches above the knees, which is similar to a mini-dress.

The babydoll was made popular from a movie titled Baby Doll. The movie came out in 1956, Carroll Baker played, a sexy 19-year-old virgin. The style of nightgown she wore in the movie was soon a “must have” for everyone. It may also be traced to the 1930s and 1940s, at that time short bed-jackets trimmed with lace, as well as an array of bed-capes, were worn by women.

Later, the babydoll was transformed into a short dress that could be worn during the day. It was at this time that it became quite popular among the younger generation because the style made people think of youthfulness and innocence. This new style of babydoll soon became a popular addition to the bedroom, as well. Some of the styles are similar to those worn by dolls, where the buttocks could easily be seen, leading to an enhancement in sexual play. Some babydolls that open in the front and are similar to a robe.

Now, the babydoll is considered a popular form of lingerie, helping to create fantasies. The short length of the hem makes legs appear to be longer. For those who do not wish to be completely exposed on the bottom part of their body, the gown is accompanied by a set of matching panties. If you are not aiming for a sexual presentation, the babydoll is also a short nightgown, which comes in a variety of elegant styles.

Babydoll’s are found in lingerie boutiques. Some boutiques have some of the styles hailing from the 1960s and 1970s, within its own department. Baby doll nighties that date back to the 1950s to the early 1980s are considered now as valuable collectibles. Another movie has made the babydoll popular, since the 1956 Baby Doll flick, . The babydoll worn by the “Fembot” in Austin Powers: International Man of Mystery and is made of marabou, a type of silk . It is a marabou bralette with a pleated chiffon skirt and a marabou hemline.

Dementia friendly projects and communities are sorely needed

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For baby boomers and their parents, there’s no biomedical solution in sight for preventing or curing dementia. That means we need to help people face the prospect of living with dementia and support families affected by it through dementia-friendly policies aligned with their needs.

Where should we start? One place is at the movies.

While I was in Liverpool this summer for the annual conference of the British Society of Gerontology, I spotted a poster for a monthly series of classic films at a local cinema. Printed inside a big pink circle in the poster’s corner were the words “dementia friendly.” I took a closer look. Tickets were about half the price of the usual discount for older adults, and free to caregivers. Screenings were at midday, with free tea and coffee. There was a 20-minute break halfway through the film. And the series was open to the public.

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A Google search turned up dementia-friendly screenings and series at cinemas throughout the United Kingdom, plus tips from the Alzheimer’s Society on how to select films for individuals with dementia and how to accommodate their needs.

The “dementia friendly” movement is well-developed in the U.K., as well as in Australia, Ireland, and other aging societies. In addition to making sure that people with dementia and caregivers have a voice in developing dementia programs, U.K.-based efforts like the Dementia Engagement and Empowerment Project (DEEP) engage people with dementia or caregivers as co-investigators in participatory research.

At the gerontology conference, a session on creating a dementia supportive community in rural North Wales was co-presented by a university researcher and a co-researcher living with dementia. The co-researcher noted that he and other participants with cognitive impairments need logistical help (“we don’t do planning”), transportation, and non-stressful arrangements. For example, meetings begin with tea and cake, a familiar form of local hospitality that encourages discussion and social ties among people with dementia, caregivers, researchers, and social service providers. Materials are shared in print ahead of meetings so participants with dementia would not need to process new information quickly or in unfamiliar formats.

Co-researchers proved to be the key in explaining the project’s goals to other older adults, and were able to stress that dementia research didn’t just mean doing brain scans. Peer-to-peer outreach led to many voices contributing insights on how to build dementia- friendly community life. The North Wales network now hosts informal meetups; a dinner group for people with early-onset dementia; peer support for people newly diagnosed with dementia; education for police officers and taxi drivers; and a project to collect Welsh-language music recordings familiar to locals from childhood.

The U.K.-based National Evaluation of Dementia Friendly Communities, also known as DEMCOM, is conducting a national evaluation of nearly 300 dementia-friendly projects to understand how they help people live well. The study, which includes as co-researchers individuals with dementia and caregivers, has found that dementia friendliness involves far more than “putting up signs” to indicate that a business is dementia friendly or to help people with cognitive impairment navigate public places. Insights from co-researchers suggest that some individuals with dementia who welcome opportunities to socialize in relaxed, supportive environments may not want to call attention to their diagnoses in a supermarket check-out lane marked as “dementia friendly.”

In the U.S., some cities, such as Denver, have started education programs to help community members recognize dementia symptoms and learn how to assist people with symptoms such as confusion. The Museum of Modern Art’s Alzheimer’s Project, popularly known as Meet Me at MoMA, is an example of an initiative to make museums more accessible to people with dementia and to dementia caregivers. But what about in everyday life?

When I went looking for U.S. examples of the types of projects — local, sociable, accessible, practical — that I’d learned about and observed in the U.K., I often found them in public libraries. Some regularly host Memory Cafes, started in the Netherlands over 20 years ago as dementia-friendly gatherings. Dementia Friendly America, a network launched in 2015 based on a statewide initiative in Minnesota, has worked with AARP’s network of age-friendly communities on recommendations for collaboration between these related but different movements.

I learned about a restaurant in Huntington, W.Va., that has started a monthly dementia-friendly night. The restaurant’s managers and another community member, all with family experiences of dementia, brainstormed a welcoming environment for people with dementia and for caregivers. “We know what people with dementia and their caregivers go through,” restaurant co-manager Bradley Tweel told the Washington Post. “We know that they could probably use a night out together, and we wanted to show that we completely understand.”

A caregiver’s advice to wait staff on how to support people who have difficulty processing new information — don’t offer seven daily specials — reflects the compassion, hospitality, and practical wisdom evident in this and other grassroots projects.

Dementia-friendly initiatives are not care systems. They do not fix basic problems such as inadequate insurance coverage for services and supports needed by individuals with dementia. In the U.S., out-of-pocket costs are 81% higher for dementia compared to cancer or heart disease, largely because so many services needed for this common age-associated condition are not covered by insurers. These problems, which make a dementia diagnosis even harder to bear, need policy solutions.

The absence of effective treatments for dementia means we must look at this increasingly common condition in a new way, centered on the experience of people facing dementia in their lives today, not around what biomedicine may offer in the future. As more and more Americans develop dementia or become dementia caregivers, dementia friendly projects can spark our imaginations about what makes a community a good place to live and show us how to learn from people with dementia and their caregivers as integral members of communities in aging societies.

Nancy Berlinger, Ph.D., is a research scholar at The Hastings Center, where she directs the Bioethics for Aging Societies: Informing Policy and Practice project.

My Tips on Improving Your Finances for Life

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There is no way to avoid dealing with money and finances these days. Therefore you should try to learn as much as possible to help you make good financial decisions and to increase your confidence about money.

When you make a budget, it should be realistic regarding your income and spending habits. Be sure to include all of your income such as alimony, child support, rental income, or any other. Always use your net income not your gross earnings in these calculations. Once you have the numbers, you can consider how to adjust your spending to stay within your income range. To maintain your budget never exceed your incoming cash flow.

The next step is to total up your expenses, and you should make a list of all monthly expenses. Your list should document each and every expense that you have whether it expense, spontaneous or just a one time expense. Remember that this list needs to have a complete breakdown of your costs. Be sure to add in expenses that you have from restaurant dinners and fast food as well as grocery bills. Reduce expenses linked to your cars, such as gas and insurance. If you have payments that you make quarterly or less frequently, divide them up to reflect a monthly payment. Make sure you include incidental expenses, for instance, baby sitters or storage unit rentals. Try to have the most accurate list possible.

Now that you have a good idea of your income and expenditures, you can start planning a new budget. Look at each expenditure on your list, and decide what you could do without. If you normally buy coffee from a cafe, calculate how much money you would save on a weekly basis if you bought it from McDonald’s instead, or made it at home. Exactly what and how much you are willing to compromise is completely up to you. The first step is identifying expenses that are not necessary so you can use the money for something else.

If your utility bills are rising, you may want to upgrade your appliances to save some money. Upgrading to well-fitted double-glazed windows, for example, can reduce your heating bill dramatically. Besides you can repair any leaky pipes and only run the dishwasher with a full load.

Swap old, inefficient appliances for those that use less energy. Although doing so may cost you some money upfront, over the long-term you will save a fair penny on your utility bills. Unplug the appliances you do not need. In time you will notice significant savings in your energy consumption.

You can make a significant decrease in your heating and cooling bills by improving your insulation, as well as the roof above it. Insulation or roofing issues can be very costly, as maintaining a regular temperature in the home can be expensive. If you invest in the upgrades, it will save you a lot of money in the long run.

Using these tips not only saves you money, but it also helps you start bringing your budget under control. An expensive upgrade can save a lot of money in lowering electricity or water bills. This is one way that you can make your budget more reliable.

This Is How Much Americans Think It Takes to Be Wealthy

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The words “rich” or “wealthy” mean different things to different people. Some people may feel rich if they can comfortably afford all the necessities in life, while others won’t feel truly wealthy unless they hit billionaire status.

Large pile of hundred dollar bills

Image source: Getty Images

according to the Insured Retirement Institute.” data-reactid=”25″>That’s a lofty goal, considering roughly half of baby boomers have no savings at all, according to the Insured Retirement Institute.

financial security — especially when you’re saving for retirement. For some people, $2.27 million will be far more than they need to enjoy a long retirement, but others may need even more than that to make ends meet. How much you’ll need to feel wealthy in retirement depends on your individual situation.” data-reactid=”26″>Sitting on $2.27 million in the bank may make you feel rich, but the truth is more money doesn’t necessarily translate to financial security — especially when you’re saving for retirement. For some people, $2.27 million will be far more than they need to enjoy a long retirement, but others may need even more than that to make ends meet. How much you’ll need to feel wealthy in retirement depends on your individual situation.

What does it really take to retire rich?

How much money it takes to be able to retire wealthy depends on your definition of wealthy. Are you planning on buying a beach house on every coast and traveling the world? Or would you prefer to stay closer to home so you can relax and enjoy time with family?

create a retirement budget, which will give you an estimate of how much money you’ll likely be spending each year during retirement. Some people spend roughly the same or even less than they did while they were working, but each situation is different. Especially if you expect to go all out during retirement and fulfill all your expensive bucket list dreams, you might be spending significantly more than you are now.” data-reactid=”29″>The first step to figuring out how much you need to save to retire rich is to create a retirement budget, which will give you an estimate of how much money you’ll likely be spending each year during retirement. Some people spend roughly the same or even less than they did while they were working, but each situation is different. Especially if you expect to go all out during retirement and fulfill all your expensive bucket list dreams, you might be spending significantly more than you are now.

Another important factor to consider is how many years you expect to spend in retirement. While nobody can predict exactly how long they’ll live, spending a few more years in retirement than you anticipated can cost hundreds of thousands of dollars. Take a look at your health and family history, and use that to estimate your life expectancy. It’s not the most enjoyable thing to think about, of course, but it can help ensure you’re as financially secure as possible for the rest of your life.

retirement calculator to see how much retirement will likely cost you. If you’ve crunched the numbers and the result is an astronomical figure, that doesn’t mean you can’t retire wealthy; it just means you’ll need to work a little harder to reach that goal.” data-reactid=”31″>Once you have these considerations in mind, input your information into a retirement calculator to see how much retirement will likely cost you. If you’ve crunched the numbers and the result is an astronomical figure, that doesn’t mean you can’t retire wealthy; it just means you’ll need to work a little harder to reach that goal.

Making sacrifices now to retire wealthy later

willing to sacrifice, it can be achieved.” data-reactid=”33″>Say you really want to save $2.27 million by the time you retire. That’s a huge goal, but depending on how much you have saved, how long you have until retirement, and how much you’re willing to sacrifice, it can be achieved.

If you’re 30 years old with nothing saved for retirement, you’d need to save around $1,200 per month earning a 7% annual return on your investments to have around $2.27 million saved by age 67. By getting off to a late start (say, age 40), you’d need to save even more — to the tune of $2,500 per month, all other factors remaining the same.

cut costs so you can save that much every month, you can retire with well over $2 million by retirement age. But it’s also important to be realistic with your goals and exactly how much you’re willing to sacrifice. You may want to live a luxurious retirement lifestyle, spending $100,000 per year on lavish vacations and expensive hobbies. But if it means giving up nearly everything but the bare essentials for the next several decades, is it really worth it? That’s up to you to decide.” data-reactid=”39″>Again, if you’re willing to make sacrifices and cut costs so you can save that much every month, you can retire with well over $2 million by retirement age. But it’s also important to be realistic with your goals and exactly how much you’re willing to sacrifice. You may want to live a luxurious retirement lifestyle, spending $100,000 per year on lavish vacations and expensive hobbies. But if it means giving up nearly everything but the bare essentials for the next several decades, is it really worth it? That’s up to you to decide.

That’s not to say you shouldn’t save anything for retirement, however. Even if you plan to live a modest life in your golden years, you still need to save as much as you can. You may not need $2.27 million to get by, but you’ll likely need at least a few hundred thousand dollars saved to live comfortably. You still might have to make sacrifices to save as much as you need, but you may not need as much as you think to be financially secure in retirement.

Becoming wealthy is a common desire, and you don’t necessarily need to launch a billion-dollar business or win the lottery to be rich. Whether “wealthy” means retiring with $500,000 or $2 million in the bank, you can retire rich if you’re willing to make sacrifices and save diligently.

disclosure policy.” data-reactid=”43″>The Motley Fool has a disclosure policy.

Fool.com” data-reactid=”44″>This article was originally published on Fool.com

Tips For a First-Time Mom

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Having a baby can be one the most life-changing experiences there are. And not all those changes will be easy to cope with. Here are some tips for a first-time Mom, to help you get through the rougher times.

The vast majority of women today, are working when they become pregnant. That means making a decision whether to stay home with the baby, or return to work. This is something you can consider during your pregnancy, weighing the pros and cons of your income, versus the benefits to this child, and any others to come in the future. If you decide to return to work, finding childcare ahead of time, will relieve you of the worries when your maternity leave is at an end.

Women who do work full-time, often find themselves swamped in things that relate to the baby, whether it's their laundry, their nap schedules, or their feedings. At times it can seem like your whole life revolves around them, where it used to involve co-workers, friends and visits to family.

One of the most valuable tips for a first-time Mom, is that you shouldn't give up your entire life to the new one that you're carrying. After the baby is born, you will be their primary caregiver, but you don't need to be tied to them every second. Make some time for you, whether it's a yoga class at night with Dad doing the babysitting, or a date out with your partner, and one of the grandparents spoiling the new arrival.

It's important that you have a break from the constant focus of your everyday activities with the baby. This can include many at-home activities as well, like reading, quilting, or even crafts that you enjoyed before the birth. The baby will be just as happy watching you relaxed and involved in your hobby, as they would be if you were doing the laundry.

You might even find a group for mothers at your church or local community center. Sharing tips for a first-time Mom with others, is one way of easing the pressures and worry of whether you are doing things right, and the time out, even with baby, will be a change in routine that you'll welcome!

Hepatitis C Drugs Reduce Liver-related Deaths by 46%

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A new study from the UT Southwestern Simmons Comprehensive Cancer Center demonstrates that antiviral drugs for hepatitis C reduce liver-related deaths by nearly 50% in patients with a history of liver cancer.

The finding builds on a December 2018 study by the same researchers who found that antiviral drugs do not increase the risk of liver cancer recurrence, as was previously feared.

Dr. Amit Singal’s study was published in the journal Gastroenterology on July 30. Dr. Singal is an Associate Professor of Internal Medicine, Medical Director of the UT Southwestern Liver Tumor Program, and Clinical Chief of Hepatology. He collaborated on these studies with Dr. Caitlin Murphy, Assistant Professor of Population and Data Sciences and Internal Medicine. They are both members of the Harold C. Simmons Comprehensive Cancer Center at UT Southwestern.

Their studies overturn prior misconceptions that made doctors reluctant to prescribe direct-acting antivirals to treat hepatitis C in patients with a history of liver cancer. Many doctors previously believed that hepatitis C, for all its harmfulness, activates the immune system when it infects the liver, and the immune system kept liver cancer recurrence at bay.

But this notion appears to be false. Drs. Singal and Murphy studied nearly 800 patients from 31 medical centers across the country and found that the drugs are not only safe, they decrease death from cirrhosis and liver cancer by 46%.

“Not only are these drugs safe in this patient population, but we have now demonstrated that they are helpful,” Dr. Singal said. “Our study changes the paradigm from you could treat a patient’s hepatitis C to you should treat it.”

Dr. Carlos L. Arteaga, Director of the Simmons Cancer Center, said the study’s scope and impact are something that can only be produced by a National Cancer Institute-designated Comprehensive Cancer Center.

“Dr. Singal had more patients involved in the study than any other participating site. As an epidemiologist, Dr. Murphy brought rigor to the data that removes prior doubt on this issue,” he said.

Dr. Murphy said previous studies compounded the misunderstandings of direct-acting antiviral therapy because they, among other things, failed to account for the timing of therapy relative to liver cancer diagnosis, did not include a comparison group, or did not properly consider clinical differences among patients.

The new study is a significant contribution because it clears the path to beneficial drug treatment.

“Hepatitis C therapy is so important because it provides a cure,” Dr. Singal said. “You take oral medications for two or three months, with minimal to no side effects, and you’re done. You’re cured of hepatitis C. There’s less than a 1% chance of relapse if you’re cured of hepatitis C.”

Defeating hepatitis C is an important step because infection can otherwise lead to cirrhosis – scarring of the liver – which can be deadly. Cirrhosis can increase the risk for liver cancer, which also may be fatal. Curing hepatitis C with antivirals breaks the first link in a deadly chain of events and can lead to improvement in liver function among those who have previously developed cirrhosis.

Hepatitis C rapidly made its way into the American blood stream in the 1970s and 1980s when intravenous drug use spiked and blood products were not screened for the hepatitis C virus. Hepatitis C infected 2 to 3% of the baby boomer population, the largest generation in U.S. history. Millions were affected.

The disease can lie dormant for 25 to 30 years and resurface as a life-threatening specter years after someone has stopped using drugs and turned to a healthy lifestyle. Hepatologists saw an alarming spike in cirrhosis as baby boomers aged. By 2017, The New York Times called hepatitis C “an enormous public health problem.” In 2018, the Centers for Disease Control and Prevention announced there were nearly 2.4 million people living with hepatitis C in the U.S.

“Dr. Singal’s and Dr. Murphy’s study reports a welcome, fact-based way to oppose the adverse effects of hepatitis C infection in various demographic groups,” Dr. Arteaga said. “Their findings will have a global, lifesaving impact on how hepatitis C is treated. It is particularly important to Texas because the liver cancer incidence rate in Texas is the highest in the nation.”

Dr. Arteaga said the study is also important because liver cancer is highest among the Hispanic population in Texas, and research-based advances in reducing cancer in underserved groups are a Simmons Cancer Center priority.

Reference: Amit G. Singal, et al. (2019) Direct-Acting Antiviral Therapy for HCV Infection is Associated with Increased Survival in Patients With a History of Hepatocellular Carcinoma. Gastroenterology DOI: https://doi.org/10.1053/j.gastro.2019.07.040

This article has been republished from the following materials. Note: material may have been edited for length and content. For further information, please contact the cited source.

The Ultimate Sinful Tour of Paris – I Missed Some, You Don’t

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Moulin Rouge… the birthplace of Cabaret

Moulin Rouge was opened by Joseph Oller and Charles Zidler back in 1889. During that time Paris was the hub of creativity and the city was going through the phase people call “one of the best times in Paris”. It is believed that Moulin Rouge was the place where cabaret originated. This seductive dance was done by the show girls who used to live and perform in Moulin Rouge. The interiors of the establishment boast of huge floor to wall mirrors, expensive chandeliers, plush carpets, huge floor for dancing and spectacular showgirls. The environment inside the establishment becomes totally electrifying and ecstatic when the show is on. Even in these digital times Moulin Rouge receives a footfall of 1000 guests per night.

Lido de Paris… the Classier Moulin Rouge

Lido de Paris is probably the most famous establishment after Moulin Rouge. It is situated at Champs-Elysees, one of the most attractive neighborhoods in Paris, particularly in the night. Lido is famous for its dance and musical shows. Every night, it hosts shows where showgirls are dressed up in the most exotic and exquisite costumes. The interior of Lido is also very extravagant and posh, adorned with bright colors and old world decor. The lighting and the sound effects are captivating. The stage and set changes almost about 60 times right in front of the audiences! The oval shape of the hall ensures that everyone has a good view. They also have shows where kids are allowed, but expect nudity in them too, though they don’t look vulgar. Earlier Lido used to be a black tie event but these days they allow you in without it. But they are particular about dressing so dump your denims for the night at Lido.

Au Lapin Agile… The Nimble Rabbit

Adult entertainment just does not cease in romantic Paris! Au Lapin Agile is another vintage joint for cabaret. Many famous people were regular visitors here and we are talking about the likes of Toulouse-Latrec, Modigliani, Utrillo and Picasso. The translation of the name Au Lapin Agile means the nimble rabbit which got its name from a painting where a rabbit is jumping out of a heated pan. During 1905 Pablo Picasso painted a picture which helped in the publicity of the establishment. The name of the painting was ‘At the Lapin Agile’. Well if Adult Activities in Paris are on your mind, then just step in! Did we mention that this place still retains the evidence of eccentric characters of Paris who visited here? They are there in form of names carved in the wooden tables and they did it themselves!

Paradis Latin… Napoleon’s Personal Theatre of Dance

Now we are on to the next Cabaret haunt which is also one of the oldest in the Latin Quarter, so located centrally. Here you would find the shows very intriguing as most of the male and female artists perform completely naked. However the dancing and artistic references are not always filled with sexual innuendos, it is more like an adult circus. Quite a Cool thing to see In Paris for Adults! Paradis Latin was built in 1803 under the command of Napoleon Bonaparte. Famous writers like Alexandre Dumas and Balzac were frequent visitors to this place.

Crazy Horse Cabaret… Go Crazy with the Tease

There are cabarets in Paris where you can see stage performances by naked dancers, moving and swaying their body in a classy yet seductive manner nad crazy horse is one of them. The iconic Crazy Horse was opened for the public in 1951. These dances are indeed provocative yet this is one of the most sophisticated cabaret clubs in Paris and well reputed too. Famous celebrities like Pamela Anderson and Dita von Teese have also performed on the dance floor of the Crazy Horse.

Cesar Palace Cabaret

If you want a taste of Paris nightlife then look no beyond the César Palace Cabaret that not only packs some sensual cabaret moves but also mind boggling acrobatic maneuvers. Traditional cancan girls dressed up elegantly perform in the shows here. And that is not all… they top up the wonderment with some super sumptuous three course french meal as well! They host the two hour show that does not let you blink your eyes. Talk of tantalizing, think of César Palace Cabaret!

Tell us you are breathless! Well we have surely given you some extra reasons to make Paris your next destination. I mean romance is passé’, it is time to get naughty!

And just like we had promised, let us take you to the next section that is going to be even more sinful, but in a different way- the French food!

Laudrey Pastry shop… the best macaroons in the entire Paris

Laduree is a famous pastry shop which is famous for selling one of the tastiest and vibrant coloured macaroons in Paris. Yep we are talking Paris Desserts here! Back in 1862, Louis Ernest Ladurée had established this small time bakery; sadly the bakery got gutted due to fire after 9 years. It was erected again but this time the shop was full time Pastry shop. Later on a tea shop was also made next to the Laduree store and now if you visit you would be able to enjoy the wonders of both of the stores.

Berthilon.. The Sweet Lovers’ Paradise

Paris is heaven for food lovers but we all know that. The trick is to find the best amongst the best. This is why best way to travel Paris is on foot where you will find a food store or a restaurant within every two steps of your journey. The most well known and famous ice cream parlor and sorbet shop the Berthilon is a treat for all the people who love like it sweet and chilled. This place was opened in 1954. This ice cream parlor serves more than 70 flavors and people swear by the aroma when you step inside the shop. Make sure that you definitely taste the strawberry sorbet here. Berthilon is definitely one of the best places to eat in Paris.

58 Tour Eiffel Tower… offering a larger than life experience

When you are in Paris, going and experiencing the 58 Tour Eiffel Tower has to be on your things to do in Paris. This is a restaurant situated on the first floor of the Eiffel tower. When you sit inside you get a lovely and “as-far-as the eye goes” panoramic view of Trocadero part of the city. The other side of the restaurant shows the interiors of the Eiffel tower’s mesh work. The restaurant serves typical French brasserie food. The restaurant offers a 2 to 3 course style food picnic for lunch. During the evening you can experience the traditional French cuisine inside the restaurant with the lights dimmed and grand view of the city lights coming alive in a distance.

Le Ombres Restaurant… Experience the Fusion of Flavours

If exploring Paris Food Culture is on your wish list then there is no way you can miss Le Ombres Restaurant. This restaurant is famous for its architecture, the beautiful view of Eiffel Tower and the special menu set by Chef Jean-François Oyon, a two starrer Michelin chef. He was announced as the Chef of the year by Le Chef Magazine. So it goes without saying that the food quality in this restaurant is really good and it serves traditional French cuisine with exquisite flavors and ingredients, served like an art on the plate. We bet you can’t have enough of it!

Latelier-des-Chefs-Cooking-School… Go a little French!

LAtelier-des- Chefs-Cooking- School is a famous cooking school in Paris, with its branches in around 14 locations located all over France. Six of the cooking schools are situated in Paris. Guinea fowl with baby gem, peas, mustard and ratte potatoes is a fowl breast recipe that is served with green salad is one of the most loved dishes taught in the school. The other popular delicacies are lamb with minted crushed potatoes, broad beans and wild mushroom sauce, and roasted lamb with fennel puree and potatoes. The chief agenda behind establishing the school was to motivate French students to take up the art of cooking as a career. Recently it has also opened its doors to visitors of different nationalities to learn French style cooking.

How to reach

Paris is very well connected by air from all the major cities in the world.

Where to stay in Paris

Paris has an amazing array of options when it comes to accommodation. Here are our top picks across the budget spectrum, so whether you are on a tight budget or looking for luxurious indulgence we have it all here.Or you many simply type Paris in the nice little hotel search box given here for a complete list of hotels.

So this was the seductive and sinful Paris tour. So what are you waiting for, pack your bag and indulge in some naughty pleasures of life!

Governor put gun lobby ahead of New Hampshire seniors

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Gov. Chris Sununu’s veto of House Bill 696, a new bill passed with bipartisan support in order to protect seniors from elder abuse, warrants special mention among the many bills he has vetoed, improvidently.

It warrants special mention because our population is aging, we face special problems responding to the needs of seniors and none of the reasons the governor gave for vetoing the bill made sense.

The record instead indicates that the governor lined up with the gun lobby against seniors. This is no El Paso and Dayton, but it is a capitulation by the governor that will have its victims in New Hampshire, even if he recaptures reason and changes positions next term.

By then, time will be lost and seniors will have suffered without the protections HB 696 could have provided.

HB 696 sought to implement a procedure by which vulnerable individuals, and the state even, could obtain protective relief from courts in New Hampshire against elder abuse. The relief looked like the sort victims of domestic violence may get in court.

However, the statute focused on the special vulnerabilities of seniors, which are often distinct from others victimized by domestic abuse. These vulnerabilities include the documented risks to seniors targeted by predators for financial exploitation.

HB 696 was shepherded by AARP and New Hampshire Legal Assistance, as well as other organizations focused on the needs of seniors. Each has a special perspective on the needs of seniors as a result of years of work in the area. The bill had support from politicians of such disparate views as Renny Cushing, a House Democrat, and Sharon Carson, a Senate Republican. No government agency opposed it. Attorney General Gordon MacDonald raised no red flags about it in the legislative history. No objection came from public health.

Instead, the consortium of organizations that sought to defeat the bill were gun rights groups such as the NRA, which called it dangerous, and other more minor gun rights lobbyists. None has any special expertise in the area of elder abuse. None of the claims these organizations made were credible.

I have litigated these issues as a prosecutor and in private practice. One of my most disturbing cases as a homicide prosecutor in New Hampshire involved a murder for hire (by gun violence) coordinated by violent people to cover up the financial exploitation of an elderly man (State v. Saunders). Had HB 696 been in place then, perhaps the government could have prevented that catastrophe before it happened.

As a private lawyer who has practiced in our probate courts since that case and has read and studied the law of undue influence and seniors, I have wondered why the state has been so passive in protecting seniors through a more specialized protective statute.

As we all read about Portsmouth police officers taking advantage of an elderly woman in the Webber case, for instance, one of a series of cases presenting facts the likes of which we will only see more of as baby boomers reach retirement and beyond, I imagined the law would not lag so far behind our needs.

This term the Legislature appeared sensitized to these problems. HB 696 passed with substantial bipartisan support. Gov. Sununu then vetoed the bill, issuing a statement that subverted the interests of senior victims while giving voice to the most expansive definition of gun rights. He did so within days of the shootings in El Paso and Dayton and as we watched the news about a shooting in our state that a Weare police officer thankfully survived.

Indeed, the governor claimed that HB 696 raised Second Amendment concerns without citing law or examples and even though its provisions do not target the guns of users as aggressively as the standing domestic violence statute.

His other claims had no greater merit.

Among his more unbelievable reasons, he claimed that the bill risked creating confusion for other victims of domestic violence that judicial officers could not address. The governor either ignored or did not understand that judicial officers are required to assist in addressing confused litigants as matter of our law.

The Judicial Branch’s Domestic Violence Protocols, for instance, provide public advice on domestic violence cases already. Court staff also routinely assists pro se litigants (and others) in identifying proper forms.

And of course we have multiple ways pro se litigants can access attorney advice, including through public interest law firms and pro bono legal services (another reason to support these organizations whose budgets the governor tried to demolish).

The governor claimed that the bill would harm seniors because it would close off other relief now available. This fact must have come as a surprise to AARP. The bill says that it supplements other available remedies by its terms.

The governor’s communication staff then tweeted that their concerns were supported by the Coalition Against Domestic and Sexual Violence. That organization, which is dependent upon the governor for appropriations and political support, confirmed that fact by tweet. If that organization provided the rationale for the veto, it has (once again) badly harmed its credibility in regard to victims’ rights by undermining efforts to protect N.H. victims by law.

What’s left from this record is the conclusion that the whole result was driven by the gun lobby and the governor’s desire to appease it. If that’s the case, then citizens have a right to consider and reflect on those priorities.

Gun rights are constitutional but they are not absolute. Seniors, in particular, should demand an accounting about the governor’s subversion of their interests to gun owners who have acted violently toward them. Whether we are committed to protecting seniors from exploitation and abuse swings in the balance and must be weighed against baseless and paranoid concerns about the regulation of guns in New Hampshire.

(Michael S. Lewis is a Concord attorney.)