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Pruebas para el VPH y el cáncer cervical podrían hacerse en casa

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Pasa un pequeño hisopo por la vagina para recoger células. Luego lo colocas en un kit de detección y lo envías por correo.

Una prueba sencilla como ésta, que se puede hacer en casa, ayudaría a los Estados Unidos a acercarse a la erradicación del cáncer de cuello uterino o cáncer cervical.

El año que viene, el Instituto Nacional del Cáncer (NCI) lanzará un estudio en diferentes localidades que involucrará a unas 5,000 mujeres para evaluar si la autoprueba casera puede equivaler a la que realiza el médico en un consultorio.

Casi 14,000 estadounidenses este año serán diagnosticadas con un cáncer que es prevenible, y más de 4,000 morirán. Las mujeres que no tienen seguro o que no pueden acceder a servicios médicos regulares tienen más probabilidades de no hacerse pruebas de detección que salvan vidas, dijo Vikrant Sahasrabuddhe, de la División de Prevención del Cáncer del NCI.

Sin salir de sus casas, las mujeres podrían recolectar células vaginales y cervicales para analizarlas en la detección del virus del papiloma humano (VPH), que causa virtualmente todos los cánceres cervicales, de la misma manera que las muestras de heces en casa pueden usarse para detectar el cáncer de colon, añadió.

“Sigue existiendo un número constante de mujeres que padece cáncer cervical cada año”, explicó Sahasrabuddhe, que supervisa los estudios sobre los cánceres relacionados con el VPH. “Y ese número no va a bajar”.

Las autoridades federales esperan que la investigación acelere un test aprobado por la Administración de Alimentos y Medicamentos (FDA) que podría formar parte de las directrices de evaluación si se demuestra que tomar la muestra en casa es eficaz, señaló Sahasrabuddhe.

En lugar de esperar a que las empresas que realizan las pruebas de VPH para los médicos hagan estudios de automuestreo, los funcionarios federales se unirán a empresas, instituciones académicas y otros en una asociación público-privada, explicó. Los funcionarios del NCI, que esperan gastar unos $6 millones en fondos federales, supervisarán los datos y el análisis del estudio.

“Queremos acelerar ese proceso”, indicó Sahasrabuddhe.

El automuestreo del VPH, existente en países como Australia y los Países Bajos, es uno de los enfoques de los investigadores del cáncer cervical en los Estados Unidos. Otra estrategia clave consiste en vacunar a las adolescentes contra el VPH, que se transmite a través de la actividad sexual. En 2018, casi el 54% de las niñas habían sido vacunadas al llegar a los 17 años, al igual que casi el 49% de los niños, según los datos federales más recientes.

Los países que han tenido más éxito en la reducción del cáncer cervical —un análisis predice que Australia está en vías de eliminar la enfermedad— han hecho hincapié en la vacunación contra el VPH en adolescentes.

Las autoridades siguen aconsejando a las mujeres vacunadas que se sometan regularmente a pruebas de detección, ya que la vacuna no protege contra todas las cepas que causan el cáncer de cuello uterino.

Sin embargo, a veces es un desafío.

Para algunas, el acceso o el costo puede ser un problema. La mayoría de los planes médicos cubren los exámenes y también hay algunos programas públicos, pero las mujeres sin seguro que no los conocen tienen que pagar por la consulta y la prueba.

Además, las mujeres no siempre salir del trabajo o encontrar una guardería, o pueden haber tenido “emociones o experiencias negativas en el pasado con los exámenes pélvicos”, señaló Rachel Winer, profesora de epidemiología de la Escuela de Salud Pública de la Universidad de Washington que estudia el automuestreo del VPH.

Invertir la tendencia

Unas 4 de cada 5 mujeres se someten regularmente a pruebas de detección de cáncer cervical, pero los índices alcanzaron su punto máximo alrededor del año 2000 y han disminuido ligeramente desde entonces, según datos federales.

Otro análisis de registros médicos de 27,418 mujeres de Minnesota, de entre 30 y 65 años, encontró que casi el 65% se había hecho la prueba en 2016, según publicó el año pasado el Journal of Women’s Health.

“Lamentablemente, creo que nuestros datos probablemente reflejan mejor lo que está sucediendo con los índices de evaluación en nuestro país”, expresó la doctora Kathy MacLaughlin, autora del estudio e investigadora de la Clínica Mayo en Rochester, Minnesota.

Un obstáculo para la prueba podría ser la complejidad de las directrices, dijo MacLaughlin. En lugar de un examen anual fácil de recordar, las evaluaciones ocurren en intervalos de más de un año. La edad de la mujer ayuda a determinar cuándo se recomienda la prueba de VPH o la citología vaginal (el Papanicolau), que recoge células del cuello uterino para buscar cambios precancerosos.

“El reto es cómo recordar que debemos hacer algo cada tres o cada cinco años”, comentó MacLaughlin.

Logística en casa

Si bien el NCI aún no ha decidido el tipo de automuestreo que utilizará, la técnica generalmente requiere que la mujer inserte un pequeño hisopo en su vagina y lo rote varias veces para recolectar las células.

Luego desliza el hisopo en un contenedor de muestras que tiene una solución conservante y devuelve el kit para el análisis del VPH.

Según un informe publicado en 2018 en la revista médica BMJ, la precisión de la identificación del VPH era similar cuando las muestras eran recogidas por las mujeres en casa que cuando lo hacía un médico.

También se estudia una prueba de VPH en orina, que podría resultar más fácil de realizar para las mujeres, dijo Jennifer Smith, profesora de epidemiología de la Escuela Gillings de Salud Pública Global de la Universidad de Carolina del Norte.

Antes que las compañías puedan aplicar para pruebas caseras aprobadas por la FDA, el automuestreo de las mujeres debe ser comparable en la detección del VPH, aunque no sea tan preciso, como cuando lo hace un médico, señaló Sahasrabuddhe.

Los funcionarios del NCI aún están ultimando los detalles del estudio. Pero el plan es invitar a participar a cuatro compañías que ya fabrican pruebas de VPH para médicos, dijo Sahasrabuddhe.

Las empresas pagarán el costo de las pruebas y las futuras tarifas relacionadas con la solicitud de licencias a través de la FDA. Sahasrabuddhe espera que los resultados del estudio estén disponibles para 2024, si no antes.

Si una mujer da positivo en las pruebas de VPH podría necesitar una biopsia, para buscar células anormales o cáncer cervical, indicó Sahasrabuddhe.

Si se desarrolla un test casero aprobado por la FDA, es crucial que las mujeres sin seguro y otras que no tienen acceso fácil a la atención médica puedan conseguirlo, enfatizó Smith.

“Porque no se envían kits al azar a los hogares”, dijo Smith, “y nadie se asegura que tengan a alguien con quien hablar sobre los resultados y que puedan tener un seguimiento”.

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By: Charlotte Huff
Title: Pruebas para el VPH y el cáncer cervical podrían hacerse en casa
Sourced From: khn.org/news/pruebas-para-el-vph-y-el-cancer-cervical-podrian-hacerse-en-casa/
Published Date: Wed, 01 Jul 2020 13:29:54 +0000

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Ends-of-the-World Every Year Since 1970

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There always has been and always will be a reason not to invest or not to stay invested. This is all the mainstream media reports to us. Below you will find a list of some of the worst global events each year since 1970. I have some commentary to follow.

1970: War: US troops invade Cambodia.
1971: Civil Unrest: Anti-war militants march on Washington.
1972: Political: Start of Watergate Scandal.
1973: Economic: OPEC raises oil prices in response to US involvement abroad.
1974: Political: Nixon resigns as President of the United States.
1975: Political: Multiple assassination attempts on President Ford.
1976: World: Ebola virus.
1977: Political: Government shutdowns.
1978: Market: U.S. Dollar plunges to record low against many European currencies.
1979: World: Iranian militants seize the U.S. embassy in Teheran and hold hostages.
1980: Economic: Inflation spiked to a high of 14.76%.
1981: Political: President Reagan assassination attempt.
1982: Economic: Recession continues in the U.S. with nationwide unemployment of 10.8%.
1983: Economic: Unemployment in the U.S. reaches 12 million.
1984: Economic: 70 U.S. banks fail during the year.
1985: World: Multiple airplane hijackings around the world.
1986: World: Chernobyl Nuclear Power Station explodes.
1987: Market: DOW drops by 22.6% on October 22.
1988: Environment: Awareness of global warming and the greenhouse effect grows.
1989: Environment: Exxon Valdez dumps 11 million gallons of crude oil into Prince William Sound.
1990: World: Persian Gulf War starts.
1991: World: Mass shooting in Killeen, TX.
1992: Human Rights: Los Angeles riots following the death of Rodney King.
1993: Terrorism: World Trade Center bombing.
1994: World: Mass genocide in Rwanda.
1995: Terrorism: Oklahoma City bombing.
1996: Terrorism: Olympic Park bombing.
1997: World: Bird flu.
1998: World: Multiple U.S. embassy bombings.
1999: World: Columbine shooting.
2000: Economic: Start of the Dotcom Market Crash.
2001: Terrorism: Terrorist Attacks in NYC, DC & PA.
2002: Economic: Nasdaq bottomed after a 76.81% drop.
2003: World: The U.S. invades Iraq.
2004: World: The U.S. launches an attack on Falluja.
2005: World: Hurricane Katrina
2006: World: Bird flu.
2007: Economic: Start of the Great Recession.
2008: Economic: Great Recession continues.
2009: Economic: S&P bottomed after a 56.8% drop.
2010: Market: Flash crash.
2011: Market: Occupy Wall Street and S&P downgrades U.S. Debt.
2012: Political: Fiscal cliff.
2013: Political: Taper tantrum.
2014: World: Ebola virus.
2015: World: Multiple mass shootings.
2016: Political: Divided U.S. Presidential election.
2017: World: North Korea testing nuclear weapons.
2018: Economic: U.S. & China trade war.
2019: Economic: Student loan debt reaches an all-time high of $1.4 trillion.
2020: World: COVID-19.

While many of these events were undoubtedly terrible (and there are certainly others not named here that were worse), most of these were broadcast as end-of-the-world events for the stock market. Despite that attention, it is worth noting that these were, for the most part, one-time events. In other words, most faded into the newspapers of history. We moved on.

Obviously, some caused monumental shifts in the way the world works. Just think about how much air travel continues to be impacted by the events of 9/11. But, outside of the resulting inconveniences (if we want to call safety protocols inconveniences) associated with air travel, flying is safer than ever before.

Take a look at just about any of the events and you will find there are many that people will hardly remember. My point here isn’t that these events are to be ignored or that they were easy to stomach at the time, but that they have become a distant memory.

I want to also make the point that we should expect these types of negative events. As investors, we know these types of crises, economic catastrophes, and global phenomena are going to happen.

But in almost all cases, here is what we can say in the next breath – this too shall pass.

Will there be legal, humanitarian, economic, or some other aid required as a result of these events? Almost certainly the answer is yes, but that doesn’t mean it they won’t eventually fade into history.

Lastly, what’s worth noting is how the market has performed over these last 50 years despite the continual advertisements of the world crashing down around us. On January 2, 1970, the Dow Jones stood at 809 and the S&P at 90 -> those are not typos. These same indexes have grown (not including dividends) to 26,387 and 3,232 respectively. Amazing, no?

Perhaps what gets overlooked more than anything else is what separates the above one-time negative events from the positive stories that go largely ignored over our lifetimes. And that is a story worth telling. See the companion post below:

Unheralded Positive Events Every Year Since 1970

Stay the Course,
Ashby


Retirement Field Guide Mission:

“To help 10 million people make better retirement decisions.”


If you would like to join us in achieving our mission, I hope you will consider sharing our site if you have found it helpful in your own retirement planning.


This post is not advice. Please see additional disclaimers.

The post Ends-of-the-World Every Year Since 1970 appeared first on Retirement Field Guide.

—————–

By: Ashby Daniels, CFP®
Title: Ends-of-the-World Every Year Since 1970
Sourced From: retirementfieldguide.com/ends-of-the-world-every-year-since-1970/?utm_source=rss&utm_medium=rss&utm_campaign=ends-of-the-world-every-year-since-1970
Published Date: Tue, 04 Aug 2020 13:26:19 +0000

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Wildfire prone property insurance bill in California due for hearing

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The post Wildfire prone property insurance bill in California due for hearing appeared first on Live Insurance News.

The bill is expected to be heard in upcoming weeks as opposing sites prepare for major battle.

A new California bill, the outcomes of which will have a lot to say about coverage for wildfire prone property in the state, will soon be headed for hearing. The hearing is expected to be a heated one as strong opposing opinions have the opportunity to be voiced.

Opponents of this bill are calling it a direct attack on consumer protections in insurance.

That said, proponents of the bill claim it is the best method for making coverage available to wildfire prone property in California. The bill in question is Assembly Bill 2167. It was written by Assemblyperson Tom Daly (D-Anaheim). If it passes,it will create the Insurance Market Action Plan (IMAP) program. The IMAP program is meant to protect residential properties.

So far, AB 2167 has progressed quickly, when taking into consideration that a chunk of the legislature has been considerably restricted by pandemic crisis precautions. It was first presented in early June and backers have been saying that it was brought forward in good timing and that it has all the momentum it needs to be passed.

That said, AB 2167 has not been without opposition. In fact, it has faced considerable opposition, having been called an attack on Proposition 103, insurance consumer protection law. California Insurance Commissioner Ricardo Lara lobbed that argument at it, calling it an “insurance industry wish list, with nothing to help consumers,” and Consumer Watchdog, whose founder, Harvey Rosenfeld, was the original author of Proposition 103.

The insurance industry strongly supports the bill, saying it will help wildfire prone property coverage.

Insurance organizations such as the American Property Casualty Insurance Association and the Personal Insurance Federation both support AB 2167. The bill also has the support of the California Association of Counties (CSAC), as well as Fire Safe Councils of California, and the CalFIRE union.

The Consumer Federation of America, another watchdog organization, has predicted that if AB 2167 passes, it will cause 40 percent increases in insurance rates. On the other hand, insurance groups claim that the bill offers owners of wildfire prone property a greater opportunity for choice and competition among insurance companies based on coverage and premiums while avoiding the limitations and high costs associated with FAIR Plan coverage.

The post Wildfire prone property insurance bill in California due for hearing appeared first on Live Insurance News.

—————–

By: Marc
Title: Wildfire prone property insurance bill in California due for hearing
Sourced From: www.liveinsurancenews.com/wildfire-prone-property-insurance-bill-in-california-due-for-hearing/8549884/
Published Date: Fri, 14 Aug 2020 09:00:14 +0000

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Is this the last hurrah for bonds?

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Recently, I have written quite a bit about the long-term return expectations for investing in bonds. See here, here, here and here.

Spoiler alert: I don’t think it’s good.

But long-term bonds this year have been quite an amazing story as the COVID pandemic has caused the Fed to take historically monumental actions. As a result, we’ve watched long-term Treasuries tear the roof off the market. For instance, a 20+ Year Treasury Bond ETF (name withheld for compliance purposes) is up more than 31% YTD as of July 31st.

That is insane!

But there is a good reason for this increase shown below.

The red circle shows a decrease in the 30-year Treasury rate of almost 40% over a span of six months. That’s practically unprecedented with only two periods (2008 and 1981-1982) having similar declines over such short periods.

But this begs the question: Is this the last hurrah for bonds as a driver of any meaningful return? Below is the 30-Year Treasury rate over the last 40+ years.

For what it’s worth, people have been forecasting the end of the bond bull market since 2012 (maybe even earlier) and yet it has continued despite those predictions. But at some point, the bond party will come to an end.

The Fed has been clear that they are going to keep rates stable until at least 2022 which means this may not change for a little while longer. Or in the near term, I could even see the high returns continuing if we experience pandemic economic shutdown round two.

But, I can’t see a world where this is the case for much longer than that – most importantly over the span of a 30-year retirement.

The official end of the bond bull market depends on a recovery from the pandemic economy as well as a few other factors causing rates to rise. But when they do, it seems likely to me that this may be the last great hurrah for bonds for quite some time.

The question is when to get off that train and that undoubtedly requires a personal answer.

Stay the Course,
Ashby


Retirement Field Guide Mission:

“To help 10 million people make better retirement decisions.”


If you would like to join us in achieving our mission, I hope you will consider sharing our site if you have found it helpful in your own retirement planning.


This post is not advice. Please see additional disclaimers.

The post Is this the last hurrah for bonds? appeared first on Retirement Field Guide.

—————–

By: Ashby Daniels, CFP®
Title: Is this the last hurrah for bonds?
Sourced From: retirementfieldguide.com/is-this-the-last-hurrah-for-bonds/?utm_source=rss&utm_medium=rss&utm_campaign=is-this-the-last-hurrah-for-bonds
Published Date: Wed, 12 Aug 2020 13:47:16 +0000

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