The Ministry reported that about 70% of dead Palestinians are women and children.

That’s since Hamas’ surprise attack on Israel on October 7, in which some 1,200 people were killed and around 240 kidnapped, according to the Israeli government.

According to the Israeli military, 576 Israeli soldiers have been killed since Oct. 7.

Now 146 days into Israel’s retaliation attacks, humanitarian workers in Gaza say thousands of people may still be trapped under the rubble, and about 70,000 people have been injured.

That’s where Dr. Khawaja Ikram, an orthopedic surgeon in DFW, felt compelled to help. He signed up with the nonprofit MedGlobal, which conducts medical missions in Gaza under the umbrella and with the assistance of the World Health Organization.

“I know that I’ve been blessed with a skill set that other people need,” said Ikram, who practices in Mesquite and Plano.

The husband and father of four had a tough conversation with his family.

“Hey, this is an active war zone. This is a humanitarian crisis and these people are suffering. Anything that we can do to help out, even if it’s for a few weeks, is probably best for us,” he recalled telling them.

Ikram said he’s gone on other medical missions before; Guatemala, Haiti, and Pakistan. But none like Gaza.

“I had the discussion with the kids and the wife that… this may be the last time that we see each other. But again, whenever time is written, we’re going to go. So I said, ‘What better way to go than serving humanity?'” Ikram said.

Some of his memories heartwarming, like a child who gave him a shell with Arabic written on it. When he asked someone to translate it, he found out it said, “From Gaza, with love, despite the pain.”

“I mean, I start crying,” he said. “These people have nothing, but they still want to give you something.”

Other memories are heartbreaking, like one day, when Dr. Ikram said the Israeli military had given them a green light, indicating it was safe to drive from the home they were staying in, to the European Gaza Hospital.

“So, we’re on the road in the van and we hear the bomb go off… maybe a block away,” he said, showing a picture of the thick, black smoke.

They arrived at the hospital a few minutes later to a chaotic scene; an ambulance had arrived, and another civilian car, carrying bomb victims.

“The cars come with their family members who had been part of this bomb. So, we rush into the emergency room. We’re just trying to do chest compressions, trying to save them, but unfortunately, the bombs that are going off are there to kill people. So from that standpoint, most of the time, not many people survive those,” Ikram recalled.

Ikram said another time, a man came in carrying his five-year-old daughter, who had a single bullet wound to the head. He said they were displaced, trying to check on their home.

“He said, ‘Supposedly the troops were pulling back. So, we thought maybe, let’s go see what is still left over our house, see if there’s anything left. There were snipers waiting for us. My five-year-old daughter was shot, and she’s my only daughter, so please save her for us,” Ikram recounted. “And of course, there’s nothing we could do.”

Another heartbreaking memory for the father was when a man came in with a little boy, around five years old.

“And he’s like, ‘I was just on the side of the road. I saw this child fall and hurt himself.’ And we’re like, ‘Where’s his family?’ He’s like, “He doesn’t have any family. All of his family has been killed,'” Ikram said. “I can’t fathom losing your whole family and being a five-year-old child, trying to raise yourself on your own.”

Ikram, with more than 20 years of experience, also found himself handling new injuries.

“[When you see] a leg blown off, when you see shrapnel throughout the whole body, when you see parts of the scalp blown out from a single bullet shot, I mean, these are nothing that I ever have seen before,” he said.

He said patients’ wounds were slow to heal due to their lack of nutrition.

“It’s surreal when, again, there is aid that’s right across the border, literally five miles away from where it’s needed and it’s not being allowed to be brought into to them,” said Ikram, who took a video of miles of aid trucks lined up at the Egyptian border with Gaza.

Israel, which had blockaded the enclave for 16 years, announced a full siege in October. Aid organizations say only a fraction of the help needed has been allowed in.

He also saw harsh living conditions, he said, with more than a million displaced people in tents, wherever they could find room– from open fields to the side of streets, to inside the European Gaza Hospital, where Ikram worked.

He said the hospital was built for 300 patients, and they were treating over 1,000 there, not including civilians crammed inside, seeking shelter.

“Even in the hallways… People are just trying to find some little space of refuge for themselves. Even as we’re walking in the stairwells, people made their own little area on the stairwells, in the storage closets,” he said.

Dr. Ikram said he hasn’t forgotten Gaza’s crowded corridors, as he makes his rounds here at home, three weeks later.

“When I saw the pain in these people’s eyes and they said, ‘This is the one thing we ask from you,’ I decided to go ahead and do this story,” he said.

He shares their message, “from Gaza, with love, despite the pain.”

“I don’t know how to change it other than to tell the stories that we need an immediate ceasefire and these people need our aid,” he said.

The complaint alleges that on Oct. 5, Raglan Road Irish Pub and Restaurant served Dr. Kanokporn Tangsuan food containing allergens despite multiple assurances it would be allergy-safe.

Tangsuan, 42, died that night of a severe allergic reaction known as anaphylaxis, according to a medical examiner’s autopsy report cited in the complaint, which was filed in a Florida circuit court Thursday on behalf of her husband, Jeffrey J. Piccolo.

Disney Parks and Resorts did not immediately respond to a request for comment Monday.

Tangsuan, Piccolo and his mother went to the restaurant at Disney Springs, a Disney World shopping and dining complex, on Oct. 5 for dinner, the complaint says.

They chose to eat there believing the restaurant could accommodate her allergies, it says. The lawsuit says Disney and Raglan Road have said that accommodating those with allergies is a top priority and that customers can consult with staff members about specific ingredients.

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The couple told their server that Tangsuan had severe allergies and couldn’t consume food with allergens. When they asked whether specific items were allergen-free, the server responded that they would be made so if ordered, the complaint says.

The party ordered dishes named “Sure I’m Frittered,” “Scallop Forest,” “This Shepherd Went Vegan” and “Onion Rings,” it says. They inquired about allergens “several more times” and were told “unequivocally” their food would be allergen-free, the complaint says.

When some of the dishes arrived without “allergen free flags,” the couple inquired again, and the answer from their server was the same, it says.

Following the meal at roughly 8 p.m., the party split up. Piccolo went back to the couple’s nearby hotel room, and Tangsuan stayed at Disney Springs to go shopping, the document says.

About 8:45 p.m. she began having difficulty breathing, went into a nearby restaurant and collapsed “while suffering from a severe acute allergic reaction to the food served at Raglan,” the complaint says.

She used her EpiPen in an attempt to stop her body’s severe allergic response. A bystander dialed 911, and paramedics rushed Tangsuan to a hospital, the document says.

Piccolo, unaware of the incident, dialed her cellphone, but a bystander answered and informed him about what had happened. He went to the hospital, where staff members told him Tangsuan had died, the complaint says.

An autopsy found she had elevated levels of dairy and nut in her system, according to the complaint. The autopsy report said her manner of death was an accident. It also noted that the tests were conducted after her death and that their validity and significance “have not been established.”

The complaint, which names the restaurant and Disney Parks and Resorts as defendants, alleges multiple counts of negligence. It seeks more than $50,000 in damages.

Nicholas F. DeBellis, an investigator for the plaintiff’s attorneys, said by email that although the defendants had not been served with the suit and have not formally responded, their lawyers have been in touch.

Tangsuan was a physician with NYU Langone Health, spokesperson Steve Ritea said Monday by email.

“We are saddened by Dr. Tangsuan’s passing and our deepest condolences are with her family,” he said.

Tangsuan is survived by Piccolo. The couple hoped to have children, said DeBellis, the plaintiff’s investigator.

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The Centers for Disease Control say positive tests for norovirus in the Northeast have reached almost 14% in recent weeks. That’s the highest number in the United States.

The city’s Department of Health website does not have specific numbers on cases, but does track symptoms reported during emergency room visits. Tens of thousands of New Yorkers have visited the ER for vomiting and diarrhea in the past few months, according to data from the city’s Health Department.

Norovirus is a common stomach virus that is highly contagious, and can be spread through food and person to person contact. Sharing eating utensils, changing diapers, consuming contaminated food or drinks, or touching infected surfaces or objects can lead to infections, the Health Department says.

In addition to vomiting and diarrhea, common symptoms include nausea, stomach cramps, fever, chills, aches and tiredness.

Doctors say the best way to avoid the virus is to wash your hands often. While it is called gastroenteritis or the “stomach flu,” noroviruses are not related to the flu, a.k.a. influenza.

Mount Sinai says symptoms can start within one to two days after infection, but typically will last only one to three days.

Cases in the Northeast have been climbing since mid-November, according to CDC data. Over the last two years, norovirus cases have spiked in February and March.

Broadbent’s father announced on Facebook that she had died “after living with Aids since birth,” but did not provide more details. The Clark County coroner’s office said Broadbent died Tuesday in Las Vegas.

“Despite facing numerous challenges throughout her life,” Loren Broadbent wrote, “Hydeia remained determined to spread hope and positivity through education around Hiv/AIDS.”

He did not immediately respond Thursday to messages seeking comment sent via Facebook and a GoFundMe page.

Broadbent became a fierce advocate for those living with the disease at a time when medications were not widely available to help manage HIV and the virus was considered a death sentence. HIV, or human immunodeficiency virus, attacks the body’s immune system and is the virus that causes AIDS.

Broadbent was adopted in Las Vegas by her parents Loren and Patricia Broadbent as a baby, but her health condition wasn’t known until she became seriously ill at age 3. By 5, Hydeia Broadbent had developed full-blown AIDS.

Her mother began giving talks to local groups about the hardship of raising a child with AIDS, and little Hydeia listened, soaking in all she heard.

Soon enough, the girl was speaking before the crowds.

She became a national symbol of HIV/AIDS advocacy at 7, when she joined Magic Johnson on a 1992 Nickelodeon television special, where the basketball legend talked about his own HIV diagnosis. The teary-eyed girl pleaded that all she wanted was for “people (to) know that we’re just normal people.”

In a post on X, formerly known as Twitter, Johnson said he was devastated by the news of her death and remembered Broadbent as an activist and hero who “changed the world with her bravery.”

“By speaking out at such a young age, she helped so many people, young and old, because she wasn’t afraid to share her story and allowed everyone to see that those living with HIV and AIDS were everyday people and should be treated with respect,” Johnson wrote. “Cookie and I are praying for the Broadbent family and everyone that knew and loved Hydeia.”

But a 1996 appearance on “The Oprah Winfrey Show,” when she was 11, propelled her path into activism.

In that tearful interview, Broadbent, wearing a silver nose ring and long earrings that swayed when she spoke, tried to smile through tears as she described the hardest part about living with AIDS — losing friends she loves to the disease. But she told the talk-show host that she didn’t spend her days feeling sorry for herself.

In a statement to The Associated Press on Thursday, Winfrey recalled how Broadbent moved her and millions of others with her refusal to sink into self-pity.

“She told me she could either feel sorry for herself or ‘try and make a difference…say, today’s another day, I can get up, I can do something, and make something positive,'” Winfrey said. “And that really is how she went on to live her life. Thirty-nine years was not enough for this bright light.”

Broadbent continued on the talk show circuit as a child, met the president and first lady, spoke at the 1996 Republican National Convention, and was featured on a segment on ABC’s “20/20.”

Her outspoken advocacy continued into adulthood. She spoke at events throughout the country, including a 2014 community forum in Los Angeles and a 2015 panel in Selma, Alabama, highlighting AIDS as a civil rights issue.

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Throughout the years, she also partnered with the AIDS Healthcare Foundation on awareness campaigns, including the organization’s “God Loves Me” billboard campaign that featured people living with HIV.

In a statement, AHF remembered Broadbent as a lifelong activist who “continued her fierce and outspoken advocacy throughout her youth and adulthood.”

Grazell Howard, board chair of the Black AIDS Institute, recalled meeting Broadbent when she was around 12 and said “her voice was as sweet as her spirit.” They kept in touch over the years, and Howard saw her grow into a woman who also cared about having a life apart from being a poster child for HIV/AIDS.

“She had what every Black woman has. She has to manage being responsible, courageous and a woman,” Howard said. “She carried a burden for us all. … We never talk about the plight of the heterosexual Black woman in the HIV movement in a real way. But we witnessed it with Hydeia up until these 39 years.”

Broadbent’s death comes two weeks after National Black HIV/AIDS Awareness Day and at a time when the virus continues to disproportionately impact Black communities. The Centers for Disease Control and Prevention found over 36,000 new HIV infections in the U.S. in 2021, a 7% drop from 2017. Black and African American people made up 40% of those new infections while being 12% of the population.

“Hydeia’s death is a highlight of all the work we still have to do in the HIV sector,” Howard said, “as well as a celebration of a young woman who was courageous, who was fearless, who was tireless, who was selfless.”

___ Associated Press writer Hillel Italie in New York contributed to this report. Tang reported from Phoenix.

The statement from her team on Thursday — just two days before Williams was set to return to television — explained that the 59-year-old’s conditions have “presented significant hurdles” in her life, while acknowledging the ongoing speculation about Williams’ health. The diagnoses came “after undergoing a battery of medical tests,” a press release from her team said.

Two years after canceling her hit talk show, the former “The Wendy Williams Show” host and her family are set to address the speculation regarding Williams’ health and cognitive abilities in a new Lifetime documentary, “Where Is Wendy Williams?” coming out Feb. 24, 2024.

It is along the same lines as the diagnosis that the family of Bruce Willis announced he first received in 2022. The 68-year-old actor stepped away from Hollywood after his aphasia diagnosis at that time, and less than a year later, it progressed to the more specific diagnosis of frontotemporal dementia.

Willis’ wife, Emma, along with his ex-wife Demi Moore and their three adult daughters Rumer, Tallulah and Scout shared in identical Instagram posts in 2022 that his diagnosis “is impacting his cognitive abilities.”

As of Oct. 2023, Willis was “not totally verbal,” according to friend Glenn Gordon Caron, the creator of the ’80s TV show “Moonlighting,” which co-starred Willis and Cybill Shepherd. Caron said that the “Die Hard” star’s “language skills are no longer available to him, and yet he’s still Bruce.”

Read more about aphasia and frontotemporal dementia, including the symptoms, causes and treatments below.

What is aphasia?

Aphasia is a condition that hinders the ability to communicate and can affect a person’s ability to speak, write and understand language, according to the Mayo Clinic.

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What causes aphasia?

The most common cause of aphasia is brain damage resulting from a stroke — the blockage or rupture of a blood vessel in the brain. Loss of blood to the brain leads to brain cell death or damage in areas that control language.

Brain damage caused by a severe head injury, a tumor, an infection or a degenerative disease also can cause aphasia. In these cases, the aphasia usually occurs with other types of cognitive problems, such as memory problems or confusion.

Meanwhile, the cause of frontotemporal dementia is not known.

What are the symptoms of aphasia?

According to the Mayo Clinic, a person with aphasia may:

• Speak in short or incomplete sentences
• Speak in sentences that don’t make sense
• Substitute one word for another or one sound for another
• Speak unrecognizable words
• Not understand other people’s conversation
• Write sentences that don’t make sense

How is it different than frontotemporal dementia?

Frontotemporal dementia, also known as FTD, is a progressive condition that effects cognitive function and tends to result in changes in behavior, speech and disposition. Primary progressive aphasia is a subtype of FTD impacting communication, including speech, writing and the ability to understand language.

Primary progressive aphasia is a type of FTD that usually results in no longer being able to speak, read, write or understand what people are saying, according to the Association for Frontotemporal Degeneration.

FTD is caused by shrinking in the frontal and temporal lobes of the brain, which control personality, behavior and language. Depending on which parts of the brain are affected, someone might experience personality changes, such as behaving erratically, inappropriately, or becoming distant, according to Mayo Clinic.

FTD is sometimes misdiagnosed as a mental health condition or Alzheimer’s disease, but it typically occurs at a younger age, between 40 and 65, than other types of dementia.

What are the symptoms of frontotemporal dementia?

Some of the symptoms of frontotemporal dementia are similar to the ones caused by aphasia, but some may be even more severe.

According to Johns Hopkins Medicine, here are a few symptoms that can develop as a result:

• Dramatic changes in personality and temperament, like swearing, stealing, mood swings, becoming easily agitated, increased sexual interest and possible decline in hygiene
• Socially inappropriate, impulsive, or repetitive behaviors
• Impaired judgment
• Apathy, a lack of empathy and losing interest in typical daily activities
• Decreased self-awareness
• Emotional withdrawal from others
• Loss of energy and motivation
• Speaking less frequently, and hesitating when they do speak
• Getting easily distracted and having trouble planning and organizing
• Increasing dependence

When to see a doctor

Because aphasia is often a sign of a serious problem, such as a stroke, the Mayo Clinic urges anyone to seek emergency medical care if they suddenly develop:

• Difficulty speaking
• Trouble understanding speech
• Difficulty with word recall
• Problems with reading or writing

How is aphasia treated?

Some people may be able to regain some ability to speak and communicate, and many undergo speech therapy to aid in that process. Other treatments, including certain medications and brain stimulation, are being studied for their potential to treat aphasia.

How is frontotemporal dementia treated?

There are no treatments currently available to cure or slow FTD progression, according to Johns Hopkins, but there are some things that can be done to address the symptoms.

The anxiety and obsessive-compulsive behaviors can be helped with antidepressants, while prescription-strength sleep aids can help with problems like insomnia and other disturbances, Johns Hopkins said. Other irrational and compulsive behaviors can be reduced with antipsychotic medicine.

Other behaviors may have to be addressed with behavior modification. As for the speech difficulties that can arise, using speech and language pathologists, as well as physical and occupational therapists, can help treat the changes stemming from FTD.

“Scot has a new heart!” Dawn Pollard posted on X, formerly known as Twitter. “Surgery went well and I’ve been told the heart is big, powerful and is a perfect fit! Now on to the crucial part of recovery. Thank you to everyone for the continued prayers and support, but most of all, deepest thanks to the donor, our hero.”

Pollard, who turned 49 on Monday, needed a transplant because of damage to his heart from a virus he caught in 2021 that likely triggered a genetic condition he has known about since it killed his father at 54, when Scot was 16. Pollard’s size complicated efforts to find a donor with a heart big enough to fit his 6-foot-11, 260-pound body.

Earlier Friday, Dawn Pollard posted that a heart had been found.

“It’s go time!” she posted on X. “Please keep the prayers coming for Scot, the surgeons, for the donor and his family who lost their loved one. This donor gave the most amazing gift of life and we are forever grateful.”

A 1997 first-round draft pick after helping Kansas reach the NCAA Sweet 16 in four straight seasons, Pollard was a useful big man off the bench for much of an NBA career that stretched over 11 years and five teams. He played 55 seconds in the Cleveland Cavaliers’ trip to the NBA Finals in 2007, and won it all the following year with the Celtics despite a season-ending ankle injury in February.

Pollard retired after that season, then dabbled in broadcasting and acting. He was a contestant on the 32nd season of “Survivor,” where he was voted out on Day 27 with eight castaways remaining.

Pollard went public with his condition last month began the process of listing himself at transplant centers. He was admitted to intensive care at Vanderbilt University Medical Center on Feb. 7.

“I’m staying here until I get a heart,” he said in a text message to The Associated Press from his Nashville, Tennessee, hospital room. “My heart got weaker. (Doctors) agree this is my best shot at getting a heart quicker.”

The man, who lived in the remote Kenai Peninsula, was hospitalized last November and died in late January, according to a bulletin last week from Alaska public health officials.

The man was undergoing cancer treatment and had a suppressed immune system because of the drugs, which may have contributed to the severity of his illness, the bulletin said. It described him as elderly but didn’t provide his age.

Alaskapox, also known as AKPV, is related to smallpox, cowpox and mpox, health officials said. Symptoms can include a rash, swollen lymph nodes and joint or muscle pain.

Only six other cases of the virus have been reported to Alaska health officials since the first one in 2015. All involved people were living in the Fairbanks area, more than 300 miles (483 kilometers) from the Kenai Peninsula, health officials said.

All had mild cases and recovered without being hospitalized.

The man who died “resided alone in a forested area and reported no recent travel and no close contacts with recent travel, illness, or similar lesions,” the health bulletin said.

It’s unclear how AKPV is transmitted but researchers say it may be zoonotic, meaning it can jump from animals to humans. The bulletin said that tests found evidence of current or previous infection in several species of small mammals in the Fairbanks area, including red-backed voles, and at least one domestic pet.

The man said he had cared for a stray cat at his home, the bulletin said.

The cat tested negative for the virus but it “regularly hunted small mammals and frequently scratched the patient,” the bulletin said.

That opens the possibility that the cat had the virus on its claws when it scratched him. The bulletin said a “notable” scratch near the armpit area where the first symptom — a red lesion — was noted.

Health officials said there hasn’t been any documented cases of humans passing on the virus but they recommended people with skin lesions possibly caused by Alaskapox to cover the affected area with a bandage.”

Other suggestions are thoroughly washing hands, avoid sharing clothing that might have touched the lesions and to launder clothing and sheets separately from other household items.

Health authorities also urged Alaskans to follow federal health precautions when around wildlife to avoid potential Alaskapox infections.

The U.S. Centers for Disease Control and Prevention recommends washing hands with soap and water after contacting wild animals or their feces. Hunters should always wear gloves when handling dead animals, even if they are freshly killed, the agency suggests.

If you are feeling extra sleepy and fatigued during the winter months, you are not alone.

One of the reasons that winter tiredness or winter fatigue occurs is because of the seasonal shifts that affects our circadian rhythm: when it’s dark out your body produces more of the sleep-inducing hormone, known as melatonin, which in turn, leads to tiredness.

Why am I more tired than usual during the winter months?

Dr. J. Ryan Fuller, clinical psychologist and executive coach at New York Behavioral Health, said that there are a variety of reasons that on their own, or combined, can cause low energy particularly during the winter months.

“A lot of it has to do with during the winter months and this hemisphere, obviously there are shorter days, so people get less sunlight exposure,” Fuller said. “That can impact things like vitamin D — people can become deficient. It also can be disruptive of circadian rhythms, which can throw off our sleep, and that can affect our mood and lead to lower energy. With the cold weather, people have a tendency to be outdoors less […] and in addition to that, they tend to be less physically active and we know that physical activity oftentimes is something that boosts our mood and energy levels. And so as that comes down, that can have an impact, as well.”

According to Fuller, who has a weight loss specialty, our habits, particularly during the holidays can impact our moods.

“What we see a lot of times is during the winter months, there’s a lot of holiday parties and celebrations and things like that,” Fuller said. “With the holidays, people have a tendency to overeat, and there tends to be this cycle where we overeat, we gain some weight, we then beat up on ourselves for gaining the weight, we feel worse and then we overeat to compensate. That cycle leads to more weight gain and sometimes lower moods.”

What is seasonal affective disorder (SAD)?

Although low energy levels tends to have an affect on people, it is important to keep track of your symptoms because they can actually be tied to another diagnosis: seasonal affective disorder, also known as SAD.

How do you know if your mood changes are tied to this disorder? According to Fuller, it has to do with the length of time you experience symptoms and a pattern in their appearance.

“If the the changes in mood are really tied to the seasons, and that can occur at least two years in a row, that’s going to typically be diagnosed as as a major depressive disorder with seasonal affective disorder as a specifier,” Fuller said, adding “really we’re looking at mood symptoms that are depressive in nature that are coming at that specific time of the year or some pattern on an ongoing basis.”

Fuller said that changes you should be on the lookout for are your energy level, changes in appetite, changes in weight, sleep, libido, thoughts, and if this manifests in a way that it interferes with your life.

If you are experiencing any of these changes, Fuller recommends seeing a professional who can evaluate you.

“They can really assess pretty quickly whether or not it’s actually a clinical disorder like major depressive disorder or seasonal affective disorder, Fuller said. “The good news is those both those disorders are highly treatable with scientifically supported therapies.”

Tips to deal with low energy levels in the winter months

There are quite a few things you can do to beat low energy during the cold, dark winter months. According to Fuller, if one was diagnosed with SAD, the following are also some tips that may help you combat those symptoms.

“I think [these] are sort of simple things, if we’re talking about something that’s just winter fatigue and subclinical, we can do,” Fuller said. “Likewise, if it was clinical in nature, [these] are some things that most likely a clinician’s going to recommend you do as well.”

1. Increase sunlight exposure

The first thing that Fuller recommends is to increase one’s exposure to sunlight.

“The easiest way to do that of course is just to make sure you’re getting outside,” Fuller said. “Make sure the windows are open. It’s typically recommended to do as much of that as you can in the morning.”

Fuller suggests that a light therapy box can also assist you “to get more more light exposure.”

2. Maintain or increase exercise routine or physical activity

“In addition, and it’s tied to getting outside, making sure that you’re maintaining or increasing your exercise or physical activity,” Fuller said, admitting that it can be challenging for because of the cold weather.

However, Fuller believes that exercise can still be done outdoors in winter.

“I really like the saying: ‘there’s no bad weather, there’s just bad clothing,'” he said.

Fuller recommends layering up with the first layer being polypropylene “which can wick the moisture away if you’re sweating.”

“We don’t want anyone slipping on ice, but the cold temperature doesn’t have to be a reason not to exercise outside,” Fuller went on to say. “And if we’re talking about winter fatigue or seasonal affective disorder, you’re getting two bangs for your buck in that you’re outside getting sunlight and your physically active.”

3. Schedule pleasurable activities

In addition, Fuller recommends to his clients to schedule activities they find pleasure in like “things that bring us joy, excitement, hope, that we’re going to find ourselves smiling or laughing could be doing something fun with a friend, could be playing a pickup soccer game on the weekends. It could be a ballroom dancing class, something that brings you pleasure. We know that bolsters people’s mood.”

4. Schedule mastery activities

“You can also schedule what we call mastery activities,” Fuller said. “That is learning a new skill, gaining some new knowledge or refining and practicing and getting even better at something you already do. We know that tends to decrease depressive symptoms.”

5. Decrease social media/screen time and opt for real social connections

According to Fuller, decreasing one’s use of social media and screen time is also a good idea that can be beneficial when it comes to combating one’s low energy levels during the winter months or SAD symptoms.

The quality of interpersonal relationships “is something that really is associated with happiness and satisfaction with life — and so we want to make sure we’re doing enough of that,” Fuller said.

6. Consistent sleep routine

Mood is tied to sleep, so it is no wonder that Fuller recommends a consistent sleep routine to keep our circadian rhythm undisrupted during the winter months.

“We want to practice, good sleep hygiene. One of the most basic things is just to make sure you’re going to bed and you’re waking up at a regular time every day,” Fuller said. “So as much as possible, preserve good quality sleep every night.”

Remember…

According to Fuller, feeling fatigued or even experiencing SAD is more common than you may think.

However, remember to talk to your doctor, clinician, psychologist or psychiatrist if you are experiencing any mood changes or other symptoms that are out of the ordinary.

“People don’t have to be alarmed” if they are experiencing any symptoms, Fuller said, adding that one should “practice good self care, but should not hesitate to go and get evaluated if it’s really starting to interfere in different areas of [one’s] life.”

“If you go to the right kinds of clinicians, they can really assess it very quickly and there are highly effective treatments, highly effective therapies that can be helpful.”

The FDA, which first warned about the tianeptine-containing products in November, said it is still receiving reports of people being poisoned by the supplements.

Tianeptine is an antidepressant that is approved in some European, Asian and Latin American countries, but not in the United States.

The substance can cause side effects in the nervous system, heart and stomach, with some effects mimicking opioid toxicity and withdrawal, according to the Centers for Disease Control and Prevention.

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According to the investigation, Jeanette Breen, a licensed midwife who operated Baldwin Midwifery in Nassau County, was found to have administered 12,449 fake immunizations to roughly 1,500 school-aged patients as pretext for submitting false information to the New York State Immunization Information System (NYSIIS), health officials said.

Those fake immunizations were administered before the COVID-19 pandemic so do not include vaccinations for that virus. They do, however, include fraudulent diphtheria, tetanus toxoid-containing and pertussis vaccines (DTaP or Tdap); hepatitis B vaccines; measles, mumps and rubella vaccines (MMR); polio vaccine; varicella (Chickenpox) vaccines; meningococcal conjugate vaccines (MenACWY); booster doses of MenACWY; and the Haemophilus influenzae type b conjugate vaccines (HiB) and pneumococcal conjugate vaccines (PCV).

Some kids were given fake vaccines for flu and hepatitis A also, though those immunizations are not required for school attendance. See the immunization requirements for enrollment and attendance in Empire State schools here.

Students who thought they were getting vaccinated by Breen for the other illnesses now have their state immunization records voided, health officials say. The roughly 1,500 children affected across the state must be fully up-to-date with all age-appropriate immunizations or be in the process of getting their missed doses before they can return to school.

Most of the affected children are from Long Island, though the alleged scheme reached as far as Erie County, officials say. It began at the start of the 2019-2020 school year, three months after non-medical exemptions were eliminated for school immunizations. Breen gave the children a series of oral pellets marketed by an out-of-state homeopath in lieu of vaccination, the investigation found. The pellets are not authorized by the FDA, nor approved by the CDC or the state.

Suffolk County accounts for about 345 affected students, state health officials said. County officials say their health department was awaiting a list of impacted students. Families can call 631-854-0222 for assistance.

The state put Nassau County’s total a bit higher. In New York City, Queens and Brooklyn each had more than 110 students affected, according to health data.

Here’s a county-by-county breakdown of false vaccinations, according to the state health department:

• Bronx: 15
• Cattaraugus: 4
• Columbia: 1
• Dutchess: 3
• Erie: 2
• Greene: 3
• Kings (Brooklyn): 113
• Nassau: 488
• New York (Manhattan): 9
• Orange: 13
• Putnam: 2
• Queens: 178
• Richmond (Staten Island): 28
• Rockland: 62
• Saratoga: 3
• Schenectady: 1
• Schoharie: 1
• Suffolk: 345
• Sullivan: 3
• Tompkins: 1
• Ulster: 3
• Warren: 2
• Westchester: 39

“Misrepresenting or falsifying vaccine records puts lives in jeopardy and undermines the system that exists to protect public health,” State Health Commissioner Dr. James McDonald said in a statement. “Let it be clear, the New York State Department of Health takes this issue seriously and will investigate and use all enforcement tools at its disposal against those who have been found to have committed such violations.”

Children attending daycare and pre-K through Grade 12 in New York state must receive all required doses of vaccines to attend or remain in school, whether public, private or religious. Only medical exemptions are permissible.

The agreed-upon settlement reached between the state and Breen is the first of its kind addressing a scheme to create false immunization records, authorities said. It includes a $300,000 monetary penalty and requires that Breen never again administer a vaccination that must be reported to the state’s database. She is also permanently forbidden from accessing that database for any reason.

Breen declined to comment Thursday. Her attorney, David Eskew, said in a statement that his client “intends to fully comply with the requirements of the agreement.” She had no additional comment regarding the settlement.

“Ms. Breen has provided excellent midwifery services for many years to many families, especially on Long Island,” the attorney’s statement read. “From her perspective, this matter is over, done with, and closed and she is now moving on with her life. She has no comment about the settlement or the conduct beyond what is contained in the settlement stipulation with the Department of Health.”

As part of the settlement, Breen has paid $150,000 of the $300,000 penalty, with the remainder suspended contingent upon her complying with state health laws and never again administering any immunization that must be reported to the state, according to the health department. She’s also permanently banned from accessing the state’s immunization records system.

Erin Clary, a health department spokesperson, said Thursday that while parents and legal guardians had sought out and paid Breen for her services, they weren’t the focus of the agency’s investigation.

What schools need to do now

State health officials say they’re now in the process of notifying hundreds of affected school districts.

The Nassau County Department of Health issued a bulletin to all school superintendents, nurses and health services staff Wednesday, after the state announced the settlement, to inform them students may be in noncompliance.

Records of vaccinations purportedly provided by Breen no longer qualify as valid proof. It has been reported that impacted schools will receive further notification from the state, and a list of students who may be affected.

In the meantime:

• Exclude students who are out of compliance with vaccine rules and requirements
• Immediately report the exclusions, including the name and address of each child, to the Nassau County Department of Health
• Notify the parents or guardians of affected children of their responsibility to vaccinate

New prescriptions for stimulants used to treat the condition jumped for young adults and women during a two-year window after the pandemic hit in March 2020, according to a study published Wednesday in JAMA Psychiatry.

Prescriptions also soared for nonstimulant treatments for adults of all ages, the U.S. Food and Drug Administration researchers found.

Attention-deficit/hyperactivity disorder is one of the most common developmental disorders in children, particularly boys. The use of drugs like Adderall to treat it climbed in general during the pandemic.

Telemedicine made it easier to get help, and regulators started allowing doctors to prescribe the drug without first seeing a patient in person.

But Dr. Ann Childress says more adults also started coming to her for help after COVID-19 hit. The Las Vegas psychiatrist sees several reasons behind the shift.

Working from home made some people realize how easily they get distracted. Childress says she diagnosed a lot of parents, especially moms, who saw it in their children and realized they may have it as well.

Plus, social media made people more aware of adult ADHD.

“People are more open to talking about mental health issues now,” said Childress, who was not involved in the study.

Rising use of ADHD treatments compounded with manufacturing problems triggered an Adderall shortage that started more than a year ago. Doctors and patients say supply problems for several treatments haven’t let up.

“Each week there about 10 things that are in shortage,” Childress said.

Wendy Terry called nearly 20 pharmacies last month looking for the drug Focalin for her third-grade son, who has ADHD. Some were a 45-minute drive from her home in Diboll, Texas, a town about 100 miles northeast of Houston.

“They all told me the same thing: We can’t get it from the manufacturer. We don’t know when we’re going to get it or if we’re going to get it,” said the 42-year-old insurance agent.

Desperate, she briefly switched her son to another ADHD medication. But that went so badly that he had to miss school.

Terry eventually found a drugstore, thanks to a tip from a friend who works at another pharmacy. She says she dreads going through the ordeal again for a refill, but her son needs the help.

“When he’s not medicated, he literally can’t sit down at school,” Terry said. “He can’t quit moving. He is constantly moving. His mind is all over the place.”

Federal regulators limit the production of some ADHD treatments because they are controlled substances. Regulators and drugmakers try to anticipate how much of a drug will be needed based in part on how it has been used in the past, said Mike Ganio, who studies drug shortages at the American Society of Health-System Pharmacists.

But he noted that predicting demand is difficult, and spikes in use can contribute to shortages.

“It’s a business. Nobody wants to produce more, or hold on their shelves more, inventory than will be needed,” he said.

Overall, the society counted more than 300 drug shortages in the U.S. as of last fall. Aside from ADHD drugs, shortages of cancer treatments like chemotherapies also have persisted.

Ganio noted that the latest shortage total is close to a 10-year high of 320 set in late 2014.

Murphy reported from Indianapolis. Hollingsworth reported from Mission, Kansas.

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.

The “CNN News Central” co-anchor, 51, asked her viewers to “take a second to recall the names of eight women who you love and know in your life.” Sidner went on to note that, according to the American Cancer Society, statistically, out of those eight women, one of them will get or have breast cancer.

“I am that one in eight in my friend group,” Sidner shared. “I have never been sick a day in my life. I don’t smoke, I rarely drink, breast cancer does not run in my family, and yet here I am with stage 3 breast cancer.”

“It is hard to say out loud,” Sidner explained while choking up.

Sidner revealed that she is currently in her second month of chemo treatments and that her treatment plan includes undergoing radiation and a double mastectomy. 

The American College of Surgeons classifies stage 3 as an invasive breast cancer that has spread beyond the region of the tumor.

The anchor explained that while stage 3 cancer is not a death sentence anymore for the vast majority of women, there is a reality to the diagnosis that “shocked” her when she first began to conduct her own research.

“If you happen to be a Black woman, you are 41 percent more likely to die from breast cancer than your white counterparts,” she explained, citing data from the American Cancer Society.

“So to all my sisters, Black and white and brown out there, please, for the love of God, get your mammograms every single year,” Sidner said. “Do your self-exams. Try to catch it before I did.”

Despite her situation, Sidner shared that she could have never predicted feeling grateful for her diagnosis.

“I have thanked cancer for choosing me. I’m learning that no matter what hell we go through in life, that I am still madly in love with this life,” she concluded. “And just being alive feels really different for me now. I am happier because I don’t stress about foolish little things that used to annoy me. And now, every single day that I breathe another breath, I can celebrate that I am still here with you.”

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The figures underscore the chaotic state of the nation’s $7 billion vaping market and raise questions about how the U.S. government can stop the flow of fruit-flavored disposable e-cigarettes used by 1 in 10 American teens and adolescents.

More than 11,500 unique vaping products are being sold in U.S. stores, up 27% from 9,000 products in June, according to tightly held industry data from analytics firm Circana.

“FDA whacks one product and then the manufacturers get around it and the kids get around it,” said Bonnie Halpern-Felsher, a Stanford University psychologist who develops anti-vaping educational materials. “It’s too easy to change your product a little bit and just relaunch it.”

Halpern-Felsher says she is “constantly” updating her curriculum to keep pace with new vaping brands and trends.

Nearly all the new products are disposable e-cigarettes, according to the sales data gathered from gas stations, convenience stores and other shops. The products generated $3.2 billion in the first 11 months of this year.

The FDA has authorized a handful of e-cigarettes for adult smokers and is still reviewing products from several major companies, including Juul. Regulators consider nearly all other e-cigarettes to be illegal.

“Those committing illegal acts don’t advertise their crimes, and those trying to import illegal tobacco products into the United States are no different,” said FDA’s tobacco director, Brian King, in a written response to AP questions. “The FDA and our federal partners are using tools, like import alerts, to stop these illegal tobacco products at the border and to deter countless others.”

The rise in e-cigarettes sold continues despite a record number of products detained.

An FDA database shows officials “refused” entry to 148 containers or pallets of “tobacco” goods last month, consisting almost entirely of vaping products from China. Refused imports are typically destroyed.

Through the end of November, U.S. officials had refused 374 such shipments this year, more than double the 118 refused in 2022.

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This year’s items included $400,000 worth of Esco Bars, a disposable brand placed on a list of banned imports in May. The agency’s posted data is often preliminary because it takes time to finalize refusals.

But recent history shows how easily companies can maneuver around import bans.

In July 2022, the FDA barred dozens of e-cigarettes from Chinese manufacturer Fume, including flavors Pineapple Ice and Blue Razz.

Fume sales dipped after the ban, but the company launched a slew of new products, posting $42 million in U.S. sales in the third quarter of 2023, the data shows. Roughly 98% of sales came from products not on the FDA’s “red list” of products that can be detained.

Industry shipping tactics are also challenging the usefulness of import restrictions.

In July, FDA and customs officials intercepted $18 million worth of illegal vapes, including leading brand Elf Bar. But the shipments were mislabeled as shoes, toys and other items — not e-cigarettes — requiring officials to individually open and verify the contents of more than two dozen containers.

Circana, formerly IRI, restricts access to its data, which it sells to companies and researchers. A person not authorized to share it gave the AP access on condition of anonymity.

The FDA has no schedule for updating its import lists but said it is “closely monitoring” instances where companies try to avoid detection.

“The FDA has a variety of tools at our disposal to take action against these tactics,” FDA’s King said.

The agency has limited powers to penalize foreign companies. Instead, regulators have sent hundreds of warning letters to U.S. stores selling their products, but those are not legally binding.

Even as the FDA attempts to work with customs officials, it is struggling to complete a yearslong review of applications submitted by manufacturers hoping to market their products to adults.

The few tobacco-flavored products currently authorized by the FDA are deeply unpopular. Their combined sales were just $174 million, or 2.4% of the vaping marketplace this year, according to Circana.

“Nobody wants them,” says Marc Silas, owner of 906 Vapor shop in Michigan. “If people wanted them, they’d be on the shelves and they’re not.”

Deeply frustrated with the pace of FDA’s review, public health groups have successfully sued the agency to speed up the process. The agency aimed to complete all major outstanding applications this year, but it recently said the process would stretch into next year.

The delays have raised questions about the viability of the current regulatory framework for e-cigarettes.

“FDA is trying to operate with an old model when the whole environment has changed,” said Scott Ballin, a health policy consultant who previously worked for the American Heart Association. “They have this long line of products that have to be reviewed one by one and now they’re in a giant hole.”

One alternative approach would be to make decisions about entire classes of e-cigarettes, rather than individual products.

The idea initially came from small vaping manufacturers who did not have the money to conduct the large studies typical of FDA applications. Public health advocates concerned about the persistence of underage vaping have embraced it.

Halpern-Felsher, of Stanford University, is among those urging the FDA to ban all flavored disposable e-cigarettes, the products used by most of the 2 million underage teens who vape.

“If we continue down this path that we’re on, we’re just going to have new and continuing generations of young people addicted to nicotine,” she said.

___

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.

The Los Angeles medical examiner determined Matthew Perry‘s cause of death to be the acute effects of ketamine, more than a month after the death of the “Friends actor on Oct. 28.

Perry had been found unresponsive in the pool at his residence in Los Angeles’ Pacific Palisades area. Paramedics responded and pronounced Perry dead at the scene.

In addition to the “acute effects” of ketamine, contributing factors in Perry’s death included drowning, coronary artery disease and the effects of buprenorphine, used to treat opioid use disorder. The manner of death was determined to be an accident.

The coroner’s autopsy report noted that Perry was on ketamine infusion therapy to deal with depression and anxiety, with the most recent therapy “reportedly one and a half weeks before death.” The autopsy report noted that the ketamine found in Perry’s system at the time of death “could not be from that infusion therapy, since ketamine’s half-life is three to four hours, or less.”

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The report said the method of intake could not be determined, but trace amounts of the drug were found in Perry’s stomach.

“At the high levels of ketamine found in his postmortem blood specimens, the main lethal effects would be from both cardiovascular overstimulation and respiratory depression,” the autopsy report stated.

Perry had taken drugs in the past but had been “reportedly clean for 19 months,” according to the report. The actor had openly talked about his struggles with addiction, dating to his time on the hit show “Friends” in the 1990s.

In his 2022 memoir, “Friends, Lovers, and the Big Terrible Thing,” Perry referenced his ketamine therapy.

“Taking K is like being hit in the head by a giant happy shovel,” he wrote. “But the hangover was rough and outweighed the shovel. Ketamine is not for me.”

Here’s an explanation about the drug found in his system when he died, and why it is becoming more popular as a treatment for mental health problems — even though it remains a largely unregulated market.

What is ketamine? How does it work?

Ketamine is a dissociative anesthetic that has some hallucinogenic effects, according to the DEA. Its medical uses include the induction and maintenance of anesthesia and as a treatment for depression.

The drug was first synthesized in 1962, and was approved for use as an anesthetic in the United States in 1970. While it can commonly be found in medications such as horse tranquilizers, it has also been used to treat smaller animals and humans for decades.

Ketamine itself gained more widespread notoriety and popularity in the 70s and 80s as an illegal party drug, otherwise known as “Special K.” It continues to be used as a popular party drug to this day.

It’s not entirely known what ketamine does to the brain or how it works. Some psychotherapists have said the drug works similarly to other anti-depressants, as it boosts the feel-good chemicals in the brain. It can also reduce inflammation and form new neural pathways associated with the ability to create new habits and behaviors. 

Is esketamine different? Is it legal?

The FDA approved a version of ketamine called esketamine, or Spravato, in 2019. It’s an inhaled version that must be administered in a doctor’s office, and it is approved only for people for whom other depression treatments have failed.

Esketamine has been found to help reducing depression with suicidal thoughts, the Columbia University Irving Medical Center said. It is believed to work differently than traditional antidepressants, which may help those who were not responsive to those treatments.

Patients will typically have eight weeks of esketamine treatments, with multiple treatments per week, according to Columbia, which added that patients receiving the treatment will “typically experience mild sedation and dissociation.”

Is ketamine safe to use?

Soaring interest in psychedelics as a mental health treatment has fueled a boom of clinics across the U.S., touting the drug most commonly known in the club scene. Using ketamine to treat depression is legal and doctors say it can be a gamechanger, but it’s also a largely unregulated industry that comes with serious risks.

According to Columbia University Irving Medical Center, ketamine is an “effective and safe anesthesia” when given intravenously (a.k.a. as an IV drip). Columbia also touted its use to treat multiple psychotic disorders, including depression.

Given the drug’s FDA-approved status, any doctor can issue off-label prescriptions, but that does not include IV ketamine, which is not FDA approved. Columbia said that the initial infusion treatment takes place over the course of two to three weeks, with each treatment lasting about an hour or two. But they note that, as it is with eskatemine, the treatment is not meant for patients who have experienced psychosis or are actively abusing drugs or alcohol.

And while legal, ketamine is not approved to be used as a treatment for psychiatric conditions. But Dr. Dan Iosifescu, a professor of psychiatry at NYU’s Grossman School of Medicine, is among the believers.

“Individuals with very severe hard to treat depression would potentially get much better in the span of 24 hours after a single treatment,” he told NBC New York back in May.

Ketamine is used as a treatment in clinics throughout the country, including the spa-like Manhattan clinic Nushama, which is part of the wave of clinics now offering ketamine assisted therapy, with medical supervision. With little regulatory oversight, clinics are relying on guidance from doctors like Iosifescu – who co-authored a paper of treatment guidelines.

“There are unfortunately clinics that I’ve referred patients to that have either not followed these monitoring protocols, which to me puts patients at some level of risk,” said Dr. Iosifescu.

What are the potential risks and side effects of using ketamine?

Dr. James Murrough, at Mt. Sinai’s Icahn School of Medicine, is encouraged by the benefits of ketamine therapy. He points out that patients typically need prolonged treatment, which comes with risks.

“We have to think very judiciously often about how much ketamine we’re using, how often to benefit a patient, to maintain a response,” Dr. Murrough said.

He said the drug often stops working if people don’t take more. And then prolonged recreational use at high-doses can have serious side effects, including memory loss, mood changes and a loss of cognitive functioning.

“The rates of people developing addiction is relatively low, but we shouldn’t let our guard down,” said. Dr. Murrough.

One patient who went to a ketamine clinic in North Carolina for treatment shared what happened during his bad experience there, when he believes he was given too high of a dose.

“I remember thinking in my head, if only I knew Morse code, you know, I could tap out SOS,” said Steven Petrow. “My lips were completely numb and then I felt that I didn’t have lips…and then I didn’t have a throat and I didn’t have a mouth.”

Experts agree that people seeking ketamine treatment must be on guard and be sure to ask about safety protocols.

NBC News’ Lauren Dunn and Kate Snow contributed to this report.

While many New Yorkers have access to health care, there is one group that faces greater challenges: indigenous migrants from Mexico, Central America, and South America.

A study conducted between 2013 and 2017 and published in 2021 by the NYC Department of Health showed that the linguistic and social conditions of these communities play a role in the lack of access to health care. In the sample, 19 percent of indigenous respondents reported needing health care in the 12 months prior to the survey and were unable to obtain it.

The Endangered Language Alliance, through Language Map, has recorded the presence of at least 63 indigenous languages of Latin American peoples, but there is no reliable data on how many of their speakers have difficulty communicating in English or Spanish.

For Próspero Martínez, a migrant from the Mixe community of Oaxaca and a member of the Council of Indigenous Peoples of New York City, these language barriers often lead members of these communities to turn to home remedies instead of going to the doctor.

“What do indigenous people do when they get sick? They prefer to use the methods they know from their communities: the “tecito”, the “sobadas” (healing massages). And when they see or feel that they are not cured, they return to their country to die. This is one of the realities, but of course it does not appear in the statistics,” he assures.

For those who need prenatal and obstetric care, however, they have no choice but to go to hospitals.

According to the study “Inequality and mistreatment during pregnancy and childbirth in the United States,” published in the Reproductive Health Journal, 32.8 percent of indigenous women surveyed said they had experienced at least one form of mistreatment by health care workers.

For Zenaida Cantú, a Tlapaneca speaker from Guerrero, Mexico, this is always a fear because patients from these communities often do not understand how the U.S. medical system works, but it is the support networks within their communities that help them cope.

“Well, we have no choice but to go to the hospital, because it is also an obligation to go there, your baby has to be born there (…) at first you are afraid, but then you start asking acquaintances or neighbors who have had the experience of going to the doctor, and that also helps you,” she says.

This lack of knowledge about the medical needs of indigenous communities has led immigrant advocacy groups like Mixteca, based in Sunset Park, Brooklyn, to conduct their own statistical surveys. Vianey Romero, the organization’s project director, said that as a result, they became aware of the presence of 40 indigenous peoples in Brooklyn.

This information helped them, with the help of translators and interpreters from the same community, to disseminate information to prevent the spread of Covid-19 during the first months of the pandemic.

“What was done in Mixteca was to provide them with information about Covid, in these native languages, so that the community that had difficulty with Spanish could be informed of what was happening and have access and reach to information in their native language,” he said.

In February 2017, the City Council passed Local Law 30, which requires all local institutions to have interpretation services that cater to communities that have difficulty communicating in English, but this does not apply to hospitals.

According to Manuel Castro, commissioner for immigrant affairs, one of the alternatives is for people to contact the city’s immigrant affairs line to request assistance with interpretation through a system called Language Line, which offers translation services in 240 languages, but he assures that the assistance goes beyond translation.

“We want them to have the confidence to dial in their language and say, ‘I’m undocumented, I feel very bad, I’m afraid to go to the hospital,’ and then we can also explain to people that the health system does not ask about their immigration status and which hospital they can go to.”

Although this system provides translation services for indigenous languages such as Mixteco, Zapoteco, Quechua, Quiché, among others, there are still many widely spoken languages, such as Mixe, Martínez’s language, or Tlapaneco, Cantú’s language, that are not included in this list of languages.

Faced with this gap, the communities themselves have come together to help and accompany people who need linguistic assistance, as in the case of the Council of Original Peoples of New York City, where people like Yoloxóchitl Marcelino provide accompaniment and assistance to those who need a translator.

“We have also done some activities with the New York Health Department, which has given us the opportunity to learn to teach them (indigenous migrants) and give them confidence, and sometimes when we have had the opportunity, with my partner Zenaida, we have accompanied them to the doctor, to the documents, for example, at the consulate,” she said.

The 38-year-old Olympic gold medalist previously opened up about receiving a preeclampsia diagnosis in 2018 before she gave birth to her daughter, Camryn. She became an advocate for Black moms after her traumatic birth experience, she told TODAY in 2020, and has continued to address the Black maternal mortality crisis following the death of her relay teammate Tori Bowie in May.

During a sit-down with Kristen Welker on “Meet the Press” Dec. 3, Felix discussed the ways the medical community has failed women of color, particularly Black women who are “three times more likely to die from a pregnancy-related cause than White women,” according to the Centers for Disease Control and Prevention. 

When she was pregnant, Felix said she was not aware of the higher rates of childbirth complications that affect women of color. 

“I felt like I should’ve known that I was at risk,” she said. “I felt like I should’ve been told the signs to look for. Instead, I wasn’t. I didn’t know what preeclampsia was. I didn’t understand that the swelling in my feet is just not simply a sign of pregnancy, but could be preeclampsia. And so I felt like I had great medical care, but that’s not always enough.”

According to Cleveland Clinic, preeclampsia is a serious blood pressure condition that can develop during pregnancy. 

She told Welker that she wishes her doctor would’ve shared more signs and symptoms to be aware of and advised her to monitor her blood pressure. The retired athlete said she had never heard of preeclampsia until her diagnosis. 

Felix recalled her frightening delivery in 2018, describing her preeclampsia as “severe.”

“They were in constant worry of me having a stroke, of my vision being lost,” she revealed.  “I went from being admitted to the hospital and being told that our goal was to stay there for another two weeks, to try to stay pregnant. And I delivered later that night.”

She continued, “And so it was a very quick progression. But I know that if I did not deliver, myself or my baby or both of us wouldn’t have made it.” 

Some of her teammates also battled childbirth complications. Bowie, who anchored the U.S. women’s 4×100 meter relay team with Felix, Tianna Bartoletta and English Gardner, was found dead inside a Florida home on May 2 at the age of 32. The three-time Olympic medalist was about eight months pregnant at the time of her death. 

An autopsy report from Florida’s Orange County Medical Examiner’s Office confirmed Bowie was “undergoing labor (crowning)” at the time of her death and listed respiratory distress and eclampsia as other possible complications, according to NBC News. 

Felix said her friend’s death was “absolutely devastating” and brought conversations about the ongoing Black maternal mortality crisis “back to the forefront.” 

“This is the reality of Black women giving birth in America,” Felix said. “And there are so many situations that are like this. And so I hate that it takes such a devastating loss to bring it back to the forefront. But it also is just such a motivation that we have to do better.”                         

The decorated Olympian also had a message for the medical community: there needs to be more implicit bias training.         

“(There are) countless stories of women not being heard when they are in the delivery room (and) at doctors appointments. I don’t think you should have to be prepared to advocate for yourself,” she pointed out.    

She said it can be “intimidating” for women to speak up to doctors who think they know best. Felix said policy change is important, too. 

“I think we just have to remember these stories, these people, and not be detached from that as well,” she added. 

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COVID-19, though, continues to cause the most hospitalizations and deaths among respiratory illnesses — about 15,000 hospitalizations and about 1,000 deaths every week, said Dr. Mandy Cohen, head of the Centers for Disease Control and Prevention.

The agency is also looking into reports of pneumonia outbreaks in children in two states, but Cohen said “there is no evidence” that they are due to anything unusual.

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As for the flu season, seven states were reporting high levels of flu-like illnesses in early November. In a new CDC report on Friday, the agency said the tally was up to 11 states — mostly in the South and Southwest.

In the last month, RSV infections rose sharply in some parts of the country, nearly filling hospital emergency departments in Georgia, Texas and some other states. But “we think we’re near the peak of RSV season or will be in the next week or so,” Cohen said.

RSV, or respiratory syncytial virus is a common cause of mild coldlike symptoms but it can be dangerous for infants and older people.

Cohen was asked about pneumonia cases in children reported in Massachusetts and in Warren County, Ohio, near Cincinnati. There are a number of possible causes of the lung infection, and it can be a complication of COVID-19, flu, or RSV.

In Ohio, health officials have reported 145 cases since August and most of the children recovered at home. The illnesses were caused by a variety of common viruses and bacteria, officials said.

Massachusetts health officials said there’s been a modest increase in pneumonia in kids but that it is appropriate for the season.

China recently had a surge in respiratory illnesses which health officials there attributed to the flu and other customary causes.

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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.

As a journalist on the road, Hylton, 30, was used to waking up feeling out of sorts. But, about two years ago, she started having constant stomach issues.

At first, it was “easy for me to just write it off,” Hylton told TODAY’s Craig Melvin. She said she’d tell herself, “I travel, I’m on planes (and) maybe I don’t have the best diet. But I love what I do, so it’s worth it and I’m not going to let these symptoms hold me back.”

In August, however, she saw a segment on the TODAY show in which Craig retold the story of his brother’s death due to colon cancer.

“Something about that really stuck with me,” she said. That, plus a TikTok video of a woman diagnosed with colon cancer at 24, convinced Hylton to take her symptoms more seriously.

At the same time, her symptoms were getting worse. “I was waking up (and) my face was swollen. I was having trouble going to the bathroom for days on end,” she said.

Knowing that Black people have the highest rate of colon cancer in the U.S. and that she has a family history of colon cancer, Hylton said, “I went to see a specialist who sent me for a colonoscopy.”

Three weeks after her screening — on her 30th birthday — Hylton came home from a reporting trip to find that her doctor had left her a bunch of messages.

The screening test revealed that she had a polyp, which turned out to be a neuroendocrine tumor, which is a rare type of cancer that releases hormones into the bloodstream.

“I was panicking,” Hylton said.

Neuroendocrine tumors are rare, Dr. Nooshin Hosseini, a gastroenterologist and Hylton’s doctor, said on the TODAY show during a Nov. 30 segment.

While the tumors can occur anywhere in the body, Hosseini explained, they most commonly develop in the gastrointestinal tract, specifically the small intestine.

The symptoms depend on where in the body the tumor is, Hosseini said. Neuroendocrine tumors that are found in the colon or rectum tend to have symptoms similar to those of colon cancer, such as:

• Blood in the stool.
• Change in bowel habits.
• Unexplained weight loss.
• Abdominal pain.
• Fatigue.

The good news for Hylton was that her doctor caught the tumor early. “I had a series of procedures to remove tissue and screening tests to see if the cancer had spread,” she said.

“The last scan showed I’m all clear.”

But the experience left Hylton with some major lessons about her body and her health.

“I learned a really important lesson at 30 to listen to myself and to put myself first,” she explained. “I love my job. I worked hard here at NBC, and I’m not going to stop doing that. But I’ve learned the lesson that I really need to put my health first and not push these things off.”

She’s also thankful that her family shared their history of health issues with her so she could be better prepared when she went to the doctor.

“On my father’s side, (I have) the more classic colon cancer and the symptoms you typically think about. And then on my mom’s side, my grandmother … actually had a neuroendocrine tumor as well,” she said. “I’m grateful that I have a family that talks about these things, so I was armed with that information.”

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One known cause is inflammation, which gets worse as people scratch and their skin becomes damaged. But there may be another trigger for itchiness, according to a study published Wednesday in the journal Cell: a bacterium called Staphylococcus aureus.

Researchers from Harvard Medical School found that the bacterium can directly activate nerve cells in mice.

“What was surprising is that in some situations where there was very little inflammation, we could still see the mice scratching. It turns out, the reason is that the bacteria was directly acting on nerve fibers that produce itch,” said a co-author of the study, Isaac Chiu, an associate professor of immunology at Harvard Medical School.

Before the study, scientists were aware that S. aureus was associated with eczema, but the exact link was unclear. The new research found that once S. aureus invades a mouse’s skin, it releases an enzyme called V8. That, in turn, activates a protein called PAR1, which is located on nerve cells in the skin. The activated protein sends a signal to the brain that makes the mouse itchy — and prompts it to start scratching.

Lab experiments involving human nerve cells showed the same mechanism is possible in people, but the researchers aren’t sure yet whether the findings directly translate.

Read the full story on NBCNews.com here.

By using health and diet creators, many of whom have large platforms on Instagram and TikTok, to market these products without adequately disclosing their connection to the advertiser, the American Beverage Association and the Canadian Sugar Institute may have violated FTC rules, according to warning letters the commission sent the two groups.

“Consumers should be able to notice the disclosure easily, and not have to look for it,” the letters, which the FTC shared in a news release, stated.

That means that in a promotional TikTok video or Instagram reel, the disclosure should be made audible in the video itself as well as visible in the text description. The rule applies to paid sponsorships, promotions in exchange for free products, and in cases of any business or familial relationships.

None of the posts targeted by the FTC included any disclosures in the videos themselves, with some creators failing entirely to indicate their material connection to the beverage association anywhere in the post.

Some in-text disclosures labeling a post as “#sponsored” or an “#ad” buried those hashtags multiple lines down in the post description, the letters stated, making them insufficiently clear to the average scroller — especially because users must click to open the full post when they have lengthier descriptions.

Read the full story on NBCNews.com here.

Sofia Produce, which operates under the brand name Trufresh, is recalling all sizes of fresh cantaloupes packaged in cardboard containers and sold between Oct. 16 and Oct. 23. 

The impacted cantaloupes were distributed to stores in Arizona, California, Maryland, New Jersey, Tennessee, Illinois, Michigan, Wisconsin, Texas, Florida and outside the U.S. to Canada. 

No illnesses have been reported, according to the FDA.

The cantaloupe’s have their own PLU sticker on each fruit, with the word “Malichita” on the top half of the sticker and the number “4050” and “Product of Mexico/produit du Mexique” prominently displayed in white letters.

Consumers who purchased the cantaloupes should not eat or serve them, and are urged to throw them away or return them to their place of purchase.

The FDA described salmonella as “an organism which can cause serious and sometimes fatal infections in young children, frail or elderly people, and others with weakened immune systems.” 

Symptoms of salmonella include diarrhea, fever higher than 102 degrees Fahrenheit, stomach cramps, excessive vomiting and signs of dehydration. Symptoms can start six hours and up to six days after ingesting the bacteria.

In most cases, people recover without medical care after four to seven days. Some people – especially children younger than 5 years old, adults 65 years and older, and people with weakened immune systems – may experience more severe illnesses that require medical treatment or hospitalization.

Every year, salmonella causes about 1.35 million illnesses, 26,500 hospitalizations, and 420 deaths in the United States, according to the CDC.

The state’s Department of Health said 21 people in Middlesex County and 20 people in Union County were sick and tested positive for legionella, the bacteria that leads to the disease. The tests were conducted between Aug. 3 and Oct. 24, when the onset of symptoms occurred.

Typically, Middlesex and Union counties only see about six to eight confirmed Legionnaires’ cases in that same time frame each year, health officials said. The health department is working with local officials to find the potential sources of the infections, which has not yet been established and can be difficult to track down.

“Early diagnosis is key to effectively treating Legionnaires’ disease,” said Acting Health Commissioner Dr. Kaitlan Baston. “Although the risk of contracting Legionnaires’ disease if you live in or have recently visited Middlesex or Union counties remains low, individuals who develop pneumonia-like respiratory symptoms should visit their health care provider immediately to be evaluated.”

Health officials clarified that no deaths have been reported, just people falling ill. Anyone who does experience symptoms should seek medical evaluation as soon as possible.

The state gets about 250-375 cases of Legionnaires’ disease each year, the health department said.

What is Legionnaires’ disease?

Legionnaires is a type of pneumonia, or a lung infection, the state DOH said.

The legionella bacteria can also lead to a milder illness called Pontiac fever, which resembles flu-like symptoms.

How does it spread?

Legionella bacteria spread when someone inhales tiny droplets of contaminated water, commonly found in hot tubs, industrial air conditioning systems, decorative fountains, plumbing systems and even drinking water.

Outbreaks often occur in large and complex water systems found in places like hotels, hospitals, and cruise ships.

The bacteria can also survive and spread in soil, occasionally causing infections when people garden using contaminated soil. 

However, in most cases, people do not transmit Legionnaires’ disease or Pontiac fever to others.

What are the symptoms?

Symptoms of Legionnaires disease typically appear between two to 10 days after exposure to the bacteria and can include: 

• Headache
• Muscle aches
• Shortness of breath
• Cough
• Fever 

The New Jersey Department of Health noted that the symptoms can be similar to those of COVID-19 and other respiratory illnesses like the flu. Only tests ordered by a doctor can confirm a diagnosis.

Who is at higher risk?

Those most susceptible to Legionnaires’ disease include adults over 50, individuals with weakened immune systems or chronic conditions, and smokers.

It is rarer for healthy people who are exposed to the legionella bacteria to develop Legionnaires’ disease.

Can it be treated?

Antibiotics are used to treat Legionnaires’ disease, though it often requires hospitalization. 

Anyone suspecting exposure to Legionella or experiencing symptoms of Legionella disease or pneumonia should promptly contact a doctor. It’s important to mention any exposure to Legionella, hot tub use, recent travels, or hospital stays in the past two weeks.

For more information on Legionnaires’ disease, visit the CDC website.

Surgeons have performed the world’s first transplant of an entire human eye, an extraordinary addition to a face transplant — although it’s far too soon to know if the man will ever see through his new left eye.

An accident with high-voltage power lines had destroyed most of Aaron James’ face and one eye. His right eye still works. But surgeons at NYU Langone Health hoped replacing the missing one would yield better cosmetic results for his new face, by supporting the transplanted eye socket and lid.

The NYU team announced Thursday that so far, it’s doing just that. James is recovering well from the dual transplant last May and the donated eye looks remarkably healthy.

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“It feels good. I still don’t have any movement in it yet. My eyelid, I can’t blink yet. But I’m getting sensation now,” James told The Associated Press as doctors examined his progress recently.

“You got to start somewhere, there’s got to be a first person somewhere,” added James, 46, of Hot Springs, Arkansas. “Maybe you’ll learn something from it that will help the next person.”

Today, transplants of the cornea — the clear tissue in front of the eye — are common to treat certain types of vision loss. But transplanting the whole eye — the eyeball, its blood supply and the critical optic nerve that must connect it to the brain — is considered a moonshot in the quest to cure blindness.

Whatever happens next, James’ surgery offers scientists an unprecedented window into how the human eye tries to heal.

“We’re not claiming that we are going to restore sight,” said Dr. Eduardo Rodriguez, NYU’s plastic surgery chief, who led the transplant. “But there’s no doubt in my mind we are one step closer.”

Some specialists had feared the eye would quickly shrivel like a raisin. Instead, when Rodriguez propped open James’ left eyelid last month, the donated hazel-colored eye was as plump and full of fluid as his own blue eye. Doctors see good blood flow and no sign of rejection.

Now researchers have begun analyzing scans of James’ brain that detected some puzzling signals from that all-important but injured optic nerve.

One scientist who has long studied how to make eye transplants a reality called the surgery exciting.

“It’s an amazing validation” of animal experiments that have kept transplanted eyes alive, said Dr. Jeffrey Goldberg, chair of ophthalmology at Stanford University.

The hurdle is how to regrow the optic nerve, although animal studies are making strides, Goldberg added. He praised the NYU team’s “audacity” in even aiming for optic nerve repair and hopes the transplant will spur more research.

“We’re really on the precipice of being able to do this,” Goldberg said.

James was working for a power line company in June 2021 when he was shocked by a live wire. He nearly died. Ultimately he lost his left arm, requiring a prosthetic. His damaged left eye was so painful it had to be removed. Multiple reconstructive surgeries couldn’t repair extensive facial injuries including his missing nose and lips.

James pushed through physical therapy until he was strong enough to escort his daughter Allie to a high school homecoming ceremony, wearing a face mask and eye patch. Still he required breathing and feeding tubes, and longed to smell, taste and eat solid food again.

“In his mind and his heart, it’s him — so I didn’t care that, you know, he didn’t have a nose. But I did care that it bothered him,” said his wife, Meagan James.

Face transplants remain rare and risky. James’ is only the 19th in the U.S., the fifth Rodriguez has performed. The eye experiment added even more complexity. But James figured he’d be no worse off if the donated eye failed.

Three months after James was placed on the national transplant waiting list, a matching donor was found. Kidneys, a liver and pancreas from the donor, a man in his 30s, saved three other people.

During James’ 21-hour operation, surgeons added another experimental twist: When they spliced together the donated optic nerve to what remained of James’ original, they injected special stem cells from the donor in hopes of spurring its repair.

Last month, tingles heralded healing facial nerves. James can’t yet open the eyelid, and wears a patch to protect it. But as Rodriguez pushed on the closed eye, James felt sensation — although on his nose rather than his eyelid, presumably until slow-growing nerves get reoriented. The surgeon also detected subtle movements beginning in muscles around the eye.

Then came a closer look. NYU ophthalmologist Dr. Vaidehi Dedania ran a battery of tests. She found expected damage in the light-sensing retina in the back of the eye. But she said it appears to have enough special cells called photoreceptors to do the job of converting light to electrical signals, one step in creating vision.

Normally, the optic nerve then would send those signals to the brain to be interpreted. James’ optic nerve clearly hasn’t healed. Yet when light was flashed into the donated eye during an MRI, the scan recorded some sort of brain signaling.

That both excited and baffled researchers, although it wasn’t the right type for vision and may simply be a fluke, cautioned Dr. Steven Galetta, NYU’s neurology chair. Only time and more study may tell.

Still, the surgery marks “a technical tour de force,” said Dr. David Klassen, chief medical officer of the United Network for Organ Sharing, which runs the nation’s transplant system. “You can learn a tremendous amount from a single transplant” that could propel the field.

As for James, “we’re just taking it one day at a time,” he said.

The person who died with influenza was a resident of Middlesex County who was between 80 and 89 years old.

One person who died with RSV was a New Haven County resident who was between 80 and 89 years old, according to the Department of Public Health.

On Thursday afternoon, the state Department of Health said a Hartford County resident between the ages of 60 and 69 who had RSV has also died.

In October, 67 COVID-19-associated deaths have also been reported in Connecticut residents, according to the Department of Public Health.

“This is a tragic reminder that the 2023-24 respiratory viral disease season is already an active one. As we approach the holidays, I strongly encourage all Connecticut residents to make sure they are up to date on their seasonal vaccines, particularly older individuals and those with multiple medical conditions,” Department of Public Health Commissioner Manisha Juthani, MD, said in a statement.

“Even if you have had COVID before and have been previously vaccinated, our immunity dwindles over time. Getting vaccinated this fall will help you protect yourself and other members of your family as we enter the holiday season. In addition, preventing illnesses, even if they might have been mild infections, will help keep our children in school and adults at work. A healthier society at large will help all of us live our best lives,” Juthani added.

Vaccine guidance

• Everyone 6 months of age or older should receive an annual dose of influenza vaccine.
• Everyone 6 months of age or older should receive an updated COVID-19 vaccine.
• Adults 60 years old and older and pregnant people are eligible to receive an RSV vaccine (Abrysvo). A monoclonal antibody, Nirsevimab (Beyfortus), is recommended for all infants younger than 8 months of age who are born during—or who are entering—RSV season.

Residents can receive vaccines from their health care provider, a retail pharmacy, or by visiting vaccines.gov to find a vaccination location near you.

The Department of Public Health and the Connecticut Immunization Coalition are partnering with local health departments throughout the state on vaccine clinics for children and adults. Get the schedule at https://datawrapper.dwcdn.net/aWVXd/5/.

Prevent the spread of virus

Prevent the spread of respiratory viruses like the flu, COVID-19, and RSV through proper respiratory virus etiquette, including handwashing, remaining home when sick, disinfecting surfaces, and masking if you have any respiratory symptoms.

Prescriptions for ketamine have soared in recent years, driven by for-profit clinics and telehealth services offering the medication as a treatment for pain, depression, anxiety and other conditions. The generic drug can be purchased cheaply and prescribed by most physicians and some nurses, regardless of their training.

With limited research on its effectiveness against pain, some experts worry the U.S. may be repeating mistakes that gave rise to the opioid crisis: overprescribing a questionable drug that carries significant safety and abuse risks.

“There’s a paucity of options for pain and so there’s a tendency to just grab the next thing that can make a difference,” said Dr. Padma Gulur, a Duke University pain specialist who is studying ketamine’s use. “A medical journal will publish a few papers saying, ‘Oh, look, this is doing good things,’ and then there’s rampant off-label use, without necessarily the science behind it.”

When Gulur and her colleagues tracked 300 patients receiving ketamine at Duke, more than a third of them reported significant side effects that required professional attention, such as hallucinations, troubling thoughts and visual disturbances.

Ketamine also didn’t result in lower rates of opioid prescribing in the months following treatment, a common goal of therapy, according to Gulur. Her research is under review for medical journal publication.

Ketamine was approved more than 50 years ago as a powerful anesthetic for patients undergoing surgery. At lower doses, it can produce psychedelic, out-of-body experiences, which made it a popular club drug in the 1990s. With its recent adoption for pain, patients are increasingly encountering those same effects.

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Daniel Bass, of Southgate, Kentucky, found the visual disturbances “horrifying.” His doctors prescribed four- to six-hour IV infusions of ketamine for pain related to a rare bone and joint disorder. Seated in a bare hospital room with no stimulation or guidance on the drug’s psychological effects, Bass says he felt “like a lab rat.”

Still, he credits ketamine with reducing his pain during the year that he received twice-a-month infusions.

“No matter how horrific an experience is, if it allows me to be more functional, I will do it,” Bass said.

Ketamine targets a brain chemical messenger called glutamate, which is thought to play a role in both pain and depression. It’s unclear whether the psychedelic experience is part of the drug’s therapeutic effect, though some practitioners consider it essential.

“We want patients to disassociate or feel separate from their pain, depression or anxiety,” said Dr. David Mahjoubi, owner of Ketamine Healing Clinic in Los Angeles. “If they feel like they’re just sitting in the chair the whole time, we actually give them more.”

Mahjoubi’s practice is typical of the burgeoning industry: He offers IV ketamine for alcohol addiction, chronic pain, anxiety and post-traumatic stress disorder. The ketamine doses for those indications are well below those used for surgery, but Mahjoubi favors higher doses for pain than for psychiatric conditions.

Patients pay cash because most insurers don’t cover non-surgical uses of ketamine, none of which are approved by the Food and Drug Administration. Mahjoubi’s background is in anesthesiology, not psychiatry or addiction.

Patients can pay extra for ketamine nasal sprays and tablets to use between infusions. Those formulations are also not FDA approved and are compounded by specialty pharmacies.

Sending ketamine through the mail has become its own profitable business for telehealth services, such as MindBloom, which jumped into the space after regulators relaxed online prescribing rules during COVID-19.

Pain specialists who study ketamine say there’s little evidence for those versions.

“The literature for the nasal and oral formulations is pretty scant,” said Dr. Eric Schwenk of Thomas Jefferson University. “There’s just not a lot of good evidence to guide you.”

Demand for ketamine has sent prescriptions soaring more than 500% since 2017, according to Epic Research, which analyzed the trend using a database of more than 125 million patients. In each year, pain was the No. 1 condition for which ketamine was prescribed, though depression has been rising quickly.

The prescribing boom has led to shortages of manufactured ketamine, driving up sales of compounded versions.

There is more evidence for ketamine’s use against depression than for pain. In 2019, the FDA approved a ketamine-related chemical developed by Johnson & Johnson for severe depression. The drug, Spravato, is subject to strict FDA safety rules on where and how it can be administered by doctors.

Guidelines from pain societies note some evidence for ketamine’s use in complex regional pain, a chronic condition that usually affects the limbs. But the experts found “weak or no evidence” for ketamine in many more conditions, including back pain, migraines, fibromyalgia and cancer pain.

While the science behind ketamine is murky, the business model is clear: Physicians can purchase ketamine for less than $100 a vial and charge $500 to $1,500 per infusion.

The recent boom has been fueled, in part, by venture capital investors. Another set of consulting businesses offer to help doctors set up new clinics.

A blog post from one, Ketamine Startup, lists “Five reasons you should open a ketamine clinic,” including: “You want to be your own boss” and “You want to take control of your money-making ability.”

The clinics are facing increasing competition from telehealth services like MindBloom and Joyous, which connect potential patients with physicians who can prescribe ketamine remotely and send it through the mail.

In May, federal regulators were scheduled to roll back the COVID-era policy that allowed online prescribing of high-risk drugs like ketamine and opioids. But the Drug Enforcement Administration, facing backlash for telehealth companies and physicians, agreed to extend the flexible approach through 2024.

The current landscape is a “wild west,” said Dr. Samuel Wilkinson, a Yale University psychiatrist who prescribes both Spravato and ketamine for depression. U.S. physicians have “quite a bit of latitude” to prescribe drugs for unapproved, or off-label, uses.

“There’s good things about that and not-so-good things about that,” he said.

When used at high doses, ketamine can cause bladder damage, sometimes seen in people who use the drug recreationally. Far less is known about the neurological effects of long-term use. Ketamine was linked to brain abnormalities in rat studies, FDA regulators note.

Last month, the FDA warned doctors and patients against compounded versions of ketamine, including lozenges and pills, saying the agency does not regulate their contents and cannot assure their safety. The warning followed a similar advisory last year about nasal spray versions of ketamine.

But most compounding pharmacies are small operations, overseen by state officials, not the FDA.

In April, Massachusetts’ board of pharmacy flagged the FDA’s warning to local pharmacies, but noted that state officials wouldn’t take any steps to stop “the continued compounding and dispensing of ketamine nasal spray.”

The FDA likewise has little leverage over physicians promoting ketamine, even those making exaggerated or misleading claims.

Drugmakers are subject to strict FDA regulation in how they promote their medicines — with requirements to balance risk and benefit information. Those rules don’t apply to physicians.

Even when the FDA has tried to regulate risky in-office procedures, such as unproven stem cell infusions, the agency has had a mixed track record of prevailing in court.

For now, experts say it’s unlikely regulators will go beyond their recent warnings about off-label ketamine.

“There’s an element of whack-a-mole and it’s essentially beyond their regulatory purview,” said Dr. Caleb Alexander, a drug safety researcher at Johns Hopkins University. “These clinics would represent yet another front that they would be hard pressed to manage and address.”

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.

In a survey, 10% of high school students said they had used electronic cigarettes in the previous month, down from 14% last year.

Use of any tobacco product — including cigarettes and cigars — also fell among high schoolers, according to the Centers for Disease Control and Prevention report.

“A lot of good news, I’d say,” said Kenneth Michael Cummings, a University of South Carolina researcher who was not involved in the CDC study.

Among middle school students, about 5% said they used e-cigarettes. That did not significantly change from last year’s survey.

This year’s survey involved more than 22,000 students who filled out an online questionnaire last spring. The agency considers the annual survey to be its best measure of youth smoking trends.

Why the drop among high schoolers? Health officials believe a number of factors could be helping, including efforts to raise prices and limit sales to kids by raising the legal age to 21.

“It’s encouraging to see this substantial decrease in e-cigarette use among high schoolers within the past year, which is a win for public health,” said Brian King, the Food and Drug Administration’s tobacco center director.

The FDA has authorized a few tobacco-flavored e-cigarettes intended to help adult smokers cut back but has struggled to stop sales of illegal products.

Other key findings in the report:

• Among students who currently use e-cigarettes, about a quarter said they use them every day.
• About 1 in 10 middle and high school students said they recently had used a tobacco product. That translates to 2.8 million U.S. kids.
• E-cigarettes were the most commonly used kind of tobacco product, and disposable ones were the most popular with teens.
• Nearly 90% of the students who vape used flavored products, with fruit and candy flavors topping the list.

In 2020, FDA regulators banned those teen-preferred flavors from reusable e-cigarettes like Juul and Vuse, which are now only sold in menthol and tobacco. But the flavor restriction didn’t apply to disposable products, and companies like Elf Bar and Esco Bar quickly stepped in to fill the gap.

The growing variety in flavors like gummy bear and watermelon has been almost entirely driven by cheap, disposable devices imported from China, which the FDA considers illegal. Those products now account for more than half of U.S. vaping sales, according to government figures.

In the latest survey, about 56% of teens who vape said they used Elf Bar, trailed by Esco Bar and Vuse, which is a reusable e-cigarette made by R.J. Reynolds. Juul, the brand widely blamed for sparking the recent spike in teen vaping, was the fourth most popular brand, used by 16% of teens.

The FDA tried to block imports of both Elf Bar and Esco Bar in May, but the products remain widely available. Elf Bar has thwarted customs officials by changing its brand name, among other steps designed to avoid detection

On Thursday, the FDA announced another round of fines against 20 stores selling Elf Bar products. The agency has sent more than 500 warning letters to retailers and manufacturers of unauthorized e-cigarettes over the past year, but those citations are not legally binding and are sometimes ignored.

In the latest report, the CDC highlighted one worrisome but puzzling finding. There was a slight increase in middle schools students who said they had used at least one tobacco product in the past month, while that rate fell among high school students. Usually those move in tandem, said Kurt Ribisl, a University of North Carolina researcher. He and Cummings cautioned against making too much of the finding, saying it might be a one-year blip.

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.

Adams unveiled his “HealthyNYC” plan Wednesday in an effort to bring the life expectancy up to 83 years by 2030. That would be a marked improvement from the mark of 80.7 years after falling for nearly two years between 2019 and 2021, according to the mayor’s office.

“On average, New Yorkers can expect to live two fewer years than they could in 2019, the first marked decline after a century of progress,” said Department of Health and Mental Hygiene Commissioner Dr. Ashwin Vasan.

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City data shows that drug overdoses and suicides continue to lead to premature deaths. But now the city-wide effort will try to “provide guideposts for our nation and its people,” said Vasan.

“Not only recovering years lost during the pandemic but also surpassing our previous high by tackling chronic disease, violence, maternal mortality, overdose, and more,” Adams said. “By refocusing all of our public health work around the goal of helping people live longer lives, we’ll build a healthier, more prosperous city where everyone can thrive.”

Before COVID, in 2019, life expectancy for New Yorkers averaged 82.6 years. That fell to 78 a year later, then rebounded to 80. The city wants to bring that back up, and to reduce the existing racial disparities.

The mayor’s office said it aims to reduce deaths connected to childbirth by 10%, overdose deaths by 25% and reduce heart- and diabetes-related deaths by 5% in the next seven years. Other goals include bringing down homicide deaths by 30%; deaths from screenable cancers (like lung, breast, colon, cervical and prostate cancers) by 20%.

The mayor made a personal connection to his mother, who suffered from diabetes for 15 years.

“I believe if we had caught some of the chronic diseases she was facing, she could’ve been with us even longer,” said Adams.

The mayor said he expects every city agency to examine issues, like housing, and make decisions to help residents live longer.

“If you don’t have stable housing, that affects sleep and mood,” Dr. Vasan said. “If you don’t have transportation, you can’t get to doctors appointments to get routine screening done.”

On Thursday, Queens Councilmember Lynn Schulman — who chairs the Health Committee — will introduce legislation setting benchmarks over five years to make sure the initiative is meeting its goals.

“‘HealthyNYC’ marks a significant step forward in our commitment to the well-being of all New Yorkers,” said Schulman. “I am proud to partner with Mayor Adams on such a comprehensive and ambitious plan to make New York City the healthiest city in the country.”

The answer to that question is the focus of a new case study in the New England Journal of Medicine, which follows a 64-year-old woman who started hearing “abnormal sounds” in her left ear.

The case study explains that the woman was having trouble sleeping for four days and hearing strange noises. These included “incessant beating, clicking and rustling sounds,” as well as “the feeling of a creature moving insider her left ear,” per the case study.

“She didn’t feel pain because the spider was very small,” Dr. Tengchin Wang, co-author and director of the otolaryngology department at Tainan Municipal Hospital, told NBC News, adding that the spider was about one-tenth of an inch.

He said the woman’s case was novel because he’d never seen an insect molt inside an ear canal before. Previously, he’d seen ants, moths, cockroaches and mosquitoes in people’s ears.

When the woman went to an ear, nose and throat clinic in Taiwan, a physical exam revealed a small spider moving in her external auditory canal and that it had even shed an exoskeleton. The external auditory canal connects the outer ear to the inner and middle ear. Her tympanic membrane, which separates the outer ear from the middle ear, was totally normal, according to the report.

A suction cannula place into an otoscope (the device that goes into your ear in ear exams) was used to remove the spider because it was quite small. For bigger creatures in the ear, they usually needed to be killed before they can be taken out to avoid further damage to the ear, the researchers explained.

Once the spider was removed, the woman’s symptoms stopped.

How common is it to have a spider in your ear?

The real question that the case study prompts is … can this happen to you? Experts told NBC News that an insect (or spider) working its way into a human’s ear is unusual but can happen.

Dr. David Kasle, a physician at ENT Sinus and Allergy of South Florida, who wasn’t involved in the research, told NBC News the average ENT doctor will encounter “tens, if not more, of bugs or some sort of arthropod” in patients’ ears over their career.

Other reports of bugs in people’s ears include a Japanese beetle and 14-year-old girl in Pennsylvania from 2020, and a tick in a 9-year-old Connecticut boy’s eardrum in 2019. A previous study estimated insects make up almost one-fifth of foreign objects found in ears.

Most of Dr. Stacey Ishman’s patients with bugs inside their ears had gone camping beforehand, the otolaryngology instructor at the University of Wisconsin School of Medicine and Public Health told NBC News. She’s seen eight patients with bugs in their ears.

Symptoms of a bug inside your ear

The symptoms described by the woman in the case study include:

• Beating sounds
• Clicking sounds
• Rustling sounds
• The feeling of something crawling in your ear

“There’s an extremely sensitive, thin layer of skin that lines the ear canal,” Kasle said. “Because of its sensitivity, you’re obviously going to feel the crawling sensation, a tickle sensation that is almost unbearable.”

How to remove a bug inside your ear

If you think you have a bug in your ear, don’t stick your finger or a Q-tip inside because it could shove it further in. Don’t try to remove it with tweezers or anything else because it could damage your ear.

Safer options include pouring vegetable oil, olive oil or baby oil into the ear, which could drown it or slide it out, or tilting your ear down and shaking your head, which could help the bug get out by itself.

“Most of the time the ear is completely fine,” Ishman said. “If there’s some injury to the ear canal, quite honestly it’s more often from people trying to get it out than it is from the bug itself.”

If you do have an insect inside your ear, consult a health care professional, even if you’re able to remove it on your own, to make sure the bug didn’t leave anything behind.

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In a historic move to protect reproductive rights since the Supreme Court overturned Roe v. Wade, New York City has become the first in the country to offer virtual abortion access through its public health system.

NYC Health + Hospitals on Monday launched Virtual ExpressCare, an online scheduling system that will connect New Yorkers seeking abortion care to healthcare professionals via phone or video call. In addition to reproductive health care, the virtual service also makes it easier for patients to seek help with non-emergency medical issues, including mental health services.

“Tough decision is made in the comfort of your environment and your home,” Mayor Eric Adams said at a news conference announcing the new service. “This is an important step forward in using technology to deal with a major demand on those who are looking for access. In New York City, we’re never going to stop fighting for a woman’s right to choose the care that she needs and the right for all families who are involved.”

How abortion access works with ExpressCare

The online service is available seven days a week from 9 a.m. to 9 p.m. in over 200 languages, according to NYC Health Hospitals. It’s also accessible by calling (718) 360-8981. Here’s a list of walk-in centers where the services are also offered.

Patients who are clinically eligible, meaning those who are up to 10 weeks into their pregnancy, can receive prescribed abortion medication by mail to a New York City address. They will also need to be in the city at the time of the telehealth call, as well as when the medication is taken.

How much does it cost?

For patients with insurance, the service will work just like any other health care provider and they may need to be responsible for a copay.

For those without health insurance, patients will still be treated and they will be connected to financial counselors who can help them enroll in health insurance coverage or financial assistance through NYC Care, Medicaid, and Medicare, according to NYC Health + Hospitals.

The report, which used data from the Centers for Disease Control and other available data on cumulative cases of sexually transmitted diseases.

The state with highest rate of STDs per 100,000 people was Mississippi, with 1,266 per 100,000. The report also found that Mississippi has a chlamydia rate of 750 per 100,000, a gonorrhea rate of 427.7 per 100,000 and a syphilis rate of 88.3 per 100,000.

Here is the report’s full list of the 10 states with the highest rates of STDs:

1. Mississippi – 1,266 per 100,000
2. Louisiana – 1,159.9 per 100,000
3. Alaska – 1,091.2 per 100,000
4. South Carolina – 1,052 per 100,000
5. South Dakota – 1,009.1 per 100,000
6. Alabama – 989.6 per 100,000
7. Georgia – 987.5 per 100,000
8. Arkansas – 942.4 per 100,000
9. New Mexico – 925.9 per 100,000
10. North Carolina – 922.2 per 100,000

Overall, more than 2.5 million cases of chlamydia, gonorrhea and syphilis were reported in the United States in 2021, according to the CDC.

The CDC also points out that more than half of all STD cases reported in 2021 (50.5%) were among adolescents between the ages of 15 and 24.

The most concerning trend in STD cases in the United States appears to be the increasing rate of syphilis and congenital syphilis (congenital syphilis is when syphilis is giving to a baby by its mother during pregnancy). The rate of syphilis jumped by 28.6% between 2020 and 2021, and the rate of congenital syphilis jumped by 30.5% to 77.9 cases per 100,000 live births, according to the CDC. The rate of congenital syphilis in 2021 also represents a 219.3% increase from 2017.

The study of rates of STDs from 2020 to 2021 represents the first year-to-year impacted by the COVID-19 pandemic. The pandemic likely led to the underreporting of STDS and an increase in transmission, according to the CDC, but it may never be possible to measure COVID-19’s full impact on STDs in the United States.

The dwindling supplies add another layer to the ongoing cancer drug shortage crisis that’s left doctors scrambling and forced patients to make difficult choices about treatments since early February.  

The Biden administration has taken steps to address the crisis, in some cases successfully: Doctors say that shortages of two cancer drugs, carboplatin and cisplatin, have eased significantly in recent weeks.

However, reports from children’s hospitals across the country are pointing to supply problems for two other chemotherapy drugs that are commonly used to treat pediatric cancers: vinblastine and dacarbazine. Another chemotherapy drug also often used in children, methotrexate, has been in short supply since March, and is still hard to come by.

Read the full story on NBC News.com here

The 58-year-old Navy veteran was facing near-certain death from heart failure but other health problems meant he wasn’t eligible for a traditional heart transplant, according to doctors at University of Maryland Medicine.

“Nobody knows from this point forward. At least now I have hope and I have a chance,” Lawrence Faucette, from Frederick, Maryland, said in a video recorded by the hospital before Wednesday’s operation. “I will fight tooth and nail for every breath I can take.”

While the next few weeks will be critical, doctors were thrilled at Faucette’s early response to the pig organ.

“You know, I just keep shaking my head – how am I talking to someone who has a pig heart?” Dr. Bartley Griffith, who performed the transplant, told The Associated Press. He said doctors are feeling “a great privilege but, you know, a lot of pressure.”

The same Maryland team last year performed the world’s first transplant of a genetically modified pig heart into another dying man, David Bennett, who survived just two months.

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There’s a huge shortage of human organs donated for transplant. Last year, there were just over 4,100 heart transplants in the U.S., a record number but the supply is so tight that only patients with the best chance of long-term survival get offered one.

Attempts at animal-to-human organ transplants have failed for decades, as people’s immune systems immediately destroyed the foreign tissue. Now scientists are trying again using pigs genetically modified to make their organs more humanlike.

Recently, scientists at other hospitals have tested pig kidneys and hearts in donated human bodies, hoping to learn enough to begin formal studies of what are called xenotransplants.

To make this new attempt in a living patient outside of a rigorous trial, the Maryland researchers required special permission from the Food and Drug Administration, under a process reserved for certain emergency cases with no other options.

It took over 300 pages of documents filed with FDA, but the Maryland researchers made their case that they’d learned enough from their first attempt last year – even though that patient died for reasons that aren’t fully understood – that it made sense to try again.

And Faucette, who retired as a lab technician at the National Institutes of Health, had to agree that he understood the procedure’s risks.

In a statement his wife, Ann Faucette, said: “We have no expectations other than hoping for more time together. That could be as simple as sitting on the front porch and having coffee together.”

What’s different this time: Only after last year’s transplant did scientists discover signs of a pig virus lurking inside the heart – and they now have better tests to look for hidden viruses. They also made some medication changes.

Possibly more important, while Faucette has end-stage heart failure and was out of other options, he wasn’t as near death as the prior patient.

By Friday, his new heart was functioning well without any supportive machinery, the hospital said.

“It’s just an amazing feeling to see this pig heart work in a human,” said Dr. Muhammad Mohiuddin, the Maryland team’s xenotransplantation expert. But, he cautioned, “we don’t want to predict anything. We will take every day as a victory and move forward.”

This kind of single-patient “compassionate use” can provide some information about how the pig organ works but not nearly as much as more formal testing, said Karen Maschke, a research scholar at the Hastings Center who is helping develop ethics and policy recommendations for xenotransplant clinical trials. That FDA allowed this second case “suggests that the agency is not ready to permit a pig heart clinical trial to start,” Mashke added.

The pig heart, provided by Blacksburg, Virginia-based Revivicor, has 10 genetic modifications – knocking out some pig genes and adding some human ones to make it more acceptable to the human immune system.

___

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.

They will have to call drugstores over several days to find one with the properly sized first dose. Then they’ll do that again for their second dose, and probably the third. And that’s only if the patient has insurance or the means to afford a drug that can cost more than $1,300 a month.

“This is not for the weak-willed,” said Fitch, who is president of the Obesity Medicine Association and also consults for drugmakers.

Supply problems and insurance complications have made it difficult for people to start — and stay on — Wegovy and similar medications that are transforming obesity treatment, according to doctors and patients around the country. They say getting the high-demand, injectable drugs requires persistence and a fair amount of luck.

People starting on Wegovy have to take injections of gradually increasing strength before they reach the so-called maintenance dose that they stay on.

The drug’s maker, Novo Nordisk, says that demand has forced it to restrict the supply of those smaller, initial doses in the U.S. The company also is warning those taking another weight-loss drug, Saxenda, to expect difficulty filling prescriptions “for the remainder of 2023 and beyond.”

Another drugmaker, Eli Lilly, has said it expects tight supplies until year’s end for its diabetes treatment Mounjaro, which also is prescribed for weight loss.

Finding Wegovy can become a part-time job for patients, said Dr. Diana Thiara, medical director of the weight management clinic at the University of California, San Francisco.

Thiara said some wind up driving 45 minutes or more to get prescriptions filled, a barrier for hourly workers who can’t leave their job and for people without cars.

“It’s usually patients who are a little bit more privileged, able to take off from work to go make those drives,” Thiara said.

One of Fitch’s patients, Mike Bouboulis, has taken Saxenda, Mounjaro or Ozempic, a Novo diabetes drug with the same active ingredient as Wegovy, since around 2019. It became much harder for him to find the drugs in the past year, after their popularity exploded.

Refilling a prescription involved calling five to seven pharmacies.

“They all know what you’re calling for, and they all have the same answer: ‘I don’t know. We’ll see tomorrow,’” said the 35-year-old small business owner who lives outside Boston.

Pharmacy technician Lizzy Nielsen used insider knowledge to start Wegovy earlier this year.

She regularly checked drug wholesalers’ supply lists, refreshing her screen each morning, and then ordering Wegovy for her pharmacy as soon as she saw it in stock.

“I was really lucky … because that’s when it was like starting to be constantly back-ordered,” the 42-year-old West Springfield, Massachusetts, resident said.

While patients have had to deal with shortages of many medications in the past year, those taking weight-loss drugs can face coverage complications too.

The federal Medicare program for people age 65 and older doesn’t cover obesity medicines, but some privately run Medicare Advantage or Medigap plans do, according to Novo. Coverage from Medicaid programs for people with low incomes varies.

Doctors and patients say many insurers have stopped covering Ozempic and Mounjaro outside their approved use for diabetes. Some insurers and employers don’t pay for Wegovy.

Novo Nordisk even offers a form letter on its Wegovy website to help doctors request coverage.

Bouboulis, the Boston-area resident, said his insurer stopped covering Mounjaro earlier this year. He then tried switching back to Ozempic but found that also was no longer covered.

He’s taking low doses of leftover Ozempic until he can find coverage.

“I know the insurance companies don’t want to pay, but between (them) and the pharmaceutical industry, they need to find some kind of nice middle ground because these medications, they can save people’s lives,” said Bouboulis, who has lost around 80 pounds since he started taking them.

Employers and insurers that do pay for the weight-loss treatments often require patients to get pre-approval or to first try other strategies like diet and exercise.

Some require patients to show they’ve lost 5% of their body weight after six months on the drugs in order to continue coverage. Supply problems make that hard, Thiara noted.

“A lot of patients are not staying on it consistently because they can’t get it,” she said.

Dr. Laura Davisson estimates that less than 30% of her patients with insurance through an employer or an individual plan have obesity medicine coverage.

Davisson directs a weight-loss program in West Virginia, a state that consistently ranks as having one of the highest obesity rates in the country. The state’s Medicaid program doesn’t cover Wegovy, but neighboring Pennsylvania’s does.

“For me, it’s either they have coverage through insurance, or they’re not taking it,” she said. “No one can afford it.”

Coverage may improve over time, as it has with other obesity treatments like bariatric surgery.

About 46% of large U.S. employers cover obesity medicines like Wegovy, according to the benefits consultant Mercer. Another 18% are considering it. Mercer’s experts say employers are still trying to learn about how the added cost will affect them and what other support patients may need.

Dr. Deborah Horn says she thinks supply problems and coverage will eventually smooth out, but it may take a couple years. She noted that the FDA may soon approve Mounjaro to treat obesity, which could improve coverage.

Drugmakers also are developing other weight-loss medications, including easier-to-take pills.

In the meantime, more patients are realizing that they can get medical help for their disease and don’t have to manage it on their own, said Horn, an obesity medicine expert at UTHealth Houston.

“I feel like this is the beginning of the change in obesity care, where we will see every year better and better medications coming to market and people getting their disease under control,” she said. “We’re just in the hard part … right now.”

___

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.

The health care giant said Thursday that it will replace the well-known signature script it has used since 1887 with a modern look that reflects its sharpened focus on pharmaceuticals and medical devices.

The original script — based on co-founder James Wood Johnson’s signature — will still be seen for now on consumer products like baby shampoo from Kenvue, a new company recently spun off from J&J.

Johnson & Johnson itself narrowed its focus to pharmaceuticals and medical devices. The new look, which includes a different shade of red, aims to recognize J&J’s shift into a “pure play health care company,” said Vanessa Broadhurst, a company executive vice president.

The signature logo was “one of the longest-used company emblems in the world,” J&J declared in a 2017 website post.

But it started showing its age in an era of texting and emojis.

Many children no longer learn to write cursive in school, noted marketing consultant Laura Ries. People may recognize the signature, but they weren’t necessarily reading it, she said. The new logo, she said, is easier to process.

“Because it’s easier, it almost even draws your attention to it,” said Ries, who wasn’t involved in the logo change.

Ries also noted people likely identified the script logo more with the Kenvue products they see on drugstore shelves, such as Band-Aids, Listerine and Tylenol.

“Everyone washed their baby with Johnson & Johnson baby shampoo,” she said.

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A Kenvue spokesperson said the J&J branding on products like Band Aids will gradually be removed.

The signature logo also could be found on bottles of the company’s now-discontinued talcum-based baby powder, which generated lawsuits alleging that it caused cancer. J&J has insisted that the powder was safe.

The consumer business helped J&J become the world’s biggest health care products maker, with annual sales topping $90 billion. But its pharmaceutical and medical device divisions had easily surpassed it in size when the spinoff was announced in late 2021.

New Brunswick, New Jersey-based J&J also said Thursday that it will relabel its Janssen pharmaceutical business Johnson & Johnson Innovative Medicine. Its medical devices and technology segment will be called Johnson & Johnson MedTech.

The dramatic experiment came to an end Wednesday as surgeons at NYU Langone Health removed the pig kidney and returned the donated body of Maurice “Mo” Miller to his family for cremation.

It marked the longest a genetically modified pig kidney has ever functioned inside a human, albeit a deceased one. And by pushing the boundaries of research with the dead, the scientists learned critical lessons they’re preparing to share with the Food and Drug Administration -– in hopes of eventually testing pig kidneys in the living.

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“It’s a combination of excitement and relief,” Dr. Robert Montgomery, the transplant surgeon who led the experiment, told The Associated Press. “Two months is a lot to have a pig kidney in this good a condition. That gives you a lot of confidence” for next attempts.

Montgomery, himself a recipient of a heart transplant, sees animal-to-human transplants as crucial to ease the nation’s organ shortage. More than 100,000 people are on the national waiting list, most who need a kidney, and thousands will die waiting.

So-called xenotransplantation attempts have failed for decades — the human immune system immediately destroyed foreign animal tissue. What’s new: Trying pigs genetically modified so their organs are more humanlike.

Some short experiments in deceased bodies avoided an immediate immune attack but shed no light on a more common form of rejection that can take a month to form. Last year, University of Maryland surgeons tried to save a dying man with a pig heart –- but he survived only two months as the organ failed for reasons that aren’t completely clear. And the FDA gave Montgomery’s team a list of questions about how pig organs really perform their jobs compared to human ones.

Montgomery gambled that maintaining Miller’s body on a ventilator for two months to see how the pig kidney worked could answer some of those questions.

“I’m so proud of you,” Miller’s sister, Mary Miller-Duffy, said in a tearful farewell at her brother’s bedside this week.

Miller had collapsed and was declared brain-dead, unable to donate his organs because of cancer. After wrestling with the choice, Miller-Duffy donated the Newburgh, New York, man’s body for the pig experiment. She recently got a card from a stranger in California who’s awaiting a kidney transplant, thanking her for helping to move forward desperately needed research.

“This has been quite the journey,” Miller-Duffy said as she and her wife Sue Duffy hugged Montgomery’s team.

On July 14, shortly before his 58th birthday, surgeons replaced Miller’s own kidneys with one pig kidney plus the animal’s thymus, a gland that trains immune cells. For the first month, the kidney worked with no signs of trouble.

But soon after, doctors measured a slight decrease in the amount of urine produced. A biopsy confirmed a subtle sign that rejection was beginning –- giving doctors an opportunity to tell if it was treatable. Sure enough, the kidney’s performance bounced back with a change in standard immune-suppressing medicines that patients use today.

“We are learning that this is actually doable,” said NYU transplant immunologist Massimo Mangiola.

The researchers checked off other FDA questions, including seeing no differences in how the pig kidney reacted to human hormones, excreted antibiotics or experienced medicine-related side effects.

“It looks beautiful, it’s exactly the way normal kidneys look,” Dr. Jeffrey Stern said Wednesday after removing the pig kidney at the 61-day mark for closer examination.

The next steps: Researchers took about 180 different tissue samples –- from every major organ, lymph nodes, the digestive tract –- to scour for any hints of problems due to the xenotransplant.

Experiments in the deceased cannot predict that the organs will work the same in the living, cautioned Karen Maschke, a research scholar at the Hastings Center who is helping develop ethics and policy recommendations for xenotransplant clinical trials.

But they can provide other valuable information, she said. That includes helping to tease out differences between pigs with up to 10 genetics changes that some research teams prefer — and those like Montgomery uses that have just a single change, removal of a gene that triggers an immediate immune attack.

“Why we’re doing this is because there are a lot of people that unfortunately die before having the opportunity of a second chance at life,” said Mangiola, the immunologist. “And we need to do something about it.”

Sheri Johnson was a child when a nurse looked at her and asked her mother, “Did your daughter have a purple sucker?”

Johnson’s lips and fingertips were purple, but candy wasn’t to blame.

She was born with a “backwards” heart, she says, where the two main arteries carrying blood out of her heart were switched in position.

Blood wasn’t being pushed through her body in the correct way, so she wasn’t getting enough oxygen, leading to a purple tint to her lips, skin and nails.

Johnson, now 56, has been dealing with the consequences of the birth defect much of her life, including heart surgery when she was 5. The fix had just been invented and doctors weren’t sure how long it would last. They hoped she’d make it past 19.

She beat those expectations by decades — until she required a heart transplant in 2021 — but she constantly felt like she was living on borrowed time.

“It was always in the back of my head that today could be my last day,” Johnson, who lives in Elk Grove, California, tells TODAY.com.

“I drove my husband crazy because at Christmas time I went overboard because I always felt like this could be the last Christmas with my girls, so I wanted it to be the best Christmas ever.”

Blue baby

Babies born with transposition of the great arteries — the medical term for Johnson’s birth defect — are typically very robust newborns because the fetal circulation in the womb allows them to grow normally, says Dr. Alison Meadows, a cardiologist at Kaiser Permanente San Francisco Medical Center. She oversees the congenital heart program for northern California and treated Johnson until she needed a heart transplant.

More than 1,150 babies are born with this condition each year in the U.S., according to the Centers for Disease Control and Prevention.

Today, it can be diagnosed in the womb, Meadows notes. But when Johnson was born in 1966, it took some time for doctors to figure out why she had a blue tint to her skin.

Her aorta and pulmonary artery were reversed, connecting to the wrong chambers in the heart. It meant oxygen-poor blood returning to her heart was pumped right back to her body instead of going to the lungs to pick up oxygen. Meanwhile, in a separate circuit, oxygenated blood went back to her lungs, instead of being pumped to the rest of her body. The baby was starving for oxygen.

As an initial fix, doctors surgically opened a hole between the top two chambers of baby Johnson’s heart, which allowed mixing of the blood. So instead of Johnson having no oxygen in her blood, she at least had oxygen saturation in the 60s, Meadows says. Normal blood oxygen levels are between 95% and 100%.

Johnson would live, but she had little energy and mostly sat a lot as a child.

“I could just hardly do anything,” she says. “I couldn’t jump. I couldn’t run.”

Surgery pioneer

By the time she was 5, the fix wasn’t enough. To survive, she had to undergo a heart surgery that had just been pioneered a few years before her birth. It created a tunnel between the upper chambers of the heart to redirect the oxygen-rich blood. But the prognosis for patients who got the procedure was unclear at that time.

“Doctors had no idea how long she would live because they just had nothing to base it on,” Meadows says.

Johnson was one of the first babies with the condition to survive to adulthood, which doctors initially told her mother would be a “miracle,” she recalls.

She went to college, got married and became a teacher. A cardiologist told her giving birth would probably kill her, so the couple adopted two children. Johnson lived her life, but always worried about her heart.

“I definitely lived with that fear of, ‘The surgery lasted longer than they expected, so when is it going to give out?’ I lived with that in the back of my mind,” Johnson says.

“Raising my girls, I was like, I have to be the mom who takes them and does everything with them because tomorrow could be the end, and I want them to have great memories of me.”

New ‘Cadillac’ heart

As years went by, heart problems began cropping up. She required a pacemaker to correct a slow heart rate. She then developed atrial flutter — an abnormal heart rhythm — and heart failure. The surgery Johnson underwent when she was 5 leaves most patients with heart issues, so doctors began using a different type of procedure in the 1980s, Meadows says.

In 2020, Johnson required several long hospital stays as her heart problems grew worse. She had no energy and was sitting much of the day again, just like she did when she was a child. Doctors put her on the heart transplant list.

In December 2021, she received her new organ, which her surgeon called a “Cadillac heart.”

“I’m able to do so much more,” she says. “Now, I’m riding my bike. I’m walking. I’m doing the classes at the gym. I’m going to the pool.”

Johnson is once again allowed to travel, so she’s about to go to Hawaii to celebrate her 30th wedding anniversary.

She’s also training for the 2024 Transplant Games of America, where she plans to take part in the 5K walk and 5K bike ride.

It’s a way to honor her heart donor, a 32-year-old woman, and to “protect this beautiful gift that she’s given me — to exercise and to eat right so that I can show my appreciation,” Johnson says.

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The unnamed woman, who is in her 20s, underwent the procedure in 2020 due to complications with her pregnancy and the patient’s “elevated maternal body mass,” according to the report, which was released on Monday by New Zealand’s Health and Disability Commissioner, Morag McDowell.

The woman complained of severe chronic pain for months after the birth of her child, and doctors eventually discovered that an Alexis wound retractor — a round, soft tubular device used to draw back the edges of a wound during surgery — had been accidentally left inside her during the operation.

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“She pretty much said, ‘You’re having a baby in about a month, and things are moving around. Things are a little different in your body because you’re about to give birth,’” Spill, 31, of Bradley Beach, New Jersey, tells TODAY.com. “That made sense to me.” 

The symptoms continued for about eight months and worsened. Doctors kept telling her that her bowel habits had changed because she recently gave birth. Finally, a doctor ordered a colonoscopy, and she learned what was behind her symptoms. Spill, then 28, had stage 3 colorectal cancer.

“I felt very exhausted, and it made me second-guess what I was actually feeling because I was being brushed off,” she says. “When you don’t have someone listening to you, it’s really, really hard to continue to keep going.”

Pregnancy and bowel changes

While Spill’s doctor told her the symptoms were likely due to being pregnant, she became worried when they persisted and progressed, especially after she gave birth.

“I still was majorly constipated. I still had blood in my stool, and it was a dark, sticky type of blood, not bright red,” she says. “I always feel weird saying this, but I know it’s important to say that it had a weird smell to it.”

When she visited her doctor for her postpartum checkup, she detailed her symptoms.

“They pretty much said they’re 99.9% positive its internal hemorrhoids,” she recalls. “That sounded right to me as a new mom.”

Her doctor recommended that Spill visit her primary care physician if the symptoms persisted. Spill and her partner were in the middle of moving from California to New Jersey, but she visited her primary care doctor before leaving. He, too, thought it was internal hemorrhoids and ordered blood work, which came back normal.

“I was very stressed about moving back to the East Coast, and I was like, ‘You know what? It seems like it’s just internal hemorrhoids. I’m just going to put my health aside right now and focus on my child, focus on moving,’” Spill recalls. “That’s exactly what I did.”

When her son was 5 months old, Spill began experiencing new, worrying symptoms.

“I was experiencing loss of appetite. I’d be really, really hungry, and then I would want something, I would take a bite and I wouldn’t be hungry anymore,” she says, adding she lost 7 pounds. “That became alarming.”

Spill struggled to work because she experienced fatigue and just didn’t feel well. One day, when she used the bathroom, she felt stunned by what she saw.

“There was a pool of blood in the toilet,” she says. “That’s when I was like, ‘Something’s not right.’”  

Spill and her mom went to the emergency room, where a doctor again told her she had internal hemorrhoids.

“He told me to lay off the spicy foods,” she says. “(I felt) like I was brushed off.”

She got into a new family clinic, and doctors again suspected hemorrhoids. But this time, she met someone who made a huge difference in Spill’s search for a diagnosis.  

“(The nurse) said to me, ‘I just want to say one thing: If you don’t find your answer here, keep searching. Keep going. You know your body best,’” Spill says. “That is something that has stuck with me from that day.”

Spill told friends and family about what she was feeling, and then a friend’s mom suggested another primary care doctor. All this time, Spill had been taking photos of what was in the toilet and showed the new doctor.

“She was like, ‘Oh, you need to get a colonoscopy, don’t you?’ And I said, ‘Yes, 100% I need a colonoscopy,’” Spill says.

Soon she met with a gastrointestinal doctor and received a colonoscopy the next day.

“I found out that I had a tumor,” she says. “It was a very weird feeling because I knew at that point something wasn’t right. I knew it wasn’t going to be good. But I didn’t get upset until I left that room.”

She broke down in the parking lot and cried. Soon, she learned it was stage 3 colorectal cancer. Doctors gave her time to preserve her eggs because she and her partner hoped to have another child, and chemotherapy and radiation would likely impact her fertility. At the time, she and her partner were engaged and planning to get married in Switzerland.

“I remember asking the doctor … ‘Can I at least go to Switzerland this summer and get married?’” she says. “He basically was like, ‘Absolutely not.’”

As she prepared for treatment, a research nurse approached her about a clinical trial. If Spill opted to do it and it shrunk her tumor, she could skip surgery, chemotherapy and radiation. If it didn’t work, Spill would have to go through traditional treatment. She opted for the clinical trial for an immunotherapy drug. With cancer, immunotherapy activates the immune system to fight the cancer.

“I didn’t know that I was only the fourth person in the country on the drug,” she says. “I knew the side effects and knew that it sounded a lot better than chemotherapy, radiation and surgery.”

Immunotherapy for colorectal cancer

In some colorectal cancers, the tumor has a genetic mutation called a mismatch repair deficiency, and immunotherapy works well in treating those cancers, Dr. Andrea Cercek, medical oncologist at Memorial Sloan Kettering Cancer Center, says. Researchers wondered if immunotherapy could replace the traditional standard of care — surgery, radiation and chemotherapy — for these types of colorectal cancers up to stage 3.

“We didn’t take away any treatment (from these patients), but we started with immunotherapy,” Cercek, a Stand Up To Cancer Colorectal Cancer Dream Team investigator, tells TODAY.com.

For the study, which is ongoing, patients receive the medication, called dostarlimab, via infusion every three weeks for six months. Dostarlimab is already used in stage 4 colorectal cancer and other cancers, so the researchers had prior data on safety and dosing. After a patient completes therapy, doctors perform an MRI of the rectum and an endoscope to see if the tumor has shrunk.

“If the tumor was completely gone by the endoscopy, as well as the MRI, then the patients had what we call a clinical complete response, meaning that there’s no sign of the tumor,” Cercek says. “We are able to follow them really closely every four months with some evaluation.” 

The study has enrolled 42 patients. A global study with the same design is also ongoing. If the trials are successful, the treatment could be transformative for colorectal cancer patients with this mutation. 

“We can spare patients the toxicity of the radiation and … surgery, which is a big deal,” Cercek says. “If the patient needs surgery, about a third of them end up needing a permanent colostomy bag, and it can really change people’s quality of life.”

It’s not yet clear how often the immunotherapy drug prevents recurrence of cancer and whether it can be effectively taken more than once, according to Cercek. Any patients in the trial whose cancer returns would receive the traditional treatment, she adds.

‘Best day of my life’

After Spill’s second infusion, she noticed a difference.

“I felt great,” she says. “I ended up being able to go to the bathroom. So, it seemed like the tumor was shrinking.”

By her fourth treatment, her tumor had shrunk by half.  

“By my ninth treatment, the tumor had completely disappeared, which was probably the best day of my life,” she says.

Every six months, Spill undergoes screening, including a PET scan, an MRI and a sigmoidoscopy.

“I’ve been feeling amazing,” she says.

What’s more, she was able to get pregnant, and she gave birth to a daughter, Maya Grace, on July 14. Thinking about having another child kept her motivated as she struggled to be diagnosed and throughout treatment.

“I had a chance to bring another life into the world, and it’s been very humbling,” she says. “I feel so grateful for every opportunity that comes my way.”

Having cancer caused her to reflect on who she is and what she wants.

“I (joined) a leadership program to learn more about myself,” she says. “I’ve been on a big finding-myself journey for a long time now, and cancer has really pushed it along for me.”

She participated in the recent Stand Up To Cancer telecast because she’s experienced the power of new cancer research firsthand. Spill hopes her story encourages others to speak up when they don’t feel right.  

“Go with your gut when you feel something is up with your body,” she says. “Really advocate for yourself, continue to push.”

This story first appeared on TODAY.com. More from TODAY:

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A James family spokesperson released a statement saying a congenital heart defect likely led to the USC basketball freshman collapsing during a July 24 practice at the Trojans’ Galen Center.

The diagnosis was made after an initial evaluation at Cedars-Sinai Medical Center in Los Angeles and follow-up visits to the Mayo Clinic and New Jersey’s Atlantic Health/Morristown Medical Center.

The defect is “anatomically and functionally significant” but one that “can and will be treated,” the statement said. The James family is confident Bronny will make a full recovery and return to the court in the “very near future.”

So what exactly is a congenital heart defect? Here’s what to know.

What is the definition of a congenital heart defect?

A congenital heart defect (CHD) is the most common type of birth defect and can “affect the structure of a baby’s heart and the way it works,” according to the CDC. CHDs can range from mild cases like a small hole in the heart to severe ones like missing or poorly formed parts of the heart, per the CDC.

CHDs are present at birth and can even be detected as early as during pregnancy, though there are instances where they go undiagnosed until adulthood.

There are an estimated two million-plus individuals in the United States living with CHD, according to the CDC.

What are the different types of congenital heart defects?

There are several different types of CHDs, with some being classified as critical. About 25 percent of babies born with a heart defect have a critical CHD, which requires surgery or other procedures within the first year of life, according to the CDC.

Here are the different types of CHDs that the Mayo Clinic lists:

• Atrial septal defect (ASD)
• Atrioventricular canal defect
• Coarctation of the aorta
• Congenital heart defects in children
• Congenital mitral valve anomalies
• Double-outlet right ventricle
• Ebstein anomaly
• Eisenmenger syndrome
• Hypoplastic left heart syndrome
• Long QT syndrome
• Partial anomalous pulmonary venous return
• Patent ductus arteriosus (PDA)
• Patent foramen ovale
• Pulmonary atresia
• Pulmonary atresia with intact ventricular septum
• Pulmonary atresia with ventricular septal defect
• Pulmonary valve stenosis
• Tetralogy of Fallot
• Total anomalous pulmonary venous return (TAPVR)
• Transposition of the great arteries
• Tricuspid atresia
• Truncus arteriosus
• Vascular rings
• Ventricular septal defect (VSD)
• Wolff-Parkinson-White (WPW) syndrome

It has not been revealed which type of CHD James was diagnosed with.

What causes congenital heart defects?

The causes of most CHDs are unknown, though some are inherited.

What are the symptoms of congenital heart defects?

The Mayo Clinic says common CHD symptoms in adults include:

• Irregular heart rhythms (arrhythmias)
• Blue skin, lips and fingernails (cyanosis)
• Shortness of breath
• Feeling tired very quickly with activity
• Swelling of body tissue or organs (edema)

What is the treatment for congenital heart defects?

Treatment for adults with CHDs can include regular checkups, medications or surgeries, according to the Mayo Clinic.

There are complications that can arise even well after a CHD has been treated, such as irregular heartbeats (arrhythmias), heart infection (endocarditis), stroke, high blood pressure in the lung arteries (pulmonary hypertension) and heart failure, according to the Mayo Clinic.

What athletes have congenital heart defects?

James isn’t the first notable athlete with a CHD. Former USWNT midfielder/forward Lauren Holiday underwent open-heart surgery at the age of 3 to repair an atrial septal defect, while legendary snowboarder/skateboarder Shaun White had two open-heart surgeries before he turned 1 to treat tetralogy of fallot.

In 2005, New England Patriots three-time Super Bowl champion linebacker Tedy Bruschi suffered a stroke caused by a previously undiagnosed patent foramen ovale. Bruschi underwent a procedure to repair the defect and was back on the field later that same year.

Two of the cases involve individuals who visited the Caesars Palace Hotel and Casino within the last 12 months, and the other is a recent guest of The Orleans Hotel & Casino. All three cases are travel-associated, according to the Health District.

Environmental samples taken from both properties tested positive for Legionella, the Health District said.

A remediation of Caesars Palace’s water system has since been performed and the most recent environmental testing did not detect Legionella. The Orleans, meanwhile, is “undergoing remediation and environmental testing to ensure elimination of the bacteria,” according to the Health District.

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Steps to notify guests at both hotels of the potential for exposure, along with ways to minimize risk of exposure, are underway.

Earlier this year, there were two other cases of the disease reported in individuals who stayed at The Orleans, prompting a remediation of the property’s water system. The Health District said Legionella bacteria was not detected in post-remediation testing.

According to the CDC, Legionnaires’ disease is “a serious type of pneumonia caused by Legionella bacteria.” The disease can be contracted by breathing in small droplets of water or swallowing water containing Legionella.

Symptoms of the disease will typically begin two to 10 days after exposure to the bacteria, according to the Health District. Recent guests of the hotels are directed to watch out for symptoms such as coughing, shortness of breath, fever, muscle aches and headaches for up to two weeks after exposure.

If guests who stayed at either property more than two weeks ago have not developed symptoms, they are not at risk for the disease, the Health District said. Guests who develop symptoms within two weeks of their stay are instructed to seek medical attention and alert their medical provider of the potential exposure.

Any individuals who stayed at Casers Palace or The Orleans dating back to Aug. 1, 2023, and have developed symptoms can report their illness to the Health District via an online survey.

Here’s what you should know:

How does it spread?

Legionella bacteria spread when someone inhales tiny droplets of contaminated water, commonly found in hot tubs, industrial air conditioning systems, and even drinking water.

Outbreaks often occur in large and complex water systems found in places like hotels, hospitals, and cruise ships.

The bacteria can also survive and spread in soil, occasionally causing infections when people garden using contaminated soil. 

However, in most cases, people do not transmit Legionnaires’ disease or Pontiac fever to others.

What are the symptoms?

Symptoms of Legionnaires disease typically appear between two to 10 days after exposure to the bacteria and can include: 

• Headache
• Muscle aches
• Shortness of breath
• Cough
• Fever 

Who is at higher risk?

Those most susceptible to Legionnaires’ disease include adults over 50, individuals with weakened immune systems, and smokers.

Can it be treated?

Antibiotics are used to treat Legionnaires’ disease, though it often requires hospitalization. 

Anyone suspecting exposure to Legionella or experiencing symptoms of Legionella disease or pneumonia should promptly contact a doctor. It’s important to mention any exposure to Legionella, hot tub use, recent travels, or hospital stays in the past two weeks.

For more information on Legionnaires’ disease, visit the CDC website.

The amino acid can be found naturally in animal products and byproducts like beef, shellfish and dairy. It is often an ingredient in popular energy drinks.

Though taurine levels naturally decline as you age, new research suggests that supplementing taurine may slow down, or reverse, aging in older animals like worms, mice and monkeys.

A research paper, published this June in the journal Science, found that daily supplements of taurine increased the lifespan of mice and worms by at least 10%. 

Not only did the animals live longer, they got healthier. 

The mice, specifically, were 14 months old at the start of the experiment. That age is equivalent to that of a 45-year-old human. Mice that received taurine supplements each day lived 10% to 12% longer than mice that didn’t. 

Additionally, they “were leaner, had an increased energy expenditure, increased bone density, improved memory and a younger-looking immune system,” Dr. Vijay Yadav, a researcher involved in the study, told BBC News.

Researchers also tested the supplement on 15-year-old monkeys for six months, but the study didn’t track the animals long enough to determine if they lived longer. Still, the scientists noticed very positive changes to the monkeys’ immune systems, blood-sugar levels, weight and bone health, according to BBC News.

‘We need to confirm in humans’

Despite the groundbreaking results, Yadav isn’t suggesting that people take taurine supplements just yet. “Let us wait for the clinical trials to be completed before recommending to the wider population that they go to the shelf in a grocery store and buy taurine,” he told BBC News.

Yadav declined to confirm or deny if he takes taurine supplements himself, to avoid encouraging people to use them before in-depth research on humans is conducted, according to the publication.

“We need to confirm in humans. This was a mouse trial,” says Neil Paulvin, a NY-based longevity and regenerative medicine doctor.

Though Paulvin takes taurine supplements daily and recommends it to his clients, he strongly suggests speaking to your doctor before taking any supplement, especially if you have certain medical conditions.

“We also need to make sure, longer term, if there are any side effects, which is not likely because this is an amino acid that we’re exposed to in food all the time. But [we still need to] make sure there aren’t any long-term side effects with these doses.”

Before turning to supplements, consider implementing the tried-and-true practices for longevity that research strongly supports, says Paulvin.

“The best anti-aging supplement is exercise, especially high-intensity exercise with weights, three times a week,” he says. “Optimizing your sleep and your circadian rhythm [too].”

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The “From Dusk till Dawn” actor has been sober for more than five decades, the 79-year-old shared on Instagram Aug. 23.

“I’m 55 years clean and sober today by the grace of God!” he captioned a smiling photo of himself. “I’ve done this one day at a time, and for anyone out there struggling YOU CAN TOO!”

The Trejo’s Tacos owner has given extensive insight into his sobriety journey over the years, recounting how he used alcohol and drugs from a young age. Trejo attended his first 12-step meeting, a substance abuse recovery program, at just 15 years old, he told Variety in 2019.

“They tell you if you leave [Alcoholics Anonymous or Narcotics Anonymous], you will die, go insane or go to jail,” Trejo says. “And I proved that right. Every time I left, I went to jail.”

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However, his life took a turn when a former inmate visited San Quentin State Prison, the correction facility where Trejo served time in the ’60s.

“That guy saved my life,” Trejo recalled. “He said, ‘Why don’t you join us? Before you do anything, just join us. Give it a try. What do you have to lose?’ It was kind of like an awakening. So when I got out of the joint, I went back to meetings.”

Nearly 20 years after getting clean, he kicked off his Hollywood career, eventually starring in Machete, Desperado, Heat and more.

Reflecting on his sobriety anniversary date, Trejo told Variety in 2021, “Everything from Aug. 23, 1968 to now is just like a dream.”

“I’ve got nothing to complain about,” he added. “I’ve got nothing to fix.”

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Health officials said that three human cases of West Nile virus have been reported in New York City.

The city stated Wednesday night that two people from Queens and a third in Manhattan were found to have the mosquito-spread illness.

All three of those infected had to go to the hospital, and two of them have already been discharged. There is also a fourth possible case under investigation on Staten Island.

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“We are working to prevent West Nile virus as much as possible through public education, treating marshy areas and spraying for mosquitoes,” said Health Commissioner Dr. Ashwin Vasan. “As New Yorkers, we can take some simple precautions to lower our risk. For example, use an EPA registered insect repellent, especially when outside at dusk and dawn when the types of mosquitoes that transmit West Nile Virus are most active. In addition, you can stop mosquitoes from laying eggs in the water by emptying outdoor containers that hold water or calling 311 if you see standing water that you cannot empty.

The city plans to have trucks spraying against mosquitoes Thursday night in parts of Queens, starting at 8:30 p.m., weather permitting.

Mosquitoes infected with West Nile virus are typically present in the city from May through October, officials said, with peak activity in August and September. The virus was first detected in the city more than two decades ago, with a little over a dozen people getting diagnosed each year on average.

Throughout the five boroughs, there were a total of 569 mosquito pools that tested positive for West Nile virus, according to the city. That compares to more than 1,000 of those pools at the same time in 2022.

It comes after a woman in Connecticut was found to have West Nile virus in the third week of July, the first-known case in that state in 2023.

Symptoms of West Nile virus

The city’s Department of Health and Mental Hygiene said that most people infected with West Nile virus don’t experience any symptoms at all. Some may develop symptoms including:

• Headaches
• Muscle aches
• Rashes
• Extreme fatigue

The majority of those who get infected fully recover, though some can experience problems months afterward. A small number of people (about 1 in 150), particularly those over 60 years old or with weakened immune systems, can develop a serious or even potentially deadly illness of the brain and spinal cord called West Nile neuroinvasive disease, health officials said, which can lead to changes in mental status and muscle weakness that requires hospitalization.

New Jersey will require school districts to offer free menstrual products for grades six through 12 under a new law Gov. Phil Murphy signed Wednesday.

Murphy, a Democrat, said in a statement that the measure is aimed at promoting equity “at every level” in the state.

“When students can’t access the menstrual products they need for their reproductive health, the potential stress and stigma too often distracts them from their classes or forces them to skip school entirely,” he said.

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Under the bill, school districts are required to ensure that students in schools with students from grade six through 12 have access to free menstrual products in at least half of the female and gender-neutral bathrooms.

The state will bear any costs incurred by schools under the legislation. The legislature’s nonpartisan Office of Legislative Services estimated the requirement will cost between $1.8 million and $3.5 million for the first full school year and from $1.4 million to $2.9 million in subsequent years. The cost is a fraction of the state’s $54.3 billion budget.

The requirement will affect about 1,400 schools. Total enrollment of female students in grades six through 12 in these schools approximated 354,497, according to the Legislature.

New Jersey joins at least 10 other states and the District of Columbia that have established or expanded requirements for free menstrual products in schools since 2010, according to the National Conference of State Legislatures. Among the states that passed similar measures recently include Alabama, Delaware and Utah.

The bill passed the Democrat-led Legislature nearly unanimously, with only one “no” vote.

“Menstrual hygiene products are a necessity, not a luxury. When this becomes an obstacle and decisions are made to not attend school, the loss is greater than just the one day,” Senate Majority Leader Teresa Ruiz said.

The Food and Drug Administration on Monday approved a vaccine from Pfizer that protects infants from respiratory syncytial virus, the leading cause of hospitalization among babies in the U.S.

Pfizer’s RSV shot is already approved and available in the U.S. for older adults.

It’s now the second treatment approved by the FDA to prevent RSV in infants and the first vaccine. It uses maternal immunization, which refers to vaccinating pregnant mothers so they can pass protective antibodies to their fetuses.

Pending a recommendation by the Centers for Disease Control and Prevention, Pfizer hopes the vaccine will be available to the public by the end of October or the beginning of November, which marks the beginning of RSV season, according to Alejandra Gurtman, the company’s senior vice president of clinical research and development for vaccines. 

“When you think globally, this vaccine could potentially have a huge public health impact,” Gurtman told CNBC. “After 50 years of trying to find a way where we can protect babies during the first three or especially six months of life, this vaccine is something I’m very proud of.” 

Dr. Peter Marks, the FDA’s vaccine head, added in a release that the approval provides another option for health care providers and pregnant individuals to “protect infants from this potentially life-threatening disease.”

The FDA in mid-July approved an RSV monoclonal antibody from Sanofi and AstraZeneca that is directly administered to infants. The CDC recommended that drug to all infants under eight months of age and some older babies.  

The agency’s panel of advisors is expected to meet and consider a recommendation for Pfizer’s vaccine in October, but it’s unclear how it will compare to the guidelines set for the first treatment since it isn’t given to infants.

Pfizer’s jab is specifically administered to expectant mothers in the late second or third trimester of their pregnancy. The single-dose vaccine triggers antibodies that are passed to the fetus, which provides it with protection against RSV from birth through the first six months of life.

RSV usually causes mild, cold-like symptoms. But younger children and older adults are particularly vulnerable to more severe RSV infections. 

Each year, the virus kills a few hundred children younger than 5, and 6,000 to 10,000 seniors, according to the CDC. 

The shot would help the U.S. combat the upcoming RSV season as it comes off an unusually severe year. 

Cases of the virus in children and older adults overwhelmed hospitals across the country, largely because the public stopped practicing Covid pandemic health measures that had helped contain the spread of RSV. 

Safety and efficacy data

The FDA’s approval of Pfizer’s vaccine was based on data from a phase three trial, which found that the shot was nearly 82% effective at preventing severe disease from RSV in newborns during the first 90 days of life. 

The vaccine was also about 70% effective during the first six months of the baby’s life.

In May, the FDA’s panel of advisors unanimously said the data showed Pfizer’s vaccine was effective. 

But some advisors expressed concerns about safety. 

A slightly higher number of premature births occurred among mothers who took the shot compared to those who received a placebo: 5.7% versus 4.7%, respectively. 

The FDA, following the approval Monday, said the available data “are insufficient to establish or exclude a causal relationship between preterm birth” and Pfizer’s vaccine.

Pfizer’s Gurtman also said the difference in premature birth rates was “not statistically significant.”

She noted that most premature births occurred 30 days after vaccination, which means “a very close causal relationship between the vaccine and preterm birth couldn’t be identified.” 

“We couldn’t find any reason why this really happened,” Gurtman said. 

She added that some upper middle-income countries, including the U.S. and Japan, didn’t see a higher rate of premature births in mothers who took the vaccine. 

Still, Gurtman said Pfizer is going to examine the risks in a post-marketing study on the vaccine. “Post-marketing” refers to research conducted on a product after it receives FDA approval.

The company’s post-marketing will also involve evaluating any pregnancy-related complications following vaccination, she added. That includes eclampsia, which refers to seizures that develop during pregnancy or shortly after birth. 

Pfizer will launch a pregnancy registry that will allow women and obstetricians to call and report any adverse events after receiving the vaccine, according to Gurtman.

Vibrio vulnificus, a dangerous strain of the vibrio bacteria that can lead to infections that can cause skin breakdown and ulcers, was confirmed in five deaths in the Tampa area, the Florida Department of Health said.

Three other deaths have been reported in other states this year, including one in New York and two in Connecticut.

Vibrio vulnificus is a naturally occurring bacteria in warm, brackish seawater. It requires salt, and can enter through fresh cuts and scrapes, the Department of Health said.

It can also cause disease in people who eat contaminated seafood.

Infections caused by the Vibrio vulnificus strain are rare and more serious than most others. There are about 100 to 200 cases reported in the U.S. every year, according to the Cleveland Clinic.

While most who contract vibrosis will recover in about three or so days with no long-term effects, a small percentage of those who get it require intensive care or even amputation, the U.S. Centers for Disease Control and Prevention said.

Florida reported 17 deaths and 74 cases in 2022, but those numbers were abnormally high due to the impacts of Hurricane Ian, the health department said.

The four cases are the first to be identified in the state this year. 

Two men who are 60 years old and up from Middlesex County and Litchfield County became ill in early July.

Two women who are 50 years old and up from Windham and Litchfield counties became ill in late July. The woman from Windham County lives in Brooklyn, according to the Northeast District Department of Health.

All patients reported having a tick bite and were hospitalized with a central nervous system disease. They have been discharged and are recovering.

The state Department of Health said lab tests performed at the Centers for Disease Control and Prevention Laboratory in Ft. Collins, CO, confirmed the presence of antibodies to POWV for all patients.

“The identification of four Connecticut residents with Powassan virus-associated illness emphasizes the importance of taking actions to protect yourself from tick bites from now through the late fall,” Department of Public Health Commissioner Manisha Juthani, MD, said in a statement. “Using insect repellent, avoiding areas where ticks are likely, and checking carefully for ticks after being outside can reduce the chance of you or your children being infected with this virus.”

As of Aug. 15, there were 11 cases of Powassan virus in the United States, according to the CDC.

• Maine: 3 cases
• Massachusetts: 3 cases
• New York: 2 cases
• New Hampshire: 1 case
• Pennsylvania: 1 case
• Minnesota: 1 case

Cases of Powassan virus in Connecticut

From 2016 to 2022, there were 19 cases of Powassan virus-associated illness in Connecticut, including six in 2022 and two of the infections were fatal last year.

How Powassan virus is spread

Powassan virus is spread to people through the bite of an infected blacklegged or deer tick.

It takes from one week to one month after the bite of an infected tick to develop symptoms of Powassan virus disease, and the virus can be transmitted in as little as 15 minutes after the tick first attaches. Powassan virus-associated illness has been reported from early spring until late fall.

Symptoms of Powassan virus

While most people infected with POWV likely experience no symptoms or a mild flu-like illness, some people will develop severe illness affecting the central nervous system.

About one out of 10 cases of severe illness are fatal and approximately half of survivors experience long-term health problems.

Severe cases may begin with fever, vomiting, headache, or weakness and rapidly progress to confusion, loss of coordination, difficulty speaking, or seizures.

There is no vaccine nor a specific treatment for POWV-associated illness.  Severe illness is treated by supportive therapy which may include hospitalization, respiratory support, and hydration.

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Tips for preventing tick bites

The state Department of Public Health offers these tips for preventing tick bites.

• Avoid areas where ticks are likely to be, such as in grassy, brushy, or wooded areas. Ticks are active from spring to fall and may also be active on warmer days during winter.
• Consider the use of CDC-recommended mosquito/tick repellents, containing DEET, picaridin, oil of lemon eucalyptus, IR3535, or 2-undecanone, and apply according to directions, when outdoors. However, repellents containing >30% DEET have been reported to be the most effective.
• Check yourself, your children, and your pet animals for ticks immediately after coming indoors. Showering within two hours of coming indoors may be effective in reducing the risk of tick-borne disease.
• Examine clothing and gear carefully after coming indoors. Tumble dry clothing in a dryer on high heat for at least 10 minutes to kill ticks that were carried inside.
• Talk to your veterinarian about the best tick-prevention products for your dog.
• Consider treating items such as boots, clothing, and hiking or camping gear with products containing 0.5 percent permethrin.

Dogs and ticks

The Northeast District Department of Health warns that dogs are quite susceptible to tick bites and tickborne diseases and vaccines aren’t available for most of the tickborne diseases that dogs can get, and they don’t keep the dogs from bringing ticks into your home.

The department urges dog owners to use a tick-prevention product on your dog.

They also said tick bites on dogs may be hard to detect and signs of tickborne disease may not appear for a week to three weeks or longer after a tick bite, so watch your dog closely for changes in behavior or appetite if you suspect that your pet has been bitten by a tick.

Levonorgestrel, often called Plan B, is the most widely available type of emergency contraception. It works by preventing or delaying ovulation.

Scientists estimate that it is about 95% effective when taken within a day after unprotected sex, dropping to 58% or lower within three days. The new study, published by the medical journal Lancet, suggests levonorgestrel can remain highly effective up to three days after unprotected sex when it is taken with piroxicam, an anti-inflammatory pain medication typically prescribed for arthritis.

“It’s really exciting and very timely that we could have a more effective emergency contraceptive option,” said Kelly Cleland, executive director for the American Society for Emergency Contraception, who was not part of the Lancet study.

Scientists tracked 836 women at a Hong Kong clinic between 2018 and 2022 who had unprotected sex and requested emergency contraception within three days. Half the women received a dose of levonorgestrel and piroxicam while the other half got the contraceptive pill plus a placebo.

Doctors calculated that 95% of pregnancies among the women who got the combination with piroxicam were prevented, compared with 63% of those who got the placebo combination.

The most common side effects in both groups were fatigue, nausea, abdominal pain, dizziness and headache. No funding was provided for the study. The researchers used a Hong Kong brand of the contraceptive that it is sold over-the-counter in the U.S. under several names, including Plan B One-Step.

The authors acknowledged that because the research was done in mostly Asian women weighing less than 70 kilograms (154 pounds), it was unclear if the results could be extrapolated to other populations. There is some evidence levonorgestrel doesn’t work as well in heavier women.

Piroxicam is in the same class of anti-inflammatories as ibuprofen and paracetamol. It requires a prescription in many countries, including the U.S. and the U.K.

“It’s fascinating that they found this already existing medication really increases the efficacy of Plan B,” said Dr. Beverly Gray, a Duke University associate professor of obstetrics and gynecology who was not part of the new study. “But any medication that requires a prescription is going to be one more barrier, so what we really need is an over-the-counter medication that people can use in conjunction with Plan B.”

Dr. Kristina Gemzell Danielsson, head of Women and Children’s Health at Sweden’s Karolinska Institute and one of the Lancet study authors, said similar anti-inflammatory drugs could have the same effect. She said there would be no risk to women who took over-the-counter ibuprofen with Plan B, though it might not prove as effective as longer-acting piroxicam.

Piroxicam can cause bleeding in the stomach or severe skin reactions and increases the risk of heart or kidney disease in people susceptible to those conditions. Still, experts said using the drug once would be less likely to cause harm, particularly for the mostly younger women who would be most likely to use emergency contraception.

Gemzell-Danielsson said further studies could examine whether anti-inflammatories boost the effectiveness of the other main emergency contraceptive pill, ellaOne.

She recommended that women keep some form of emergency contraception at home, especially in places with highly restrictive abortion policies.

“It is a simple, effective and really smart solution to have,” Gemzell-Danielsson said. “You don’t buy (Band-Aids) because you plan to cut yourself, but you have it because you think it might happen.”

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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.

Gov. Kathy Hochul said Wednesday that vibrosis, a bacterial infection that can cause skin breakdown and ulcers, was found in an individual in Suffolk County who had recently died. That individual, a man from Brookhaven over the age of 55, had a leg wound and an underlying health condition before his death in early July.

Officials said that the man, who has not been identified, had a wound on his leg that wasn’t healing. Once the bacteria got into his bloodstream, the man began experiencing chest pains and died after several days. It was not clear where the man went into the water and likely contracted the bacterial infection.

The state added that two fatal cases have also been identified in Connecticut recently. Doctors there said the two were infected with the bacteria after swimming in the Long Island Sound. A third case stemmed from a person who ate raw oysters outside of the state.

“While rare, the vibrio bacteria has unfortunately made it to this region and can be extraordinarily dangerous,” Hochul said. “As we investigate further, it is critical that all New Yorkers stay vigilant and take responsible precautions to keep themselves and their loved ones safe.”

The governor and State Health Commissioner Dr. James McDonald said that the best ways to avoid potential vibriosis infections is to protect open wounds from seawater, particularly warm seawater, as well as for those with compromised immune systems to avoid raw or undercooked shellfish, which could carry the bacteria.

“While we continue to investigate the source of this rare infection, it is important for residents to remain aware and vigilant on precautions that can be taken. As always, if any residents have health concerns we encourage them to contact their health care provider,” said Suffolk County Executive Steve Bellone.

What is vibriosis?

According to the Centers for Disease Control and Prevention, the vibrio bacteria naturally live in coastal waters, and are more common during warm weather months between May and October. The most common way people contract the bacteria is by eating raw or undercooked shellfish, particularly oysters.

Some species of vibrio can cause a rash or skin infection when exposed to salt water or brackish water (mixture of fresh and salt water). The CDC said that those with chronic liver disease are most at risk to contract the bacteria infection.

About 80,000 cases are found each year in the U.S., the CDC says, with more than half a result of consuming contaminated food. Vibrosis is responsible for about 100 deaths each year, according to the CDC.

There are several different species of vibrio bacteria, with the one tied to the infection of the person who died on Long Island identified as vibrio vulnificus, a particularly dangerous strain, officials said. There are vibriosis cases reported every year in Suffolk County, but there hadn’t been any deadly ones until now.

Symptoms and treatment

While most who contract vibrosis will recover in about three or so days with no long-term effects, a small percentage of those who get it require intensive care or even amputation, the CDC states.

The New York Department of Health said that the bacteria can cause skin breakdown and ulcers, and said that health care providers should consider vibrosis when diagnosing wound infections or sepsis of unknown origins.

For those who get vibrosis from consuming contaminated food, symptoms can include diarrhea, stomach cramps, vomiting, fever and chills, according to the state health department. Exposure can also lead to ear infections.