First, as a cardiovascular physician I want to reinforce that no one should stop or alter their aspirin regimen before speaking with their doctor or health care provider. And second, I will help sort through the news and the research on this topic.

There are two main categories of patients who take a daily low-dose aspirin for cardiovascular (CV) event prevention: patients who have not yet had serious cardiovascular problems but may be at risk of having these problems AND patients who have already experienced serious cardiovascular problems like a heart attack or clot-related stroke. What the updated guidelines tell us is that certain individuals in the first category (have not yet had an event, often called primary prevention) may not need to continue taking aspirin due to the increased risks of bleeding outweighing the cardio-protection benefit. Whether or not you are one of these individuals in this category depends on your own personal risk factors, which is why it is important to consult your doctor who can help you understand the benefits and risks and what is best for your health.

For people in the secondary category - those who have already experienced a cardiovascular event - aspirin can be a lifesaver. Not only is it proven to help prevent another heart attack or clot-related stroke, aspirin is also one of the most extensively studied drugs in history. This is why aspirin remains the cornerstone preventative therapy for secondary prevention. In the United States, aspirin's professional label is approved for secondary prevention of a CV event.

Some of the media coverage around the new guidance was not clear on this crucial distinction. For those who have already experienced a heart attack, or clot-related stroke there is evidence that discontinuing an aspirin regimen without a doctor's guidance can increase the risk of another heart attack by 63 percent and a clot-related stroke due to a blood clot by 40 percent.

Cardiovascular disease is the number one cause of death in the United States, affecting more than 92 million American adults and causing about 2,200 deaths per day. That's one life every forty seconds. Each year 790,000 Americans alone will suffer from a heart attack, while another 795,000 will have a stroke.

Many factors can contribute to a person's risk of cardiovascular disease, including high blood pressure, high cholesterol and smoking - and almost half of Americans (47 percent) have at least one of these risk factors.

Clinical studies and cardiovascular professional guidelines have continued to support the lifesaving benefits of aspirin. Studies have found that an aspirin regimen under the direction of a doctor can help reduce the chances of a second heart attack by 31 percent and a second clot-related stroke by 22 percent.

Importantly, even though aspirin is the gold standard of preventative therapy for those who have experienced a heart attack, clot-related stroke, chronic stable and unstable angina, a stent placement (PCI) or open heart surgery (CABG), it may not be for everyone. Anyone who has questions about starting or continuing an aspirin regimen should talk to their doctor.

Aspirin is not appropriate for everyone, so patients should talk to their doctor before they begin an aspirin regimen. For more information on safe and responsible use of OTC medicines, visit www.KnowYourOTCs.org.

Disclosure: Dr. Gurbel is compensated by Bayer to advise on cardiovascular health issues.

Dr. Gurbel is the Director of Cardiovascular Research at Sinai Hospital of Baltimore, MD and Director of the Sinai Center for Thrombosis Research and Drug Development. He is also Professor of Medicine at Johns Hopkins University School of Medicine and Adjunct Professor of Medicine at Duke University School of Medicine.

Doctors and patient groups say it doesn't have to stay this way.

"Lung cancer is the leading cause of cancer death in men and women. Finally, we have a screening exam that will make a major impact and change the face of lung cancer for the future to a survivable cancer, not a death sentence," says Ella Kazerooni, MD, MS, chair of the National Lung Cancer Roundtable and Professor of Radiology and Internal Medicine at the University of Michigan.

Screening older current and former smokers each year with low-dose computed tomography or "CAT" scans is a cost-effective system proven to significantly reduce lung cancer deaths.

CT lung cancer screening exams for high-risk individuals are recommended by the American Cancer Society, the American Lung Association, the National Lung Cancer Roundtable, The U.S. Preventive Services Task Force, GO2 Foundation for Lung Cancer and many other medical and scientific organizations.

"After decades of having little to offer adults at high risk for lung cancer, we've entered a new era where we now have evidence that lung cancer screening saves lives, and new targeted therapies and immunotherapy are offering new hope to patients diagnosed with advanced lung cancer," says Richard Wender, MD, Chief Cancer Control Officer at the American Cancer Society.

"CT lung cancer screening is a game changer. We finally have a weapon to fight back against this terrible disease - if patients who need this screening get tested," says Debra Dyer, MD, chair of the American College of Radiology Lung Cancer Screening 2.0 Committee.

"Most lung cancers are not diagnosed until it is too late. This screening provides critical early detection that saves lives," says Carolyn Aldigé, founder and chief executive officer of the Prevent Cancer Foundation.

Insurance companies cover these exams with no copay for people 55-80 years of age with a history of heavy smoking who are current or former smokers. Medicare ends coverage at age 77. If you were a heavy smoker, meet the age specifications and stopped tobacco use in the last 15 years, you are covered.

However, unlike breast and colon cancer screening, if you are covered by Medicare, your health care provider must discuss the risk and benefits of a lung cancer screening CT exam with you during a "shared-decision making visit" before ordering your first screening CT.

Lung cancer care advocates urge those who think lung cancer screening can help them or a loved one to have that conversation with their doctor.

"Lung cancer screening is a proven, valuable tool in finding the number-one cancer killer at its most treatable, and even curable, stage," says Laurie Fenton Ambrose, Co-Founder of the GO2 Foundation for Lung Cancer.

For more lung cancer screening information, visit NLCRT.org and RadiologyInfo.org

Source: National Lung Cancer Roundtable (NLCRT.org)

So when Gunnar started having difficulty hearing at work and home, he did what he preaches to his clients: he attacked the problem and got a pair of hearing aids. Now as a hearing loss advocate, Gunnar offers the following tips to get your hearing in shape this fall.

* Be "present" with your hearing: Being present with your hearing means being aware of how you hear throughout the day. If your family members are complaining the TV is too loud, or if you're the one complaining that everyone else is mumbling, you may have a hearing problem that needs to be corrected.

* Get your hearing checked: At least once a year, you go to the doctor for a physical, or to get your eyesight checked. But when was the last time you got your hearing checked? Even if you're not having issues right now, just go and get a baseline to compare it to in the future.

* Preserve your current hearing: Noise-induced hearing loss is a problem that is completely preventable. If you work around a lot of noise, you need to use protection. If you go to loud concerts or enjoy firing up the leaf blower or lawnmower on the weekend, use protection. Remember, once you lose your hearing, it doesn't come back.

* Don't brush off tinnitus: If you have an annoying ringing or buzzing in your ears, especially when it's quiet, it may be tinnitus. Tinnitus and hearing loss often go hand-in-hand, so don't brush it off as a minor annoyance. Go see a hearing care professional and have it checked out.

Consider invisible hearing aids: If you need hearing aids but are worried people will judge you if they see you wearing them, know that invisible hearing aids such as the Phonak Lyric exist. They are 100 percent invisible and can stay in your ears for months at a time. A recent study even showed that Lyric relieves tinnitus faster than regular hearing aids, thanks to 24-hour amplification.

Neauvia International Group recognizes this incongruity and aims to transform the way we practice beauty and solve skin care challenges by extending its premium energy-based devices into the United States.

In the hands of trained medical aesthetics professionals, Neauvia devices leverage sophisticated technology such as thermo-lifting and water peeling to deeply target your areas of concern. With years in the global skin care market, Neauvia's approach pairs this advanced technology with specially formulated skin care for remarkable results.

"Over a decade of Neauvia's international skin care success has taught us that a single product does not meet the overall demands of and desired outcomes for patients or providers," says Sean Wilson, President of newly launched Neauvia North America. Best-in-class treatments do, however. They also require training and certification. So, take time to research your local plastic surgeons, dermatologists, aestheticians and med spas because they offer you access to these revolutionary non-invasive treatments that are not available for home use, and to professionals qualified to use them. They'll work with you to customize an optimal treatment plan to achieve your desired results.

Often, using multiple technologies per session yields a marked difference. The Zaffiro treatment combines thermo-lift technology with the gentle exfoliation of water-resurfacing and specific solutions for your skin type and desired results. It delivers lifted, tightened and hydrated skin with less visible lines and wrinkles.

Energy-based devices strengthen and surpass home treatments. Let's say you love the fresh feeling and smooth, even texture of your skin after you do an at-home face scrub. Try adding a water-peeling facial like the Zaffiro treatment once a month for more deeply cleansed and revitalized skin.

Treatments can rejuvenate beyond your face and neck. Zaffiro's thermo-lift technology gradually heats the deep layers of the skin, stimulating collagen and prompting lifting and tightening effects. It can be applied to tighten the décolleté and upper arm skin, give the tummy and derriere a firm appearance and even help tighten up post-pregnancy belly skin.

Innovative energy-based devices can yield beautiful effects by working with the body's natural functions in a way that is safe, reliable, and non-invasive. They're less costly and require little to no downtime. This makes them an excellent way to fine tune your appearance and delay signs of aging without a lengthy recovery time. In fact, many of these innovative treatments provide results when done over a lunch hour! Dr. Joshua Weitz, MD, CEO of Dermatology Associates of Rochester sees them growing in appeal and use. "The non-invasive market is the future, and I anticipate Neauvia will be a guiding light in providing exceptional solutions," Weitz says.

A well-rounded skin routine ensures that your actions - daily, monthly, over time - compound for outstanding outcomes. Incorporating treatments using Neauvia energy-based devices is simple yet addresses the complexity of your skin and helps attain your best overall skin health and appearance.

To learn more and connect: Instagram, Facebook, Twitter, YouTube, LinkedIn.

* Are my doctors in network? Use online tools to confirm which doctors and hospitals are in a plan's network. A licensed health insurance agent can also help you see if a specific doctor or hospital is in a plan's network and taking new patients, and can determine what's in network if you're a seasonal resident.

* Are my prescription drugs covered? Although Original Medicare does not cover most prescription drugs, many Medicare Advantage plans include prescription drug coverage, or you can sign up for a Part D Prescription Drug Plan separately. A licensed sales agent can look up the medications you would like covered and help you estimate what the cost of each drug would be on a plan.

* What new, innovative benefits are available? Beyond vision, hearing and dental coverage, if you aim to become healthier, look for fitness program benefits as many Medicare Advantage plans offer a gym membership. If you travel or appreciate technology, virtual doctor visits are helpful when you can't see a doctor right away. Most Medicare Advantage plans now offer transportation to doctor appointments and the gym, when a fitness center membership is offered as a plan benefit.

* What if I'm still working? If you or your spouse have health insurance from an employer, you may be able to delay enrolling in Medicare until the employment or the coverage stops. At that point, you would be entitled to a special enrollment period of up to eight months to sign up for Medicare without incurring any late penalties. Talk with your employer to find out how your coverage works with Medicare.

While the clock is ticking until the Dec. 7 Medicare annual enrollment deadline, remember that you're not alone.

Take advantage of resources including licensed sales agents and websites such as medicare.gov and www.humana.com/medicare. You can also call 1-800-MEDICARE (1-800-633-4227) (or TTY: 1-877-486-2048) 24 hours a day, seven days a week, or call Humana at 1-800-213-5286 (TTY: 711) 8 a.m. to 8 p.m. local time seven days a week.

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Identifying these so-called "social determinants of health" helps doctors determine the root causes of their patients' medical conditions and is critical to improving whole-person health. The Physicians Foundation found that nearly 90 percent of doctors have patients whose health is affected by these key factors.1

Below are some examples to illustrate how social factors can affect you and your health:

* Loneliness and social isolation. More than a quarter of the U.S. population live alone. Loneliness and social isolation are associated with increased mortality and poor health outcomes. Identifying individuals at risk for these factors allows doctors to recommend prevention and care strategies to improve their patients' health.

* Food insecurity. The U.S. Department of Agriculture defines food insecurity as a lack of consistent access to enough food for a healthy life. According to Feeding America, food insecurity exists in every state in the United States. Seniors face challenges that put them at risk of food insecurity, such as being on a fixed income and having to choose between buying food or medicine, or struggling to obtain food without reliable transportation.

* Transportation Barriers. A lack of transportation affects an individual's health and well-being - from accessing health care services and healthy food options to maintaining social connections. Lack of transportation is the leading cause of patient no-shows for medical appointments, and missed appointments are associated with increased medical care costs and increased emergency room visits.2

But many Medicare Advantage plans, provided by private health insurers such as Humana, offer their members health and wellness benefits, programs and services to help address social determinants, with rides to medical appointments, meal benefits, social interaction and screening for food insecurity.

Humana is working to address social determinants of health through its Bold Goal, by working with Humana care teams, physicians, nonprofit organizations, and business and government leaders to identify, screen and refer members to community resources and long-term support.

The Bold Goal is a population health strategy to help improve the health of the communities we serve by 20 percent by 2020 and beyond.

For more information, visit populationhealth.humana.com.

1 https://physiciansfoundation.org/wp-content/uploads/2018/09/physicians-survey-results-final-2018.pdf

2 http://www.aha.org/transportation  

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The BABOR skin care product line, developed in 1956 in Germany by biochemist Dr. Michael Babor, has an established reputation of science-based skin care. Each item in the company's latest line of Power Serum Ampoules is designed with advanced-strength active ingredients to address specific skin issues quickly and effectively with precision single doses of targeted ingredients.

"At BABOR, our highly innovative active formulations are carefully combined with our exclusive treatment methods to provide outstanding results and a uniquely indulgent experience," according to the company website.

The new DOCTOR BABOR Power Serum Ampoule collection launched in January 2020 and features six products: Ceramides, Ferulic Acid, Growth Factor Concentrate, Hyaluronic Acid, Retinol, and Vitamin C. The collection continues the high standards and precision use of clinical ingredients for individualized skin care.

The Growth Factor serum is of particular interest to individuals seeking treatment for fine lines and wrinkles, as well as maintaining the skins elasticity and firmness and preserve the cell's optimal metabolic efficiency.

The serum contains two active ingredients, cyclopeptide and oligopeptide, that stimulate the skin's natural growth factors and promote collagen and elastic production.

The Vitamin C serum is targeted to brighten the skin and protect against the development of age-related skin damage. The Hyaluronic Acid serum is formulated to help promote skin hydration, and the Retinol serum focuses on resurfacing, improving skin elasticity and reducing the appearance of pores.

The Ferulic Acid serum promotes skin regeneration and is engineered to support the skin's natural defenses, and the Ceramides serum contains a blend of three skin ceramides that combine with the skin's natural lipids to protect against moisture loss and promote skin barrier repair.

All BABOR products comply with the European Cosmetic Safety Standards. In addition, the Power Serum Ampoules contain no artificial colors, fragrances, sulfates, parabens, phthalates, or gluten.

For more information about precision, targeted skin care and the BABOR skin care product line, visit BABOR.com.

Easy to say, but hard to do, as many smokers can confirm. Encouraging smokers to quit saves billions in health care costs, promotes longer, healthier lives, and restores lost productivity, according to the Consumer Healthcare Products Association (CHPA).

Quitting smoking is a challenge, but today the widespread availability of many over-the-counter (OTC) nicotine replacement therapy (NRT) products can make a huge difference in helping smokers quit.

CHPA estimates that quitting smoking with OTC NRT products could save $1.3 billion per year in direct medical care costs in the United States.

In addition, data suggest that former smokers are worth an increase in productivity of approximately $1,300 to $1,800 per employee per year compared with current smokers.

Of course, the health benefits of quitting smoking are as significant as the financial ones.

According to the Centers for Disease Control and Prevention, smokers who quit may reduce their risk of health problems including lung and other cancers, heart disease, stroke, respiratory problems, and vascular disease, while their lung function and circulation can improve by as much as 30 percent.

In a recent study, CHPA analyzed nine categories of OTC medications, including those for smoking-cessation. Although smoking cessation products were a smaller part of overall OTC savings than other categories, including allergy medications, cold and flu products, and gastrointestinal products, the data suggests that approximately 1.8 million smokers would not seek help if OTC products were not available.

"In a scenario where OTC medicines are not available in the marketplace, a patient would have to visit a physician to get treatment or diagnosed during normal working hours, causing them to miss work," according to CHPA.

The main types of OTC NRT products available in the United States include nicotine gum, nicotine patches, and nicotine lozenges. These FDA-approved products are available in a range of dosages, and they are designed to help reduce the nicotine cravings and withdrawal symptoms that come with quitting smoking. NRT products can be purchased in most pharmacies, and pharmacists can answer questions and help individuals choose which option may work best for them.

For more information about how OTC medications make a difference in smoking cessation and other areas of health, visit overthecountervalue.org.

To keep themselves and their patients safe, these workers, who may have potentially been exposed to this deadly virus, may have to stay home until they are tested, losing valuable time on a now critical job.

Here's where organizations such as xymbio are stepping up to the challenge. xymbio, an infectious disease testing company, has offered the use of its high-speed testing program to help run tests on health care personnel and first responders to keep them healthy and return them to their demanding roles as soon as possible.

The Las Vegas based company, uses industry leading technologies from ThermoFisher and operates under the Emergency Use Authorization (EUA) guidance issued by the Federal Drug Administration and highest diagnostic standards.

xymbio is readying to process COVID-19 tests for hospitals and health care systems, and the company can provide both on-site testing and at-home testing kits for employees who believe they may have been exposed to the virus. In addition, individual physicians can request test kits and testing for patients using forms available online on the xymbio website.

The company has been waiting on a response from the Centers for Disease Control and Prevention (CDC), National Institute of Health (NIH), and the National Institute of Allergy and Infectious Diseases for necessary funding to accelerate its capabilities to acquire test kits so that it can rapidly scale testing capacity.

"xymbio has developed state of the art qPCR technology using ThermoFisher reagents to detect coronavirus protein n,s,e antigens. Their test is highly specific, accurate and scalable. They are now only limited by government funding to expand capacity from 500 tests per day to thousands of tests per day. Time is of the essence. They have the fix. They need the support to expand their operations now!" Dr. Larry Emdur, Chief Medical Officer of Alvarado Hospital in California.

"We are in a war against a dangerous virus, and with federal assistance we are prepared to ramp up our testing capacity over the next 35 days to 20,000 tests a day, or 120,000 tests a week, with immediate plans to expand operations to Las Vegas and Atlanta, which would more than quadruple our testing capacity," according to Dr. Heath Wills, CEO and Chief Medical Officers of xymbio.

"We are ready to undertake the rapid action on behalf of many more citizens, and await prompt action on our proposal to the NIH, HHS, CDC, FEMA or the White House Task Force on Coronavirus testing during this national crisis," Wills emphasizes.

xymbio has also been working with the Swab for Life campaign of the Give Life Foundation, a non-profit organization dedicated to raise awareness of blood donation.

"We chose to partner with xymbio because of its extremely accurate COVID-19 testing capabilities that we believe will accelerate help to Americans during this national healthcare crisis," says Bart S. Fisher, chairman of the Foundation.

For more information about xymbio and their efforts to work with individual health care providers, hospitals, and the government, visit xymbio.com.

Potentially severe vaginal infections with symptoms similar to those of a yeast infection include bacterial vaginosis, a condition caused by abnormal bacterial growth in the vagina; and trichomoniasis, a parasitic infection. Both of these conditions require antibiotics from a doctor. Self-treating these conditions with a yeast medication may delay getting the right diagnosis and an effective treatment.

Fortunately, at-home tests can help women learn what to look for and determine whether their discomfort is indeed caused by a yeast infection or by something else that requires a doctor visit and prescription medication to resolve.

A vaginal health test kit is available over the counter at most pharmacies. The test measures the acidity of vaginal discharge using a hand-held detector with a tip resembling a cotton swab. The tip is designed to detect acidity, or pH, to help distinguish the type of infection that is present, and shows results in 10 seconds.

In the case of a typical yeast infection, the test kit swab will not change from its original yellow color, and you can likely treat yourself with an over-the-counter yeast infection medication.

However, if bacterial vaginosis or trichomoniasis is the source of the symptoms, the swab will change color to a blue or green, and the kit instructions strongly advise a visit to your doctor. Even in cases where there is a mixed infection caused by a combination of candida and bacterial vaginosis / trichomoniasis, the test will give a positive result and send the user to the doctor.

Other features that distinguish a yeast infection from a bacterial infection include:

- Smell. Bacterial vaginosis and trichomoniasis are usually accompanied by fishy, musty, or otherwise unpleasant odors, while yeast infections are usually odorless.

- Texture. The discharge associated with yeast infections is usually thick and white, while discharge from bacterial vaginosis is often thin and milky white or gray in color. By contrast, discharge in cases of trichomoniasis may be frothy and yellowish-green.

- Sting. Yeast infections usually involve an itching, burning, or stinging feeling, but these symptoms are not always present or as severe in cases of bacterial vaginosis or trichomoniasis.

The over-the-counter vaginal health tests available today are approved by the Food and Drug Administration and are the same as those used by doctors in their offices.

For more information about vaginal health and vaginal health tests, visit checkbeforeyoutreat.com