Daily Archives: May 1, 2021

Psoriasis on Lips: Symptoms, Treatment, Other Rashes – Greatist

Posted: May 1, 2021 at 5:50 am

Mirror, mirror, on the wall. Is it the doctor I should call?

If your lips are looking flaky, it might just be a case of chapped lips. Its pretty rare for psoriasis to break out on your lips. But if you have the signs of a psoriasis rash (scaly plaque or a burning sensation) its a good idea to get it checked out by a doctor or dermatologist.

Heres what you need to know about psoriasis on your lips.

Not just lip service: Psoriasis on lips

Psoriasis is a chronic medical condition that causes red, sometimes itchy or burning patches covered by silver, scaly plaques. During a flare-up you might even find these spots on your lips.

Theres no cure for psoriasis, but your doctor can prescribe effective treatments (like steroids) that can ease your symptoms.

You can also help prevent future by trying to avoid any of your personal triggers. (These might include stress, sudden weather changes, or spicy foods.)

FYI: If youre dealing with a psoriasis rash, exfoliators or makeup could irritate it. Please, step away from the lipstick and let yourself heal.

Although its rare, its possible to get a psoriasis rash on your lips.

Psoriasis is a chronic skin disease that affects 7.5 million people in the U.S. alone. Theres no proven cause, but your immune system and your genetics both seem to have something to do with psoriasis. It often shows up as red, scaly plaques on your skin.

Usually, those plaques show up on your knees, elbows, or chest. But no part of your body is truly immune. That includes the area around your eyes, your cheeks, your genitals, and yep, even your lips.

The rashes are usually thick and whitish-silver, but can come with thick red patches as well. On darker skin, it can appear more purple in color. Sometimes, those patches can crack and bleed.

Psoriasis can be uncomfortable anywhere on your body. When its on your lips, it may affect the way you talk or eat.

How does psoriasis work?

If you have psoriasis, your immune system attacks your own healthy skin cells. Your body hurries to make more skin cells in response, but that leads to overproduction.

When you have so many new skin cells that they dont have time to fall off, these extra cells build up on each other. This causes those flaky scales that can show up across your body and on your lips.

Whats the deal with the redness underneath? The friendly-fire from your white blood cells (the misplaced immune response) can cause inflammation.

First, the bad news: Theres no cure for psoriasis.

Now, the good news: There are effective and safe treatments for managing your symptoms.

There are a few different treatments your doctor might explore with you, according to Dr. Orit Markowitz, Board-Certified Dermatologist.

For example, they may explore topical anti-inflammatory creams, such as corticosteroids. Corticosteroids control the inflammatory responses in the body, she explains. Steroids come in different strengths from strong and super-potent to weak and less potent. Your doctor will decide what kind you need.

If you have psoriasis, you might also be prescribed systemic immunossupressants. These lower the immune response that is telling your system to attack the skin, Markowitz says, and they work on the entire body.

Other treatments could include:

There are also some home remedies that can help you manage the appearance of your symptoms.

Psoriasis PSA

At-home remedies should never replace medical treatments prescribed by your doctor. You should also check in with your doc before starting a new DIY remedy for psoriasis to make sure it wont interfere with your treatment plan.

The best remedies for chronically psoriatic lips are over-the-counter (OTC) hydrocortisone ointment and [hydrating] ointments, Markowitz says.

In addition, youll want to avoid using any scrubs (like a sugar scrub) on your face because these could aggravate your skin. And unhappy skin would make your symptoms worse.

Psoriatic patients are tempted to use scrubs and exfoliants, says Markowitz, but this will further damage their already damaged skin and irritate their psoriasis, possibly causing a flare-up.

You should also avoid most things that cover up your psoriatic lips. Makeup or lipstick arent great ideas at least not every day while youre experiencing a flare-up.

Lips are sensitive, just like most of the skin in and around the face, so its important to treat it carefully, Markowitz says.

Markowitz also recommends using moisturizing products that have SPF. Its important to keep the affected lip area protected from the sun, she says. Look for OTC products with the National Psoriasis Foundations Seal of Recognition program.

If you do use makeup, do so sparingly, so as to not further irritate or infect the lips, Markowitz says. I always recommend keeping the lips moist, especially under makeup.

If you must use a coverup, she continues, try to avoid cosmetics that contain fragrance and drying ingredients. Makeup that is not easily absorbed into the skin, such as water or sweat resistant ones, will most likely work better here.

A psoriasis flare-up can usually be traced to a specific trigger. If you can figure out whats setting off your rashes, it might be possible to avoid it.

Here are some of the most common triggers for psoriasis:

If youre not sure whats triggering your psoriasis, you can try keeping a log of your symptoms to see if you can make any connections.

In general, if this is the first time youre noticing red, flaky lips, give your doc a call. Theyll be able to diagnose whether its a psoriasis rash. Its also important to reach out if your symptoms are getting worse.

If you start to notice symptoms such as pain, swelling, tenderness, stiff muscles and joints, or a noticeable change in the appearance of your nails, says Markowitz, call your doctor.

Never try a new treatment including OTC ones without checking with your doctor either.

The short answer: Yes.

Psoriasis on lips is pretty rare. Here are some more common things that can cause a rash on your lips:

Here are a few examples of what psoriasis and other causes may look like on lips.

Remember, its always best to see a doctor for a diagnosis. That way youll know what kinds of treatments will work best for you.

Psoriasis on your lips is possible but its rare. If you do have psoriasis on your lips, theyll likely be red, inflamed, cracked, or covered in whitish scales.

Just remember that theres other conditions that could be causing your cracked lips. Your doctor is the one who can truly diagnose psoriasis. Theyll also be able to recommend the most effective, safe treatments for you.

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Psoriasis on Lips: Symptoms, Treatment, Other Rashes - Greatist

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Complete Skin Clearance and Improved Joint Symptoms With Guselkumab in Moderate to Severe Plaque Psoriasis and Psoriatic Arthritis – Dermatology…

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The following article is part of our coverage of the American Academy of Dermatologys annual meeting (AAD 2021) that is being held virtually from April 23-25, 2021. Dermatology Advisors staff will report on the top research in dermatologic advances and clinical care. Check back for the latest news from AAD 2021.

Treatment with guselkumab was found to be associated with durable, complete skin clearance through 5 years in patients with moderate to severe plaque psoriasis (PsO) and improved disease activity and axial symptoms in adults with active psoriatic arthritis (PsA) through 1 year, according to a recent press release and study results presented at the American Academy of Dermatologys Virtual Meeting Experience (AAD VMX) 2021, held online from April 23 to April 25, 2021.

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In the VOYAGE 2 trial (ClinicalTrials.gov Identifier: NCT02207244), approximately 55.5% of patients who received guselkumab had complete skin clearance, as determined by an Investigators Global Assessment (IGA) score of 0, by week 252. In addition, 53% of patients had a Psoriasis Area Severity Index (PASI) 100 skin clearance response (PASI 100) by the 252-week follow-up. Up to 82% of patients achieved a PASI 90 skin clearance response, and 85% of patients had an IGA score of 0/1, indicating complete skin clearance. Efficacy rates were maintained through the 5-year treatment period.

In the DISCOVER-1 and -2 trials (ClinicalTrials.gov Identifiers: NCT03162796 and NCT03158285, respectively), patients with active psoriatic arthritis (PsA) received either placebo or 100 mg guselkumab every 4 weeks and every 8 weeks. Treatment with guselkumab improved disease activity in the joints as well as across several different domains through 52 weeks. Differences in response rates between the active treatment and placebo groups were observed at 8 weeks of treatment.

In addition, in the phase 3 VOYAGE 2 trial, the researchers showed that a significantly greater percentage of patients who received guselkumab vs placebo for 16 weeks had an IGA 0/1 response (84% vs 9%, respectively; P <.001).

Safety data from the VOYAGE 1 and 2 trials show that 78.3% of patients who received guselkumab continued treatment through week 252. Guselkumab featured a safety profile from year 1 through year 5 that was consistent with its safety profile shown in other studies. Low rates of adverse events due to treatment discontinuation were reported.

The signs and symptom improvement seen with [guselkumab] is noteworthy for both patients who live with fear of disease recurrence and their physicians, as these data add to a growing body of evidence for this first-in-class [interleukin] (IL)-23 inhibitor treatment for moderate to severe plaque [PsO] and active [PsA], noted the lead author of the VOYAGE 2 study.

Disclosure: The clinical trials included in this analysis were supported by Janssen Pharmaceutical Companies of Johnson & Johnson. Please see the original reference for a full list of study authors disclosures.

New phase 3 data showed first-in-class TREMFYA (guselkumab) provided durable complete skin clearance through 5 years in moderate to severe plaque psoriasis (PsO) and robust joint symptom improvement through 52 weeks in active psoriatic arthritis (PsA). Press release. Published April 23, 2021. Accessed April 26, 2021. https://www.biospace.com/article/releases/new-phase-3-data-show-first-in-class-tremfya-guselkumab-achieved-complete-skin-clearance-and-favorable-joint-efficacy-in-adult-patients-with-active-psoriatic-arthritis-psa-through-two-years/

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Taltz delivers more cumulative days with completely clear skin for adults with psoriasis compared to seven other biologics in novel network…

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Results from first network meta-analysis based on area under the curve of 52-week clinical trial data. Taltz also helped patients stay on treatment longer and have more days without additional therapy in three real-world analyses of U.S. claims data

TORONTO, April 30, 2021 /CNW/ - Through clinical trial meta-analysis and real-world evidence, Eli Lilly and Company's Taltz (ixekizumab) demonstrated greater success in key measured treatment outcomes compared to other biologics in adults with moderate- to severe plaque psoriasis. In the first one-year network meta-analysis based on area under the curve, Taltz showed numerically greater cumulative benefits on completely clear skin over one year compared to seven other biologics, as measured by Psoriasis Area Severity Index (PASI) 100. In three real-world analyses of U.S. claims data ranging from one to three years, patients treated with Taltz stayed on treatment longer, were more adherent to the prescription and had more days on monotherapy compared to the other biologics studied. These results were presented virtually at the American Academy of Dermatology's Virtual Meeting Experience (AAD VMX), April 23-25, 2021.

"Results of the clinical trial meta-analysis showed Taltz offered more cumulative days of clear skin for patients with moderate- to severe psoriasis, compared to seven other biologics," says Dr. Doron Sagman, vice president, R&D and Medical Affairs, Eli Lilly Canada. "This further anchors Taltz as an important treatment option for patients who are looking for completely clear skin long-term."

Taltz provided patients with longest-lasting complete skin clearance over a one-year period1

In the network meta-analysis to assess the cumulative clinical benefits of biologics in psoriasis, using PASI 100 to measure the early and sustained effect of biologic medications approved for psoriasis over one year, Taltz offered patients with psoriasis the greatest number of cumulative days of completely clear skin compared to adalimumab, brodalumab, etanercept, guselkumab, risankizumab, secukinumab and ustekinumab. In this analysis, Taltz showed one to 18 more cumulative weeks of completely clear skin over one year compared to these seven other biologics.

Taltz provided patients with a total of 159 cumulative days (95% credible interval, 147.4-170.0 days), or 23 weeks of completely clear skin (PASI 100), which translates into a patient having completely clear skin for approximately 44% of the year compared to:

For methodology, see "About the studies" section below.

Taltz helped patients stay on prescribed treatment, and to avoid additional psoriasis therapy significantly longer, compared to secukinumab, ustekinumab, adalimumab and etanercept2

People with psoriasis taking Taltz achieved greater success taking medication as prescribed (adherence) and staying on medication for the prescribed duration (persistence), without needing additional medications (monotherapy), compared to those taking secukinumab, ustekinumab, adalimumab and etanercept up to three years. Patients on Taltz stayed on treatment an observed median of nearly 22 weeks longer vs. all other biologics pooled (414 vs. 259 days, [59 vs. 37 weeks], p<0.001) and approximately 11 to 34 weeks longer vs. individual treatments: secukinumab (335 days [48 weeks]), adalimumab (301 days [43 weeks]), etanercept (181 days [26 weeks]) and ustekinumab (176 days [25 weeks]). Compared with the pooled set of other biologics where patients stayed on prescription for less than half of the year (45.7%), patients on Taltz took treatment as prescribed for over half of the year (53.2%), as measured by proportion of days covered (PDC) by prescribed treatment (p<0.001). Patients taking Taltz also experienced more time (52.7% of the year) on monotherapy compared to the pooled set of other biologics (44.8% of the year) (p<0.001). For methodology, see "About the studies" section below.

Patients on Taltz took treatment as prescribed nearly eight weeks longer than guselkumab, despite more frequent dosing3

Compared to guselkumab, patients with psoriasis on Taltz adhered to treatment for nearly eight weeks more time (Taltz: median of 272 days or 39 weeks [PDC=0.75]; guselkumab: 219 days or 31 weeks [PDC=0.60], p=0.001) and had approximately six weeks more time on monotherapy (Taltz: median of 247 days or 35 weeks [PDC=0.68]; guselkumab: 202 days or 29 weeks [PDC=0.55], p=0.002) over one year. Among those patients who required additional psoriasis therapies, the need for systemic medication was similar for patients taking Taltz or guselkumab over the year. For methodology, see "About the studies" section below.

Patients on Taltz with prior biologic use were more likely to continue treatment as prescribed compared to secukinumab4

Among participants who had previously used a biologic, patients with psoriasis treated with Taltz were more likely to be "highly adherent," which was measured by more than 80% of days where they took treatments as prescribed (Taltz: 42.0% vs. secukinumab: 35.0%, p=0.019). Taltz was associated with 25% lower risk of switching treatments, 20% lower risk of stopping treatment before the end of the prescribed duration (non-persistence), 19% lower risk of discontinuing treatment, and 36% higher odds of taking treatment as prescribed (adherence) than secukinumab. For methodology, see "About the studies" section below.

"When compared to seven other biologics over a period of one year, Taltz provided patients with the greatest number of days of complete skin clearance. This real-world evidence demonstrates the effectiveness of Taltz. Taltz-treated patients had more days without the need for additional therapy," says Dr. Kim Papp, MD, PhD, FRCPC.

More than 175,000 patients have been treated with Taltz worldwide since launch, giving healthcare providers confidence in making informed prescribing decisions for patients with moderate- to severe plaque psoriasis and psoriatic arthritis, as well as in other approved conditions including ankylosing spondylitis and non-radiographic axial spondyloarthritis.

About the studies

About Taltz Taltz is approved for the treatment of patients 6 years of age and older with moderate- to severe plaque psoriasis who are candidates for systemic therapy or phototherapy and for the treatment of adults with active psoriatic arthritis, active ankylosing spondylitis, or active non-radiographic axial spondyloarthritis with objective signs of inflammation.5

About Moderate- to Severe Plaque Psoriasis Psoriasis is a chronic, immune disease that affects the skin. It occurs when the immune system sends out faulty signals that speed up the growth cycle of skin cells. Psoriasis affects approximately 125 million people worldwide, approximately 20 percent of whom have moderate- to severe plaque psoriasis. The most common form of psoriasis, plaque psoriasis, appears as raised, red patches covered with a silvery white buildup of dead skin cells. Patients with plaque psoriasis often have other serious health conditions, such as diabetes and heart disease and experience negative impact on their quality of life.

About Lilly in Dermatology By following the science through uncharted territory, we continue Lilly's legacy of delivering innovative medicines that address unmet needs and have significant impacts on people's lives around the world. Skin-related diseases are more than skin deep. We understand the devastating impact this can have on people's lives. At Lilly, we are relentlessly pursuing a robust dermatology pipeline to provide innovative, patient-centered solutions so patients with skin-related diseases can aspire to live life without limitations.

About Lilly CanadaEli Lilly and Company is a global healthcare leader that unites caring with discovery to make life better for people around the world. We were founded more than a century ago by Colonel Eli Lilly, who was committed to creating high quality medicines that meet people's needs, and today we remain true to that mission in all our work. Lilly employees work to discover and bring life-changing medicines to people who need them, improve the understanding and management of disease, and contribute to our communities through philanthropy and volunteerism.

Eli Lilly Canada was established in 1938, the result of a research collaboration with scientists at the University of Toronto which eventually produced the world's first commercially available insulin. Our work focuses on oncology, diabetes, autoimmunity, neurodegeneration, and pain. To learn more about Lilly Canada, please visit us at http://www.lilly.ca.

For our perspective on issues in healthcare and innovation, follow us on twitter @LillyPadCA and @LillyMedicalCA.

This press release contains forward-looking statements (as that term is defined in the Private Securities Litigation Reform Act of 1995) about Taltz (ixekizumab) as a treatment for patients with psoriasis or psoriatic arthritis and reflects Lilly's current belief and expectations. However, as with any pharmaceutical product, there are substantial risks and uncertainties in the process of research, development and commercialization. Among other things, there can be no guarantee that future study results will be consistent with the results to date or that Taltz will receive additional regulatory approvals or be commercially successful. For further discussion of these and other risks and uncertainties, see Lilly's most recent Form 10-K and Form 10-Q filings with the United States Securities and Exchange Commission. Except as required by law, Lilly undertakes no duty to update forward-looking statements to reflect events after the date of this release.

References

1Blauvelt et al. Cumulative Clinical Benefits of Biologic Treatments for Psoriasis Over 1 Year. American Academy of Dermatology (AAD VMX); Virtual; 23-25 April 2021.

2Blauvelt et al. Ixekizumab Demonstrates Greater Medication Adherence, Persistence, and Longer Monotherapy Duration Than Secukinumab, Adalimumab, Ustekinumab, and Etanercept up to 3 Years in the Treatment of Psoriasis: Real-world Results From IBM MarketScan Databases. American Academy of Dermatology (AAD VMX); Virtual; 23-25 April 2021.

3Blauvelt et al. Real-World Comparison of Monotherapy and Concomitant Medication Use with Biologic Therapies for Psoriasis: Ixekizumab vs. Guselkumab. American Academy of Dermatology (AAD VMX); Virtual; 23-25 April 2021.

4Blauvelt et al. Comparison of Long-Term Treatment Patterns between Ixekizumab and Secukinumab Users among Biologic-experienced Psoriasis Patients. American Academy of Dermatology (AAD VMX); Virtual; 23-25 April 2021.

5Taltz Product Monograph, March 29, 2021

To read Lilly's 2021 AAD disclosures, click here.

SOURCE Eli Lilly Canada Inc.

For further information: Media Contact: Samira Rehman, [emailprotected], 647-617-1994

http://www.lilly.ca

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Safety and efficacy of faecal microbiota transplantation for active peripheral psoriatic arthritis: an exploratory randomised placebo-controlled trial…

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Objectives:Although causality remains to be established, targeting dysbiosis of the intestinal microbiota by faecal microbiota transplantation (FMT) has been proposed as a novel treatment for inflammatory diseases. In this exploratory, proof-of-concept study, we evaluated the safety and efficacy of FMT in psoriatic arthritis (PsA).

Methods:In this double-blind, parallel-group, placebo-controlled, superiority trial, we randomly allocated (1:1) adults with active peripheral PsA (3 swollen joints) despite ongoing treatment with methotrexate to one gastroscopic-guided FMT or sham transplantation into the duodenum. Safety was monitored throughout the trial. The primary efficacy endpoint was the proportion of participants experiencing treatment failure (ie, needing treatment intensification) through 26 weeks. Key secondary endpoints were change in Health Assessment Questionnaire Disability Index (HAQ-DI) and American College of Rheumatology (ACR20) response at week 26.

Results:Of 97 screened, 31 (32%) underwent randomisation (15 allocated to FMT) and 30 (97%) completed the 26-week clinical evaluation. No serious adverse events were observed. Treatment failure occurred more frequently in the FMT group than in the sham group (9 (60%) vs 3 (19%); risk ratio, 3.20; 95% CI 1.06 to 9.62; p=0.018). Improvement in HAQ-DI differed between groups (0.07 vs 0.30) by 0.23 points (95% CI 0.02 to 0.44; p=0.031) in favour of sham. There was no difference in the proportion of ACR20 responders between groups (7 of 15 (47%) vs 8 of 16 (50%)).

Conclusions:In this first preliminary, interventional randomised controlled trial of FMT in immune-mediated arthritis, we did not observe any serious adverse events. Overall, FMT appeared to be inferior to sham in treating active peripheral PsA.

Trial registration number:NCT03058900.

Keywords:arthritis; inflammation; psoriatic; therapeutics.

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Fat People Dont Have To Be On A Perpetual Diet – Yahoo Lifestyle

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I have psoriasis. Ive had it since I was in elementary school, and I have finally decided Ive had enough. I recently started a new injectable biologic to control it. While I was digging for good news about my skin, I found a video of a guy discussing all the things he tried before turning to injectables. He started off discussing a psoriasis diet he had tried for several months.

It wasnt the diet that caught my attention.

It was the way he talked about it. He was visibly frustrated as he explained that the strict diet he was on actually did help his psoriasis. He saw marked improvement. But he couldnt stick to it long term because it was so all-consuming.

His basic sentiment was, It came to a point where I could do this diet to help my skin, or I could have all the other parts of the rest of my life. I chose a normal life. As a thin person, I am sure this felt like a big revelation to him.

As a fat person, I was like NO EFFING KIDDING.

Limiting your diet is an emotional roller coaster no matter what the reason, but when its motivated by diet cultures hatred for the way your body looks, its literally 24/7 hard. Its maintaining constant focus on the ways your body doesnt stack up to societys standards.

That SUCKS. Its soul-crushing. It hurts. Even when it works.

I know that I could stick to a very strict, very large calorie deficit and lose weight. I could prioritize a time-consuming, intense exercise regimen and change my body to some extent.

Theres a high likelihood that, for me, it would be disordered, motivated by self-loathing, and feel like total misery.

But it would work if you consider success to be shrinking my body into a more acceptable size and shape. Because its not technically impossible for me to become thinner, many people believe that I should be on a perpetual diet every single day of my life until I attain a level of thinness that makes me sexually acceptable to the men who dictate our beauty standards.

Story continues

It doesnt matter that its unreasonably hard for some people. That truth is constantly brushed off as an excuse or laziness. Nobody wants to hear that every body actually doesnt respond the same way to every diet, and that what worked for them might not work for me. A lot of people dont allow a fat person the space and respect to say, Dieting, for me, gets to a point where it controls my life, and I get to choose between that and my own happiness and mental health. We dont get to prioritize our mental health and happiness without judgment.

Fat people are supposed to be constantly in progress until we are thinand then?

We are supposed to spend the rest of our lives working to maintain that thinness.

And we are supposed to do this without any complaint, without any sympathy for how incredibly hard it is because we are supposed to want to be thin more than we want to enjoy food along with everyone else, and relax into our bodies as they are.

Its interesting to me because there actually was one time in my life when people seemed to feel for me when I was on a very restricted diet. I wasnt thin. I was pregnant. In my third trimester with my last baby, I found out I had gestational diabetes. Luckily, I didnt have any trouble controlling my blood sugars, and we both turned out no worse for the wear.

But I had to navigate the holiday season without a single treat, with very few carbs, carefully measuring my portions and ensuring that I created a safe environment for my growing baby.

It is the one time in my life that I did not struggle one little bit. My health and my babys health depended on my restricted diet. It was a no-brainer that I would do what I needed to do in order to keep us both safe.

Its also the one time when I was inundated with compassion. People wanted to tell me that they understood how tough it was. They seemed to fully understand how overwhelmed I must be asking about ingredients, tracking everything I ate, testing my blood, checking my babys weight via weekly ultrasounds. A lot of people even promised to bring my favorite sweet treats to the hospital after my baby was born, realizing how comforting and yummy that would be for me.

The fact that gestational diabetes was largely out of my control seemed to be my golden ticket to understanding.

My higher weight, despite much scientific evidence to the contrary, is still largely regarded as something that is completely within my control, and therefore, I am not entitled to be okay with it.

Why can people muster up sympathy for people who have to limit their diets due to illnesses, but they expect fat people in good health (we do exist!) to be on a perpetual diet, never ever just eating whats available, letting their body exist as it is? Why is it still such a no-go to just accept that youre fat and let that be the case, even if only for a season?

I fought my body for years. For most of my teens and twenties and even a couple years of my very early thirties, I was always on a diet. Every time I ate a meal or treat without knowing how many calories, carbs or fat was in it, I felt a nagging guilt that I was cheating on my diet. Despite my best efforts, I never quite changed my body enough to become acceptable. Not even close.

And then, I decided to see what it felt like to try to make peace with my body instead of constantly fighting it. I didnt gain weight as I always thought I would. Sometimes, I even lose weight without trying. My weight fluctuates naturally almost as much as it did when I was frequently actively dieting.

I still diet once in a while. I have learned to make peace with my body, but I live in this thin-obsessed culture and sometimes I still find myself itching to see if I can get a little closer to thin.

Because dieting isnt all tough. The high of watching the weight come off is enough to keep me going sometimes. When its working and your body is shrinking, dieting can feel good. (But it can also quickly evolve into a really harmful pattern of disordered eating if youre susceptible to that.) Inching closer to societys idea of what you should look like feels hopeful sometimes.

But, for me, theres something really draining about trying to convince myself to frame the experience as a permanent change of lifestyle, when it almost always feels like an unsustainable way to live. Im not alone in that exhaustion.

https://www.instagram.com/p/COGvdHwBhwz/

Most fat people I have spoken to agree that its just really heavy to be so focused on the ways your body doesnt stack up to societys standards. Dieting can bring that to the forefront in ways that are really tough to handle for extended periods of time.

There is so much you dont know about a fat persons health, history and choices just by looking at them. If you know a fat person who seems to you to be letting themselves go or not caring about their health, mind your own business, and let them be. Mental health IS health, and we dont owe anyone a smaller body or an explanation as to why we arent killing ourselves to attain one.

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Fat People Dont Have To Be On A Perpetual Diet - Yahoo Lifestyle

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Rheum Round-up: More Rheumatic Pts Got Flu Shot, VTE in PsA, and more – DocWire News

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As the United States looks to combat vaccine hesitancy, at least one group is feeling even more confident in a vaccinebut not the COVID-19 shot: Patients with autoimmune rheumatic diseases (ARDs) had a higher rate of flu vaccinations during the pandemic, researchers discovered.

A total of 1,015 patients were interviewed. A greater proportion of patients received the flu shot during the pandemic (2020-21 season) than before (2019-20 season). Fewer than 1% of patients who got the shot reported disease flares.

In the pre-pandemic period, patients were more likely to say their rheumatologist did not recommend the shot compared to during the pandemic. During both flu seasons, other reasons patients skipped out on the shot included they didnt think it would have any benefit, they didnt feel it was safe, and other.

Another study analyzed the prevalence of and risk factors for venous thromboembolism (VTE) in patients with psoriasis and psoriatic arthritis (PsA). Final analysis included 2,433 patients, and there were 26 incident VTEs. The incident rate of the first VTE was 12 events per 10,000 patient-years. By age 80, 4.6% of patients had developed their first VTE. Factors independently correlated with VTE were older age, diabetes mellitus, and corticosteroid usage.

Finally, a study compared golimumab treatment retention among patients with rheumatoid arthritis (RA), axial spondyloarthritis (AxSpA), and PsA. Compared to patients with RA, those with AxSpA or PsA had higher rates of retention. Further, retention rates were higher when golimumab was a first-line treatment instead of third or later. Use as first-line biological therapy, having AxSpA or PsA (instead of RA), and concomitant methotrexate therapy were all correlated with increased golimumab retention, while steroid use reduced retention.

In Case You Missed It

Flu Shot Rates Increased During COVID-19 Pandemic among Patients with Autoimmune Rheumatic Diseases

Risk Factors for VTE in Patients with Psoriasis, Psoriatic Arthritis

Golimumab Treatment Retention Comparison: RA, AxSpA, and PsA

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Rheum Round-up: More Rheumatic Pts Got Flu Shot, VTE in PsA, and more - DocWire News

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Psoriasis Therapeutics Market 2021 Size, Status and Business Outlook Astellas Pharma Inc., AstraZeneca plc, Boehringer Ingelheim GmbH The Courier -…

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The Global Psoriasis Therapeutics Market Research Report 2021-2027 is a significant source of keen information for business specialists. A report published by Market Insights Reports is an overall investigation and thorough information in regards to the market size and market elements of the Psoriasis Therapeutics. It furnishes the business outline with development, historical and futuristic cost analysis, income, demand, and supply information (upcoming identifiers). The research analysts give a detailed depiction of the worth chain and its wholesaler examination. The Psoriasis Therapeutics market study gives extensive information which upgrades the agreement, degree, and use of this report. This is a latest report, covering the COVID-19impact on the market.

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Top Companies in the Global Psoriasis Therapeutics Market are Astellas Pharma Inc., AstraZeneca plc, Boehringer Ingelheim GmbH, F. Hofffmann-La Roche, GlaxoSmithKline plc, Merck & Co., Inc., Valeant Pharmaceuticals International, Inc., Biocon Limited, Eli Lilly and Company, G & W Laboratories Inc.

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TNF Inhibitors

PDE4 Inhibitors

Interleukin Blockers

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Oral

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Topical

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MarketInsightsReports provides syndicated market research on industry verticals including Healthcare, Information, and Communication Technology (ICT), Technology and Media, Chemicals, Materials, Energy, Heavy Industry, etc. MarketInsightsReports provides global and regional market intelligence coverage, a 360-degree market view which includes statistical forecasts, competitive landscape, detailed segmentation, key trends, and strategic recommendations.

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Psoriasis Therapeutics Market 2021 Size, Status and Business Outlook Astellas Pharma Inc., AstraZeneca plc, Boehringer Ingelheim GmbH The Courier -...

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Six Tips for Handling Key Issues in Tricky Bankruptcy Valuations – BVWire News

Posted: at 5:47 am

A number of issues have emerged that analysts will encounter when performing a valuation in a bankruptcy context. Valuation analysts who become involved in bankruptcy-related assignments should expect their work to come under a great deal of scrutiny because most of these engagements are done within a litigation or some other adversarial context, cautioned Robert Reilly, a managing director at Willamette Management Associates, during a BVR webinar back in 2017. While his remarks were made a few years ago, they continue to resonate, and a chapter from Business Valuation and Bankruptcy: Case Law Compendium, 3rd edition, contains more of his timeless advice on how to handle the challenges valuation experts will face.

Tip:Be familiar with the relevant sections of the Bankruptcy Code and the Bankruptcy Rules, but you should not be making legal decisions. Do not hesitate to ask for legal instructions from counsel with regard to any bankruptcy-related legal issues.

Tip:The courts seem to adopt the known or knowable rule, Reilly says. You should consider only that information that was known or knowable as of the time of the valuation date.

3. Reliance on management projections. In a bankruptcy context, it is not uncommon for debtor company management to prepare various financial projection versions. One version could be prepared for the debtor board, one for the debtors bank, one for a potential acquirer, and maybe others. In this case, you should perform sufficient due diligence regarding these projections to conclude which version is most appropriate for the purpose and objective of the bankruptcy valuation. If possible, you should avoid relying on projections prepared after the bankruptcy litigation is filed. Even if such post-petition filing projections are perfectly reasonable, some party in interest may allege that the projections are biased and litigation-driven. Also, try to learn who prepared the projections and whether those individuals were qualified to do it.

Tip:If you say that you relied on managements projections, be prepared for this question from the judge: So these projections were prepared by management. This is the same management team that led this company into bankruptcy today. Why are you relying on this management team again? Obviously, they didnt do a very good job of managing the company. Good point, and thats probably right, but that may be the most reliable data you have available. You need to take that into consideration and be ready to explain.

4. Debt interest rates.The current commercial debt interest rates may be considered unreasonably low, Reilly points out. You need to determine whether the use of such interest rates is appropriate in determining the debtor company weighted average cost of capital (WACC).

Tip:An unreasonably low cost of debt can understate WACC, which may overstate the debtor company value. Ask yourself this question: If the debtor company obtained new financing today, could it actually enjoy the benefit of current relatively low interest rates?

5. Due diligence. Rest assured that you will always be questioned on the reasonableness of your due diligence because you typically have limited access to financial or operational documents (troubled firms are lax in filing documents) and company management has typically moved on, so you may not even be able to talk with certain key people.

Tip:Keep in mind that hindsight is always 20-20 and its easy for the opposition to point out that everyone knows what really happened. So be prepared to show that you did enough due diligence to be convinced that the valuation was correct as of the valuation date.

6. Rules of thumb. The bankruptcy court does not look very favorably on rules of thumb, notes Reilly. If they apply at all, they may apply to an average company in that industry, but your subject company is in financial distress, so its probably not average.

Tip:Do not use industry rules of thumb as a primary valuation method. If rules of thumb are used at all, they should be supported by actual empirical data.

Conclusion

Of course, this just hits the high points of one facet of valuations in a bankruptcy context. One interesting piece of advice Reilly gave when summing up is that your valuation report should be your best friend, available at your fingertips to help you answer every question you will face. But, to fulfill this role, your report must be clear, convincing, and cogent. It also must be replicable, transparent, and well-supported with source documents. Then you can answer every question by starting with As I said in my report, which will heighten your credibility.

To see the complete list of tips on how to handle issues in bankruptcy valuations or to learn more about bankruptcy as it relates to business valuation, be sure to check out BVRs Business Valuation and Bankruptcy: Case Law Compendium, 3rd edition. Preview the table of contents and look inside to learn more about this invaluable resource for business valuation professionals to stay ahead of the game.

Editors note: The full version of this work originally appeared in an articlein the July 2017 issue of Business Valuation Update.

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Six Tips for Handling Key Issues in Tricky Bankruptcy Valuations - BVWire News

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The Ascent drops you into a living, breathing cyberpunk world that is "completely seamless from beginning to end" – Gamesradar

Posted: at 5:46 am

The Ascent may leave its camera hanging in the clouds, but theres something about its world thatll pull you right into the thick of it: the crime, the corruption, and the gangs and corporations vying for control in an atmospheric metropolis. Neon Giant has built a wondrous space for its Xbox Series X debut. Watching The Ascent in action, I can't help but be drawn to just how alive this cyberpunk setting seems and to its civilians just trying their best to survive in a world of unending chaos, much of it created by whoever is holding the controller. Alien locals have conversations beside neon-tinted signage, muttering about the violence that you have engineered, as others attend to completing the daily grind of life around them. The Ascent might be an action-shooter RPG at heart, but it's one set in a living, breathing world.

Graphically, it looks incredible too, with realistic light reflections on the ground and impressive architecture and environments. But what is perhaps more noticeable is the absence of any kind of loading screen as we're taken through each area and transition between cutscenes and gameplay. "It's completely seamless, in that we don't have loading screens," says Tor Frick, co-founder of Neon Giant and creative director of The Ascent. "We have, of course, fast travel with the train and the taxi, but the game is completely seamless from beginning to end."

"We wanted to take some of the tropes in cyberpunk and apply a little bit [of] a different flair to it."

This seamless experience takes place in a world where a mega-corporation known as The Ascent Group owns everyone and everything. When something happens that causes the corporation to suddenly go under, you set out to find answers. With a story-driven main campaign, side missions with their own little stories, and boss fights to experience, there's also plenty of room for you to explore at your own pace and discover everything the cyberpunk setting has to offer.

The Ascent plays out across an isometric layout, letting you tactically read the environment and use architecture around you as cover, should you happen to run into some enemies and find yourself in a gunfight. Taking into consideration the height of your foes, you can adjust your aim to go high or low, and shoot over cover. How (and if) you engage in combat is entirely left up to you, though. Neon Giant is building The Ascent with flexibility in mind, with a host of handcrafted weapons to try out, along with a range of gear and cyberware that can be switched up at any time.

As co-founder and creative director Arcade Berg explains, when you start the game you can create a character, but you're "not locked in" to any options you choose. Instead of having set classes, it's left up to you to determine how you want to customize your character to suit your preferred playstyle. From cyberware modifications such as augmentations and modules which determine your passive and active abilities in combat, to hairstyles and tattoos, you can change up your style and skill set at any time by visiting the Grafter an NPC that will let you customise just about any part of your character. "[It's] purely on how you choose to do things, we're completely classless," Berg says. "We also let you adjust that as you play because we feel it's more interesting and more fun to be allowed to experiment and play around with it, instead of locking yourself into something before you've even played the game"

Playable as both a single-player experience and in co-op, it's clear from what I've seen so far that Neon Giant has put a lot of care and effort into delivering on isometric RPG action and creating a fully realized world with their own take on cyberpunk. "We draw inspiration from many, many different works. From movies, books, comics. There's a whole influx of inspiration," says Frick. "But we wanted to take some of the tropes in cyberpunk and apply a little bit [of] a different flair to it. We have aliens and a lot more of a sci-fi feel to our game than the traditional cyberpunk does."

The Ascent is set to release on PC, Xbox One, and Xbox Series X/S sometime in 2021.

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The Ascent drops you into a living, breathing cyberpunk world that is "completely seamless from beginning to end" - Gamesradar

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Navigate Night City with the Cyberpunk 2077 Official Guide starting at just $10.50 (Save 40%) – 9to5Toys

Posted: at 5:46 am

Amazon is offering the Cyberpunk 2077 Official Guide Paperback for $10.56. Shipping is free for Prime shoppers or on orders over $25. Typically running for $17.50, you can save up to 40% for a new all-time low price. Complete with every gig, side job, cyberpsycho, and more, this is your one-stop guide to navigating Night City. You can chart your path with the expanded hi-resolution maps, or use the free download code to explore an interactive layout. This 461-page book is designed to offer every possible option without giving away the consequences, so you can still enjoy an informed playing experience. Rated 4.6/5 stars from over 900 customers. Head below for more.

If youre looking to find an ideal gift for any Cyberpunk fan, (especially if that fan is you,) check out the Official Guide Collectors Edition at $21.24. It comes with the original in-depth guide to the world of Cyberpunk 2077, plus an exclusive 32-page map of Night City, printed on premium art paper, and bound in a sturdy hardcover. Over 2,300 customers have left a glowing 4.8/5 star rating.

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Navigate Night City with the Cyberpunk 2077 Official Guide starting at just $10.50 (Save 40%) - 9to5Toys

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