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Woman, 29, is diagnosed with cyclical vomiting syndrome

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woman 29 is diagnosed with cyclical vomiting syndrome

The flower-arranging class were putting the finishing touches to their creations when nausea swept over one student, Miranda Spencer.

Before she was able to make any excuses, she vomited into a bucket in front of her classmates at the adult education centre. Sadly, the bout of unexpected sickness — and mortification — was no isolated experience.

In fact, there have been many days over the past 17 years when the 29-year-old fitness instructor has been sick repeatedly.

Miranda has had cyclical vomiting syndrome (CVS) since the age of 12. Little understood, it causes people to vomit many times a day.

Fitness instructor Miranda Spencer (pictured), 29, who lives in south-west London has had cyclical vomiting syndrome (CVS) since the age of 12

Fitness instructor Miranda Spencer (pictured), 29, who lives in south-west London has had cyclical vomiting syndrome (CVS) since the age of 12

Fitness instructor Miranda Spencer (pictured), 29, who lives in south-west London has had cyclical vomiting syndrome (CVS) since the age of 12

It’s difficult to diagnose, as it is barely even heard of — even among doctors — and because there is no specific test for it.

As a result, CVS gets misdiagnosed as everything from allergies to kidney infections. CVS can begin at any age, from infancy through to old age (73 is the oldest known).

One theory is that the condition arises due to abnormal messages being sent between the brain and gut. As emotional responses can affect gut function, it is thought emotional events can trigger CVS symptoms, too.

In addition to hospital stays for symptoms such as severe dehydration the illness has caused Miranda much embarrassment.

‘That flower arranging class was typical of how it comes on without warning,’ reflects Miranda, who lives in South-West London with her husband, Jack, 31, who works in cyber security.

‘I’ve been shouted at because people think I’m a hopeless drunk. At times, when it’s particularly bad, just a sip of water will come straight back up.’

CVS was first described by paediatrician Samuel Gee in 1882. It causes recurrent and prolonged attacks, usually five or six times an hour, says CVS expert Dr Sonny Chong, a consultant paediatric gastroenterologist at Epsom and St Helier NHS Trust in Surrey.

Flare-ups of CVS have distinct phases. In the prodrome (early symptoms) phase, there is mild nausea but no actual sickness. This is followed by the vomiting phase, characterised by persistent nausea and repeated vomiting, lasting from a few hours to days.

‘CVS usually starts in childhood and affects more women than men,’ says Dr Chong.

The condition is difficult to diagnose, as it is barely even heard of and because there is no specific test for it. (Stock image)

The condition is difficult to diagnose, as it is barely even heard of and because there is no specific test for it. (Stock image)

The condition is difficult to diagnose, as it is barely even heard of and because there is no specific test for it. (Stock image)

Why it affects more women is, however, not well understood. ‘In most cases, it continues until adolescence although CVS can persist and even develop through adulthood,’ adds Dr Chong.

‘Interestingly, many sufferers who have CVS as children will experience migraines as adults, and CVS is often described as a form of abdominal migraine.’

About 25 per cent of adults with CVS also have regular migraines.

‘The problem is that there are no diagnostic tests for CVS, so it is a process of elimination — and is only diagnosed when other conditions have been ruled out,’ says Dr Chong.

Under NHS guidelines, CVS can be considered in children if there are at least two continuous episodes of nausea and vomiting lasting hours or days within a six-month period. For adults, it is two episodes within 12 months. 

As some doctors may not be familiar with the condition, it can go untreated for a long time. In Miranda’s case, it took nine years to be diagnosed.

‘I started having occasional vomiting episodes every few months, where I’d be sick for hours and for several days at a time,’ she says. ‘My GP couldn’t find a cause. I had blood tests but everything came back normal.’

At first the condition, though unpleasant, was manageable. But the episodes increased and by age 18, Miranda was vomiting five times a day, three or four times a week. 

‘I had to inject the anti-sickness drug cyclizine two to three times a day. But eventually the jabs didn’t work well and I needed the medication to be delivered through a drip instead.

‘My parents were frantic, there didn’t seem to be a diagnosis.’

Miranda also had a feeding tube in her stomach as she wasn’t getting enough nutrients.

‘I felt like a shadow of a teenager,’ she says.

‘My social life was ruined and though I finished school, my gap year was cancelled. I tried to occupy myself — taking the flower arranging course, for example — but the sickness would ruin that, too.’

Finally, after seeing countless specialists and after other causes such as allergy and even eating disorders were ruled out, Miranda was then diagnosed with CVS.

It can be treated with medication, including anti-sickness drugs, and medicine to control stomach acid production — such as omeprazole. (The acid could exacerbate sickness.)

Miranda recalls the relief of finally being diagnosed: ‘I’d never heard of CVS before but I was elated. Finally the nightmare could be coming to an end.’

Miranda was told that in her case surgery could help. The operation, under general anaesthetic, involved implanting a gastric pacemaker beneath the skin of her abdomen. 

Two leads attached to the device are fixed to stomach muscles which send electrical impulses to help pace the passage of food through the stomach. The device, turned on with an external controller, is thought to influence the nausea centre in the brain by activating the link between the stomach and brain.

After the surgery six years ago, Miranda’s CVS episodes became less frequent and less severe.

‘My life seemed to be on track, I was exercising regularly, eating well, and had an incredible new boyfriend, Jack,’ she recalls. ‘I went to cookery school and got a job in an art gallery.’

However, one morning, aged 27, Miranda felt a crippling stomach pain. She was rushed to A&E, where it was found that wires from the gastric pacemaker had wrapped around her bowel and gut, causing a blockage.

She needed a nine-hour operation to remove the pacemaker, weeks in intensive care and a further month in hospital.

‘It was horrendous,’ she says. ‘I was in so much pain. I had about 15 tubes and drains in my body. I couldn’t talk for weeks and felt confused from the pain relief. It was often hard to stay positive.’

One good thing did happen after Miranda was discharged. ‘Jack drove to my parents’ house and asked me to marry him, it was a very big YES,’ she says. ‘He had looked after me incredibly well.’

It took a year for Miranda to recover and since then, the vomiting has subsided and now occurs about three times a week.

‘I have also changed how I manage the attacks,’ she says. ‘Instead of stressing, I treat it like a migraine. I go to bed and take it easy. It has helped enormously.’

Dr Chong adds: ‘It’s true that stress plays a key role in some patients and the control of stress, perhaps through psychotherapy, may help manage the condition.’

Many of those with CVS try to manage symptoms by avoiding possible triggers such as spicy food or chocolate.

The condition has had knock-on effects for Miranda. For example, the constant sickness has caused acid damage to her teeth. ‘I’m having constant dental work to fill holes or replace teeth as they break so easily,’ she says.

Miranda, who managed to get through her wedding day last year without being sick, is passionate about raising awareness of CVS.

‘There are few specialists and not enough is known about it,’ she says ‘There needs to be more research for something that can take over your whole life.’

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Beer belly raises the risk of early death from illnesses such as type 2 diabetes and heart disease

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beer belly raises the risk of early death from illnesses such as type 2 diabetes and heart disease

Having a beer belly raises the risk of premature death – even if the rest of your body is slim, research shows.

But having broad hips or larger thighs can help us to live longer, the study said.

Researchers looked at data from more than 2.5million people and found that every extra 4in (10cm) of waist size was associated with an 11 per cent higher chance of dying prematurely.

Many academics believe waist circumference is a more accurate indicator of obesity, and risk for illnesses such as type 2 diabetes and heart disease, than the commonly-used body mass index (BMI). 

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Researchers looked at data from more than 2.5million people and found that every extra 4in (10cm) of waist size was associated with an 11 per cent higher chance of dying prematurely (file image)

This is because fat around the waist – or ‘visceral fat’ – sits around vital organs including the liver, kidneys, intestines and pancreas.

The new study was published in the British Medical Journal.

Study author Tauseef Ahmad Khan, from the department of nutritional sciences at the University of Toronto, said: ‘People should be more concerned about their waist rather than focusing only on weight or BMI.

Is diabetes pill key to dementia fight? 

A common diabetes pill taken by more than three million Britons may prevent dementia, research has suggested.

A study found that patients who took metformin, sold under the name Glucophage, have slower rates of mental decline and dementia.

Metformin is used to treat type 2 diabetes, which affects nearly four million in the UK. The study looked at 1,037 Australians aged 70 to 90 of whom 123 had type 2 diabetes. Those taking metformin had much better brain function and lower dementia risk compared to those not taking the drug.

Author Professor Katherine Samaras, of the Garvan Institute in Sydney, said: ‘This study has provided promising initial evidence that metformin may protect against cognitive decline.’ 

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‘Waist is a better indicator of belly fat and while one cannot target where one loses fat from, losing weight through diet and exercise will also reduce waist and therefore belly fat.’

Dr Khan added: ‘Belly fat is the fat that is stored around the organs in the abdomen and its excess is linked to high cholesterol, high blood pressure, heart disease, diabetes, and stroke. Therefore, having more belly fat can increase the risk of dying from these diseases.’

The researchers found that most measures of abdominal fat were ‘significantly and positively associated with a higher all-cause mortality risk’ even after BMI was taken into account.

They said: ‘We found that the associations remained significant after body mass index was accounted for, which indicated that abdominal deposition of fat, independent of overall obesity, is associated with a higher risk.’

But their findings suggested that thigh and hip circumference were ‘inversely associated with all-cause mortality risk’. 

Each 10cm increase in hip circumference was associated with a 10 per cent lower risk of death from all causes – and each 5cm increase in thigh circumference was associated with an 18 per cent lower risk.

Dr Khan said hip fat is considered beneficial and thigh size is an indicator of the amount of muscle.

The risks of belly fat were the same when accounting for BMI, suggesting that it increases a person’s chances of death regardless of their overall weight.

More than 70 health studies, which followed more than 2.5million people for between three and 24 years, were analysed by the researchers. 

The NHS says that, regardless of height or BMI, men should try to lose weight if their waist is above 37in (94cm), while women should do so if their waist is above 31.5in (80cm). 

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CDC director says more than 90% of US susceptible to COVID-19 but vaccine predicted by spring 2021

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cdc director says more than 90 of us susceptible to covid 19 but vaccine predicted by spring 2021

The majority of Americans are vulnerable to contracting the novel coronavirus, the director of the Centers for Disease Control and Prevention (CDC) said on Wednesday.

Dr Robert Redfield was testifying during a Senate Health, Education, Labor, and Pensions Committee hearing when he revealed most of the US population is at risk of falling ill with the potentially deadly disease. 

‘The preliminary results in the first round [of testing] show that a majority of our nation, more than 90 percent of the population, remains susceptible,’ Redfield said.

‘A majority of Americans are still susceptible to this virus.’

Later in the hearing, Redfield and Dr Anthony Fauci, the nation’s top infectious disease expert, testified that they expect a vaccine to be widely available to the public by spring 2021.

Dr Robert Redfield revealed preliminary results from a CDC study during a Senate hearing on Wednesday, which found about 90% of Americans are susceptible to contracting coronavirus. Pictured: Redfield testifies before the Senate, Wednesday

Dr Robert Redfield revealed preliminary results from a CDC study during a Senate hearing on Wednesday, which found about 90% of Americans are susceptible to contracting coronavirus. Pictured: Redfield testifies before the Senate, Wednesday

Redfield and Dr Anthony Fauci (pictured) said they expect 700 million doses of a COVID-19 vaccine will be available by spring 2021. Pictured: Fauci testifies before the Senate, Wednesday

Redfield and Dr Anthony Fauci (pictured) said they expect 700 million doses of a COVID-19 vaccine will be available by spring 2021. Pictured: Fauci testifies before the Senate, Wednesday

Dr Robert Redfield (left) revealed preliminary results from a CDC study during a Senate hearing on Wednesday, which found about 90% of Americans are susceptible to contracting coronavirus. Redfield and Dr Anthony Fauci (right) said they expect 700 million doses of a COVID-19 vaccine will be available by spring 2021

Fauci said, if a vaccine is approved in 2020, only about 50 million doses would be available in December for frontline workers. Pictured: Fauci (left) and Redfield before a House Oversight Committee hearing on preparedness for and response to the coronavirus outbreak, March 11

Fauci said, if a vaccine is approved in 2020, only about 50 million doses would be available in December for frontline workers. Pictured: Fauci (left) and Redfield before a House Oversight Committee hearing on preparedness for and response to the coronavirus outbreak, March 11

Fauci said, if a vaccine is approved in 2020, only about 50 million doses would be available in December for frontline workers. Pictured: Fauci (left) and Redfield before a House Oversight Committee hearing on preparedness for and response to the coronavirus outbreak, March 11

During the hearing, Redfield said the CDC is currently conducting a study to determine how many Americans have been sickened with COVID-19.

He said infection rates have varied from state-to-state with one as high as 24 percent and others as low as less than one percent.  

‘Preliminary results appear to show that most Americans have not been infected with the virus and are still vulnerable to the infection, serious illness and death,’ Redfield said.

‘It varies in different geographic parts from states…We’ll have that finalized and probably published in the next week or so.’ 

The results seem to combat President Donald Trump’s opinion that the US could curb the pandemic with herd immunity, which would require up to 85 percent of the population having antibodies against the virus. 

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This is similar to an estimate Redfield made to reporters during a press conference in June, in which he revealed that the CDC believed the virus has infected 10 times more people in the US than the official count.

At the time, there were 2.3 million confirmed cases, with a 10-fold increase equating to 20 million cases, about six percent of the US population. 

Later in the hearing, Redfield testified that he predicted 700 million doses would be available of a coronavirus vaccine by late March or early April.

That would be enough doses to inoculate 350 million people.  

‘I think that’s going to take us April, May, June, you know, possibly July, to get the American public completely vaccinated,’ he said. 

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Fauci, director of the National Institute of Allergy and Infectious Diseases, said he also expects 700 million doses to be available by April 2021.

He added that if a vaccine is approved by year’s end, only about 50 million doses would be available in December, so ‘it is not going to be a large proportion of the population’ that receives the vaccine in 2020.

Fauci said those prioritized will ‘likely will be health care providers and likely will be those who are vulnerable with preexisting conditions.’ 

There are more than 170 coronavirus vaccine candidates in various stages of development around the globe, according to the World Health Organization.

At least 10 are currently in large-scale trials in humans in the US and around the world to prove the jabs are both safe and effective.   

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During his opening statement, Fauci said he expects results showing any vaccine’s efficacy by November or December.

‘We feel strongly that if we have a combination of adherence to the public health measures together with a vaccine…we may be able to turn around this terrible pandemic which we have been experiencing,’ he said.

Recently there have been fears that the US Food and Drug Administration (FDA) will approve a vaccine before there is enough data to review due to pressure from the Trump administration.

FDA Commissioner Hahn said an immunization will only be approved if FDA scientists find it is safe and effective.

‘I will fight for science. I will fight for the integrity of the agency,’ Hahn said. 

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Smoking marijuana during pregnancy increases risk of psychotic-like behaviors in children

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smoking marijuana during pregnancy increases risk of psychotic like behaviors in children

Using marijuana while pregnant increases the risk of psychotic-like behaviors and sleep problems in children, a new study suggests.

Researchers found expecting mothers who smoked or vaped cannabis were more likely to have children who had anxiety, difficulty concentrating and experienced hallucinations compared to children not exposed in utero.

If the woman continued using pot after learning she was pregnant, the higher the risk of detrimental effects. 

Cannabis use among pregnant women has become more common, doubling over the last two decades.

The team, Washington University School of Medicine in St Louis, says the findings confirm marijuana’s harmful effects on developing babies and advises that there are no safe levels when it comes to expecting mothers. 

A new study from Washington University School of Medicine in St Louis looked at nearly 11,500 children and found more than 600 whose mothers had used marijuana while pregnant (file image)

A new study from Washington University School of Medicine in St Louis looked at nearly 11,500 children and found more than 600 whose mothers had used marijuana while pregnant (file image)

A new study from Washington University School of Medicine in St Louis looked at nearly 11,500 children and found more than 600 whose mothers had used marijuana while pregnant (file image)

Children exposed to cannabis in utero were more likely to have psychotic-like behaviors such as delusions and hallucinations (above)

Children exposed to cannabis in utero were more likely to have psychotic-like behaviors such as delusions and hallucinations (above)

Children exposed to cannabis in utero were more likely to have psychotic-like behaviors such as delusions and hallucinations (above)

For the study, published in JAMA Psychiatry, the team looked at data from the Adolescent Brain Cognitive Development.

It is self-described as ‘the largest long-term study of brain development and child health in the United States.’

Of the nearly 11,500 children looked at from June 2016 to October 2018, 655 of them were exposed to cannabis in the womb.

Researchers found that children with prenatal exposure to weed were more likely to suffer from psychosis, which occurs when someone has delusions and hallucinations, and is often a symptom of schizophrenia.

They were also likely to suffer from attention disorders, sleep issues and social problems such as bullying and drug abuse.

Children who were exposed before and after their mothers knew they were pregnant were more likely to have these issues than kids of mothers who only used marijuana before they knew they were expecting.  

‘This study suggests that prenatal cannabis exposure and its correlated factors are associated with greater risk for psychopathology during middle childhood,’ the authors wrote. 

‘Cannabis use during pregnancy should be discouraged.’ 

They were also at greater risk of suffering from anxiety, difficulty concentrating and sleep problems, and the risk was greater among women who used pot before and after learning they were pregnant (above)

They were also at greater risk of suffering from anxiety, difficulty concentrating and sleep problems, and the risk was greater among women who used pot before and after learning they were pregnant (above)

They were also at greater risk of suffering from anxiety, difficulty concentrating and sleep problems, and the risk was greater among women who used pot before and after learning they were pregnant (above)

Recent research has shown that self-reported marijuana use among pregnant women has exponentially risen.

Between 2002 and 2017, use increased two-fold from 3.4 percent to seven percent, according to the National Institute on Drug Abuse.

The Centers for Disease Control and Prevention (CDC) states that cannabis use during pregnancy can lead to low birth weight, attention issues and development disabilities.

A study from April 2019 found that pregnant women who use marijuana heavily to treat morning sickness affect part of the baby’s brain associated with memory.

Another study from August 2020 found that expecting mothers who used pot were 1.5 times more likely to have a child diagnosed with autism. 

In light of the growing problem, US Surgeon Jerome Adams issued an advisory last year against using marijuana during pregnancy.

‘Recent increases in access to marijuana and in its potency, along with misperceptions of safety of marijuana endanger our most precious resource, our nation’s youth,’ he wrote. 

Adams referenced past research, which has found that tetrahydrocannabinol (THC), the main psychoactive ingredient in marijuana, can pass from mother to fetus.

‘THC has been found in breast milk for up to six days after the last recorded use. It may affect the newborn’s brain development and result in hyperactivity, poor cognitive function, and other long-term consequences,’ he wrote.

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