Category: 8. Health

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Understanding the link between job strain, stress, and smoking to severe climacteric symptoms, urging better workplace and healthcare support for midlife women. 

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Researchers conducted a retrospective study published in the July 2025 issue of European Journal of Obstetrics and Gynecology and Reproductive Biology to explore how work- and health-related factors were associated with climacteric symptoms among middle-aged full-time working women prior to receiving any treatment.  

They assessed 313 Finnish women aged 52–56 years who were employed full-time and had never used any treatment for climacteric symptoms (n = 313). Symptom experience was measured based on the presence and severity of menopause-related symptoms negatively affecting general or work-related well-being. These symptoms included hot flushes, sweat, sleeping problems, vaginal dryness and tenderness, loss of sexual desire, and depressive symptoms. The analyzed work- and health-related factors included psychosocial work environment, health behaviors such as body size, physical activity, smoking, perceived stress, and social support.  

The results showed that a high-strain job, active smoking status, elevated stress levels, and limited social support were linked to both higher frequency and greater severity of climacteric symptoms. Women presenting these characteristics experienced menopause-related symptoms more often and with an increased intensity compared to those without these traits.  

Investigators concluded that multiple factors impacted how full-time working women experienced climacteric symptoms before treatment, underscoring the need for collaborative efforts between healthcare professionals and employers to support women’s health and well-being. 

Source: ejog.org/article/S0301-2115(25)00307-0/fulltext 

Varicose veins bulge and twist across the calves of up to 30 percent of adults, a reminder that blood sometimes pools instead of flowing home to the heart. When sluggish blood flow lingers, clots can form and, in rare cases, travel to the lungs or brain.

Centuries ago physicians in China brewed teas from Ginkgo biloba leaves to sharpen memory. Today researchers wonder whether the same ginkgo leaves might support weary leg veins and cut the risk of small, yet dangerous, blood clots.

Why circulation can falter

Blood rising from the feet must fight gravity, and faulty valves can leave veins stretched and valves leaky. The lingering pressure distends vein walls, encourages inflammation, and slows platelet aggregation, the first step toward clotting.

Slow venous return creates the setting for deep‑vein thrombosis as well as the aching, throbbing symptoms many patients feel after a day of standing.

That overlap has pushed vascular specialists toward plant‑based compounds that might tone the vein wall and limit sticky platelets.

After logging stroke cases at Xuanwu Hospital in Beijing, neurologist Xiangqian Huang of Capital Medical University began probing ginkgo’s effects on clot behavior in the brain, work that now informs leg‑vein research.

Ginkgo leaves and blood flow

Ginkgo extract made blood platelets less sticky when triggered by one type of chemical but didn’t have much effect when triggered by another.

Dr. Xiangqian Huang and the team also noticed that blood took slightly longer to clot after treatment with the extract.

The leaf contains natural compounds that seem to interact with enzymes responsible for forming clots.

In a 2025 animal study, researchers found that ginkgo reduced damage inside blood vessels in rats with clotting problems and slightly increased the time it took for their blood to clot. 

Insights from a Beijing stroke ward

Huang’s real‑world study followed 99 patients for five days. Among stroke survivors who received ginkgo plus baby aspirin, arachidonic‑acid platelet aggregation fell more than in peers on aspirin alone, while major bleeding did not rise.

Minor nose or gum bleeds surfaced in four of thirty‑three combination patients, a signal that enhanced anticoagulation deserves monitoring. No severe hemorrhages occurred, suggesting short‑term safety when doses stay low.

The design also enrolled participants with internal jugular venous stenosis, a group whose clots mirror those in leg veins.

In that arm ginkgo alone curbed blood platelet stickiness within 24 hours, and the effect held steady through day five.

Aspirin, ginkgo, and blood clots

A team of scientists led by Christopher Gardner from Stanford Department of Medicine examined the potential adverse effects of concomitant aspirin and Ginkgo biloba on blood platelet function after giving the duo to older adults for four weeks. The worry was that the herbs might blunt or boost common drugs. 

Gardner and colleagues detected no dangerous bleeding, yet laboratory tests showed additive platelet inhibition, suggesting that low‑dose pairings could protect high‑risk patients who cannot tolerate stronger pharmaceuticals.

Doctors, however, should adjust regimens around surgeries or when other blood thinners enter the mix.

Because the leaf targets arachidonic‑acid pathways that aspirin already touches, the partnership makes pharmacologic sense.

Still, anyone taking nonsteroidal anti‑inflammatory drugs should discuss timing and dosage to avoid stacking identical mechanisms.

Helping legs feel lighter

Deep veins are not the only place where endothelial cells detach under strain.

In a classic double‑blind trial, scientists found that a capsule combining ginkgo, troxerutin, and heptaminol cut circulating endothelial cell counts by 14.5 percent in patients with chronic varicose veins, placebo achieved only 8.4 percent.

Endothelial cells are early barometers of vein injury, so their decline hints at real structural healing.

Participants also reported reduced ankle swelling and night cramps, benefits echoed by later Russian and Italian studies that tracked leg circumference.

Modern phlebology still relies on compression stockings and laser ablation, yet many sufferers ask for gentler first steps.

A standardized ginkgo formula, already licensed for vascular disorders in parts of Europe, may slot neatly between lifestyle changes and invasive procedures.

Blood clot prevention with ginkgo

Yang’s rat data showed lighter clots, higher nitric‑oxide levels, and longer clotting times after gavage with 60 milligrams per kilogram of extract.

Nitric oxide relaxes vessel walls and counters platelet stickiness, aligning with human data from stroke and vein clinics.

Network‑pharmacology maps place AKT1, ALB, and TNF at the center of ginkgo’s target web. Those same genes regulate inflammation, suggesting that the tree’s reach extends beyond platelets to the very lining of our veins.

Because oxidative stress weakens venous valves, the antioxidant side of the extract warrants equal attention.

Flavonols scavenge free radicals, potentially slowing the progressive dilation that makes early spider veins blossom into rope‑like cords.

Talking with your doctor

Ginkgo supplements crowd store shelves, yet extracts used in clinical trials are highly standardized. Look for EGb 761 or products specifying at least 24 percent flavonol glycosides and 6 percent terpene lactones.

Patients on warfarin, direct oral anticoagulants, or upcoming dental work should alert their clinicians before starting any form of ginkgo.

Health professionals may stagger doses, check clotting labs, or advise pausing the herb to keep bleeding risk low.

For those with aching calves and a family history of clots, discussing ginkgo as an adjunct to compression or low‑intensity exercise could make sense.

Evidence remains preliminary, yet the plant’s dual action on platelets and vein walls is steadily moving from bench to bedside.

Future multicenter trials ought to track long‑term safety and measure quality‑of‑life changes such as heaviness, itch, and nightly restlessness. If findings stay positive, an ancient tree might soon earn a modern role in vascular medicine.

The study is published in Thrombosis Journal.

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The explosive growth of food trucks across American cities has introduced not only new and exciting cuisines, but also unique food safety complexities as a result of their compact, mobile kitchens. These operations face distinctive sanitation hurdles compared to traditional restaurants, primarily stemming from spatial constraints and operational mobility.  

Temperature Control Vulnerabilities  

Maintaining proper food temperatures remains a critical challenge, with Suffolk County, NY, citing improper holding temperatures in 43% of food truck violations.  Limited refrigeration space and power fluctuations during transit increase risks of foods entering the “danger zone” (40°F-140°F) where pathogens multiply rapidly. The confined workspace also complicates monitoring, as thermometers may be inaccessible during peak service.   

Hand Hygiene Limitations  

Inadequate hand washing accounted for nearly 19% of violations in the same study.  Tiny kitchens often accommodate only one handwashing sink, which may be obstructed during service. Water tank capacities limit available water for frequent washing, while high-volume periods pressure staff to skip proper 20-second protocols.   

Cross-Contamination Threats  

Proximity of raw and ready-to-eat ingredients in tight quarters elevates contamination risks. Suffolk County documented unprotected food storage in 17.8% of inspections.  Single cutting boards may handle proteins and produce consecutively, while utensil storage challenges,  such as knives kept in drawers rather than holders, further exacerbate risks.   

Spatial and Operational Constraints  

The average food truck kitchen spans 50 to 80 square feet, complicating:  

• Separation of cleaning chemicals from food zones  
• Implementation of first-in-first-out inventory systems  
• Access to hidden surfaces for sanitation (e.g., under equipment)   
• Waste management is particularly challenging without dedicated disposal areas, increasing risks of pest attraction.   

Regulatory and Inspection Gaps  

Jurisdictional variations in codes create compliance complexity, says leading food poisoning law firm Ron Simon & Associates. Meanwhile, inspections frequently occur during non-operational hours when temperature controls and handling practices can’t be evaluated. California researchers noted 90 of 95 trucks had at least one critical violation during operational assessments, risks missed during stationary inspections.  Additionally, 16.9% of Suffolk County violations involved absent certified managers.   

Innovative approaches, including mobile-specific manager certifications, unannounced operational inspections, and space-efficient sanitation protocols, are emerging to address these challenges without compromising the culinary innovation that defines the industry. 

On June 30, 2025, the Society for Cardiovascular Angiography and Interventions (SCAI) published its first clinical practice guidelines on the treatment of chronic venous disease (CVD).¹

Composed of 9 formal recommendations for 8 clinical scenarios addressed by the guideline panel, “SCAI Clinical Practice Guidelines for the Management of Chronic Venous Disease” provides recommendations on a variety of therapeutic options, including compression therapy, wound care, ablation, sclerotherapy, phlebectomy, and deep vein stenting. The guidelines also provide practical insights on which patients may benefit from conservative therapy and when to escalate to invasive options.¹

“These are the first SCAI guidelines focused on chronic venous disease, and they come at a time of increasing recognition of the burden it places on patients and healthcare systems,” said Robert Attaran, MD, MBBS, chair of the guideline writing community and member of the SCAI Vascular Disease Council. “CVD may present with discomfort, heaviness, and swelling, but it can progress to venous ulcers that are difficult to heal and severely impair quality of life. Our recommendations aim to provide clinicians and patients with a roadmap for personalized, evidence-informed care.”¹

The guidelines are based on a technical review conducted by the SCAI, which aimed to answer 8 separate research questions regarding the safety and efficacy of several treatment modalities in patients with symptomatic varicose veins and/or venous ulceration. Each of these questions was based on specific clinical scenarios. Special consideration was given to varied levels of evidence relevant to venous autonomy.²

The SCAI’s technical review consisted of 2 major sections. The first involved looking for high-quality published systematic reviews relevant to the questions, and the second was 3 de novo systematic reviews on ablation therapy, sclerotherapy, and phlebectomy. An initial total of 3648 titles and abstracts were collected; after filtering for eligibility criteria, 19 were selected to inform the technical review.²

Individual recommendations were categorized as “strong” or “conditional” based on the evidence’s certainty, among other contextual considerations. The guidelines also introduce 2 algorithms of treatment: the first for patients with symptomatic varicose veins, and the second for patients with venous ulcer disease.¹

Despite the in-depth analysis, the SCAI notes in the guidelines themselves the uncertainty of evidence for the effect on healing rate, symptom score, quality of life, and disease recurrence of perforator vein ablation, venoplasty, and stenting for iliocaval obstruction, sclerotherapy, and phlebectomy of symptomatic varicose veins.²

Additionally, the panel reported an inability to meaningfully pool data for questions 5, 7, and 8, as the underlying studies were deemed too dissimilar from each other. Similarly, very low certainty evidence suggests sclerotherapy of varicose veins for the reduction of symptom scores, as well as demonstrating a benefit of IPV ablation compared to conservative management for the treatment of venous ulcer disease.²

Considering these limitations, the SCAI panel also endorses further research, acknowledging knowledge gaps in the review and suggesting examination of specific ablation modalities for C2-C4 disease, treatment of perforator and accessory reflux, and other specific clinical situations.²

“These guidelines reflect SCAI’s commitment to bringing high-quality, evidence-based standards to areas where our members are increasingly practicing,” said SCAI president Srihari Naidu, MD. “As interventional cardiologists take a larger role in managing chronic venous disease, a common problem affecting millions of people, these recommendations will help ensure that patient care remains both consistent and personalized.”¹

References

1. Society for Cardiovascular Angiography and Interventions. SCAI clinical document provides clinical practice guidelines for the management of chronic venous disease. Eurekalert! July 1, 2025. Accessed July 2, 2025. https://www.eurekalert.org/news-releases/1089598

2. Attaran R, Edwards M, Bunte M, et al. SCAI Technical Review on Management of Chronic Venous Disease. JSCAI. doi:10.1016/j.jscai.2025.103730

Nearly 35 US states are grappling with outbreaks of vaccine-preventable diseases like measles and whooping cough. A recent American Community Media press briefing highlighted concerns from physicians and scientists about the impact of these healthcare challenges on American families and global communities. This article distills the key concerns raised by medical experts, providing a clear understanding of the risks to public health and potential solutions.

1. **Measles Resurgence Due to Vaccine Skepticism**

A sudden rise in measles cases, even in educated communities, is linked to a lack of awareness and growing vaccine skepticism. Dr. William Schaffner notes this stems from “not wanting anyone to tell them what to do, a lack of trust in public health, conventional medicine, and the pediatricians who care for them.” This skepticism undermines decades of progress in eradicating the disease.

2. **Funding Cuts Threaten Healthcare Access**

Cuts to funding for Medicaid and children’s programs will disproportionately affect economically disadvantaged populations. Experts fear a return to disparities in healthcare access, reversing gains made in eliminating differences based on race, location, ethnicity, and language. These cuts could undo years of progress in equitable healthcare.

3. **Undermining Scientific Publications Harms Progress**

Efforts to undermine established scientific journals, such as *The Lancet*, pose a threat to the integrity of scientific research. Dr. Ben Neuman warns that creating alternative scientific journals could degrade science, undermining America’s role as a leader in ideas, products, and services in the scientific field.

4. **Global Health Policies are Interconnected**

Changes in American healthcare policy can have far-reaching global consequences, affecting vaccine access and disease control worldwide. Dr. Neuman cautions that factors like money, nationality, and religion should not influence vaccination efforts, as infectious diseases do not discriminate. The interconnected nature of global health requires a unified approach.

5. **Political Influence on COVID-19 Vaccines**

The COVID-19 vaccine has become increasingly politicized, leading to mistrust despite endorsements from health ministries and safe administration of millions of doses. This mistrust complicates efforts to control the virus and protect vulnerable populations. “Though ministries of health in America and other countries have reviewed vaccine data, endorsed them, and safely administered millions of doses, it was difficult to comprehend the level of mistrust growing among vaccine skeptics.”

6. **PEPFAR Cuts Jeopardize HIV Control**

Funding cuts to PEPFAR could result in up to 100,000 preventable deaths in just one year, with potentially millions of new HIV infections and deaths by 2030. Dr. Jirair Ratevosian emphasizes that antiretroviral therapy (ART) is crucial for suppressing the virus, saving lives, and preventing HIV transmission. Without a 5-year reauthorization path for PEPFAR, ending the program could result in up to 11 million additional new HIV infections and 3 million additional deaths by 2030.

7. **GAVI Funding Cuts Undermine Global Vaccination**

As the largest donor to Gavi, the global vaccine program, U.S. funding cuts would undermine international efforts to combat infectious diseases. Dr. Neuman notes that Gavi programs are essential for testing vaccine effectiveness in endemic areas, ensuring both safety and efficacy. “By the time an outbreak of something new gets to the United States, it has passed through many people, and it may actually be too late to do anything about it.”

8. **New COVID-19 Vaccine Protocols Exclude Vulnerable Groups**

The new COVID-19 vaccine distribution protocols, focusing only on people 65 and older, exclude vulnerable groups such as healthy children, pregnant individuals, and healthcare workers under 65. Dr. Peter Chin-Hong highlights the particular risk to pregnant people and infants under six months due to their immune system vulnerabilities. “There’s a reason why we’re worried about those two populations in particular,” said Dr.Chin-Hong, “Pregnant people are relatively immune-compromised because your immune system doesn’t want to recognize the growing fetus too much. That puts them at risk for lots of other infections in general, including serious COVID. The second group is those who are under 2 years old, specifically those under 6 months. Their immune system is not mature enough, and they rely on the antibodies going across the placenta from the mother.”

These insights from medical experts underscore the critical challenges facing American and global healthcare systems. Addressing vaccine skepticism, restoring funding to essential programs, and ensuring equitable vaccine distribution are crucial steps to safeguarding public health. Read the full story at [https://americacommunitymedia.org/2024/06/03/americas-health-at-risk-from-shifting-healthcare-protocols-on-preventable-diseases/](https://americacommunitymedia.org/2024/06/03/americas-health-at-risk-from-shifting-healthcare-protocols-on-preventable-diseases/)

Related

Nicholas James Hornstein, MD, PhD, discussed results from the phase 3 CHALLENGE trial (NCT00819208) that were presented at the 2025 American Society of Clinical Oncology (ASCO) Annual Meeting. According to Hornstein, this trial has garnered significant attention, particularly for its exploration of exercise as a therapeutic intervention in colorectal cancer.

This randomized study enrolled patients who had undergone resection for localized colon cancer and assigned them to 1 of 2 arms: a regimented exercise program with a personal trainer or an educational arm providing general advice on the benefits of exercise.

Hornstein, an assistant professor at the Donald and Barbara Zucker School of Medicine of Hofstra University and Northwell Health, noted that the study yielded remarkably positive results. The disease-free survival (DFS) in the group that participated in the structured exercise intervention was substantially higher. The observed DFS benefit from exercise was, according to Hornstein, surprisingly even greater than that seen with oxaliplatin chemotherapy, a standard component of adjuvant treatment for colorectal cancer.

Transcript:

This was not a plenary session. This was an oral [session], and this study has gotten a lot of press. I’ve heard the saying, exercise is the best medicine, and this was explored in the clinical trial. This was a randomized trial taking patients who were status post-resection for localized colon cancer, and it put them into 2 buckets. One, you get a personal trainer and regimented exercise over the course of a week. The other was that you got [educated] about exercise. Somebody sat down and said, “Hey, exercise is great. You should think about it.” [They’re] very different interventions. A lot of people would have expected that this wouldn’t be that positive of a study, but when they randomized the data, the DFS in the group that did exercise as their intervention was drastically higher.

Comparing this with what we normally get, things like oxaliplatin and chemotherapy, there was a higher DFS benefit with exercise than there was with oxaliplatin. This is shocking in terms of the degree of benefit that was observed in this study. Most people would have said, “Oh, yeah, there probably is going to be some benefit to exercise”, but the fact that this is looking to be on the same level as one of our chemotherapy moieties is incredible. This was an interesting study. It is something that I am discussing with all my patients now in the adjuvant setting. I’ve even had some patients who have said, “Hey, can you write me a prescription for a gym pass membership? Can you see if we can get this covered?”, because, to them and me, this is something that needs to be incorporated into our daily practice now, and a lot of patients can benefit. It’s just nice to have a study to point to and say, “Exercise is worth it.”

Reference

Booth CM, Vardy JL, O’Callaghan CJ, et al. A randomized phase III trial of the impact of a structured exercise program on disease-free survival (DFS) in stage 3 or high-risk stage 2 colon cancer: Canadian Cancer Trials Group (CCTG) CO.21 (CHALLENGE). J Clin Oncol. 2025;43(17):LBA3510. doi:10.1200/JCO.2025.43.17_suppl.LBA3510

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Groundbreaking research by the University of Sydney has identified a new brain protein involved in the development of Parkinson’s disease and a way to modify it, paving the way for future treatments for the disease.

With the aim of finding new treatments to slow or stop its progression, the research team has spent more than a decade studying the biological mechanisms underpinning the condition—which is the second most common neurological condition after dementia.

In 2017, they identified for the first time the presence of an abnormal form of a protein—called SOD1—in the brains of patients diagnosed with Parkinson’s disease.

Normally, the SOD1 protein provides protective benefits to the brain, but in Parkinson’s patients it becomes faulty, causing the protein to clump and damage brain cells.

The newest study by the same team, led by Professor Kay Double from the Brain and Mind Centre, was just published in Acta Neuropathologica Communications. It found that targeting the faulty SOD1 protein with a drug treatment using copper improved the motor function in mice.

“We hoped that by treating this malfunctioning protein, we might be able to improve the Parkinson-like symptoms in the mice we were treating – but even we were astonished by the success of the intervention,” said Professor Double in a media release.

“All the mice we treated saw a dramatic improvement in their motor skills, which is a really promising sign that it could be effective in treating people who have Parkinson disease too.

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The study involved two groups of mice with Parkinson-like symptoms. One group was treated with a special copper supplement for three months, while the other received a placebo.

Throughout the study (which was partly funded by the Michael J. Fox Foundation), the mice receiving only the placebo saw a decline in their motor symptoms. The mice receiving the special copper supplement, however, did not develop movement problems.

“The results were beyond our expectations,” said Prof. Double. “They suggest, once further studies are carried out, this treatment approach could slow the progression of Parkinson’s disease in humans.”

At present there is no known cure and only limited treatments for Parkinson’s disease, which is a degenerative disorder in which dopamine-producing cells in the brain die, leading to a range of symptoms including tremors, muscle stiffness, slow movement and impaired balance.

But researchers hope understanding the causes of the disease will lead to improved treatments.

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“As our understanding of Parkinson’s disease grows, we are finding that there are many factors contributing to its development and progression in humans – and faulty forms of the SOD1 protein is likely one of them.

“Just as researchers found with HIV, Parkinson’s disease is a complex condition that likely requires multiple interventions. A single treatment may have a small effect when used alone but, when combined with other interventions, contributes to a significant overall improvement in health.”

The researchers’ next step is to identify the best approach to targeting the faulty SOD1 protein in a clinical trial, which could be the start of a new therapy to slow the development of Parkinson’s disease.

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