<![CDATA[NBC New York - Health News - [NY Feature Page] Health]]>Copyright 2019http://www.nbcnewyork.com/news/healthen-usTue, 15 Jan 2019 22:36:27 -0500Tue, 15 Jan 2019 22:36:27 -0500NBC Local Integrated Media<![CDATA[Good Luck Making Sense of Your Hospital's Price List]]>Tue, 15 Jan 2019 20:45:15 -0500https://media.nbcnewyork.com/images/213*120/hospGettyImages-906006634.jpg

Hospitals have posted the prices of their services, NBC News reported. Good luck making sense of them.

Since Jan. 1, hospitals across the country have been publishing price lists online to comply with a new Trump administration rule.

But the resulting documents, which can include as many as 60,000 items, are hard to decipher, with descriptions like “ABBOTT TECNIS TORIC ASPHERIC IOL ZCT300 21.0D SE 3.00 CYL.” and “FILL, PULL, VOID.” And if you're not a data analyst or a programmer, you might have trouble reading the files at all.



Photo Credit: Getty Images/Tetra images RF]]>
<![CDATA[FDA Resuming Some Food Inspections Halted by Shutdown]]>Tue, 15 Jan 2019 07:22:22 -0500https://media.nbcnewyork.com/images/213*120/992264322-Cheese-Production.jpg

The Food and Drug Administration said it will resume inspections of some of the riskiest foods such as cheeses, produce and infant formula as early as Tuesday.

The routine inspections had been briefly halted as a result of the partial government shutdown.

FDA Commissioner Scott Gottlieb said Monday that the agency is bringing back about 150 unpaid employees for the inspections. Riskier foods account for about a third of the agency's roughly 8,400 routine inspections each year.

Gottlieb told NBC News his staff put calls out to furloughed workers to gauge whether they would come back to work despite not getting paychecks.

"We got an overwhelming response from our very dedicated and mission-driven field force who are coming back to work unpaid," he said.

The FDA oversees packaged foods and produce. Meat, poultry and processed eggs are checked by the Department of Agriculture and have continued. States handle about half of the FDA's inspections and those haven't stopped. FDA inspections of imported foods and other core functions such as monitoring for food poisoning outbreaks have continued as well, the agency said.

The FDA is required to inspect facilities that handle high-risk foods once every three years, and once every five years for other foods.

Copyright Associated Press / NBC New York



Photo Credit: Daniel Acker/Bloomberg via Getty Images, File]]>
<![CDATA[Democrats Roll Out Big Healthcare Proposals at State Level]]>Sun, 13 Jan 2019 08:34:17 -0500https://media.nbcnewyork.com/images/201*120/GavinNewsomGovernor.jpg

Riding the momentum from November's elections, Democratic leaders in the states are wasting no time delivering on their biggest campaign promise — to expand access to health care and make it more affordable.

The first full week of state legislative sessions and swearings-in for governors saw a flurry of proposals.

In his initial actions, newly elected California Gov. Gavin Newsom announced plans to expand Medicaid to those in the country illegally up to age 26, implement a mandate that everyone buys insurance or face a fine, and consolidate the state's prescription drug purchases in the hope that it will dramatically lower costs.

Washington Gov. Jay Inslee proposed a public health insurance option for people who are not covered by Medicaid or private employers and have trouble affording policies on the private market.

Democrats in several states where they now control the legislature and governor's office, including New Mexico, are considering ways that people who are uninsured but make too much to qualify for Medicaid or other subsidized coverage can buy Medicaid policies.

And in the nation's most populous city, New York Mayor Bill de Blasio announced a publicly run plan to link the uninsured, who already receive treatment in city hospitals, with primary care.

It's all in keeping with the main theme Democratic candidates promoted on the campaign trail in 2018.

They touted the benefits of former President Barack Obama's health overhaul — such as protections for people with pre-existing conditions, allowing young adults to remain on their parents' health insurance policies and expanded coverage options for lower-income Americans. At the same time, they painted Republicans as seeking to eliminate or greatly reduce health care options and protections.

"Once you give something to somebody, it's pretty hard to take it away, and I think we see that with how the support for the (Affordable Care Act) has grown over the last two years," said Washington House Rep. Eileen Cody, who is leading the state's public option proposal.

The actions also represent a pushback to steps taken by the Trump administration and congressional Republicans to undermine the Affordable Care Act.

The GOP tax law stripped away the individual mandate, which was intended to stabilize insurance markets by encouraging younger and healthier people to buy policies. And last summer, the Trump administration said it would freeze payments under an "Obamacare" program that protects insurers with sicker patients from financial losses. That move is expected to contribute to higher premiums.

The Democratic proposals fall short of providing universal health care, a goal of many Democrats but also an elusive one because of its cost. In recent years, California, Colorado and Vermont have all considered and then abandoned attempts to create state-run health care systems.

Still, many Democrats are eager to take steps that get them closer to that.

"This is not just a moral right," Inslee said in announcing his public option proposal this past week. "It is an economic wisdom, and this is very possible."

Some lawmakers in Colorado, where Democrats now control the legislature and the governor's office, are proposing a state-run health insurance plan similar to that announced by Inlsee. It would reach those who don't qualify for federal assistance or who live in rural areas with few health care choices.

Both states plan to rely on their agencies that administer Medicaid, the state-federal program that provides health coverage for roughly one-in-five Americans. Republicans are skeptical about whether the states can afford it, since they already pick up a portion of Medicaid costs.

"This is about having the government competing in the private market. Medicare-for-all will be priced out," Washington state Rep. Joe Schmick said.

Taking incremental steps to increase coverage options and make health care more affordable may be a smarter strategy than pursuing a costly and complicated all-or-nothing proposal for universal coverage, said Katherine Hempstead, senior policy adviser at the Robert Wood Johnson Foundation.

"Everybody wants to pay less for health care," she said.

Democrats now have more leverage to experiment. Campaign messaging around health care helped them flip seven governor's seats to bolster their numbers to 23 across the country and win back several state legislative chambers. They gained full control of state government in several states, including New York and Nevada.

That power will allow them to consider health care expansions that Republicans have resisted.

In Nevada, for example, the state's Democratically controlled legislature passed a bill in 2017 that would have let anyone in the state buy into a Medicaid insurance plan, similar to the option being pushed in New Mexico. But former Gov. Brian Sandoval, a Republican, vetoed it.

The new governor, Democrat Steve Sisolak, is forming a committee to look at health care options, including the possibility of requiring everyone to have insurance. In addition to the California proposal, that mandate already is in place in Massachusetts and New Jersey, with Vermont following in 2020.

It's a similar dynamic in New Mexico, where Democratic lawmakers have talked for years about allowing people, including non-citizens, to buy into Medicaid if they cannot afford insurance any other way.

Colin Baillio, policy director for the advocacy group Health Action New Mexico, said a bill is being drafted with the goal of getting it adopted this year and implemented for 2020. The optimism comes because the new governor, Michelle Lujan Grisham, is a Democrat.

"Folks are going to need to have health care one way or another," he said. "We think health coverage is a good investment for our state."

Copyright Associated Press / NBC New York



Photo Credit: Rich Pedroncelli/AP]]>
<![CDATA[CDC Says It’s Another Severe Flu Season]]>Fri, 11 Jan 2019 14:31:05 -0500https://media.nbcnewyork.com/images/213*120/Giving_Flu_Shots_to_Thousands.jpg

Flu seasons have been particularly bad in recent years and this one in no different. 

An estimated 6.2 million to 7.3 million people in the United States have been sick with the flu since October, federal health officials said Friday. At least half of those people have sought medical care for their illness and 69,000 to 84,000 people have been hospitalized during the Oct. 1 to Jan. 5 period, the Centers for Disease Control and Prevention estimated. 

This is the first time the CDC has provided such flu estimates for the 2018-2019 season. The estimates are extrapolated from data from about 27 million people, or about 8.5 percent of the U.S. population, federal health officials said. 

While the numbers are milder than last season, the CDC’s “influenza like illness level” last week was elevated at 4.1 percent, almost twice national baseline. There were widespread flu outbreaks across 31 states, including New York, California and Florida, last week, the CDC said. It was widespread throughout almost every state during the same period last year. 

The CDC hasn’t released data on the total number of deaths so far this season, saying 16 influenza-associated pediatric deaths have been reported to the agency this season. Reports of flu-related mortality are starting to come in across the country. The Oklahoma State Department of Health has attributed 13 deaths there to the flu since Sept. 1, two of them since the new year. 

The City of El Paso Department of Public Health confirmed its first flu-related death Monday, a man in his 80s with other medical issues who hadn’t been vaccinated. The New Jersey Department of Health confirmed Tuesday that a child died of the flu, the first of the season, and said there were high levels of flu throughout the state. 

The flu season typically runs from October to as late as May, with activity tending to peak between December and February, according to the CDC. The agency recommends getting vaccinated early, ideally by the end of October, before the flu starts spreading. 

Babies older than 6 months should get vaccinated with a traditional shot. For toddlers age 2 or older a shot or a nasal spray called FluMist is recommended. 

The CDC also recommends that people with a flu-like illness should stay home for at least 24 hours after the fever is gone except to get medical care or for other necessities. 

Thirty-seven percent of U.S. adults were estimated to have been vaccinated last flu season, down 6 percentage points from the previous year, according to the CDC. It estimates that the flu killed more than 80,000 people and caused more than 900,000 hospitalizations last year.

—CNBC’s Angelica LaVito contributed to this report.

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

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<![CDATA[Starbucks Exploring Adding Needle-Disposal Boxes in Bathroom]]>Fri, 11 Jan 2019 05:43:37 -0500https://media.nbcnewyork.com/images/213*120/starbucksbathroomblack-background.jpg

Starbucks is exploring installing needle-disposal boxes in the bathrooms of certain stores to provide a safe way of throwing out syringes and other drug paraphernalia, NBC News reported.

The company's announcement comes after more than 3,000 people signed a petition on Coworker.org calling on the coffee giant to provide a safe way of disposing of needles used for drugs that are left inside bathrooms.

"These societal issues affect us all and can sometimes place our partners (employees) in scary situations," Starbucks said in a statement Thursday.

The company announced in May a new policy that allows anyone to sit in their restaurants or use their bathrooms, regardless of whether they make a purchase.

The online petition says, "Employees risk getting poked, and DO get poked, even when following 'protocol' of using gloves and tongs to dispose of used needles left in bathrooms, tampon disposal boxes, and diaper changing stations."



Photo Credit: Ken Faught/Toronto Star via Getty Images]]>
<![CDATA[NBC 4 New York & NY Giants Health & Fitness Expo]]>Thu, 07 May 2015 17:17:38 -0500https://media.nbcnewyork.com/images/225*120/300x160_HFE.jpg]]><![CDATA[US Drug Overdoses Rose Most Among Middle-Aged Women: CDC]]>Thu, 10 Jan 2019 18:16:52 -0500https://media.nbcnewyork.com/images/213*120/AP_18207034769345-Drug-Overdose.jpg

Federal health experts reported Thursday that the U.S. drug overdose rate has soared for middle-aged women between 1999 and 2017, NBC News reported.

It rose a startling 260 percent for women between 30 and 64 years old, according to new research from the Centers for Disease Control and Prevention. The rate of drug overdose deaths rose 492 percent for the same group over the same time period.

"Prescription opioids clearly were overutilized for more than a decade," said Dr. Michael Lynch, medical director of the the University of Pittsburgh Medical Center's poison center, who was not involved in the study.

Last year, the government reported that overdoses killed more than 70,000 Americans, driven most by opioid drugs like fentanyl.



Photo Credit: Rick Bowmer/AP, File]]>
<![CDATA[Norovirus Outbreak Sickens 277 on Oasis of the Seas Ship]]>Thu, 10 Jan 2019 16:45:50 -0500https://media.nbcnewyork.com/images/213*120/GettyImages-4572407661.jpg

Royal Caribbean's Oasis of the Seas is returning to a Florida port a day early and giving passengers full refunds of their fare after 277 guests and crew members were hit with an outbreak of Norovirus as it sailed to Jamaica.

Cruise line spokesman Owen Torres told The Associated Press "we think the right thing to do is get everyone home early rather than have guests worry about their health."

He says the ship will return to Port Canaveral on Saturday. It sailed from there Sunday on a seven-day Caribbean cruise.

Passengers took to social media on Wednesday, tweeting they were forced to stay onboard after docking in Falmouth, Jamaica, for what was supposed to be a day of excursions.

Torres says returning a day early gives the cruise line "more time to completely clean and sanitize the ship" before it sails again.

Copyright Associated Press / NBC New York



Photo Credit: Getty Images]]>
<![CDATA[Scientists Seek Ways to Finally Take a Real Measure of Pain]]>Thu, 10 Jan 2019 07:44:27 -0500https://media.nbcnewyork.com/images/213*120/AP_18344718299328-Pain-o-Meter.jpg

Is the pain stabbing or burning? On a scale from 1 to 10, is it a 6 or an 8?

Over and over, 17-year-old Sarah Taylor struggled to make doctors understand her sometimes debilitating levels of pain, first from joint-damaging childhood arthritis and then from fibromyalgia.

"It's really hard when people can't see how much pain you're in, because they have to take your word on it and sometimes, they don't quite believe you," she said.

Now scientists are peeking into Sarah's eyes to track how her pupils react when she's hurting and when she's not — part of a quest to develop the first objective way to measure pain.

"If we can't measure pain, we can't fix it," said Dr. Julia Finkel, a pediatric anesthesiologist at Children's National Medical Center in Washington, who invented the experimental eye-tracking device.

At just about every doctor's visit you'll get your temperature, heart rate and blood pressure measured. But there's no stethoscope for pain. Patients must convey how bad it is using that 10-point scale or emoji-style charts that show faces turning from smiles to frowns.

That's problematic for lots of reasons. Doctors and nurses have to guess at babies' pain by their cries and squirms, for example. The aching that one person rates a 7 might be a 4 to someone who's more used to serious pain or genetically more tolerant. Patient-to-patient variability makes it hard to test if potential new painkillers really work.

Nor do self-ratings determine what kind of pain someone has — one reason for trial-and-error treatment. Are opioids necessary? Or is the pain, like Sarah's, better suited to nerve-targeting medicines?

"It's very frustrating to be in pain and you have to wait like six weeks, two months, to see if the drug's working," said Sarah, who uses a combination of medications, acupuncture and lots of exercise to counter her pain.

The National Institutes of Health is pushing for development of what its director, Dr. Francis Collins, has called a "pain-o-meter." Spurred by the opioid crisis, the goal isn't just to signal how much pain someone's in. It's also to determine what kind it is and what drug might be the most effective.

"We're not creating a lie detector for pain," stressed David Thomas of NIH's National Institute on Drug Abuse, who oversees the research. "We do not want to lose the patient voice."

Around the country, NIH-funded scientists have begun studies of brain scans, pupil reactions and other possible markers of pain in hopes of finally "seeing" the ouch so they can better treat it. It's early-stage research, and it's not clear how soon any of the attempts might pan out.

"There won't be a single signature of pain," Thomas predicted. "My vision is that someday we'll pull these different metrics together for something of a fingerprint of pain."

NIH estimates 25 million people in the U.S. experience daily pain. Most days Sarah Taylor is one of them. Now living in Potomac, Maryland, she was a toddler in her native Australia when the swollen, aching joints of juvenile arthritis appeared. She's had migraines and spinal inflammation. Then two years ago, the body-wide pain of fibromyalgia struck; a flare-up last winter hospitalized her for two weeks.

One recent morning, Sarah climbed onto an acupuncture table at Children's National, rated that day's pain a not-too-bad 3, and opened her eyes wide for the experimental pain test.

"There'll be a flash of light for 10 seconds. All you have to do is try not to blink," researcher Kevin Jackson told Sarah as he lined up the pupil-tracking device, mounted on a smartphone.

The eyes offer a window to pain centers in the brain, said Finkel, who directs pain research at Children's Sheikh Zayed Institute for Pediatric Surgical Innovation.

How? Some pain-sensing nerves transmit "ouch" signals to the brain along pathways that also alter muscles of the pupils as they react to different stimuli. Finkel's device tracks pupillary reactions to light or to non-painful stimulation of certain nerve fibers, aiming to link different patterns to different intensities and types of pain.

Consider the shooting hip and leg pain of sciatica: "Everyone knows someone who's been started on oxycodone for their sciatic nerve pain. And they'll tell you that they feel it — it still hurts — and they just don't care," Finkel said.

What's going on? An opioid like oxycodone brings some relief by dulling the perception of pain but not its transmission — while a different kind of drug might block the pain by targeting the culprit nerve fiber, she said.

Certain medications also can be detected by other changes in a resting pupil, she said. Last month the Food and Drug Administration announced it would help AlgometRx, a biotech company Finkel founded, speed development of the device as a rapid drug screen.

Looking deeper than the eyes, scientists at Harvard and Massachusetts General Hospital found MRI scans revealed patterns of inflammation in the brain that identified either fibromyalgia or chronic back pain.

Other researchers have found changes in brain activity — where different areas "light up" on scans — that signal certain types of pain. Still others are using electrodes on the scalp to measure pain through brain waves.

Ultimately, NIH wants to uncover biological markers that explain why some people recover from acute pain while others develop hard-to-treat chronic pain.

"Your brain changes with pain," Thomas explained. "A zero-to-10 scale or a happy-face scale doesn't capture anywhere near the totality of the pain experience."

Copyright Associated Press / NBC New York



Photo Credit: Manuel Balce Ceneta/AP, File]]>
<![CDATA[Liberals Dare Trump to Back Their Bills Lowering Drug Prices]]>Thu, 10 Jan 2019 13:52:18 -0500https://media.nbcnewyork.com/images/213*120/1089974760-Prescription-Drugs.jpg

Challenging President Donald Trump to make good on his pledge to cut prescription drug prices, congressional liberals proposed legislation Thursday to bring U.S. prices in line with the much lower costs in other countries.

The Democratic bills stand little chance of becoming law in a divided government. But the effort could put Republicans on the defensive by echoing Trump's pledge to force drugmakers to cut prices.

Democrats and Trump agree that people in the United States shouldn't have to pay more for their medications than do those in other economically advanced countries.

The Trump administration has put forward its own plan for reducing drug prices, but industry analysts have seen little impact so far. The pharmaceutical industry said the Democratic bills would "wreak havoc on the U.S. health care system."

The new legislation was offered by Sen. Bernie Sanders, I-Vt., Rep. Elijah Cummings, D-Md., and others. Cummings leads the House Oversight and Government Reform Committee, which is expected to take a major role on drug pricing.

The lawmakers want to:

  • Open up generic competition to patent-protected U.S. brand-name drugs that are deemed "excessively priced."
  • Allow Medicare to directly negotiate with drugmakers.
  • Let consumers import lower-priced medications from Canada.

There was no immediate response from the administration.

"Today I say to President Trump, if you are serious about lowering the cost of prescription drugs in this country, support our legislation and get your Republican colleagues on board," Sanders said at a Capitol Hill press conference.

"No more talk. No more tweets," said Cummings. "The American people want action."

Holly Campbell, a spokeswoman for the Pharmaceutical Research and Manufacturers of America, said Sanders' plan would harm U.S. patients. The industry argues that government price regulation could limit access to some medicines, undermine financial incentives for research, and compromise safety standards. Sanders says drugmakers are primarily interested in protecting profits.

As a presidential candidate, Trump initially called for Medicare to negotiate drug prices and favored allowing people to legally import lower-priced medications from abroad.

But Medicare negotiation is a political nonstarter for most Republicans, who favor a free-market approach to the U.S. pharmaceutical industry and prize its capacity for innovation.

As president, Trump has come out with a plan to lower drug costs that relies on dozens of regulatory actions. The goal is to eliminate incentives for drugmakers, pharmacy benefit managers and insurers to stifle competition at the expense of consumers. Independent experts say the administration proposals would have an impact, but not limit the ability of drug companies to set high prices.

Time and again, Trump has complained that other countries where governments set drug prices are taking advantage of Americans. Indeed, one of his ideas would shift Medicare payments for drugs administered in doctors' offices to a level based on international prices.

"We are taking aim at the global freeloading that forces American consumers to subsidize lower prices in foreign countries through higher prices in our country," the president said when he made that proposal shortly before last year's congressional elections.

The Democratic bills would go far beyond Trump's approach.

The newest idea would essentially apply to any U.S. patent-protected brand-name drug, whether or not government programs are bearing the cost. By comparison, Trump's international pricing proposal would not apply to retail pharmacy drugs purchased by Medicare beneficiaries or to medications for privately insured people. It's the result of a joint effort between Sanders and Rep. Ro Khanna, D-Calif.

Drugs found to be "excessively priced" by the government could face generic competition. A medication's cost would be deemed "excessive" if its price in the U.S. was higher than the median, or midpoint, price in Canada, the United Kingdom, Germany, France and Japan.

If the manufacturer was unwilling to cut its U.S. price, then the government could allow generic companies to make a more affordable version of the medication. Generic drugmakers would have to pay "reasonable" royalties to the company holding the patent.

Copyright Associated Press / NBC New York



Photo Credit: Getty Images/iStockphoto, File]]>
<![CDATA[USDA: Food Stamps Will Be Funded Through February]]>Tue, 08 Jan 2019 19:38:02 -0500https://media.nbcnewyork.com/images/213*120/AP_17076738181835_opt.jpg

The Trump administration says benefits under the Supplemental Nutrition Assistance Program, also known as food stamps, will be funded through February should the government shutdown continue.

Agriculture Secretary Sonny Perdue is asking states to issue the February benefits on or before Jan. 20 so that they can be paid to the nearly 40 million Americans in the program. SNAP is already fully funded for January.

The USDA said it can fund SNAP through February thanks to the short-term funding bill that ran out on Dec. 22. That bill included a provision giving federal agencies the authority to make obligated payments to support certain programs for 30 days after its expiration date.

Brandon Lipps, an acting deputy undersecretary, said other USDA programs will also be funded through February, including school lunches, food distribution programs on Indian reservations and child nutrition programs. The latter includes WIC, which provides nutritional assistance to pregnant women, mothers and babies.

Under the provision, the SNAP program will operate as it normally does and without any lapse in service, but with an earlier deadline for states to request benefits through a process called early issuance. That process is typically used during natural disasters, Lipps said, enabling states anticipating hurricanes or other weather events to distribute monthly benefits ahead of time.

Lipps said the USDA is sending letters to all state agencies to explain the process and will issue a blanket waiver of department regulations to allow for the early issuance.

"We know this is a time of great uncertainty, and no doubt anxiety for people who rely on SNAP and are dealing with tough times," Lipps said. "I hope it's reassuring for us to make clear today that we're committed to maintaining service to SNAP clients without interruption to the extent possible under the law."

The SNAP program will cost roughly $4.8 billion for February, and those funds have already been appropriated through the expired spending bill. But if the shutdown lasts until March, the USDA could be forced to dip into its reserves to help fund the program, and its $3 billion SNAP contingency fund won't cover a full month of benefits.

Perdue is a strong proponent of scaling back the SNAP program, and publicly supported a GOP House measure to strengthen work requirements for food stamp recipients. The measure garnered no support in the Senate and didn't make it into the final farm bill, which President Donald Trump signed into law in December.

The Trump administration has announced its intent to try and limit SNAP use through regulation, crafting a proposal to limit the ability of states to waive the program's work requirements.

Copyright Associated Press / NBC New York



Photo Credit: Robert F. Bukaty/AP (File)]]>
<![CDATA[NYC Guarantees Comprehensive Health Care for All]]>Wed, 09 Jan 2019 12:34:46 -0500https://media.nbcnewyork.com/images/213*120/mayor+announce.jpg

New York City will begin guaranteeing comprehensive health care to every single resident regardless of someone's ability to pay or immigration status, an unprecedented plan that will protect the more than half-a-million New Yorkers currently using the ER as a primary provider, Mayor Bill de Blasio said. 

It's not health insurance, his spokesman clarified after the surprise announcement on MSNBC Tuesday morning. 

"This is the city paying for direct comprehensive care (not just ERs) for people who can't afford it, or can't get comprehensive Medicaid — including 300,000 undocumented New Yorkers," spokesman Eric Phillips tweeted.

At a press conference Tuesday, de Blasio said the plan will provide primary and specialty care, from pediatrics to OBGYN, geriatric, mental health and other services, to the city's roughly 600,000 uninsured. 

The city already has the foundation for such a plan — a public health insurance option that helps get direct care to undocumented residents. 

That option will be expanded, the mayor said, and supported with the addition of a new program called NYC Care. Patients who seek health coverage through NYC Care will receive a card that allows them to see a primary care doctor and seek specialty care services, de Blasio said. 

Those who can afford to pay will pay for services on a sliding scale, while those who can't will receive free coverage, he noted. 

New Yorkers will be able to access the program through the city's website or simply by calling 311. There will be no tax hikes to fund it, the mayor said. 

"The programs will include customer-friendly call lines to help New Yorkers — regardless of their insurance — make appointments with general practitioners, cardiologists, pediatricians, gynecologists and a full spectrum of health care services," his office said in a release. 

NYC Care is expected to launch in the Bronx this summer and be available in the other four boroughs in 2021, the release said. 

It'll cost at least $100 million, accordinng to the release. 

"We'll put the money in to make it work; it's going to save us money down the line," de Blasio said on MSNBC. "We're already paying an exorbitant amount to pay for health care the wrong way when what we should be doing is helping them get the primary care."

"This has never been done in the country in a comprehensive way," de Blasio said on MSNBC. "Health care isn't just a right in theory, it must be a right in practice. And we're doing that here in this city."

Primary care doctors are already scarce in many areas, according to Dr. Tamara Moise, who runs an urgent care center in East Flatbush.

"For the primary care doctors, we will have a large influx of people who did not have insurance who now will," she told News 4. "Will we have a large enough pool of primary care doctors to support that?" 



Photo Credit: Kathy Willens/AP]]>
<![CDATA[Making Your Own Home-Cleaning Products? Some Pro Tips]]>Tue, 08 Jan 2019 11:37:24 -0500https://media.nbcnewyork.com/images/213*120/cleaning-solution.jpg

To reduce waste and avoid unnecessary plastic bottles and chemicals — and to save money — many people are opting to make cleaning products from scratch at home. You can find an abundance of recipes for household cleaning products online, along with reusable glass spray bottles designed to hold them.

But not all homemade cleaning products are created equal, and some simple concoctions can be downright dangerous.

"To have an unlabeled cleaning product in a Mason jar with kids around can be a dangerous thing," warns Carolyn Forte, director of the home appliances and cleaning products lab at Good Housekeeping. "And be careful never to mix bleach with anything but water. Certain combinations can be toxic."

Baking soda and vinegar also should not be combined. Mixed together they are ineffective at cleaning and, if contained in a jar, likely to explode, she warns.

So when making your own cleaning mixtures at home:

  • Double check the safety of the combination you choose;
  • Keep all products out of reach of children or pets;
  • And list all ingredients clearly on the jar or spray bottle.

Test your cleaning mixture before using it. "Making your own window cleaner may be OK, but years of chemistry and safety research have gone into products like laundry and dishwasher detergents and furniture polishes, and you don't want to risk accidentally damaging something that's precious to you," Forte says.

Even so, it can be useful to know what to use in a pinch when you don't have time to rush to the store, says Stephanie Sisco, home editor at Real Simple magazine.

And many homemade cleaning combinations do work, with far fewer chemicals than in many store-bought brands.

To help people make gentle cleaning products at home, Mike and Martha Robinson founded Cleaning Essentials, which sells sturdy glass bottles in various colors and sizes, labeled with recipes for solutions that can be made using mostly vinegar, water and essential oils.

"Sixty years ago our grandparents wouldn't have gone to the store for cleaners. They would have used vinegar, baking soda, some elbow grease, and been healthier for it," says Mike Robinson.

Katy Kiick Condon, senior editor for home design at Better Homes & Gardens magazine, agrees: "Just steam, hot water and some elbow grease can accomplish a lot."

DO's:
Know the basics about the cleaning properties of various household products:

  • Baking soda is a great deodorizer and is useful as a mild abrasive;
  • Vinegar cuts grease, removes mineral deposits and has disinfectant qualities;
  • Lemon juice with some salt can remove rust stains.

DON'Ts:

  •  NEVER combine bleach with anything but water. And remember that baking soda and vinegar, while trusted standbys individually, are ineffective for cleaning if combined — and will bubble up explosively.
  • Don't use lemon on wood, since it can destroy protective finishes, says Sisco.
  • Don't overdo it with vinegar, which can dull surfaces, she says. There's a reason that cleaning-product recipes call for adding water.

RECIPES:
With the above basics in mind, here are a few recipes recommended by the pros.

Window cleaner: For clean, streak-free windows, Condon, at Better Homes & Gardens, swears by the combination of 2 cups hot water, 1 tablespoon corn starch, 1/4 cup white vinegar and 1/4 cup rubbing alcohol. "I tested a bunch of recipes, and this one is hands-down the best for mirrors and windows," she says.

All-purpose cleaner: Sisco, at Real Simple, recommends combining 2 tablespoons lemon juice, 2 cups of water and 1/2 teaspoon of castille soap, such as Dr. Bonner's. For a stronger cleaner, she recommends mixing 1/2 cup vinegar, 1/2 cup vodka, 10 to 20 drops of essential oil and 1 1/2 cups water.

Carpet cleaner: Sisco recommends blotting the stain then saturating it with club soda. "The bubbles will work the stain to the surface," she says. Then coat it with a hefty dose of table salt, which will absorb the stain, she says. "Then just vacuum it up once it's dry, maybe 12 hours later. It's a good overnight cleaning solution, and great for wine and other stains. The key is to blot all excess stain before starting with club soda and salt." 

Copyright Associated Press / NBC New York



Photo Credit: Handout via AP]]>
<![CDATA[US Cancer Death Rate Hits Major Milestone: 25 Years of Decline]]>Tue, 08 Jan 2019 18:45:31 -0500https://media.nbcnewyork.com/images/213*120/AP_19005725993033-Chemotherapy-drug.jpg

The U.S. cancer death rate has hit a milestone: It's been falling for at least 25 years, according to a new report.

Lower smoking rates are translating into fewer deaths. Advances in early detection and treatment also are having a positive impact, experts say.

But it's not all good news. Obesity-related cancer deaths are rising, and prostate cancer deaths are no longer dropping, said Rebecca Siegel, lead author of the American Cancer Society report published Tuesday.

Cancer also remains the nation's No. 2 killer. The society predicts there will be more than 1.7 million new cancer cases, and more than 600,000 cancer deaths, in the U.S. this year.

A breakdown of what the report says:

DECLINE
There's been a lot of bad news recently regarding U.S. death rates. In 2017, increases were seen in fatalities from seven of the 10 leading causes of death, according to recently released government data. But cancer has been something of a bright spot.

The nation's cancer death rate was increasing until the early 1990s. It has been dropping since, falling 27 percent between 1991 and 2016, the Cancer Society reported.

Lung cancer is the main reason. Among cancers, it has long killed the most people, especially men. But the lung cancer death rate dropped by nearly 50 percent among men since 1991. It was a delayed effect from a decline in smoking that began in the 1960s, Siegel said.

PROSTATE CANCER
The report has some mixed news about prostate cancer, the second leading cause of cancer death in men.

The prostate cancer death rate fell by half over two decades, but experts have been wondering whether the trend changed after a 2011 decision by the U.S. Preventive Services Task Force to stop recommending routine testing of men using the PSA blood test. That decision was prompted by concerns the test was leading to overdiagnosis and overtreatment.

The prostate cancer death rate flattened from 2013 to 2016. So while the PSA testing may have surfaced cases that didn't actually need treatment, it may also have prevented some cancer deaths, the report suggests.

OBESITY
Of the most common types of cancer in the U.S., all the ones with increasing death rates are linked to obesity, including cancers of the thyroid, pancreas and uterus.

Another is liver cancer. Liver cancer deaths have been increasing since the 1970s, and initially most of the increase was tied to hepatitis C infections spread among people who abuse drugs. But now obesity accounts for a third of liver cancer deaths, and is more of a factor than hepatitis, Siegel said.

The nation's growing obesity epidemic was first identified as a problem in the 1990s. It can take decades to see how a risk factor influences cancer rates, "so we may just be seeing the tip of the iceberg in terms of the effect of the obesity epidemic on cancer," Siegel said.

DISPARITY
There's been a decline in the historic racial gap in cancer death rates, but an economic gap is growing — especially when it comes to deaths that could be prevented by early screening and treatment, better eating and less smoking.

In the early 1970s, colon cancer death rates in the poorest counties were 20 percent lower than those in affluent counties; now they're 35 percent higher. Cervical cancer deaths are twice as high for women in poor counties now, compared with women in affluent counties. And lung and liver cancer death rates are 40 percent higher for men in poor counties.

Dr. Darrell Gray, deputy director of Ohio State University's Center for Cancer Health Equity, called the findings "important but not surprising."

"We've known for some time that race is a surrogate" for other factors, like poverty and difficulty getting to — or paying for — doctor's appointments, he said.

Copyright Associated Press / NBC New York



Photo Credit: Gerry Broome/AP, File]]>
<![CDATA[States Grapple With Setting Limits On Weed Use Behind Wheel]]>Fri, 04 Jan 2019 06:09:24 -0500https://media.nbcnewyork.com/images/213*120/Marijuanaleaf1.jpg

It used to be the stuff of stoner comedies and “Just Say No” campaigns. Today, marijuana is becoming mainstream as voters across the country approve ballot questions for legalization or medical use.

In response, state governments are testing ways to ensure that the integration of this once-illicit substance into everyday life doesn’t create new public health risks. These efforts are sparking a difficult question: At what point is someone too high to get behind the wheel?

The answer is complicated. Brain scientists and pharmacologists don’t know how to measure if and to what extent marijuana causes impairment.

The reason: Existing blood and urine tests can detect marijuana use, but, because traces of the drug stay in the human body for a long time, those tests can’t specify whether the use occurred earlier that day or that month. They also don’t indicate the level at which a driver would be considered “under the influence.”

“It’s a really hard problem,” said Keith Humphreys, a psychiatry professor and drug policy expert at Stanford University in California, the first state to legalize medical marijuana and where recreational pot use among adults became legal in 2016. “We don’t really have good evidence — even if we know someone has been using — [to gauge] what their level of impairment is.”

Marijuana is now legal for recreational use in 10 states and the District of Columbia — including Michigan, where a ballot initiative passed in November took effect Dec. 6. In New York, the governor said Dec. 17 that legalization would be a top priority for 2019. And nearly three dozen states have cleared the use of medical cannabis.

For alcohol, there is a clear, national standard. If your blood alcohol content (BAC) is 0.08 percent or higher, you’re considered cognitively impaired at a level that is unsafe to drive. Extensive research supports this determination, and the clarity makes enforcement of drunken driving laws easier.

Setting a marijuana-related impairment level is a much murkier proposition. But states that have legalized pot have to figure it out, experts said.

“You can’t legalize a substance and not have a coherent policy for controlling driving under the influence of that substance,” said Steven Davenport, an assistant policy researcher at the nonprofit Rand Corp., who specializes in marijuana research.

Marijuana, after all, weakens a driver’s ability to maintain focus, and it slows reflexes. But regulators are “playing catch-up,” suggested Thomas Marcotte, a psychiatry professor at the University of California-San Diego and one of a number of academics around the country who is researching driving while high.

States have put forth a bevy of approaches. At least five have what’s called a “per se” law, which outlaws driving if someone’s blood level of tetrahydrocannabinol, or THC, exceeds a set amount. THC is marijuana’s main intoxicant.

Colorado, where voters approved legalization of recreational marijuana in 2012, has this type of driving law on the books. It took three years to pass amid fiery debate and deems “intoxicated” any driver who tests higher than 5 nanograms of THC per milliliter of blood.

Rhode Island, Pennsylvania and Indiana are among states that forbid driving at any THC level. Still others say drivers should be penalized only if they are impaired by the chemical — a standard that sounds reasonable but quickly gets difficult to measure or even define.

None of these approaches offers an ideal solution, experts said.

“We’re still definitely evaluating which policies are the most effective,” said Ann Kitch, who tracks the marijuana and driving issue for the National Conference of State Legislatures.

States that set a THC-level standard confront weak technology and limited science. THC testing is imprecise at best, since the chemical can stay in someone’s bloodstream for weeks after it was ingested. Someone could legally smoke a joint and still have THC appear in blood or urine samples long after the high passes.

There’s general agreement that driving while high is bad, but there’s no linear relationship between THC levels and degree of impairment. States that have picked a number to reflect when THC in the bloodstream becomes a hazard have “made it up,” argued Humphreys.

“The ones who wrote [a number] into legislation felt they had to say something,” he said. But “we don’t know what would be the analogy. Is the legal amount [of THC] equal to a beer? Is that how impaired you are? Is it a six-pack?”

Roadside testing for THC is also logistically difficult.

Blood, for instance, needs to be analyzed in a lab, and collecting urine gets … complicated.

In Canada, which legalized recreational pot just this year, law enforcement will test drivers with a saliva test called the Dräger DrugTest 5000, but that isn’t perfect, either.

Some private companies are trying to develop a sort of breathalyzer for marijuana. But Jonathan Caulkins, a drug policy researcher at Carnegie Mellon University, said, “There are fundamental issues with the chemistry and pharmacokinetics. It’s really hard to have an objective, easy-to-administer roadside test.”

Some states rely on law enforcement to assess whether someone’s driving appears impaired, and ascertain after the fact if marijuana was involved.

In California, every highway patrol member learns to administer “field sobriety tests” — undergoing an extra 16 hours of training to recognize the influence of different drugs, including marijuana. Because medical marijuana has been legal there since 1996, officers are “very used” to recognizing its influence, said Glenn Glazer, the state’s coordinator for its drug recognition expert training program.

That kind of training is taking off in other states, too, Kitch said. Lobbying groups such as Mothers Against Drunk Driving are pushing to bump up law enforcement training and rely on officers to assess whether a driver is impaired.

These tests, though, risk their own kind of error.

“They are subjective,” Rand Corp.’s Davenport warned.

For one thing, officer-administered tests can be influenced by racial bias. Someone who has previously had poor experiences with law enforcement may also perform worse, not because of greater impairment but nervousness.

Indeed, relying on more subjective testing is in some ways the direct opposite of conventional wisdom.

“A general pattern of the last … 40 years is to try to take human judgment out of decision-making processes when possible. Because we fear exactly these issues,” Caulkins said. “The idea that you could come up with a completely objective test of performance … is ambitious.”

Researchers like Marcotte are trying to devise some kind of test that can, in fact, gauge whether someone is showing signs of marijuana impairment. But that could take years.

In the meantime, the public health threat is real. States with legalized pot do appear to experience more car crashes, though the relationship is muddled. “This is going to be a headache of an issue for a decade,” Caulkins said.

Kaiser Health News (KHN) is a national health policy news service. It is an editorially independent program of the Henry J. Kaiser Family Foundation which is not affiliated with Kaiser Permanente.



Photo Credit: Mathew Sumner/AP, File]]>
<![CDATA[Phone Apps Could Monitor Depression, Mental Health in Teens]]>Thu, 03 Jan 2019 14:46:51 -0500https://media.nbcnewyork.com/images/213*120/GettyImages-764786083.jpg

Rising suicide rates and depression in U.S. teens and young adults have prompted researchers to ask a provocative question: Could the same devices that some people blame for contributing to tech-age angst also be used to detect it?

The idea has sparked a race to develop apps that warn of impending mental health crises. Call it smartphone psychiatry or child psychology 2.0.

Studies have linked heavy smartphone use with worsening teen mental health. But as teens scroll through Instagram and Snapchat, tap out texts or watch YouTube videos, they also leave digital footprints that might offer clues to their psychological well-being.

Changes in typing speed, voice tone, word choice and how often kids stay home could signal trouble, according to preliminary studies.

There might be as many as 1,000 smartphone "biomarkers" for depression, said Dr. Thomas Insel, former head of the National Institute of Mental Health and now a leader in the smartphone psychiatry movement.

Researchers are testing experimental apps that use artificial intelligence to try to predict depression episodes or potential self-harm.

"We are tracking the equivalent of a heartbeat for the human brain," said Dr. Alex Leow, an app developer and associate professor of psychiatry and bioengineering at the University of Illinois' Chicago campus.

At least, that's the goal. There are technical and ethical kinks to work out — including privacy issues and making sure kids grant permission to be monitored so closely. Developers say proven, commercially available mood-detecting apps are likely years — but not decades — away.

"People often feel that these things are creepy," because of the tech industry's surreptitious tracking of online habits for commercial purposes, said University of Oregon psychologist Nick Allen.

Using smartphones as mental illness detectors would require informed consent from users to install an app, "and they could withdraw permission at any time," said Allen, one of the creators of an app that is being tested on young people who have attempted suicide.

"The biggest hurdle at the moment," Allen said, "is to learn about what's the signal and what's the noise — what is in this enormous amount of data that people accumulate on their phones that is indicative of a mental health crisis."

Depression affects about 3 million U.S. teens, and rates have climbed in the past decade. Last year, 13 percent of 12- to 17-year-olds had depression, up from 8 percent in 2010, U.S. government data show. One in 10 college-aged Americans is affected.

Suicide has risen to the second leading cause of death for ages 10 to 34. Rates among teen girls doubled from 2007 to 2015, climbing to 5 per 100,000. And among boys, rates jumped 30 percent, to 14 in 100,000.

A recent study suggested a parallel rise in smartphone use likely contributed.

People with mental illness typically get treatment "when they're in crisis and very late in the course of an illness. We want to have a method to identify the earliest signs," in an objective way, Insel said.

If smartphones prove to be accurate mood predictors, developers say the ultimate goal would be to use them to offer real-time help, perhaps with automated text messages and links to help lines, or digital alerts to parents, doctors or first responders.

Facebook is already doing just that with what it calls "proactive detection." Last year, after a live-streamed suicide, Facebook trained its AI systems to flag certain words or phrases in online posts that could indicate imminent self-harm. Friends' comments expressing concern about the user's well-being are part of the equation.

"In the last year, we've helped first responders quickly reach around 3,500 people globally who needed help," Facebook CEO Mark Zuckerberg announced in November. Facebook has not disclosed outcomes of those cases.

The ongoing research includes:

— A Stanford University study involving about 200 teens, including kids at risk for depression because of bullying, family circumstances or other life stresses. As part of the research, teens who have been tracked since grade school get an experimental phone app that surveys them three times daily for two weeks with questions about their mood.

Researchers are combining those answers with passive smartphone data, including how active or sedentary kids are, to identify any changes that might be linked with future depression.

Study participant Laurel Foster, 15, acknowledges feeling stress over academics and "the usual" teen friendship pressures and says depression is rampant at her San Francisco high school. She said using the smartphone app felt a bit like being spied on, but with so many online sites already tracking users' habits "one more isn't really a big difference."

"I feel like it's good to actually find out what is stressing you," Laurel said, endorsing the idea of using smartphones to try to answer that question.

— At UCLA, as part of a broader effort to battle campus depression launched in 2017, researchers are offering online counseling and an experimental phone app to students who show signs of at least mild depression on a screening test. About 250 freshmen agreed to use the app in the first year. Personal sensing data collected from the app is being analyzed to see how it correlates with any worsening or improvement in depression symptoms seen in internet therapy.

Sophomore Alyssa Lizarraga, who had the app on her phone for about six months, said it was "a little like the Big Brother thing. Half of me felt that way. The other half felt like I hope it will be useful."

Lizarraga, 19, has had depression since high school in Whittier, California. She has worried that she's "addicted" to her phone and spends a lot of time on social media sites. "People need to see the best side of me" there, she said, and comparing herself with others online sometimes gets her down.

But using smartphones in a positive way for mental health might help nudge people to seek early treatment, if they could see how their phone use showed signs of depression, she said.

— At the University of Illinois' Chicago campus, researchers studying depression and mania in bipolar disorder are using crowdsourcing to test their experimental phone app. Anyone can download the free app, and nearly 2,000 have so far, agreeing to let the researchers continuously track things such as typing speed, number of keystrokes and use of spellcheck. Participants include healthy people, and their data will help researchers zero in on changes in phone use that may signal onset of mood problems, said Leow, the psychiatry and bioengineering expert who helped develop it.

The study is for ages 18 and up, but if proven to work, the technology could be used in kids too, Leow said.

— Mindstrong, a Palo Alto, California, tech health company co-founded by Insel, the former NIH official, is testing a "digital phenotyping" app in several studies. Insel thinks the technology has promise to transform psychiatry, but that the most important question is whether it can be used to improve patient health.

— Verily, a tech health arm of Google parent company Alphabet, is developing a similar app but declined to elaborate beyond a statement from its mental health leader, Menachem Fromer. He cited two key goals: making predictions about someone's mental health and their symptoms and "discovering new subtypes of disease that may inform treatment decisions."

___

If you or someone you know needs help, call the U.S. National Suicide Prevention Lifeline at 800-273-8255 or text TALK to 741741.

___

CORRECTION (Jan. 3, 2019, 2:45 p.m. ET): This story has been corrected to fix the company's name to Mindstrong, not Mindspring, and to fix the agenc's name to National Institute of Mental Health, not Mental Illness.

Copyright Associated Press / NBC New York



Photo Credit: Getty Images/Maskot, File]]>
<![CDATA[More Blood Pressure Meds Recalled Over Cancer Concerns]]>Thu, 03 Jan 2019 11:13:14 -0500https://media.nbcnewyork.com/images/213*120/080618bloodpressire.jpg

Another drugmaker is recalling a medication used to treat high blood pressure and heart failure over concerns that tablets could be contaminated with a cancer-causing agent.

Drug maker Aurobindo Pharma USA is voluntarily recalling 80 lots Amlodipine Valsartan Tablets USP, Valsartan HCTZ Tablets, USP and Valsartan Tablets USP.

The U.S. Food and Drug Administration reported that traces of N-nitrosodimethylamine (NDMA), a "probable human carcinogen," was found in the active ingredient valsartan in the recalled products.

The recalled medications were distributed nationwide. The New Jersey-based company has not received any reports of adverse effects related to the drugs as of Dec. 31, 2018, when the recall was announced, the FDA said.

A full list of the recalled products is available here. Products can be identified by checking the product name, manufacturer details, and batch or lot number on the bottles. Expiration dates range from May 2019 to March 2021.

Valsartan tablets are used to control high blood pressure and for treatment of heart failure. The FDA says patients who are prescribed Amlodipine Valsartan Tablets USP, Valsartan HCTZ Tablets, USP and Valsartan Tablets USP should continue taking their medication, “as the risk of harm to the patient’s health may be higher if the treatment is stopped immediately without any alternative treatment.”

If a patient's medicine is included in the recall, they should contact their health care professional to discuss alternative treatment options before returning their medication.

Consumers can contact the company at 1-866-850-2876 or by email at: pvg@aurobindousa.com.

Aurobino’s recall follows a growing list of companies recalling their blood pressure medication in the last year. In November, Teva Pharmaceuticals voluntarily recalled two of its drugs over the same concerns. In July, the FDA announced a recall of several medicines containing valsartan due to traces of NDMA contamination. A month later, the agency expanded the recall list of medications that contained the active ingredient valsartan over concerns that it could be contaminated with the cancer-causing agent.

"The agency continues to investigate and test all angiotensin II receptor blockers (ARBs) for the presence of NDEA and N-Nitrosodimethylamine (NDMA) and is taking swift action when it identifies these impurities that are above interim acceptable daily intake levels," the FDA said in a news release.

The FDA also updated the list of valsartan products under the recall and the list of valsartan products not under recall.

The agency encourages patients and health care professionals to report any adverse reaction to the FDA’s MedWatch program.



Photo Credit: Joe Raedle/Getty Images]]>
<![CDATA[Low Carb? Low Fat? What The Latest Dieting Studies Tell Us]]>Tue, 01 Jan 2019 14:14:46 -0500https://media.nbcnewyork.com/images/213*120/AP_18355563951342.jpg

Bacon and black coffee for breakfast, or oatmeal and bananas?

If you're planning to try to lose weight in 2019, you're sure to find a fierce debate online and among friends and family about how best to do it. It seems like everyone has an opinion, and new fads emerge every year.

Two major studies last year provided more fuel for a particularly polarizing topic — the role carbs play in making us fat. The studies gave scientists some clues, but, like other nutrition studies, they can't say which diet — if any — is best for everyone.

That's not going to satisfy people who want black-and-white answers, but nutrition research is extremely difficult and even the most respected studies come with big caveats. People are so different that it's all but impossible to conduct studies that show what really works over long periods of time.

Before embarking on a weight loss plan for the new year, here's a look at some of what was learned last year.

FEWER CARBS, FEWER POUNDS?

It's no longer called the Atkins Diet, but the low-carb school of dieting has been enjoying a comeback. The idea is that the refined carbohydrates in foods like white bread are quickly converted into sugar in our bodies, leading to energy swings and hunger.

By cutting carbs, the claim is that weight loss will be easier because your body will instead burn fat for fuel while feeling less hungry. A recent study seems to offer more support for low-carb proponents. But, like many studies, it tried to understand just one sliver of how the body works.

The study, co-led by an author of books promoting low-carb diets, looked at whether varying carb levels might affect how the body uses energy. Among 164 participants, it found those on low-carb diets burned more calories in a resting state than those on high-carb diets.

The study did not say people lost more weight on a low-carb diet — and didn't try to measure that. Meals and snacks were tightly controlled and continually adjusted so everyone's weights stayed stable.

David Ludwig, a lead author of the paper and researcher at Boston Children's Hospital, said it suggests limiting carbs could make it easier for people to keep weight off once they've lost it. He said the approach might work best for those with diabetes or pre-diabetes.

Ludwig noted the study wasn't intended to test long-term health effects or real-world scenarios where people make their own food. The findings also need to be replicated to be validated, he said.

Caroline Apovian of Boston University's School of Medicine said the findings are interesting fodder for the scientific community, but that they shouldn't be taken as advice for the average person looking to lose weight.

DO I AVOID FAT TO BE SKINNY?

For years people were advised to curb fats , which are found in foods including meat, nuts, eggs, butter and oil. Cutting fat was seen as a way to control weight, since a gram of fat has twice as many calories than the same amount of carbs or protein.

Many say the advice had the opposite effect by inadvertently giving us license to gobble up fat-free cookies, cakes and other foods that were instead full of the refined carbs and sugars now blamed for our wider waistlines.

Nutrition experts gradually moved away from blanket recommendations to limit fats for weight loss. Fats are necessary for absorbing important nutrients and can help us feel full. That doesn't mean you have to subsist on steak drizzled in butter to be healthy.

Bruce Y. Lee, a professor of international health at Johns Hopkins, said the lessons learned from the anti-fat fad should be applied to the anti-carb fad: don't oversimplify advice.

"There's a constant look for an easy way out," Lee said.

SO WHICH IS BETTER?

Another big study this past year found low-carb diets and low-fat diets were about equally as effective for weight loss. Results varied by individual, but after a year, people in both groups shed an average of 12 to 13 pounds.

The author noted the findings don't contradict Ludwig's low-carb study. Instead, they suggest there may be some flexibility in the ways we can lose weight. Participants in both groups were encouraged to focus on minimally processed foods like produce and meat prepared at home. Everyone was advised to limit added sugar and refined flour.

"If you got that foundation right, for many, that would be an enormous change," said Christopher Gardner of Stanford University and one of the study's authors.

Limiting processed foods could improve most diets by cutting down overall calories, while still leaving wiggle room for people's preferences. That's important, because for a diet to be effective, a person has to be able to stick to it. A breakfast of fruit and oatmeal may be filling for one person, but leave another hungry soon after.

Gardner notes the study had its limitations, too. Participants' diets weren't controlled. People were instead instructed on how to achieve eating a low-carb or low-fat in regular meetings with dietitians, which may have provided a support network most dieters don't have.

SO, WHAT WORKS?

In the short term you can probably lose weight by eating only raw foods, or going vegan, or cutting out gluten, or following another diet plan that catches your eye. But what will work for you over the long term is a different question.

Zhaoping Li, director of clinical nutrition division at the University of California, Los Angeles, says there is no a single set of guidelines that help everyone lose weight and keep it off. It's why diets often fail — they don't factor into account the many factors that drive us to eat what we do.

To help people lose weight, Li examines her patients' eating and physical activity routines to identify improvements people will be able to live with.

"What sticks is what matters," Li said.

___

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.

Copyright Associated Press / NBC New York



Photo Credit: Matthew Mead/AP, File]]>
<![CDATA[Judge Clears the Way for Appeal of Ruling Against Health Law]]>Mon, 31 Dec 2018 00:10:55 -0500https://media.nbcnewyork.com/images/213*120/ACAAP_18346561695404.jpg

A federal judge in Fort Worth, Texas who recently declared the Affordable Care Act unconstitutional has stayed his ruling to allow for appeals.

That means "Obamacare" remains in effect while litigation continues.

In a ruling issued Sunday, Judge Reed O'Connor wrote that he stands by his earlier conclusion that the entire law is invalidated by congressional repeal of its fines on people who remain uninsured, like a house of cards collapsing.

However, because "many everyday Americans would ... face great uncertainty" if that ruling were immediately put into effect, O'Connor issued a stay to allow for appeals.

A group of Republican-led states brought the lawsuit. A coalition of Democratic state attorneys general, led by California's Xavier Becerra, intends to appeal. Congressional Democrats also plan to appeal.

Copyright Associated Press / NBC New York



Photo Credit: AP Photo/Pablo Martinez Monsivais]]>
<![CDATA[Neb. Center Monitors American for Possible Ebola Exposure]]>Thu, 03 Jan 2019 13:37:30 -0500https://media.nbcnewyork.com/images/213*120/ebolaGettyImages-453210018.jpg

An American who was providing medical assistance in Congo may have been exposed to the deadly Ebola virus and is being monitored at a Nebraska medical center.

The University of Nebraska Medical Center in Omaha confirmed Saturday that it was housing the person in a secure area that is not accessible to other patients or the public. Spokesman Taylor Wilson said the person arrived Saturday afternoon.

The medical center is not providing any details to honor the person's request for privacy. The facility also is not identifying the person as a patient or when the person was in Africa.

Officials say the person is not ill and has no Ebola symptoms but will be monitored for up to two weeks.

The medical center has a dedicated biocontainment unit and treated three Ebola patients in 2014.

Copyright Associated Press / NBC New York



Photo Credit: Center for Disease Control (CDC) via Getty Images]]>
<![CDATA[Lawsuit Filed After Safety Issues Found at NJ Surgery Center]]>Sat, 29 Dec 2018 18:20:45 -0500https://media.nbcnewyork.com/images/213*120/Hospital-Generic.jpg

State investigators say a New Jersey surgery center that may have exposed more than 3,000 patients to HIV, hepatitis B and hepatitis C used poor drug storage methods, an outdated infection control plan and unacceptable sterilization practices.

Operating rooms at the HealthPlus Surgery Center in Saddle Brook were not properly cleaned and disinfected between procedures, according to the report from the state Department of Health that was made public Friday.

In one instance, an inspector saw a stretcher in a hallway with a blood-stained sheet that wasn't properly disinfected even after the inspector pointed it out to staffers.

State surveyors also found the facility improperly stored sterilized items, jeopardizing their cleanliness, while other sterilized instruments revealed rust-like stains, the report said.

During a news conference Saturday, facility representatives said an investigation determined that "a handful of people who have been removed" were mostly responsible for the lapses that occurred. Two employees were fired after revelations that thousands may have been exposed to the diseases.

Nearly 3,800 former patients have been urged to get tested, but authorities say no illnesses have been reported. The health department says the risk of infection is low, noting the recommendation for testing was made out of "an abundance of caution."

State health officials have said anyone who had a procedure performed at the center from January to Sept. 7 this year may have been exposed.

The facility was shuttered for three weeks in September after the state Department of Health received a complaint.

The center's nursing director resigned a day before the facility was shuttered. Mark Manigan, a Roseland attorney representing the center, declined to say if that was related to the complaint and closure. He said the center's administrator is not expected to resign.

As part of a corrective plan implemented with the center's reopening, HealthPlus must conduct quarterly infection control audits and sterilization audits every six months.

The people have been urged to get tested, but authorities say no illnesses have been reported.

At Saturday's press conference, Manigan said 186 patients have been tested so far — one of whom received a preliminary result indicating he or she had chronic hepatitis. 

The chronic nature of the hepatitis indicates a "preexisting condition" that the patient most likely had prior to treatment at the center, the attorney noted. 

The center is already facing a proposed class action lawsuit filed by two Passaic County residents on Friday, one of whom received medical treatment at the center at some point between Jan. 1 and Sept. 7 of this year. 

"As a result of [HealthPlus's] failures, individuals who sought medical treatment at HealthPlus, as well as their spouses, with whom they have been in close physical and sexual contact, were exposed to harmful and potentially fatal viruses, including but not limited to HIV, hepatitis B and hepatitis C," the suit says. 

"The plaintiffs and other similarly situated now live in fear of their exposure to these potentially fatal viruses," it adds. 

Staff at the center said patients can see its plan of action and sign up to get tested on its website

Copyright Associated Press / NBC New York



Photo Credit: File Photo]]>
<![CDATA[NJ Warns of Possible Measles Exposure at Newark Airport]]>Fri, 28 Dec 2018 17:14:06 -0500https://media.nbcnewyork.com/images/213*120/newark+airport+terminal+b.jpg

Health officials are warning of a possible measles exposure at Newark Liberty International Airport over the busy Christmas travel days.

The international traveler diagnosed with the highly contagious disease went through Terminal B on Christmas Eve on a flight from Brussels, but health officials warn that person could have passed through other areas of the airport as well.

If you were in the airport on Dec. 24 between 12 p.m. and 4 p.m., you may have been exposed to measles and, if infected, could develop symptoms as late as Jan. 14, officials say. New Jersey residents identified as potentially exposed on the sick person's flights will be notified by their local health departments. 

Anyone who suspects they've been exposed is urged to call a health care provider before going to a medical office to prevent additional spread of the disease, which is transmitted by airborne particles, droplets, and direct contact with the respiratory secretions of an infected person. 

Authorities say this case is unrelated to the ongoing outbreak in the state, which has 30 confirmed cases in Ocean County and three in Passaic County. Two doses of the measles vaccine are 97 percent effective in preventing measles, so health officials urge anyone who hasn't been vaccinated to do so.

Young children, pregnant women and people with weakened immune systems are at highest risk for severe complications, which can include pneumonia and encephalitis. 

Symptoms include rash, high fever, cough and red, watery eyes. The rash usually starts on the face, proceeds down the body, and may include the palms and soles. The rash lasts several days. Infected individuals are contagious from four days before rash onset through the fourth day after rash appearance.



Photo Credit: AP]]>
<![CDATA[Newly FDA-Approved Children's Vaccine Protects Against 6 Diseases]]>Fri, 28 Dec 2018 06:56:33 -0500https://media.nbcnewyork.com/images/213*120/953760962-Sanofi.jpg

A new pediatric vaccine that immunizes children against six diseases was approved by the U.S. Food and Drug Administration, French pharmaceutical company Sanofi said Wednesday.

Reuters reported that the vaccine, Vaxelis, for children between 6 weeks and 4 years of age helps prevent diptheria, hepatitis B, pertussis, poliomyelitis, tetanus and invasive disease due to haemophilus influenza type B.

Sanofi and its partner, Merck, aim to have the drug available in 2020 or later.



Photo Credit: Eric Piermont/AFP/Getty Images, File]]>
<![CDATA[Confirmed Cases of Flu Rising Across New York State]]>Fri, 28 Dec 2018 01:23:05 -0500https://media.nbcnewyork.com/images/213*120/close-up-doctor-health-42273.jpg

The Cuomo administration says the number of confirmed cases of influenza is rising across New York state, with more than 5,400 people coming down with the illness so far this season.

The state Department of Health says as of Thursday new cases of flu have been reported in 58 counties, including the five boroughs of New York City. Only Wyoming, Yates, Seneca and Hamilton counties are not reporting any cases yet.

Officials say the number of people hospitalized with laboratory-confirmed flu was 363 this past week, a 41 percent increase over the previous week. So far this season more than 1,300 people have been hospitalized with the flu.

Gov. Cuomo is urging flu vaccinations for all New Yorkers six months of age and older. 

Copyright Associated Press / NBC New York



Photo Credit: Pexels/CC]]>
<![CDATA[Ex-CEO of Insys to Plead Guilty in Major Opioid Case]]>Wed, 26 Dec 2018 21:52:10 -0500https://media.nbcnewyork.com/images/213*120/judge6.jpg

The former CEO of a drug company that produced a powerful and addictive painkiller containing fentanyl for cancer patients has agreed to plead guilty in connection with a scheme in which the firm's leaders bribed doctors in return for their prescribing the drug, court documents filed Wednesday show.

Michael Babich, a former president and CEO of the Arizona-based Insys Therapeutics Inc., producer of the drug Subsys, will plead guilty to one count of conspiracy and one count of mail fraud for his role in the alleged conspiracy, according to court documents.

As NBC News reported, Insys executives allegedly defrauded insurance companies through their actions because the insurance providers made payments to doctors without knowledge of the bribes and kickbacks, according to court documents filed by the Andrew Lelling, the U.S. Attorney for Massachusetts. 

"The bribes and kickbacks took multiple forms," the prosecutor's motion filed Wednesday states. Babich and other company executives allegedly paid doctors fees that were purportedly for speaking engagements. They also allegedly hired and paid the salaries of some office staff for "certain targeted practitioners."

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<![CDATA[3,000+ NJ Patients Possibly Exposed to HIV, Hepatitis]]>Wed, 26 Dec 2018 20:18:17 -0500https://media.nbcnewyork.com/images/213*120/Hospital-Generic.jpg

The New Jersey Department of Health says more than 3,000 patients at a surgery center may have been exposed to HIV, hepatitis B and hepatitis C.

Officials say patients who had procedures done at the HealthPlus Surgery Center in Saddle Brook between January 2018 and Sept. 7, 2018 may have been exposed.

Surgery center administrator Betty McCabe says the exposure was due to "deficiencies in infection control" involving the cleaning of instruments and injection of medications. McCabe says 3,778 patients are being urged to get their blood tested.

The health department says the risk of infection is low, and no illnesses have been reported. The department called it "an abundance of caution" to suggest that people be tested.

McCabe says the center is offering to pay medical costs associated with testing.

Copyright Associated Press / NBC New York

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<![CDATA[Secret Santas: Charity Buys and Erases Past-Due Medical Debt]]>Mon, 24 Dec 2018 20:00:16 -0500https://media.nbcnewyork.com/images/213*120/AP_18358263508677.jpg

Philip Sasser had a familiar, sinking feeling when he saw the yellow envelope in his mailbox. He figured it was another past-due medical bill, but it turned out to be quite the opposite.

"I opened it up and it said these bills had been paid off," said Sasser, of Milton, Florida. "I didn't understand. It was out of the blue."

Sasser is among the lucky recipients of a letter from RIP Medical Debt, a Rye, New York-based nonprofit that uses money from donors to eliminate crushing medical debt that threatens the financial well-being of hundreds of thousands of American families. The charity says it has erased $475 million in debt for more than 250,000 people since it was founded four years ago.

"It's a random act of kindness, a no-strings-attached gift," said Craig Antico, RIP's co-founder and CEO.

Antico and RIP co-founder Jerry Ashton spent decades as executives in the debt resolution business. Now they do the same thing debt collectors do — buy portfolios of past-due bills for pennies on the dollar. But instead of hounding people for payment, they send letters announcing their debt is now zero. Forgiven debts have ranged from $100 to over $250,000, Antico said.

A $10 donation can buy — and eliminate — $1,000 in long-delinquent debt.

"You get a lot of bang for your charity buck," said Judith Jones of Ithaca, New York. She and Carolyn Kenyon, members of a group advocating universal health coverage, raised $12,500 that RIP Medical Debt used to purchase a portfolio of $1.5 million in debts owed by 1,284 people.

More than 43 million Americans have about $75 billion in past-due medical debt on their credit reports, according to Antico, Ashton and co-author Robert Goff's book, "End Medical Debt." They estimate a total of $1 trillion in reported and unreported unpaid medical debt, and say debt forgiveness is their best interim solution until a better financial structure is worked out for the U.S. health care system.

"We're not the solution," Ashton said. "We're just dealing with the symptoms."

Now they're trying to raise $50,000 for RIP to buy $50 million in medical debts owed by veterans.

For Sasser, 45, the debt relieved was $1,200 not covered by his high-deductible insurance for his wife's debilitating medical condition she's been grappling with for six years. Sasser had to cut way back on his advertising and graphic design business to care for her and their two teenage boys.

"To have these large bills looming and no way to pay was a source of constant stress," Sasser said. "When I opened that letter, it lifted a huge weight off."

Reagan Adair, a fifth-grade teacher in Murchison, Texas, had $3,100 in debt erased by RIP. She was inspired to pay it forward by making a donation to the charity to help others struggling with medical bills.

"The system is broken," Adair said. "We have a problem with our health care system. What we have now is not working."

RIP Medical Debt has its origins in Occupy Wall Street. Ashton's office overlooked the park where social activists camped out in 2011 to protest income inequality and seek solutions.

When people associated with the Occupy movement launched a project to buy debt and erase it, Ashton and Antico offered their expertise. They turned that project into RIP Medical Debt in 2014.

It limped along until 2016, when HBO's "Last Week Tonight with John Oliver" did a segment where they gave the nonprofit $60,000 to purchase $15 million in medical debt and wipe it out.

Publicity from Oliver's segment was a game-changer. Donations went from less than $12,000 in 2015 to more than $2.4 million in 2017.

In addition to individual donations, fundraising campaigns for RIP have been held across the country by health care groups, television stations and other organizations.

In November, an anonymous couple donated $2 million to RIP to eliminate $250 million in medical debt.

Because the nonprofit's model revolves around buying portfolios of bulk debt from hospitals or investors, it is unable, at this point, to abolish bills for specific individuals.

"When we get these emails from people begging us for help, it would melt the heart of a stone statue," Ashton said. RIP's website has a registry where people can sign up in case the charity one day is able to help individual people. Ashton said there are more than 10,000 names.

"My goal in life is to be able to help people who come to us," Antico said.

Copyright Associated Press / NBC New York



Photo Credit: AP]]>
<![CDATA[FDA Says Teething Necklaces Should Be Avoided]]>Fri, 21 Dec 2018 17:26:59 -0500https://media.nbcnewyork.com/images/213*120/amberteethingGettyImages-925809116.jpg

The FDA issued a warning on Thursday to parents with teething babies: teething jewelry is dangerous. It can cause strangulation or choking.

"There is no scientific information that teething necklaces are effective and safe. They are really quite dangerous," said Jennifer Hoekstra, an injury prevention specialist at Helen DeVos Children’s Hospital in Grand Rapids, Michigan. She's not with the FDA, but fully supports the warning, she said: "The American Association of Pediatrics does not recommend any teething jewelry."

Those who dress their children in Baltic amber necklaces or bracelets believe that the amber releases succinic acid into the skin, acting as an analgesic, and thus diminishing pain. 

The evidence does not support that theory. The FDA also received a report of one death after an 18-month old child was strangled by his amber teething necklace during a nap.



Photo Credit: BSIP/UIG via Getty Images]]>
<![CDATA[American Adults Getting Heavier, Staying the Same Height: CDC]]>Thu, 20 Dec 2018 08:37:32 -0500https://media.nbcnewyork.com/images/213*120/183758075-Beam-Scale.jpg

You don't need to hang the mistletoe higher but you might want to skip the holiday cookies.

A new report released Thursday shows U.S. adults aren't getting any taller but they are still getting fatter.

The average U.S. adult is overweight and just a few pounds from obese, thanks to average weight increases in all groups — but particularly whites and Hispanics.

Overall, the average height for men actually fell very slightly over the past decade. There was no change for women.

One factor may be the shift in the country's population. There's a growing number of Mexican-Americans, and that group tends to be a little shorter, said one of the report's authors, Cynthia Ogden of the Centers for Disease Control and Prevention.

The findings come from a 2015-16 health survey that measures height and weight. More than 5,000 U.S. adults took part.

CDC records date back to the early 1960s, when the average man was a little over 5 feet, 8 inches tall and weighed 166 pounds. Now, men are almost 1 inch taller and more than 30 pounds heavier. But today's average height of 5 feet, 9 inches is about a tenth of an inch shorter than about a decade ago.

The average woman in the early 1960s was 5 feet, 3 inches and 140 pounds. Now, women are a half-inch taller and about 30 pounds heavier, on average. The average height is about the same as it was a decade earlier: 5 feet, 4 inches.

Other survey findings:

  • In the last decade, the average weight of men rose about 2 pounds, to 198. For women, it rose 6 pounds, to nearly 171.
  • Men have 40-inch waistlines, on average. Women's waistlines are a little under 39 inches.
  • The average height of black men and white men has been holding about steady, at a little under 5 feet 10.
  • Mexican-American and Asian-American men are roughly 3 inches shorter than whites and blacks, on average. There was a similar height gap in women.

In 2016, about 18 percent of the nation's population was Hispanic, up from about 13 percent in 2000, according to U.S. Census figures. Mexican-Americans account for nearly two-thirds of the Hispanic population.

Copyright Associated Press / NBC New York



Photo Credit: Getty Images/iStockphoto]]>
<![CDATA[Guns Kill Twice as Many Kids as Cancer Does, New Study Finds]]>Thu, 20 Dec 2018 08:18:20 -0500https://media.nbcnewyork.com/images/213*120/907084844-Gun-Generic.jpg

A new study out Wednesday found that nearly twice as many children died from gun injuries in 2016 than from cancer, making guns the second-leading killer of children in the U.S., NBC News reported.

Only car crashes killed more children than guns, and the U.S. gun fatality rate for children — which rose 28 percent between 2013 and 2016 — is 36 times higher than in other developed nations, according to the study from a team at the University of Michigan's Injury Prevention Center .

The nation is failing to protect children, wrote the executive editor of the New England Journal of Medicine in an editorial that accompanied the report.

"Children in America are dying or being killed at rates that are shameful," Dr. Edward Campion wrote.



Photo Credit: Getty Images, File]]>
<![CDATA[Getting Over 'Fortnite' Addiction]]>Wed, 19 Dec 2018 18:29:02 -0500https://media.nbcnewyork.com/images/213*120/NC_fortnite1217_1500x845.jpg

Parents of "Fortnite"-addicted players are being urged to set limits for the wildly popular third-person shooter video game and learn how to spot signs of gaming addiction in their child. ]]>
<![CDATA[Calif. Doctor Arrested After 5 People Overdose on Opioids]]>Wed, 19 Dec 2018 03:51:23 -0500https://media.nbcnewyork.com/images/213*120/irvine-doctor-court-sketch.PNG

A doctor who owns an urgent care facility in Irvine was arrested Tuesday on charges of illegally distributing opioids, including to a man charged with running over and killing an off-duty Costa Mesa fire captain riding his bicycle in Mission Viejo.

Dzung Ahn Pham, 57, of Tustin, who owns Irvine Village Urgent Care at 15435 Jeffrey Road, was arrested on two counts of illegally distributing oxycodone, according to Thom Mrozek of the U.S. Attorney's Office. Federal authorities said five people who received drug prescriptions from Pham have died of overdoses.

Federal authorities also contend that Pham sent a text message expressing concern that Borderline Bar and Grill mass killer David Ian Long had prescription drugs in his possession that Pham had prescribed for someone else.

Pham is accused of writing prescriptions to people without examining them, and he allegedly sold prescriptions to drug addicts or to dealers selling the narcotics on the black market, Mrozek said.

Prosecutors allege Pham wrote "an extremely high amount'' of prescriptions over three years, so much so that a CVS pharmacy in Irvine stopped taking prescriptions from Pham more than five years ago.

Over the summer, Drug Enforcement Administration agents conducted two undercover operations targeting Pham in which he allegedly steered the agents two a pharmacy in Irvine that filled many of his prescriptions, Mrozek said.

Five people who obtained drugs from Pham from 2014 through last year overdosed and died, prosecutors said.

Stephen Taylor Scarpa, 25, of Mission Viejo, who is charged with second-degree murder in the death of 44-year-old Costa Mesa fire Capt. Mike Kreza, was allegedly high on drugs from Pham at the time of the deadly collision on Nov. 3, Mrozek said. Prescription bottles with Pham's name on them were found in Scarpa's van after the collision, according to a DEA affidavit.

Pham charged between $100 and $150 per office visit, Mrozek said. The doctor deposited over $5 million, mostly in cash, into his and his wife's bank accounts between 2013 and September of this year, according to the DEA affidavit. He also deposited about $1.7 million into a business bank account that investigators suspect came from insurance payments, Mrozek said.



Photo Credit: Bill Robles]]>
<![CDATA[Unemployment, Income Affect Life Expectancy, Data Show]]>Tue, 18 Dec 2018 08:48:25 -0500https://media.nbcnewyork.com/images/213*120/157533457-Hospital-Gurneys-Generic.jpg

Even your lifespan can be local.

Researchers have long said that health disparities are heavily influenced by where you live. New data from the National Center for Health Statistics show just how much your neighborhood can impact the length of your life.

In recent years, the U.S. has seen overall life expectancy decrease, from 78.7 years in 2015 to 78.6 years in 2017. Experts have pointed to opioid addiction and an increase in suicides as the main reasons.

Behind that national average are American neighborhoods where recently born residents can expect to live much longer, or much shorter, lives.

The Associated Press analyzed life expectancy and demographic data for 65,662 census tracts, which are geographic areas that encompass roughly 4,000 residents. The AP found that certain demographic qualities — high rates of unemployment, low household income, a concentration of black or Native American residents and low rates of high school education — affected life expectancy in most neighborhoods.

An increase of 10 percentage points in the unemployment rate in a neighborhood translated to a loss of roughly a year and a half of life expectancy, the AP found. A neighborhood where more adults failed to graduate high school had shorter predicted longevity.

New York state had the largest range for life expectancy among its neighborhoods, spanning 34.5 years. The places with the highest and lowest estimates are both in New York City. Children born between 2010 and 2015 in part of the northern half of Roosevelt Island have an estimated life expectancy of 59 years; a child born 6 miles away in Chinatown in lower Manhattan can expect to live 93.6 years.

In one North Carolina neighborhood — Fearrington Village in Chatham County — a child born between 2010 and 2015 can expect to live 97.5 years, the highest estimated lifespan for any neighborhood in the U.S. A child in part of Stilwell in Adair County, Oklahoma, can expect 59 years on average, the nation's lowest.

The AP analysis also found discrepancies among states. Life expectancy in Hawaii topped all other states at 82 years. Mississippi's estimate of 74.9 was the lowest, followed closely by West Virginia, Alabama, Oklahoma and Kentucky.

The AP analyzed 88.7 percent of all U.S. census tracts. Maine and Wisconsin were excluded because some of their death records lacked home addresses of the deceased.

The data is part of a new partnership between the National Center for Health Statistics, The Robert Wood Johnson Foundation, The National Association for Public Health Statistics and Information Systems (NAPHSIS), and the National Center for Health Statistics (NCHS). Through the collaboration, researchers used six years of death records and demographic data to create a longevity estimate for nearly every census tract in the country.

Copyright Associated Press / NBC New York



Photo Credit: Getty Images, File]]>
<![CDATA[US Surgeon General Warns of Teen Risks From E-Cigarettes]]>Tue, 18 Dec 2018 07:47:37 -0500https://media.nbcnewyork.com/images/213*120/vaping1.jpg

The government's top doctor is taking aim at the best-selling electronic cigarette brand in the U.S., urging swift action to prevent Juul and similar vaping brands from addicting millions of teenagers.

In an advisory Tuesday, Surgeon General Jerome Adams said parents, teachers, health professionals and government officials must take "aggressive steps" to keep children from using e-cigarettes. Federal law bars the sale of e-cigarettes to those under 18.

For young people, "nicotine is dangerous and it can have negative health effects," Adams said in an interview. "It can impact learning, attention and memory, and it can prime the youth brain for addiction."

Federal officials are scrambling to reverse a recent explosion in teen vaping that public health officials fear could undermine decades of declines in tobacco use. An estimated 3.6 million U.S. teens are now using e-cigarettes, representing 1 in 5 high school students and 1 in 20 middle schoolers, according to the latest federal figures.

Separate survey results released Monday showed twice as many high school students used e-cigarettes this year compared to last year.

E-cigarettes and other vaping devices have been sold in the U.S. since 2007, growing into a $6.6 billion business. Most devices heat a flavored nicotine solution into an inhalable vapor. They have been pitched to adult smokers as a less-harmful alternative to cigarettes, though there's been little research on the long-term health effects or on whether they help people quit. Even more worrisome, a growing body of research suggests that teens who vape are more likely to try regular cigarettes.

Adams singled out Silicon Valley startup Juul. The company leapfrogged over its larger competitors with online promotions portraying their small device as the latest high-tech gadget for hip, attractive young people. Analysts now estimate the company controls more than 75 percent of the U.S. e-cigarette market.

The surgeon general's advisory notes that each Juul cartridge, or pod, contains as much nicotine as a pack of cigarettes. Additionally, Adams states that Juul's liquid nicotine mixture is specially formulated to give a smoother, more potent nicotine buzz. That effect poses special risks for young people, Adams says.

"We do know that these newer products, such as Juul, can promote dependence in just a few uses," Adams said.

Juul said in a statement that it shares the surgeon general's goal: "We are committed to preventing youth access of Juul products."

Last month, San Francisco-based Juul shut down its Facebook and Instagram accounts and halted in-store sales of its flavored pods. The flavors remain available via age-restricted online sales. That voluntary action came days before the Food and Drug Administration proposed industrywide restrictions on online and convenience store sales of e-cigarettes to deter use by kids.

Adams recommends parents, teachers and health professionals learn about e-cigarettes, talk to children about the risks and set an example by not using tobacco products.

Copyright Associated Press / NBC New York



Photo Credit: Steven Senne/AP, File]]>
<![CDATA[After Judge's Ruling Against 'Obamacare,' What Happens Now?]]>Mon, 17 Dec 2018 17:04:22 -0500https://media.nbcnewyork.com/images/213*120/ACA1.jpg

A federal judge's ruling would, if upheld, wipe away the entire Affordable Care Act, the health care overhaul championed by President Barack Obama and twice sustained by the Supreme Court.

Judge Reed O'Connor's opinion was issued late Friday, and supporters of the law vowed to appeal and take other steps to preserve health benefits in the law sometimes called "Obamacare."

Some questions and answers about O'Connor's ruling:

WHAT IS THE IMMEDIATE EFFECT OF THE RULING FOR AMERICANS COVERED UNDER OBAMACARE?
In a word, nothing. Although O'Connor said the entire law must fall, he did not grant a request from its opponents to have his ruling take effect immediately. That means that all the law's provisions remain in effect. The federal Health and Human Services Department put out a statement making clear that it "will continue administering and enforcing all aspects of the ACA as it had before the court issued its decision."

HOW WOULD THE AVERAGE PERSON'S HEALTH CARE BE AFFECTED IF THE RULING IS UPHELD?
The impact would go well beyond the more than 20 million people who are directly covered through Obamacare.

More than 170 million Americans are covered by employers, and they could lose no-cost preventive care, from screening tests like colonoscopies to birth control for women. Employers would no longer be required to keep the young adult children of their workers covered up to age 26. Gone would be limits on annual out-of-pocket expenses, which provide greater financial protection for people with job-based coverage. Another kind of limit — lifetime caps on what insurance will pay for medical bills — could stage a comeback.

Medicare would be affected because the ACA expanded no-cost coverage of preventive services and reduced the bills of seniors with high prescription drug costs. Program finances would also take a hit. Medicaid, the federal-state program for low-income people, was expanded under the ACA. So about 12 million people who gained coverage could be left uninsured. Efforts to counter the opioid epidemic would be dealt a severe blow since Medicaid has become a mainstay for treatment.

HealthCare.gov and state insurance markets offering subsidized private insurance would disappear, potentially leaving 10 million people or more uninsured.

And the list would go on. The health law made hundreds of changes.

WHAT WAS THE JUDGE'S REASONING IN STRIKING DOWN THE ENTIRE HEALTH CARE LAW?
A key part of the Affordable Care Act that Obama signed into law in 2010 was the provision requiring people to have health insurance or pay a penalty if they refused. The Supreme Court upheld this individual mandate in 2012. Congress reduced that penalty to zero as part of the tax legislation it passed, and President Donald Trump signed, in 2017. That means that beginning in January, there no longer will be a penalty for not purchasing health insurance.

O'Connor agreed with Texas and other Republican-led states that challenged the law that the elimination of the penalty rendered the requirement to have health insurance unconstitutional. In a crucial step in his logic, O'Connor then held that because the individual mandate is so important to the overall law, the whole thing can no longer stand. The legal explanation is that O'Connor found that the mandate could not be severed from the rest of the law, meaning he struck it down in its entirety.

HOW LIKELY IS IT THAT HIGHER COURTS WILL AGREE WITH O'CONNOR'S RULING?
Even some opponents of the health care law, including The Wall Street Journal editorial page, have said O'Connor went too far and predicted he would be reversed in the appeals process. Congress did indeed render the individual mandate unenforceable when it reduced the penalty for not complying to zero. But that very same Congress left the rest of the law intact. What's more, Republican efforts to repeal the ACA failed in the same Congress. In addition, even if the federal appeals court that oversees Texas were to agree with O'Connor, it seems improbable at best that Chief Justice John Roberts, who twice wrote opinions upholding the law — in 2012 and 2015, would now strike it down.

WHO WILL APPEAL THE RULING, AND HOW LONG MIGHT THE PROCESS TAKE?
California Attorney General Xavier Becerra, the leader of a coalition of states defending the law in court, already has promised to appeal. The process will take months at a minimum, even with the states pressing for a speedy resolution because of the uncertainty O'Connor's ruling creates and the potential effects on the insurance markets.

If the 5th U.S. Circuit Court of Appeals reverses O'Connor, chances that the Supreme Court would hear the case are slim. If the 5th Circuit agrees with O'Connor, high court review becomes very likely because the justices almost always weigh in when a federal law has been struck down. But even then, the Supreme Court wouldn't hear the case before the fall of 2019 at the earliest, with a decision unlikely before the spring of 2020 — amid the presidential and congressional campaigns.

HOW WILL CONGRESS RESPOND?
Democrats in the House say they plan to intervene in the defense of the law, joining Democrat-led states. In addition, expect hearings in the House to focus on Trump administration efforts that Democrats, who take charge of the House in January, say are intended to undermine the health care law. These include encouraging the use of low-cost short-term policies with limited coverage and cuts to government attempts to sign up beneficiaries.

Rep. Frank Pallone, the incoming chairman of the House Energy and Commerce Committee, said Democrats are readying bills to curb the use of the short-term plans and bolster the Obama law's coverage of people with pre-existing conditions. The bill could also make federal subsidies for lower-earning beneficiaries more generous and shore up insurers for covering seriously ill customers with extremely high costs of care, he said.

Associated Press writers Ricardo Alonso-Zaldivar and Alan Fram contributed to this report.

Copyright Associated Press / NBC New York



Photo Credit: Joe Raedle/Getty Images (File)]]>
<![CDATA[Startup's On-Demand Health Insurance Draws Attention]]>Mon, 17 Dec 2018 14:09:32 -0500https://media.nbcnewyork.com/images/213*120/AP_18348760155126-Bind-Health-Insurance.jpg

People with health insurance often pay for coverage they never use. A startup wants to shake that up.

It's a radical idea: On-demand insurance that lets customers buy some of their coverage only if and when they need it, similar to how TV viewers might rent a new release from Amazon instead of paying every month for a pricey cable package they rarely use.

This approach from Bind Benefits is one of the latest wrinkles in a yearslong push by companies and insurers to control costs and make patients smarter health care shoppers. And it's drawing attention from the nation's largest health insurer, UnitedHealthcare, and some sizeable employers.

"It's the sort of thing we need entrepreneurs to be doing," said Robert Laszewski, a health care consultant and former insurance executive. "We haven't had a new idea in managed care in I don't know how long."

Bind's plan draws concern from researchers worried about how this may hurt some pocketbooks, but it also has attracted employers hungry for a fresh way to tame expenses.

School superintendent Barry Rose picked Bind as the only coverage option earlier this year for the Cumberland, Wisconsin, school district after cycling through numerous health plans in the last six years. Rose said about two-thirds of his workers use $500 or less in health care every year, and he didn't want to charge them premiums for care they weren't using.

"We have quality health care. If people need it, great. If they don't, at least we're not soaking them for it," he said.

Minneapolis-based Bind is not an insurer, but it designs health plans for big employers that pay their own bills.

Here's how it works. Under Bind's plan, customers pay a base monthly premium that can be as much as 40 percent cheaper than other options their employer offers, the company says.

That covers most care, like doctor visits, hospital stays, maternity care, cancer treatment and prescriptions.

A patient can then buy additional coverage for some procedures that aren't urgent like a knee surgery or hip replacement. In these cases, the patient has time to plan for the care and look at different options for who performs it.

The additional coverage comes with an extra premium and possibly a copayment, depending on the care provider and what is being purchased. In these cases, patients might get stuck paying more than $1,000 in additional costs.

Users log onto Bind's website or app to see what is covered, what it will cost them. That can vary based on Bind's quality rating for a provider and how efficiently it provides care. Someone with an ear infection might pay nothing for a telemedicine visit. But a trip to an expensive emergency room for such a minor illness might cost a few hundred dollars.

"If we get everyone buying better, we actually make the product more affordable for all of us," said Bind CEO Tony Miller.

If patients stick to the plan's provider network in that core coverage, they will have one bill — a copayment. Miller said Bind avoids high deductibles or co-insurance payments that make it hard for some to understand how much care really costs.

That simplicity helped Nancy Buchholz when she was trying to track her husband's expenses for cancer treatment last spring. She said he died six weeks after being diagnosed, and she became overwhelmed by billing notices from the hospital showing that care costs were approaching $300,000.

But the only bill she had to pay for his hospital stay was the $1,900 copayment laid out in the insurance plan.

"When you go through something that's emotionally devastating, the last thing you want to worry about is having to make sure something is paid for," said the Cadott, Wisconsin, resident, who got Bind coverage through her employer, Dove Healthcare.

The potential for unexpected additional costs under Bind's system concerns Sabrina Corlette, a research professor at Georgetown's Center on Health Insurance Reforms. She noted that older customers are more likely to wind up with these big bills because they tend to have more expensive procedures.

"This gets close to the line if not a little bit over the line of being discriminatory because it would only be people who have certain health conditions that would face higher premiums," she said.

Miller said his plans comply with federal anti-discrimination laws, and they provide all covered members the same benefit at the same cost.

Bind started selling coverage this year and only has a few thousand people enrolled. But it is expanding nationally, with help from UnitedHealthcare, which covers more than 40 million people. UnitedHealthcare is offering Bind coverage to some employer customers for 2019.

The company will need to offer big discounts to attract more business, said Laszewski, the health care consultant.

He noted that customers are slow to accept new insurance ideas, and Bind relies on patients trusting its quality rating for the doctor they pick. That's a gamble in health care, where it's hard for people to understand and feel comfortable with those measurements.

"If you're going to expect employers and consumers to take risks, they're going to have to see a premium up front," he said. "They're not going to buy the sales pitch."

Copyright Associated Press / NBC New York



Photo Credit: Stacy Bengs/AP]]>
<![CDATA[Child Abuse Climbs After Friday Report Cards, Study Says]]>Mon, 17 Dec 2018 13:57:14 -0500https://media.nbcnewyork.com/images/213*120/school+bus+generic+nbc+4+new+york.jpg

Child abuse increases the day after school report cards are released — but only when kids get their grades on a Friday, a study in Florida suggests.

The curious finding startled researchers, who had figured abuse might go up regardless of the specific day kids got their grades.

But their study of reports to a child abuse hotline that included broken bones, burns and other confirmed abuse found otherwise. An increase only occurred on Saturdays after a report-card Friday. Though overall rates were small, there were almost four times more cases on those Saturdays than on other Saturdays. No apparent connection between report cards and abuse was found on other days of the week.

"Anecdotally, we know a lot of parents will spank their children or use corporal punishment if they're unsatisfied with their school work," said University of Florida psychologist Melissa Bright, the lead author.

That punishment may become abusive when kids don't have school the next day and parents think injuries might be more likely to go unnoticed, the researchers said, noting that teachers are required to report suspected child abuse. Or, it could be that severe punishment is less likely on weekdays when parents are too busy to focus on report cards, Bright said,

But she acknowledged those theories are speculation and that the findings aren't proof.

The study was published Monday in JAMA Pediatrics.

The researchers reviewed calls to a Florida child abuse hotline and school report card release dates in most of Florida's 67 counties during the 2015-2016 academic year. Nearly 2,000 cases of physical abuse in kids aged 5 to 11, confirmed by child welfare authorities, were included.

There was an average of slightly more than 0.6 cases of abuse per 100,000 children on Saturdays after a report-card Friday compared with slightly less than 0.2 cases per 100,000 children on other Saturdays. The average was less than one per day because so many days were included in the analysis. But in a state like Florida, with a school-age population of just over 3 million kids, this could amount to 19 cases of report card-related abuse compared to 5 on other Saturdays, the researchers said.

Outside experts noted study limitations, including no evidence that kids who were abused had received poor grades and no information on when parents first learned of kids' grades. But they said the study was useful for highlighting that child abuse and corporal punishment are still too common even though rates have declined since the 1990s. Rates were 9 per 1,000 U.S. kids in 2016 compared with 13 per 1,000 in 1990.

Dr. Robert Sege, a Boston pediatrician and Tufts University professor of medicine, said bad grades should be a time for parents to find out what's causing their childrens' struggles. "There's no place for corporal punishment for school failure because it doesn't work and misses the point."

Sege is lead author of an American Academy of Pediatrics policy update released last month that recommends against corporal punishment and spanking.

An editorial published with study said the United States deserves a C-minus "for effective discipline strategies."

Changing a report card release day may reduce some abuse, the editorial said, "but it will not solve the larger issue: It is still socially acceptable to hit a child to correct their behavior."

Copyright Associated Press / NBC New York



Photo Credit: NBC 4 New York, File]]>
<![CDATA[Teen Vaping Boom Alarms Health Officials]]>Mon, 17 Dec 2018 10:37:37 -0500https://media.nbcnewyork.com/images/213*120/NC_teendrugs1214_1500x845.jpg

Twice as many high school students have picked up a vaping habit compared to last year - a large, unprecedented jump that is alarming health officials who say teenagers do not realize there is nicotine in e-cigarettes. ]]>
<![CDATA[Most Teen Drug Use Is Down, But Officials Fret Vaping Boom]]>Mon, 17 Dec 2018 10:34:47 -0500https://media.nbcnewyork.com/images/213*120/vapingAP_18346804555667.jpg

Twice as many high school students used nicotine-tinged electronic cigarettes this year compared with last year, an unprecedented jump in a large annual survey of teen smoking, drinking and drug use.

It was the largest single-year increase in the survey's 44-year history, far surpassing a mid-1970s surge in marijuana smoking.

The findings, released Monday, echo those of a government survey earlier this year. That survey also found a dramatic rise in vaping among children and prompted federal regulators to press for measures that make it harder for kids to get them.

Experts attribute the jump to newer versions of e-cigarettes, like those by Juul Labs Inc. that resemble computer flash drives and can be used discreetly.

Most vaping products, including Juul, use nicotine and students may not realize the product is addictive, NBC News reported. More than 25 percent claimed they vaped “just flavoring” in the past year, compared to 20.6 percent the prior year.

Trina Hale, a junior at South Charleston High School in West Virginia, said vaping — specifically Juul — exploded at her school this year.

"They can put it in their sleeve or their pocket. They can do it wherever, whenever. They can do it in class if they're sneaky about it," she said.

Olivia Turman, a freshman at Cabell Midland High School in Ona, West Virginia, said she too has seen kids "hit their vape in class."

The federally funded survey released Monday is conducted by University of Michigan researchers and has been operating since 1975. This year's findings are based on responses from about 45,000 students in grades 8, 10 and 12 in schools across the country. It found 1 in 5 high school seniors reported having vaped nicotine in the previous month.

After vaping and alcohol, the most common thing teens use is marijuana, the survey found. About 1 in 4 students said they'd used marijuana at least once in the past year. It was more common in older kids — about 1 in 17 high school seniors said they use marijuana every day.

Overall, marijuana smoking is about the same level as it was the past few years. Vaping of marijuana rose, however.

More teens, however, are saying no to lots of other substances. Usage of alcohol, cigarettes, cocaine, LSD, ecstasy, heroin and opioid pills all declined.

Experts say it's not clear what's behind those trends, especially since the nation is in the midst of the deadliest drug overdose epidemic ever.

"What is it that we're doing right with teenagers that we're not doing with adults?" said Dr. Nora Volkow, director of the National Institute on Drug Abuse, a federal agency that funds the Michigan study.

One leading theory is that kids today are staying home and communicating on smartphones rather than hanging out and smoking, drinking or trying drugs.

"Drug experimentation is a group activity," Volkow said.

What about vaping? "Vaping mostly is an individual activity," said David Jernigan, a Boston University researcher who tracks alcohol use.

The vaping explosion is a big worry, however. Health officials say nicotine is harmful to developing brains. Some researchers also believe vaping will make kids more likely to take up cigarettes, and perhaps later try other drugs.

So far that hasn't happened, surveys show. But the Juul phenomenon is recent, noted Richard Miech, who oversees the Michigan survey.

If vaping does lead to cigarette use among teens, that may start to show up in the survey as early as next year, he added.

Copyright Associated Press / NBC New York



Photo Credit: Steven Senne/AP, File ]]>
<![CDATA[Sign-Up Deadline Is Saturday for ACA Health Law Coverage]]>Sat, 15 Dec 2018 17:51:48 -0500https://media.nbcnewyork.com/images/213*120/ACAAP_18346561695404.jpg

Saturday is the last day to sign up for health insurance next year under the Affordable Care Act in most of the country.

For 2019, premiums are stable, more plans are available, and millions of uninsured people can still get financial help. But so far sign-ups have been lagging when compared to last year.

Consumers can enroll online at HealthCare.gov or by reaching the federal call center at 1-800-318-2596.

People can also sign up through approved community organizations, online insurance sellers, and insurance companies.

The deadline is 12 a.m. Pacific time in states served by the HealthCare.gov website. A few states that run their own enrollment campaigns may have later deadlines. Consumer advocates say interested customers should check carefully and avoid procrastination.

Coverage takes effect Jan. 1.

The health care law still faces legal challenges, A conservative federal judge in Texas ruled the Affordable Care Act "invalid" Friday on the eve of the sign-up deadline for next year. But with appeals certain, even the Trump White House said the law will remain in place for now.

Copyright Associated Press / NBC New York



Photo Credit: Pablo Martinez Monsivais/AP]]>
<![CDATA[Ruling to Strike Down Health Law Puts GOP in a Quandary]]>Sat, 15 Dec 2018 18:59:09 -0500https://media.nbcnewyork.com/images/213*120/AP_18349124253004.jpg

A federal judge's ruling that the Obama health law is unconstitutional has landed like a stink bomb among Republicans, who've seen the politics of health care flip as Americans increasingly value the overhaul's core parts, including protections for pre-existing medical conditions and Medicaid for more low-income people.

While the decision by the Republican-appointed judge in Texas was sweeping, it has little immediate practical impact because the Affordable Care Act remains in place while the legal battle continues, possibly to the Supreme Court.

HealthCare.gov, the government's site for signing up, was taking applications Saturday, the deadline in most states for enrolling for coverage next year, and those benefits will take effect as scheduled Jan. 1. Medicaid expansion will proceed in Virginia, one of the latest states to accept that option. Employers will still be required to cover the young adult children of workers, and Medicare recipients will still get discounted prescription drugs.

But Republicans, still stinging from their loss of the House in the midterm elections, are facing a fresh political quandary after U.S. District Judge Reed O'Connor said the entire 2010 health law was invalid.

Warnings about the Texas lawsuit were part of the political narrative behind Democrats' electoral gains. Health care was the top issue for about one-fourth of voters in the November election, ahead of immigration and jobs and the economy, according to VoteCast, a nationwide survey for The Associated Press. Those most concerned with health care supported Democrats overwhelmingly.

In his ruling, O'Connor reasoned that the body of the law could not be surgically separated from its now-meaningless requirement for people to have health insurance.

"On the assumption that the Supreme Court upholds, we will get great, great health care for our people," President Donald Trump told reporters during a visit Saturday to Arlington National Cemetery. "We'll have to sit down with the Democrats to do it, but I'm sure they want to do it also."

Economist Gail Wilensky, who oversaw the Medicare program for President George H.W. Bush, said the state attorneys general from GOP strongholds who filed the lawsuit really weren't very considerate of their fellow Republicans.

"The fact that they could cause their fellow Republicans harm did not seem to bother them," said Wilensky, a critic of President Barack Obama's signature domestic achievement.

"The people who raised it are a bunch of guys who don't have serious election issues, mostly from states where saber-rattling against the ACA is fine," she added. "How many elections do you have to get battered before you find another issue?"

Douglas Holtz-Eakin, top policy adviser to Republican John McCain's 2008 presidential campaign, said he was struck by the relative silence from top Republicans after the ruling issued.

A prominent example: "The House was not privy to this suit, and we are reviewing the ruling and its impact," said AshLee Strong, spokeswoman for House Speaker Paul Ryan, R-Wis.

Republicans are "going to have to figure out what to do," Holtz-Eakin said. "If it's invalidated by the courts, it's not ... 'We're going to do it our way.' They're going to have to get together with the Democrats in the House."

The GOP's failed effort last year to repeal the law showed there's no consensus within the party itself.

Trump tweeted Friday night that "Congress must pass a STRONG law that provides GREAT healthcare and protects pre-existing conditions."

"Get it done!" he told Senate Majority Leader Mitch McConnell, R-Ky., and Rep. Nancy Pelosi, D-Calif., who is expected to be speaker in January. But Trump had no plan of his own to offer in the 2017 "repeal and replace" debate.

Two top House Republicans issued diverging statements.

Majority Leader Kevin McCarthy of California said "Obamacare is a broken law," but added, "I am committed to working with my colleagues on both sides of the aisle to make sure America's healthcare system works for all Americans."

The third-ranking GOP leader, Louisiana Rep. Steve Scalise, praised the judge's ruling and made no mention of working with Democrats, whom he accused of "running a fear-mongering campaign" to win control of the House last month.

The chairman of the House Ways and Means Committee, Rep. Kevin Brady, R-Texas, said that if the law is ultimately overturned, then members of Congress from both parties should start over, working together. He urged maintaining provisions such as protections for pre-existing medical conditions, no lifetime dollar limits on insurance coverage, and allowing young adults to stay on parental coverage until age 26.

Democrats were united in condemning the ruling.

Senate Democratic leader Chuck Schumer of New York said voters will remember. "What will stand is Republican ownership of such a harmful and disastrous lawsuit," Schumer tweeted.

The next chapter in the legal case could take months to play out.

A coalition of Democratic state officials led by California Attorney General Xavier Becerra will appeal O'Connor's decision, most likely to the U.S. Court of Appeals for the 5th Circuit in New Orleans.

"The legal merits of the case are frivolous," said University of Michigan law professor Nicholas Bagley. "The notion that the unconstitutionality of an unenforceable mandate somehow requires toppling the entire ACA is bonkers." Bagley supports the law generally, but has been critical of how it has been put into effect.

Copyright Associated Press / NBC New York



Photo Credit: AP Photo/Alan Diaz, File]]>
<![CDATA[Calif. Man Who Thought He Was 'Fat' Had a 77-Pound Tumor]]>Fri, 14 Dec 2018 22:20:11 -0500https://media.nbcnewyork.com/images/213*120/hernandez-gut-tumor-121418.jpg

Hector Hernandez thought he was "fat." Then he received some shocking news: What he thought was stomach fat was actually a 77-pound cancerous tumor.

"I just thought I was fat," said Hernandez of Downey, California. "I’ve always been a big guy, so I didn’t really put too much worry into it."

Hernandez told NBC4 he would get a lot of stares in public because of his large stomach, which caused him to stop using the Metro.

"I always wore big jackets. I got in the Metro, and a police officer came and tapped me on my jacket and asked me what I had in my jacket," Hernandez said. "He just looked at [my stomach] and kind of just felt bad and walked away."

Hernandez began to exercise and started losing weight all over his body — except his stomach, which felt rock hard. But he said he did not feel any type of pain.

"That’s when I knew there was something wrong," he said.

Editor's note: An image of the removed tumor is at the bottom of this article. Viewer discretion is advised. 

At the time, Hernandez had high blood pressure, shortness of breath and diabetes. His doctor performed an ultrasound, did a CT scan and some bloodwork in hopes of figuring out what Hernandez had. But despite all the tests, it still wasn't clear what was wrong.

His local doctor referred him to surgical oncologist Dr. William Tseng at Keck Medicine of USC.

Dr. Tseng told Hernandez that it was not weight gain. In fact, he had Retroperitoneal liposarcoma, a rare cancer formed in fat cells.

"We don’t know what causes it," Tseng said. "It has nothing to do with obesity."

He added that it can happen to anyone. 

Tseng is one of the few people who specializes in treating sarcomas and said this type of rare cancer can actually develop anywhere in the body, and it does not come with specific symptoms.

Hernandez’s tumor was in the back of the abdomen, Tseng said. He explained that because it was in that particular location, the body adapted to it as it grew.  It was able to grow to such a large size without the patient noticing because from the outside, it just appears as if the abdomen is bloated, or as Hernandez thought, it just looks like weight gain.

Tseng added that doctors who are not specialized in this field can misdiagnose the tumor or even completely miss it.

The surgical oncologist encounters this type of tumor on a regular basis and said Hernandez's wasn't anything out of the ordinary. But, it was "definitely the biggest one" he had come across.

The removal of the 77-pound tumor required a six-hour surgery where Hernadez’s kidney had to be removed as Tseng couldn’t separate it from the tumor.

Now, Hernandez says he feels more confident.

"I’m glad my arms are back, my shoulders are back, my face is plump. I just couldn’t be any happier," he said, adding that when he began exercising and losing weight, his body was not proportional. 

Hernandez has to get CT scans every four months along with frequent checkups.

"Even though we got everything out completely, statistically it will come back in some point in his life," Tseng said.

The sarcoma specialist told NBC4 that for the vast majority of patients, it does show up again. 

"Because the tumors are so big, you really can’t get rid of the microscopic disease. There’s no way of getting all the cells out," he explained.

If you would like to contribute to Hernandez’s medical expenses, you can do so here at his GoFundMe account. 



Photo Credit: Courtesy Hector Hernandez
This story uses functionality that may not work in our app. Click here to open the story in your web browser.]]>
<![CDATA[Calif. Farm Linked to Tainted Romaine Recalls Other Products]]>Fri, 14 Dec 2018 15:06:10 -0500https://media.nbcnewyork.com/images/213*120/531808415-Cauliflower.jpg

U.S. health officials have traced a food poisoning outbreak from romaine lettuce to at least one farm in California, which voluntarily recalled red and green leaf lettuce as well as cauliflower because they may be contaminated with E. coli.

Adam Bros. Farms in Santa Barbara County said Thursday it was issuing the new recall, for the listed products harvested between Nov. 27 and Nov. 30, "out of an abundance of caution."

The Food and Drug Administration cautioned Thursday that other farms are likely involved in the romaine lettuce E. coli outbreak and consumers should continue checking the label before purchasing the product.

The Food and Drug Administration said 59 people in 15 states have now been sickened by the tainted lettuce. That's seven more cases than previously reported, but regulators said they are fairly confident that the lettuce which first triggered the outbreak has been removed from the market. The FDA told consumers to avoid romaine lettuce just before Thanksgiving.

Officials said a water reservoir at Adam Bros. Farms in Santa Barbara County tested positive for the bacterial strain and the owners are cooperating with U.S. officials. Officials from the FDA and the Centers for Disease Control and Prevention have not determined how the water reservoir — which is used to irrigate lettuce — became contaminated.

Adam Bros. said in a statement that "sediment from a reservoir near where the
produce was grown tested positive for E. coli" but said that while harvested produce may have come into contact with filtered, treated water from the reservoir, none of that water tested positive for the bacteria.

The company said that there have been no illnesses reported in the recall of red leaf lettuce, green leaf lettuce and cauliflower. Those products were distributed across the country; find identifying product information here.

A man who answered the phone at Adam Bros. Farms Thursday said he could not comment on the government announcement. According to the company's website, it only grows vegetables products, including broccoli, cauliflower, celery and various types of lettuce. Not all Adam Bros. products have been recalled, according to the statement.

E. coli can get into water and soil through multiple routes, including waste from domesticated animals or wild animals, fertilizer and other agricultural products.

The FDA's Dr. Stephen Ostroff said investigators have linked the tainted romaine lettuce to multiple distributors and processors, suggesting it must have come from several farms.

The government also narrowed the source of the outbreak to three California counties: Santa Barbara, Monterey and San Benito. That's down from six California counties under investigation when regulators began warning the public last month.

Regulators said people should only buy romaine lettuce with a label listing where and when it was harvested. Lettuce from outside the three California counties that was harvested after Nov. 23 should be safe to eat.

Romaine harvesting recently began shifting from California's Central Coast to winter growing areas, primarily Arizona, Florida, Mexico and California's Imperial Valley. Those winter regions weren't yet shipping when the illnesses began.

E. coli, the bacteria often associated with food poisoning, usually causes sickness two to eight days later, according to health authorities. Most people with the infection get diarrhea and abdominal cramps. Some cases can be life-threatening, causing kidney failure and seizures.

Copyright Associated Press / NBC New York



Photo Credit: Getty Images/iStockphoto, File]]>
<![CDATA[J&J Reportedly Knew for Years About Asbestos in Baby Powder]]>Fri, 14 Dec 2018 12:39:24 -0500https://media.nbcnewyork.com/images/213*120/AP_16124554600374.jpg

Johnson & Johnson knew for decades that its baby powder contained asbestos, Reuters said in a new report that drove the company's shares down nearly 11 percent Friday. 

Reuters based its report on a review of documents and deposition and trial testimony. It said the review showed that from 1971 to the early 2000s, J&J executives, mine managers, doctors and lawyers were aware the company's raw talc and finished powders sometimes tested positive for small amounts of asbestos. Those involved discussed the problem but they did not disclose it to regulators or the public, Reuters' examination found. 

By late morning Friday, J&J stock was down 10.8 percent, on pace for its worst day in more than a decade, when its shares closed down 15.85 on July 19, 2002. 

On top of likely being the stock's biggest drop since 2002, the plunge was likely a shock for shareholders used to a boring consumer staple that moves in much steadier increments than the overall market and more volatile stocks. J&J's stock beta over the last five years is 0.72, meaning that it swings much less than the market on a daily basis (a beta of 1 would mean it moves equal to the market and greater than 1 means it is more volatile than the S&P 500). 

"Plaintiffs' attorneys out for personal financial gain are distorting historical documents and intentionally creating confusion in the courtroom and in the media," Ernie Knewitz, J&J's vice president of global media relations, told Reuters in an email. "This is all a calculated attempt to distract from the fact that thousands of independent tests prove our talc does not contain asbestos or cause cancer. Any suggestion that Johnson & Johnson knew or hid information about the safety of talc is false." 

J&J referred Reuters to its outside lawyers, who rejected Reuters' findings as "false and misleading."

"The scientific consensus is that the talc used in talc-based body powders does not cause cancer, regardless of what is in that talc," Peter Bicks told Reuters in an email. "This is true even if — and it does not — Johnson & Johnson's cosmetic talc had ever contained minute, undetectable amounts of asbestos." He dismissed the tests cited in Reuter's article as "outlier" results, Reuters said. 

The company has faced a wave of lawsuits alleging its talc baby powder products contain asbestos and caused ovarian and other cancers. Some juries have sided with J&J and others have been unable to reach verdicts. A Missouri jury in July ordered J&J to pay $4.9 billion in a case involving 22 women and their families. A judge affirmed the verdict in August and J&J vowed to appeal it. 

J&J has filed thousands of documents in court proceedings, though most have been designated as confidential.

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

 



Photo Credit: AP Photo/Matt Rourke, File]]>
<![CDATA[Know Where Your Romaine Is From: Health Officials]]>Thu, 13 Dec 2018 16:49:23 -0500https://media.nbcnewyork.com/images/213*120/GettyImages-907729104.jpg

Health officials on Thursday issued an update to their previous warnings about romaine lettuce, urging consumers to find out where their lettuce originated.

In a statement Thursday, the Centers for Disease Control and Prevention advises consumers to "not eat and retailers and restaurants not serve or sell any romaine lettuce harvested from certain counties in the Central Coastal growing regions of northern and central California."

"If you do not know where the romaine is from, do not eat it," the statement says.

Officials focused especially on three California counties — Monterey, San Benito and Santa Barbara — and warned the public not to "buy, serve, sell, or eat romaine lettuce" from those regions.

Some romaine lettuce products are now labeled with a harvest location by region. Consumers, restaurants, and retailers should check bags or boxes of romaine lettuce for a label indicating where the lettuce was harvested.

Read the full warning from the CDC here.



Photo Credit: Aniko Hobel/Getty Images]]>
<![CDATA[Del Monte Recalls Cans of Corn Because They Could Spoil]]>Thu, 13 Dec 2018 09:54:52 -0500https://media.nbcnewyork.com/images/213*120/fiesta+corn+recall.jpg

Del Monte has recalled more than 64,000 cases of corn because they could spoil and lead to life-threatening illnesses if eaten. 

Cans of Fiesta Corn seasoned with red and green peppers were shipped to 25 U.S. states, including: Alaska, Alabama, California, Connecticut, Florida, Georgia, Illinois, Indiana, Kansas, Louisiana, Maryland, Michigan, Mississippi, Missouri, North Carolina, New Jersey, New York, Oklahoma, Pennsylvania, South Carolina, Texas, Vermont, Virginia, Washington and Wisconsin.

The cans of corn were under-processed during the sterilization process, which could result in contamination by spoilage organisms or pathogens. 

The company has not received any reports of illness, according to Tuesday's announcement from the FDA, but consuming the product could result in a life-threatening illness.

The affected cans are 15.24 ounces and have the number "24000 02770" printed on the label.

Customers who purchased the product are encouraged to return it to the place they purchased it from for a full refund or exchange. 

The cans were also shipped to 12 international locations. 

]]>
<![CDATA[Curb Your Waistline and Avoid the 'Holiday Binge' with These 11 Tips]]>Thu, 13 Dec 2018 14:29:00 -0500https://media.nbcnewyork.com/images/180*120/hmh-thanksgiving+binge.jpgWhen mass quantities of festive foods and delectable desserts nearly mask tabletops completely, it can be overwhelming. Check out these tips to curb your waistline and avoid the holiday binge. ]]><![CDATA[10 Tips to Keep Your Skin Soft and Hydrated this Winter]]>Thu, 13 Dec 2018 14:30:10 -0500https://media.nbcnewyork.com/images/178*120/hmh-Keep+Your+Skin+Healthy-Glowing.jpgCold, winter weather can leave your skin feeling dry, itchy and irritated. Learn how to keep your skin soft and hydrated all winter long.

Photo Credit: Getty Images]]>
<![CDATA[Health Officials Confirm Case of Measles in New York ]]>Thu, 13 Dec 2018 01:06:52 -0500https://media.nbcnewyork.com/images/213*120/cms1428.jpg

Health officials in western New York say they've confirmed a case of measles.

Now they're warning people who may have been exposed at several Buffalo-area locations over the past week to be aware of symptoms.

The Erie County Health Department says a recent immigrant was recently diagnosed with the highly contagious virus at Millard Fillmore Suburban Hospital. The patient visited several venues between Dec. 4 and 11, including Catholic Charities and a county health clinic in Buffalo, Sweet Home High School in Amherst, and several stores in and around Buffalo.

Authorities say the virus remains alive in the air and on surfaces for up to two hours.

People who haven't been vaccinated should see a doctor if they develop a fever, watery eyes and a rash.

Amid a measles outbreak in the Orthodox Jewish communities of Williamsburg and Borough Park in Brooklyn, the city health department is ordering unvaccinated students to stay home from school.

And in New Jersey, health officials say 86 people who attended a private event may have been exposed to measles.

Copyright Associated Press / NBC New York



Photo Credit: Pexels/CC]]>
<![CDATA[Cuba Health Mystery: Diplomats Had Inner-Ear Damage Early On]]>Wed, 12 Dec 2018 21:59:23 -0500https://media.nbcnewyork.com/images/213*120/US-embassy-cuba.jpg

American diplomats affected by mysterious health incidents in Cuba showed damage in the inner ear shortly after they complained of weird noises and sensations, according to their earliest medical exams, publicized Wednesday.

The detailed findings were published in a medical journal nearly two years after what the U.S. calls "health attacks" began — and they shed no new light on a possible culprit.

"What caused it, who did it, why it was done — we don't know any of those things," said Dr. Michael Hoffer of the University of Miami Miller School of Medicine, who led the exams.

The U.S. says since late 2016, 26 people associated with the embassy in Havana suffered problems that include dizziness, ear pain and ringing, and cognitive problems such as difficulty thinking — a health mystery that has damaged U.S.-Cuba relations.

The Miami researchers examined 25 of those people, who reported hearing a piercing noise or experiencing a sensation of pressure before their symptoms began. The patients failed a variety of tests that detect inner-ear problems associated with balance, what's called the vestibular system — although there were no pre-symptom medical records to compare.

Testing of 10 other people who were in the same building at the time of the incidents found they were fine, Hoffer reported in the journal Laryngoscope Investigative Otolaryngology. Hoffer also traveled to Cuba to check 100 other Americans stationed there, who also turned out to be healthy.

Those inner-ear balance problems have been central to the government's ongoing health investigation. And earlier this year, a team of doctors at the University of Pennsylvania who also examined many of these patients, but months later, reported they suffered a concussion-like brain injury, despite no blow to the head.

In a brief interview with The Associated Press, Hoffer said the two studies aren't contradictory, but they have different findings because patients were tested at different times and in different ways.

"Is the brain affected from the ear? Is the brain affected directly? We don't know yet," Hoffer said at Wednesday's news conference.

For doctors, Wednesday's paper adds specifics about the pattern of damage, abnormalities in structures involved with sensing gravity and acceleration, said Dr. Maura Cosetti of the New York Eye and Ear Infirmary of Mount Sinai. She isn't involved with research related to the Cuba incidents.

"This provides an important step in creating a picture of the injury that people sustained," she said. She added that often people with long-term balance problems also report a "brain fog."

Cuba has adamantly denied any involvement, and even doubts there were attacks.

"There's no evidence that can prove that something occurred in Cuba that could have damaged the health situation of a few U.S. diplomats," Carlos Fernandez de Cossio, Cuba's director-general of U.S. affairs, said Wednesday.

The U.S. has not said what caused the incidents, although initial speculation centered on some type of sonic attack. The AP has reported that an interim FBI report last January found no evidence that sound waves could have caused the damage.

Copyright Associated Press / NBC New York



Photo Credit: Desmond Boylan/AP (File)]]>
<![CDATA[Jimmy Dean Sausage Links Recalled for Metal Pieces]]>Wed, 12 Dec 2018 10:36:42 -0500https://media.nbcnewyork.com/images/213*120/jimmy-dean-photo.jpg

Attention Jimmy Dean sausage lovers: check your freezer because your links might be under recall due to possible metal contamination.

Kentucky-based CTI Foods LLC has recalled more than 29,000 pounds of frozen, ready-to-eat pork and poultry products that may be contaminated with metal pieces, the U.S. Department of Agriculture’s Food Safety and Inspection Service (FSIS) said on Monday. 

There haven't been any reports of "adverse reactions" thus far, but the government still classified the recall as a high health risk, defined as a "reasonable probability that the use of the product will cause serious, adverse health consequences or death." 

Under recall are: 23.4-oz. pouches of “Jimmy Dean HEAT ’n SERVE Original SAUSAGE LINKS Made with Pork & Turkey” with a "use by" date of Jan. 31, 2019. The sausages have the case code A6382168, and a time stamp range of 11:58 through 01:49. The back of the packaging also includes the number “EST. 19085.” 

The government was notified on Dec. 10 of five complaints of metal pieces found in the sausages. 

Jimmy Dean said in a separate release about the voluntary recall that the consumers who complained had spotted small, string-like fragments of metal in the product.

About 2,845 cases of the product were made at one plant location on Aug. 4.

It's not immediately clear which retailers sold the potentially contaminated sausages. But Jimmy Dean said the product was sent from a Tennessee distribution center to 21 states: Arizona, California, Connecticut, Florida, Georgia, Iowa, Idaho, Illinois, Kansas, Minnesota, Missouri, North Dakota, Nebraska, New York, Ohio, Oregon, Pennsylvania, Texas, Virginia, Washington and Wisconsin.

Jimmy Dean spokesman Worth Sparkman said "there's always a little post investigation" and that the FSIS would eventually publish the list of retailers. A USDA spokeswoman confirmed that list will be posted on the FSIS website here when available. 

Sparkman noted CTI Foods "wanted to get the news out" on the recall so that anybody who might have the product can look for it in their fridge and discard it.

Consumers should throw away the affected sausages or return them to the store where they were purchased. 

Those with questions can call the Jimmy Dean customer service line at (855) 382-3101. The toll-free USDA Meat and Poultry Hotline 1-888-MPHotline (1-888-674-6854) is available in English and Spanish from 10 a.m. to 6 p.m. ET on weekdays. 



Photo Credit: Jimmy Dean]]>
<![CDATA[Up to 86 Potentially Exposed to Measles at Private NJ Event]]>Mon, 10 Dec 2018 08:51:52 -0500https://media.nbcnewyork.com/images/213*120/ambulance-architecture-building-2634021.jpg

Health officials in one New Jersey county say 86 people who attended a private event may have been exposed to measles.

The Asbury Park Press reports the Ocean County Health Department is currently contacting the attendees of the invitation-only event.

Officials have not said when or where the event happened.

There are currently 18 confirmed measles cases and six suspected cases under investigation in Ocean County.

Measles is a highly contagious disease, and symptoms include rash, high fever, cough and red, watery eyes.

Health officials are urging schools to exclude students who haven't been vaccinated to help slow the spread of the virus.

Copyright Associated Press / NBC New York



Photo Credit: Pexels/CC]]>
<![CDATA[How a Teen Girl Got Sexual Consent to Be Taught in Md. Schools]]>Sat, 08 Dec 2018 09:57:57 -0500https://media.nbcnewyork.com/images/213*120/maeve+testifying.jpg

News about sexual assault in fall 2016 left then-12-year-old Maeve Sanford-Kelly disheartened. She was appalled by the crimes of Bill Cosby and Brock Turner, and how their victims were treated. 

But, even at age 12, she wasn't surprised. 

"My whole world and my whole life has been: This is what happens. This is how power dynamics play out," said Sanford-Kelly, a Bethesda, Maryland, resident who's now 14. 

The middle-schooler considered what she could do to prevent sexual assault and landed on the concept of sexual consent education. She started locally, with help from her friends and her mother, Del. Ariana Kelly, who represents a portion of Montgomery County. Eventually, their efforts had a greater impact. 

Maryland is now one of the 10 states, plus D.C., that requires public schools to include information on sexual consent in their sex ed curriculum.

This is the story of how a teen girl and her middle school friends changed sex ed lessons for students statewide. 

As of fall 2018, Maryland students in seventh grade and 10th grade are taught what consent is, how to respect others' boundaries and how to respect one's own. 

Sanford-Kelly testified that this is crucial. 

“Before we are taught about pregnancy prevention and STDs, we have to be taught about consent,” she said before the Montgomery County Delegation. 

Maryland law defines consent as "the unambiguous and voluntary agreement between all participants in each physical act within the course of interpersonal relationships."

Sanford-Kelly said her teachers at North Bethesda Middle School used an analogy about offering someone tea to teach about consent. Someone might want tea on Monday but not on Tuesday. They might want tea with honey but not sugar. Just as you wouldn't force someone to drink a cup of tea if they didn't want to, you wouldn't force them to have sex, the teen said she was taught. 

The lessons were "really accessible" and "stick in your mind," Sanford-Kelly said. 

She, her mother and her friends first wrote a bill about consent education and took it to the Montgomery County Delegation in December 2016. Sanford-Kelly and her friends testified for the passage of the bill.

After the teens presented the idea at the local level, they decided to think bigger. 

"I really felt empowered by the process," Sanford-Kelly said. 

The group rewrote and expanded the bill and introduced it before the Maryland House of Delegates. 

The bill later died in the State Senate because of a lack of support by Republicans and conservative Democrats.

"I was crushed," Kelly said. "But Maeve said, 'We are coming back next year.'"

Despite the failed statewide attempt, Montgomery County and Baltimore City schools voluntarily implemented the bill in 2017.

When the #MeToo movement took hold in fall 2017, Kelly and the teens gained a second wave of support at the state level. In early 2018, their bill was approved in the House of Delegates and State Senate. Then, Gov. Larry Hogan signed consent education into law in May 2018.

Kelly said she hopes Maryland will set a precedent for other states to follow.

Maryland students learn about consent as middle schoolers and high schoolers. Some educators say the concepts should be introduced even earlier. 

Irene van der Zande is the executive director and founder of Kidpower, a nonprofit that works with educators to teach personal safety to students of all ages. The group has collaborated with schools in several states and designed curricula to teach and reinforce skills for students to carry with them long after they leave the classroom. 

Van der Zande urged schools to teach students about consent repeatedly. 

“Raising awareness does not create competence,” she said. “Practice is key.”

Sanford-Kelly said she thinks her efforts have already had an impact. Her classmates seemed to understand the allegations against Supreme Court Justice Brett Kavanaugh during his nomination hearing. 

"They were really able to take it in and register it," she said.

Sanford-Kelly said she and her friends saw that they could create change, despite their youth. 

"It made me look forward to the future. I'm excited for what it means for students and what it means for society," she said. 



Photo Credit: Courtesy of family]]>
<![CDATA[Seattle Woman Contracts Brain Infection From Neti Pot]]>Fri, 07 Dec 2018 21:10:47 -0500https://media.nbcnewyork.com/images/213*120/netipotGettyImages-113112076.jpg

Doctors believe a woman who died from rare brain-eating amoebas used tap water to rinse her sinuses.

The 69-year-old Seattle resident died in February after undergoing brain surgery at Swedish Medical Center. Her doctor tells The Seattle Times there was "amoeba all over the place just eating brain cells."

According to a study published in the International Journal of Infectious Diseases, doctors believe the woman likely became infected when she used tap water in her neti pot, a teapot-like vessel used to flush out nasal passages.

Health officials suggest using only distilled, sterile or previously boiled water to rinse sinuses. Tap water can contain tiny organisms that are safe to drink but could survive in nasal passages.

Such infections are very rare. There were three similar U.S. cases from 2008 to 2017.

HOW TO USE A NETI POT
A neti pot is a container designed to rinse debris or mucus from the nasal cavity. People use it to treat symptoms of nasal allergies, sinus problems or colds.

  1. Use distilled or sterile water. If using tap or filtered water, boil for several minutes and let cool until lukewarm.
  2. Tilt your head sideways over the sink and place the spout of the neti pot in the upper nostril.
  3. Breathing through your open mouth, gently pour the saltwater solution into your upper nostril so that the liquid drains through the lower nostril.
  4. Repeat on the other side.
  5. Rinse the irrigation device after each use with similarly distilled, sterile, previously boiled and cooled, or filtered water and leave open to air-dry.

Copyright Associated Press / NBC New York



Photo Credit: Tom Sumlin/Charlotte Observer/MCT via Getty Images]]>
<![CDATA[Woman Dies From Brain-Eating Amoeba, Tap Water in Neti Pot Blamed]]>Fri, 07 Dec 2018 12:18:39 -0500https://media.nbcnewyork.com/images/213*120/neti-pot.jpg

Doctors believe a woman who died from rare brain-eating amoebas used tap water to rinse her sinuses.

The 69-year-old Seattle resident died in February after undergoing brain surgery at Swedish Medical Center. Her doctor tells The Seattle Times there was "amoeba all over the place just eating brain cells."

According to a study published in the International Journal of Infectious Diseases, doctors believe the woman likely became infected when she used tap water in her neti pot, a teapot-like vessel used to flush out nasal passages.

Health officials suggest using only distilled, sterile or previously boiled water to rinse sinuses. Tap water can contain tiny organisms that are safe to drink but could survive in nasal passages.

Such infections are very rare. There were three similar U.S. cases from 2008 to 2017. 

Copyright Associated Press / NBC New York



Photo Credit: MCT via Getty Images, File]]>
<![CDATA[1st Baby Born Using Uterus Transplanted From Deceased Donor]]>Wed, 05 Dec 2018 21:48:45 -0500https://media.nbcnewyork.com/images/213*120/babyAP_18338660378672.jpg

Brazilian doctors are reporting the world's first baby born to a woman with a uterus transplanted from a deceased donor.

Eleven previous births have used a transplanted womb but from a living donor, usually a relative or friend.

Experts said using uteruses from women who have died could make more transplants possible. Ten previous attempts using deceased donors in the Czech Republic, Turkey and the U.S. have failed.

The baby girl was delivered last December by a woman born without a uterus because of a rare syndrome. The woman — a 32-year-old psychologist — was initially apprehensive about the transplant, said Dr. Dani Ejzenberg, the transplant team's lead doctor at the University of Sao Paulo School of Medicine.

"This was the most important thing in her life," he said. "Now she comes in to show us the baby and she is so happy,"

The woman became pregnant through in vitro fertilization seven months after the transplant. The donor was a 45-year-old woman who had three children and died of a stroke.

The recipient, who was not identified, gave birth by cesarean section. Doctors also removed the womb, partly so the woman would no longer have to take anti-rejection medicines. Nearly a year later, mother and baby are both healthy.

Two more transplants are planned as part of the Brazilian study. Details of the first case were published Tuesday in the medical journal Lancet.

Uterus transplantation was pioneered by Swedish doctor Mats Brannstrom, who has delivered eight children from women who got wombs from family members or friends. Two babies have been born at Baylor University Medical Center in Texas and one in Serbia, also from transplants from living donors.

In 2016, doctors at the Cleveland Clinic transplanted a uterus from a deceased donor, but it failed after an infection developed.

"The Brazilian group has proven that using deceased donors is a viable option," said the clinic's Dr. Tommaso Falcone, who was involved in the Ohio case. "It may give us a bigger supply of organs than we thought were possible."

The Cleveland program is continuing to use deceased donors. Falcone said the fact that the transplant was successful after the uterus was preserved in ice for nearly eight hours demonstrated how resilient the uterus is. Doctors try to keep the time an organ is without blood flow to a minimum.

Other experts said the knowledge gained from such procedures might also solve some lingering mysteries about pregnancies.

"There are still lots of things we don't understand about pregnancies, like how embryos implant," said Dr. Cesar Diaz, who co-authored an accompanying commentary in the journal. "These transplants will help us understand implantation and every stage of pregnancy."  

Copyright Associated Press / NBC New York



Photo Credit: AP]]>
<![CDATA[Top Tot Toys? Blocks, Boxes Over High-Tech Toys, Doctors Say]]>Mon, 03 Dec 2018 07:52:50 -0500https://media.nbcnewyork.com/images/213*120/AP_18333628200853-Toys-for-Tots-APA.jpg

Skip the costly electronic games and flashy digital gizmos. Pediatricians say the best toys for tots are old-fashioned hands-on playthings that young children can enjoy with parents — things like blocks, puzzles — even throwaway cardboard boxes — that spark imagination and creativity.

"A cardboard box can be used to draw on, or made into a house," said Dr. Alan Mendelsohn, co-author of a new report on selecting toys for young children, up to around age 5.

Many parents feel pressured by ads promoting tablet-based toys and games as educational and brain-stimulating but there's not much science to back up those claims, Mendelsohn said. Their main misconception: "The toy that is best is the one that is the most expensive or has the most bells and whistles or is the most technologically sophisticated."

Simpler hands-on toys that parents and young children can play with together are preferable for healthy development, said Mendelsohn, a pediatrician at NYU Langone Health in New York.

The report published Monday by the American Academy of Pediatrics cites studies suggesting that heavy use of electronic media may interfere with children's speech and language development, replace important playtime with parents and lead to obesity.

Studies also have found that more than 90 percent of U.S. kids have used mobile devices and most started using them before age 1.

The pediatricians' group recommends no screen time for children up to age 2, and says total screen time including TV and computer use should be less than one hour daily for ages 2 and older.

"A little bit of screen time here and there is unlikely to have much harm if a child otherwise has other activity," Mendelsohn said. But he added that screen time can overwhelm young children and is difficult to limit and control.

The academy's website offers suggestions on ideal toys for young children, including balls, puzzles, coloring books and card games.

Shopping recently at Dancing Bear Toys in Asheville, N.C., a store that doesn't sell electronic toys, Leah Graham Stewart said she supports the academy's advice even if avoiding digital toys and games is tough.

She said she's noticed her two young boys tend to misbehave after playing on an iPad she typically reserves for long airplane rides.

"We try to keep it as minimal as possible," Graham Stewart said. "I just tell them to go outside and play."

Erika Evers, Dancing Bear's co-owner, said the store's mission is to give kids an alternative to tech toys.

"Not that video games and electronic toys don't have their place — in moderation, in our opinion," she said. "But we feel like kids really need opportunities to socialize and interact with their environment in a way that is hands-on and tangible."

Copyright Associated Press / NBC New York



Photo Credit: David J. Phillip/AP, File]]>
<![CDATA[NJ Elementary Student Diagnosed With Measles Amid Outbreak]]>Sat, 01 Dec 2018 17:36:32 -0500https://media.nbcnewyork.com/images/213*120/Second_Case_of_Measles_Confirmed_in_Lowell.jpg

A student at a New Jersey elementary school was diagnosed with measles as the outbreak in Rockland County grew to 87 confirmed cases, officials said. 

Parents were notified Friday that a child who attends Hempstead Elementary school was among those confirmed cases. 

Although some unvaccinated children have been asked to stay home during the outbreak, officials said they learned of this case after the 21-day incubation period, so no further action was taken. 

Parents were asked to monitor their children for symptoms and provide their immunization status. The school has previously had a high immunization rate, said John Lyon, spokesman for Rockland County Executive Ed Day. 

Measles is highly contagious. Young children, the immunocompromised, and non-immune pregnant women are at highest risk for severe complications. Measles is transmitted by airborne particles, droplets, and direct contact with the respiratory secretions of an infected person.

Measles typically presents in adults and children as an acute viral illness characterized by fever and generalized rash. The rash usually starts on the face, proceeds down the body, and may include the palms and soles. The rash lasts several days. Infected individuals are contagious from four days before rash onset through the fourth day after rash appearance.

Rockland officials encourage everyone to be up-to-date with the measles, mumps, rubella (MMR) vaccine to help protect them in case of any future exposure to measles in Rockland.

To prevent the spread of illness, the Rockland County Health Department advises anyone who may have measles to contact their health care provider, local clinic, or local emergency department before going for care. This will help to prevent others at these facilities from being exposed to the illness.

Rockland County is not the only local area dealing with a measles outbreak, as Ocean County and Brooklyn have faced confirmed measles cases in recent weeks as well.

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<![CDATA[Bloomberg Donating $50 Million to Fight Opioid Epidemic]]>Fri, 30 Nov 2018 13:12:44 -0500https://media.nbcnewyork.com/images/213*120/AP_18333687340617-Michael-Bloomberg.jpg

Former New York Mayor Michael Bloomberg's charity has announced a $50 million donation to help fight the nation's opioid epidemic.

Bloomberg Philanthropies said over the next three years it will help up to 10 states address the causes of opioid addiction and strengthen prevention and treatment programs. Its initiative involves a partnership with the Centers for Disease Control and Prevention, The Pew Charitable Trusts, Johns Hopkins University and Vital Strategies.

Bloomberg said on Friday during his keynote address at The Bloomberg American Health Summit in Washington that he believes "we can turn the tide on this epidemic."

"And if we do," he said, "we can begin reversing the decline in life expectancy that has been happening across the country, thanks largely to opioid overdoses."

Pennsylvania will be the first state to get funding and will receive at least $10 million. Pennsylvania had the highest number of drug overdose deaths in 2017 among all states and twice as many as in 2014. Nearly 5,400 Pennsylvania residents died of drug overdoses in 2017.

Pennsylvania's rate of 44.3 drug overdose deaths per 100,000 residents is more than double the national average.

Bloomberg has been considering a 2020 Democratic presidential bid, but a spokeswoman said there was "no stated link" between his political aspirations and the $50 million investment to fight opioids.

Bloomberg's charity said CDC data shows there were more than 70,000 U.S. drug overdose deaths last year, including more than 47,000 from opioids, the highest numbers on record. It said those numbers are a leading factor in the decline of U.S. life expectancy over the past three years.

Bloomberg called the sobering numbers part of "a national crisis."

"For the first time since World War I, life expectancy in the U.S. has declined over the past three years — and opioids are a big reason why," he said. "We cannot sit by and allow this alarming trend to continue — not when so many Americans are being killed in what should be the prime of their lives."

He said in a statement he hoped his charity's work in Pennsylvania, one of the states hardest hit by the opioids crisis, would lay the groundwork "for more effective action across the country."

The partnership focuses on identifying new approaches to tackle opioids and plugging gaps in current treatment and prevention programs. Staff members from partner organizations will support state and local programs to reduce opioid-related deaths, and successful initiatives and guidelines will be replicated elsewhere, with the goal of creating a model for the rest of the nation.

Pennsylvania Gov. Tom Wolf said he was "deeply grateful" for the financial and technical resources his state will receive through the partnership with Bloomberg Philanthropies.

"From our first responders and health care professionals to teachers and social service providers, heroes across our commonwealth are saving lives and protecting residents in our communities every day from this awful scourge," Wolf, a Democrat, said in a statement issued by the Bloomberg charity. "We are doing everything we can to help them, and I am confident that this partnership will mark a turning point in our efforts."

The Drug Enforcement Administration said this month in its National Drug Threat Assessment that heroin, fentanyl and other opioids continue to be the highest drug threat in the nation.

Bloomberg, who has been an independent, a Republican and a Democrat, declared lifetime allegiance to the Democratic Party and outlined an aggressive timeline for deciding whether to run for president in an interview with The Associated Press this month. He has regularly criticized President Donald Trump and spent a fortune to help elect Democrats in the midterm elections.

Copyright Associated Press / NBC New York



Photo Credit: Rogelio V. Solis/AP]]>
<![CDATA[Miami Duo Arrested For Operating Dental Practice Out Of Bus]]>Thu, 29 Nov 2018 19:51:29 -0500https://media.nbcnewyork.com/images/213*120/112918+dental+suspects.jpg

Two people are behind bars after allegedly running an illegal dental practice out of a bus in Miami.

According to Miami-Dade Police officials, Daniela Sulbaran and Victor Bernal were arrested earlier this month for practicing health care without a license. Bernal was also charged with possession of drugs with intent to sell.

During an undercover investigation, officials scheduled an appointment with Bernal for a dental procedure.

They arrived at the bus, which parked in a parking lot at the 6000 block of Northwest 74th Avenue.

Sulbaran diagnosed, evaluated and offered to treat the officer. That’s when police moved in and arrested the two.

While police were searching the bus, they found a bag containing various prescription drugs, including lidocaine, mepivacaine, ibuprofen, and other dental products.

Investigators are asking people who may have been treated by Sulbaran and Bernal to come forward.

Anyone with information is asked to call Miami-Dade Crime Stoppers at 305-471-TIPS.

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<![CDATA[Congo's Ebola Outbreak Now 2nd Largest in History, WHO Says]]>Thu, 29 Nov 2018 16:38:17 -0500https://media.nbcnewyork.com/images/213*120/ebolaAP_18286321091624.jpg

The World Health Organization says Congo's deadly Ebola outbreak is now the second largest in history, behind the devastating West Africa outbreak that killed thousands a few years ago.

WHO emergencies chief Dr. Peter Salama late Thursday called it "a sad toll" as Congo's health ministry announced the number of cases has reached 426. That includes 379 confirmed cases and 47 probable ones.

Attacks by rebel groups and open hostility by some wary locals have posed serious challenges that Ebola workers say they have never faced before. Many venture out on critical virus containment work only with the accompaniment of U.N. peacekeepers while gunfire echoes daily.

Salama this month predicted that the outbreak in northeastern Congo will last at least another six months before it can be contained.

Copyright Associated Press / NBC New York



Photo Credit: AP, File]]>
<![CDATA[Man Reveals Face Transplant, Shares Medical Odyssey]]>Thu, 29 Nov 2018 18:49:47 -0500https://media.nbcnewyork.com/images/213*120/Cameron+Underwood+resized.jpg

The remarkable aftermath of an extraordinary surgery and medical odyssey was center stage Thursday, as a plastic surgeon and his patient spoke publicly for the first time following a milestone face transplant that occurred earlier this year. 

NYU Langone Health plastic surgeon Dr. Eduardo D. Rodriguez explained in full detail why his 26-year-old patient, Cameron Underwood, was the ideal candidate for a face transplant and the surgical journey the Yuba City, California, native lived through.

“We ultimately feel that every patient deserves a second chance and Cameron, certainly, was worthy of it,” Rodriguez said.

Underwood’s medical journey began due to a self-inflicted facial gunshot wound in June 2016.

As a result of the traumatic injuries sustained, and despite several attempts at conventional reconstruction, Underwood ended up missing a great portion of his lower jaw, all but one tooth, and his nose. He also suffered extensive damage to his upper face region and palate, which severely impacted his ability to lead a normal life.

On July 13, 2017, 13 months after his initial injury, Underwood was placed on the waiting list for a face transplant. Underwood, who resides in California, was required to travel to New York City for monthly evaluations, including clinical, psychological and social exams.

However, before the transplant could take place, the search for the ideal donor long began.

“It’s like finding a needle in a haystack,” Rodriguez said.

That’s when William Fisher, a 23-year-old Manhattan resident, a chess champion, aspiring writer and filmmaker, and a student at Johns Hopkins University, comes into play and unexpectedly became a hero.

Fisher, who is fondly remembered by his family and friends as extremely intelligent, funny, and compassionate, was a registered organ donor, a status he designated in his teens.

According to Rodriguez, “Willy,” as he was affectionately known, died unexpectedly.

Still deeply saddened by the loss of her son, Sally acknowledged the importance of her son’s decision to be an organ donor and gave the family's consent.

“My son’s death was a tragedy,” Sally said. “I am thankful that, in honoring his decision, we were able to give life to others, and especially that Will and Dr. Rodriguez have given Cameron and his family a chance to recapture their dreams.”

Underwood’s surgery began Jan. 5, lasted about 25 hours and took a team of more than 100 medical professionals, including surgeons and nurses.

This is the third face transplant performed under Rodriguez’ medical leadership. In August 2015, he and his team at NYU Langone performed what is widely considered the most extensive face transplant on record.

However, Underwood’s face transplant set several important medical milestones including having the shortest period of time from injury to transplant in the United States; the longest distance traveled for a face transplant, with 2,800 miles; one of the shortest wait times for a donor (six months); and the fact that financial reimbursement was provided by commercial insurance.

Additionally, there were also significant improvements in medical care compared to a previous patient, including reductions in surgical time and hospital stay, which was roughly reduced by half.

Underwood’s face transplant was also deemed the most technologically advanced in modern medicine, including the first use of a 3-D printed donor facial mask in the United States, which doctors provided to Fisher’s family.

Almost 11 months after the transplant, Underwood is still rejection free.

“He’s far more open, far more jovial, far more interactive and I suspect we are going to see much more of this and this gives us confirmation that this operation and the risk that we all take are ultimately worth it,” Rodriguez said, sharing photos of Underwood once again enjoying an active lifestyle and sports, including skydiving.

Underwood and Sally met unexpectedly before the transplant and, subsequently, had a planned meeting post-transplant months after the 25-hour surgery.

“I feel for Cameron and his family that they’ve inherited another family and for Willy’s family as well,” Rodriguez said, adding that "Willy continues to live in Cam. “The families have now been bound by this remarkable gift.”

During Thursday’s press conference, Underwood said his story needed to be told.

“I think it is important to share my story. I hope it inspires others to have hope and to seek help,” he said.

Underwood also publicly expressed his gratitude toward every person involved in his medical journey, transplant and subsequent recovery, including thanking, through tears, Sally and her son Willy.

“I’m so grateful to have a face transplant because it has given me a second chance at life,” Underwood said, adding he no longer gets stares or questions from strangers.

“Thank you for not giving up on me,” Underwood said to his supporters. “It hasn’t been easy, but it has been worth it.”

Summarizing Underwood’s medical odyssey, Rodriguez said: “The life that had been in pause, is now back in play.”



Photo Credit: Mary Spano and Eduardo D. Rodriguez, MD, DDS / Hansjorg Wyss Dept. of Plastic Surgery at NYU Langone Health
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<![CDATA[Best Buy, Grocery Shoppers May Have Been Exposed to Measles]]>Thu, 29 Nov 2018 12:17:12 -0500https://media.nbcnewyork.com/images/213*120/bestbuy+measles.png

Health officials are warning of new locations where shoppers may have been exposed to measles in New York's Rockland County, which has seen nearly 100 confirmed cases of the virus amid an outbreak that has yet to be contained.

Officials say the latest exposures were at Best Buy at the Palisades Center between 7 p.m. and 9:30 p.m. on Nov. 24, Jalapa Express in Spring Valley between 5:30 p.m. and 7:45 p.m. on Nov. 24 and Compare Supermarket in Spring Valley between 7 p.m. and 9:30 p.m. on Nov. 22. 

Those times reflect when the infected person was inside the location and the two-hour period after he or she left, officials said. The person who was in the Best Buy was only in that store, not anywhere else in the mall. 

The current outbreak stands at 83 confirmed cases, with eight more under investigation. The outbreak has gotten so bad the county has asked parents not to send their children to school if they are unvaccinated. 

Measles is highly contagious. Young children, the immunocompromised, and non-immune pregnant women are at highest risk for severe complications. Measles is transmitted by airborne particles, droplets, and direct contact with the respiratory secretions of an infected person.

Measles typically presents in adults and children as an acute viral illness characterized by fever and generalized rash. The rash usually starts on the face, proceeds down the body, and may include the palms and soles. The rash lasts several days. Infected individuals are contagious from four days before rash onset through the fourth day after rash appearance.

Rockland officials encourage everyone to be up-to-date with the measles, mumps, rubella (MMR) vaccine to help protect them in case of any future exposure to measles in Rockland.

To prevent the spread of illness, the Rockland County Health Department advises anyone who may have measles to contact their health care provider, local clinic, or local emergency department before going for care. This will help to prevent others at these facilities from being exposed to the illness.

Rockland County is not the only local area dealing with a measles outbreak, as Brooklyn has faced confirmed measles cases in recent weeks as well.

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<![CDATA[Mental Health Clinic Opens Inside a Walmart in Texas]]>Thu, 29 Nov 2018 14:58:35 -0500https://media.nbcnewyork.com/images/213*120/walmart30.jpg

You can go to Walmart to buy toothpaste and shampoo, order glasses or fulfill a drug prescription. Now, some customers can also get therapy, Today.com reported.

A new outpatient mental health clinic has opened inside a Walmart store in Carrollton, Texas, north of Dallas. People can walk in, call or make an appointment online to see a licensed mental health professional about problems such as anxiety, depression, grief, relationship troubles or the stresses of everyday living. 

Beacon Health Options, a Boston-based behavioral health services company, is leasing space in the store and runs the clinic. It’s the first such practice Beacon has opened in a retail setting, the company announced in a news release this week, noting the location was chosen for its convenience. More than 10 million Texans live in an area considered to have a shortage of mental health care professionals, the company added.

Executives said the goal is to offer mental health services to people in rural communities who might otherwise not get care.



Photo Credit: Jae C. Hong/AP, File]]>
<![CDATA[Opioid Case Has New Complication: Babies Born in Withdrawal]]>Thu, 29 Nov 2018 06:29:06 -0500https://media.nbcnewyork.com/images/213*120/oxycontinAP_18030107233349.jpg

The long-running federal court case seeking to hold drugmakers responsible for the nation's opioid crisis has a new complication: How does it deal with claims covering the thousands of babies born to addicts?

Attorneys representing the children and their guardians want their claims separated from the federal case in Cleveland that involves hundreds of local governments and other entities such as hospitals. They will argue that Thursday before a federal judicial panel in New York.

Babies, unlike governments or businesses, have been directly harmed by the actions of drugmakers and are entitled to their own payments, said Scott Bickford, a lead lawyer for the children and their guardians.

He said initial hospital stays for babies born to an opioid-addicted mother can cost $200,000 to $250,000 more than other infants born without complications.

"Then you have to address their developmental and learning problems," Bickford said. "A lot of them have organ problems. A lot of them have problems we don't even know about."

Drug manufacturers and distributors oppose creating a new structure for the lawsuits over the children.

Separating the cases would "open the door to the inconsistency and inefficiency that coordinated proceedings are designed to avoid," the manufacturers said in a legal filing.

Other plaintiffs in the omnibus opioid litigation have not objected formally, but some are cool to the idea of separating the cases involving the children. One of the lead lawyers for the local governments, Paul Farrell Jr., said he is trying to get help for children born with opioid dependency and have prenatal care funded by the drug industry.

He said all the plaintiffs share a goal: holding drug manufacturers liable for the crisis. Unless that happens, he said, no one will get the payouts they're seeking.

"You've only got to shoot the pig once," he said.

The dispute offers a window into the complicated nature of the litigation in Cleveland, which is the main avenue to a potential nationwide settlement over the opioid crisis.

Opioids — including prescription painkillers, heroin and synthetic substances including fentanyl — killed nearly 48,000 Americans last year, according to the U.S Centers for Disease Control and Prevention. The cost of treatment, providing an overdose antidote, foster care, jail stays, ambulance runs and addressing a growing homeless crisis have added up for governments and taxpayers. Studies have found that opioid addiction also has depleted the workforce, harming the economy.

More than 1,400 plaintiffs have had their federal cases consolidated under a single judge. They include county and local governments, hospitals, unions, American Indian tribes and individuals. Hundreds of others have sued in state courts.

The federal judge, Cleveland-based Judge Dan Polster, has been pushing the parties to reach a settlement.

The sides have been negotiating regularly behind closed doors. The drug industry argues that it should not be held liable because its products are approved by the federal government and prescribed by doctors and because people who overdose often do so on illicit drugs.

Lawyers representing children and their guardians say there is precedent for their request to go it alone, after Polster granted the tribes a separate legal track for their claims. In August, the judge denied similar status for the cases brought on behalf of babies.

That decision prompted the lawyers to ask the Judicial Panel on Multidistrict Litigation to put their cases under another judge in West Virginia or Illinois. The federal panel in New York will decide whether to grant that request.

Copyright Associated Press / NBC New York



Photo Credit: Toby Talbot/AP, File ]]>
<![CDATA[China Halts Work of Team Claiming It Made Gene-Edited Babies]]>Thu, 29 Nov 2018 07:37:25 -0500https://media.nbcnewyork.com/images/213*120/geneeditingconferenceAP_18332238054521.jpg

China's government ordered a halt Thursday to work by a medical team that claimed to have helped make the world's first gene-edited babies, as a group of leading scientists declared that it's still too soon to try to make permanent changes to DNA that can be inherited by future generations.

Chinese Vice Minister of Science and Technology Xu Nanping told state broadcaster CCTV that his ministry is strongly opposed to the efforts that reportedly produced twin girls born earlier this month. Xu called the team's actions illegal and unacceptable and said an investigation had been ordered, but made no mention of specific actions taken.

Researcher He Jiankui claims to have altered the DNA of the twins to try to make them resistant to infection with the AIDS virus. Mainstream scientists have condemned the experiment, and universities and government groups are investigating.

He's experiment "crossed the line of morality and ethics adhered to by the academic community and was shocking and unacceptable," Xu said.

A group of leading scientists gathered in Hong Kong this week for an international conference on gene editing, the ability to rewrite the code of life to try to correct or prevent diseases.

Although the science holds promise for helping people already born and studies testing that are underway, a statement issued Thursday by the 14-member conference leaders says it's irresponsible to try it on eggs, sperm or embryos except in lab research because not enough is known yet about its risks or safety.

The conference was rocked by the Chinese researcher's claim to have helped make the world's first gene-edited babies. Conference leaders called for an independent investigation of the claim by He, who spoke to the group Wednesday as international criticism of his claim mounted.

There is no independent confirmation of what He says he did. He was scheduled to speak again at the conference on Thursday, but he left Hong Kong and through a spokesman sent a statement saying "I will remain in China, my home country, and cooperate fully with all inquiries about my work. My raw data will be made available for third party review."

Several prominent scientists said the case showed a failure of the field to police itself and the need for stricter principles or regulations.

"It's not unreasonable to expect the scientific community" to follow guidelines, said David Baltimore, a Nobel laureate from California Institute of Technology who led the panel.

There already are some rules that should have prevented what He says he did, said Alta Charo, a University of Wisconsin lawyer and bioethicist and a conference organizer.

"I think the failure was his, not the scientific community," Charo said.

Gene editing for reproductive purposes might be considered in the future "but only when there is compelling medical need," with clear understanding of risks and benefits, and certain other conditions, said Dr. Victor Dzau, president of the U.S. National Academy of Medicine, one of the conference sponsors.

"Not following these guidelines would be an irresponsible act," he added.

Other sponsors of the three-day conference are the Academy of Sciences of Hong Kong, the Royal Society of the United Kingdom and the U.S. National Academy of Sciences and U.S. National Academy Sciences.

___

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

Copyright Associated Press / NBC New York



Photo Credit: Kin Cheung/AP]]>
<![CDATA[Suicide, Drug Overdoses Push Down US Life Expectancy]]>Thu, 29 Nov 2018 00:12:09 -0500https://media.nbcnewyork.com/images/213*120/pillsGettyImages-169093207.jpg

Suicides and drug overdoses pushed up U.S. deaths last year, and drove a continuing decline in how long Americans are expected to live.

Overall, there were more than 2.8 million U.S. deaths in 2017, or nearly 70,000 more than the previous year, the Centers for Disease Control and Prevention said Thursday. It was the most deaths in a single year since the government began counting more than a century ago.

The increase partly reflects the nation's growing and aging population. But it's deaths in younger age groups — particularly middle-aged people — that have had the largest impact on calculations of life expectancy, experts said.

"These sobering statistics are a wake-up call that we are losing too many Americans, too early and too often, to conditions that are preventable," Dr. Robert Redfield, the CDC's director, said in a statement.

The suicide death rate last year was the highest it's been in at least 50 years, according to U.S. government records. There were more than 47,000 suicides, up from a little under 45,000 the year before.

A GENERAL DECLINE
For decades, U.S. life expectancy was on the upswing, rising a few months nearly every year. Now it's trending the other way: It fell in 2015, stayed level in 2016, and declined again last year, the CDC said.

The nation is in the longest period of a generally declining life expectancy since the late 1910s, when World War I and the worst flu pandemic in modern history combined to kill nearly 1 million Americans. Life expectancy in 1918 was 39.

Aside from that, "we've never really seen anything like this," said Robert Anderson, who oversees CDC death statistics.

In the nation's 10 leading causes of death, only the cancer death rate fell in 2017. Meanwhile, there were increases in seven others — suicide, stroke, diabetes, Alzheimer's, flu/pneumonia, chronic lower respiratory diseases and unintentional injuries.

An underlying factor is that the death rate for heart disease — the nation's No. 1 killer — has stopped falling. In years past, declines in heart disease deaths were enough to offset increases in some other kinds of death, but no longer, Anderson said.

(The CDC's numbers do sometimes change. This week, CDC officials said they had revised their life expectancy estimate for 2016 after some additional data came in.)

WHAT'S DRIVING IT?
CDC officials did not speculate about what's behind declining life expectancy, but Dr. William Dietz, a disease prevention expert at George Washington University, sees a sense of hopelessness.

Financial struggles, a widening income gap and divisive politics are all casting a pall over many Americans, he suggested. "I really do believe that people are increasingly hopeless, and that that leads to drug use, it leads potentially to suicide," he said.

Drug overdose deaths also continued to climb, surpassing 70,000 last year, in the midst of the deadliest drug overdose epidemic in U.S. history. The death rate rose 10 percent from the previous year, smaller than the 21 percent jump seen between 2016 and 2017.

That's not quite cause for celebration, said Dr. John Rowe, a professor of health policy and aging at Columbia University.

"Maybe it's starting to slow down, but it hasn't turned around yet," Rowe said. "I think it will take several years."

Accidental drug overdoses account for more than a third of the unintentional injury deaths, and intentional drug overdoses account for about a tenth of the suicides, said Dr. Holly Hedegaard, a CDC injury researcher.

OTHER FINDINGS
The CDC figures are based mainly on a review of 2017 death certificates. The life expectancy figure is based on current death trends and other factors.

The agency also said:

—A baby born last year in the U.S. is expected to live about 78 years and 7 months, on average. An American born in 2015 or 2016 was expected to live about a month longer, and one born in 2014 about two months longer than that.

—The suicide rate was 14 deaths per 100,000 people. That's the highest since at least 1975.

—The percentage of suicides due to drug overdose has been inching downward.

—Deaths from flu and pneumonia rose by about 6 percent. The 2017-2018 flu season was one of the worst in more than a decade, and some of the deaths from early in that season appeared in the new death dates.

—West Virginia was once again the state with the highest rate of drug overdose deaths. The CDC did not release state rates for suicides.

—Death rates for heroin, methadone and prescription opioid painkillers were flat. But deaths from the powerful painkiller fentanyl and its close opioid cousins continued to soar in 2017.

The CDC did not discuss 2017 gun deaths in the reports released Thursday. But earlier CDC reports noted increase rates of suicide by gun and by suffocation or hanging.

SUICIDE PREVENTION HELP: The National Suicide Prevention Hotline (1-800-273-8255) is open 24 hours a day, 7 days a week.

AP video journalist Federica Narancio contributed to this report.

Copyright Associated Press / NBC New York



Photo Credit: Getty Images]]>
<![CDATA[Scientist Claiming Gene-Edited Babies Reports 2nd Pregnancy]]>Wed, 28 Nov 2018 06:40:55 -0500https://media.nbcnewyork.com/images/213*120/AP_18332254310207-He-Jiankui-gene-editing.jpg

A Chinese researcher who claims to have helped make the world's first genetically edited babies says a second pregnancy may be underway.

The researcher, He Jiankui of Shenzhen, revealed the possible pregnancy Wednesday while making his first public comments about his controversial work at an international conference in Hong Kong.

He claims to have altered the DNA of twin girls born earlier this month to try to make them resistant to infection with the AIDS virus. Mainstream scientists have condemned the experiment, and universities and government groups are investigating.

The second potential pregnancy is in a very early stage and needs more time to be monitored to see if it will last, He said.

Leading scientists said there are now even more reasons to worry, and more questions than answers, after He's talk. The leader of the conference called the experiment "irresponsible" and evidence that the scientific community had failed to regulate itself to prevent premature efforts to alter DNA.

Altering DNA before or at the time of conception is highly controversial because the changes can be inherited and might harm other genes. It's banned in some countries including the United States except for lab research.

He defended his choice of HIV, rather than a fatal inherited disease, as a test case for gene editing, and insisted the girls could benefit from it.

"They need this protection since a vaccine is not available," He said.

Scientists weren't buying it.

"This is a truly unacceptable development," said Jennifer Doudna, a University of California-Berkeley scientist and one of the inventors of the CRISPR gene-editing tool that He said he used. "I'm grateful that he appeared today, but I don't think that we heard answers. We still need to understand the motivation for this."

Doudna is paid by the Howard Hughes Medical Institute, which also supports AP's Health & Science Department.

"I feel more disturbed now," said David Liu of Harvard and MIT's Broad Institute, and inventor of a variation of the gene-editing tool. "It's an appalling example of what not to do about a promising technology that has great potential to benefit society. I hope it never happens again."

There is no independent confirmation of He's claim and he has not yet published in any scientific journal where it would be vetted by experts. At the conference, He failed or refused to answer many questions including who paid for his work, how he ensured that participants understood potential risks and benefits, and why he kept his work secret until after it was done.

After He spoke, David Baltimore, a Nobel laureate from the California Institute of Technology and a leader of the conference, said He's work "would still be considered irresponsible" because it did not meet criteria many scientists agreed on several years ago before gene editing could be considered.

"I personally don't think that it was medically necessary. The choice of the diseases that we heard discussions about earlier today are much more pressing" than trying to prevent HIV infection this way, Baltimore said.

The case shows "there has been a failure of self-regulation by the scientific community" and said the conference committee would meet and issue a statement on Thursday about the future of the field, Baltimore said.

Before He's talk, Dr. George Daley, Harvard Medical School's dean and one of the conference organizers, warned against a backlash to gene editing because of He's experiment. Just because the first case may have been a misstep "should in no way, I think, lead us to stick our heads in the sand and not consider the very, very positive aspects that could come forth by a more responsible pathway," Daley said.

"Scientists who go rogue ... it carries a deep, deep cost to the scientific community," Daley said.

Regulators have been swift to condemn the experiment as unethical and unscientific.

The National Health Commission has ordered local officials in Guangdong province to investigate He's actions, and his employer, Southern University of Science and Technology of China, is investigating as well.

On Tuesday, Qui Renzong of the Chinese Academy of Social Science criticized the decision to let He speak at the conference, saying the claim "should not be on our agenda" until it has been reviewed by independent experts. Whether He violated reproductive medicine laws in China has been unclear; Qui contends that it did, but said, "the problem is, there's no penalty."

He called on the United Nations to convene a meeting to discuss heritable gene editing to promote international agreement on when it might be OK.

Meanwhile, more American scientists said they had contact with He and were aware of or suspected what he was doing.

Dr. Matthew Porteus, a genetics researcher at Stanford University, where He did postdoctoral research, said He told him in February that he intended to try human gene editing. Porteus said he discouraged He and told him "that it was irresponsible, that he could risk the entire field of gene editing by doing this in a cavalier fashion."

Dr. William Hurlbut, a Stanford ethicist, said he has "spent many hours" talking with He over the last two years about situations where gene editing might be appropriate.

"I knew his early work. I knew where he was heading," Hurlbut said. When he saw He four or five weeks ago, He did not say he had tried or achieved pregnancy with edited embryos but "I strongly suspected" it, Hurlbut said.

"I disagree with the notion of stepping out of the general consensus of the scientific community," Hurlbut said. If the science is not considered ready or safe enough, "it's going to create misunderstanding, discordance and distrust."

Copyright Associated Press / NBC New York



Photo Credit: Kin Cheung/AP]]>
<![CDATA[DOH: 3 Babies Dead at NJ Hospital Amid Infection Outbreak]]>Wed, 28 Nov 2018 07:45:38 -0500https://media.nbcnewyork.com/images/213*120/Generic+Premature+Baby+Generic.jpg

Two premature babies who contracted a bacterial infection at a New Jersey hospital in the throes of an outbreak, died last week, officials say.

It is the third death of a premature baby in Newark's University Hospital after the Department of Health became aware that the hospital had an outbreak of the bacteria A. baumannii in its neonatal intensive care unit.

The department says that, while the babies were infected with A. baumannii, it may not have been what killed them, as they also suffered from other medical conditions due to being born premature.

Four babies have been infected in total at the hospital, officials say.

At the end of September, a premature baby who had been cared for at the hospital and had the bacteria died after being transferred to another facility, and before the Department's notification of problems in the NICU, health officials say. Another baby was effectively treated for the bacteria and was discharged last month.

No new infections have been confirmed since October. 

The department issued the news about the deaths of the other two babies Tuesday as part of an ongoing investigation into the outbreak of A. baumannii in the neonatal intensive care unit (NICU) of University Hospital.

It said it was on-site at the hospital Tuesday to investigate the facility's internal processes around reporting deaths amid ongoing outbreaks. The department said as of Monday, the hospital's own infection control program was not aware of the most recent deaths when contacted.

A University Hospital spokesperson on Tuesday said the hospital has "continue[d] to reinforce proper procedures and protocols with our team."

"We have worked diligently since the Acinetobacter baumannii bacteria was discovered in our neonatal intensive care unit to control the outbreak, and there have been no new cases in the NICU since October," the spokesperson said.



Photo Credit: NBC10]]>
<![CDATA[How Many Kids Have Autism? US Government Measures 3 Ways]]>Tue, 27 Nov 2018 15:46:14 -0500https://media.nbcnewyork.com/images/213*120/AP_18326662192449.jpg

How many American children have autism? The U.S. government answers that question at least three different ways and says the latest estimate — 1 in 40 kids — doesn't necessarily mean the numbers are rising.

The new number, published Monday in Pediatrics, is from one of three periodic surveys the government uses to assess autism rates. It's higher than a different survey's estimate published earlier this year, but the surveys use different methods and measure different populations of kids so the results aren't really comparable.

Because there's no medical test, "autism spectrum disorder is a particularly challenging condition to track," government researchers wrote in the Pediatrics report.

The true occurrence of autism likely ranges from about 1 in 59 kids to 1 in 40 kids, researchers say, taking into account information from all three surveys.

"All contribute different information to form a fuller picture," said Michael Kogan, lead author of the new report conducted by the U.S. Health Resources & Services Administration, a federal agency.

Various reports in recent years have suggested autism rates are rising slightly. Experts think that's mostly because of earlier diagnosis, an expanded definition and more awareness, but say they can't rule out a true increase caused by unknown factors.

Here's a rundown on the three surveys:

— The latest estimate is based on responses from about 43,000 parents of kids aged 3 to 17. They were asked if their child had ever been diagnosed with autism spectrum disorder, the formal name that encompasses mild to severe cases. The 2016 survey was internet-based; earlier ones were telephone surveys showing slightly higher rates but the researchers say the results aren't comparable.

The nationally representative survey suggests that about 1.5 million U.S. kids have autism — 2.5 percent or 1 in 40.

— The Centers for Disease Control and Prevention collects nationally representative information from in-person interviews. In 2016, it also asked parents of kids aged 3 to 17 about an ever-diagnosis of autism and came up with a rate slightly higher than in previous years but similar to the 1 in 40 estimate.

— The CDC also uses an 11-state tracking system. It's based on health and school records showing which kids meet criteria for autism, focusing on 8-year-olds because most cases are diagnosed by that age. A report from this network released in April, showed that 1 in 59 kids have autism although much higher rates were found in some places. This estimate is considered the most rigorous, but it's not nationally representative.

Autism Speaks, an advocacy group, is among organizations that use the CDC's network estimate. It tends be more conservative and potentially more accurate than parents' reports, said neuroscientist Dean Hartley, a senior director for the group.

Autism is a developmental disorder that can involve varying degrees of language and social impairments, often including repetitive behaviors.

Experts say affected kids fare best with early diagnosis and treatment, but some doctors may dismiss early signs and some parents may be unaware of autism symptoms, the CDC's Dr. Stuart Shapira said.

The Pediatrics survey found that about one-third of kids with parent-reported autism received no behavior treatment and showed that many parents had trouble getting services for their children, echoing earlier studies.

Shapira noted the agency has a free Milestone Tracker phone app to help parents recognize developmental delays.

Copyright Associated Press / NBC New York



Photo Credit: Jenny Kane/AP (File)]]>
<![CDATA[US Goal to Be 'First' on Devices Worries Former Regulator]]>Tue, 27 Nov 2018 15:36:38 -0500https://media.nbcnewyork.com/images/212*120/skull3.jpg

Dr. Jeffrey Shuren was adamant: The United States would never cut corners to fast-track the approval of medical devices.

"We don't use our people as guinea pigs in the U.S.," Shuren said, holding firm as the new director of the U.S. Food and Drug Administration's medical devices division.

Again and again in 2011 — four times in all — Shuren was summoned before Congress. Lawmakers accused the agency of being too slow and too demanding in reviewing new devices like heart valves and spinal implants, driving U.S. manufacturers overseas where products faced less rigorous review. Each time, he pushed back.

And yet the next year, Shuren and his team adopted an approach that surprised even some of his closest colleagues: The FDA would strive to be "first in the world" to approve devices it considered important to public health.

The agency's shift mirrored the talking points of the $400 billion medical device industry — a lobbying behemoth on Capitol Hill — and ushered in a series of changes that critics say have allowed manufacturers to seek regulatory approval for high-risk devices using smaller, shorter, less rigorous studies that provide less certainty of safety and effectiveness.

Under Shuren, annual new device approvals have more than tripled, while warnings letters to device manufacturers about product safety and quality issues have fallen roughly 80 percent, an Associated Press investigation found.

The assortment of medical devices now on the market includes spinal rods that can leave metal shards in children and a nerve-zapping obesity implant that may not work for many patients.

The cheaper and faster medical device approvals began despite multiple, high-profile safety problems involving pelvic mesh, hip replacements and other implants.

An AP analysis of FDA data shows that since 2012, tens of thousands of injury and death reports have been filed in connection with devices that were cleared through a streamlined pathway that minimizes clinical trial testing. The FDA's database for reporting device problems often includes incomplete, unverified information submitted by manufacturers, physicians, lawyers and patients. Because of these limitations, it's often unclear whether a device played any role in an injury or death.

In response to questions from the AP, the FDA said its "first in the world" goal was not about a competition with other countries but rather was adopted as part of a strategy that also focused on quickly identifying defective products to ensure U.S. devices "remain safe, effective and of high quality."

The agency said it has focused on taking steps to reduce the time and cost of device development "that do not compromise our standard of reasonable assurance of safety and effectiveness."

Warning letters have declined, the FDA said, because the agency is using a new approach that involves fewer warnings but more inspections to oversee companies that violate its rules.

Last week, the FDA announced a new goal to be "consistently first" among the world's regulatory agencies to identify and address medical device safety issues.

The agency also rejected the idea that Shuren's approach to regulation has changed over time, saying he has worked for years to improve patient safety.

Still, some current and former FDA officials are worried about the ambition to be first on approvals. They include Dr. Peter Lurie, who calls the agency's new direction "an invitation to a race to the bottom for scientific standards" seemingly prompted by industry pressure. Lurie held senior posts at FDA from 2009 to 2017 and now heads the nonprofit Center for Science in the Public Interest.

The FDA's medical device standards are still considered among the highest in the world, requiring "reasonable assurance" of both safety and effectiveness. But by trying to outpace countries with less stringent requirements, Lurie said, the FDA has opened the door to lowering its own standards to achieve its goal.

The FDA's struggle to find the right mix of regulation and innovation in overseeing more than 190,000 medical devices — from pacemakers to contact lenses to surgical robots — has been chronicled for decades by government inspectors and outside researchers.

For almost as long, the agency has had a symbiotic relationship with industry.

Fees paid by medical device manufacturers for the review of their products now cover about 35 percent of the annual budget of the agency's Center for Devices and Radiological Health. The last four officials in Shuren's position have gone on to higher-paid positions in industry.

In addition, Shuren's wife, Allison, is a former lobbyist who now leads her law firm's health-care practice group and advises medical device clients, among others, on regulatory and legislative issues. The FDA said Shuren passed a "rigorous ethics review process" before assuming his position that addressed potential conflicts of interest. He also recuses himself from FDA matters involving clients represented by his wife or her firm, the agency said.

Joshua Sharfstein, a former FDA deputy commissioner now teaching at Johns Hopkins University, praised Shuren for balancing the competing demands of protecting the public while promptly approving beneficial new devices.

"I don't think there's a viable way to be the head of devices and be in open warfare with industry all the time," he said.

But some who spent years working under Shuren say speeding up product reviews became the clear priority after 2012.

"Basically, it was 'We need to find ways to get products on the market quicker, faster and we need to figure out how to reduce the premarket data requirements,'" said Christy Foreman, an industry consultant who spent 22 years at the FDA, including four years leading its device review office.

The FDA notes that laws passed by Congress require the agency to emphasize the "least burdensome approach" to reviewing new devices. But the agency itself helped fashion those laws, working with industry lobbyists and lawmakers on provisions that effectively limit its ability to request additional evidence from manufacturers.

The philosophy of "acceptable uncertainty" is sometimes the price of making life-saving devices quickly available, according to the FDA. At the same time, it acknowledges its main system for tracking problems is riddled with "incomplete, inaccurate, untimely, unverified or biased data."

"So instead, you have devices of unknown benefit on the market that still harm patients," said Dr. Rita Redberg, a prominent medical researcher and cardiologist at the University of California San Francisco. "I do feel that the FDA sees their role as making industry happy and not as much protecting the public health."

___

Every day, patients in the U.S. and around the world benefit from medical technology. The inventions of this global industry include implants that help the deaf hear, implantable lenses that restore sight to the elderly and cardiac pumps that keep failing hearts beating.

For most of the last century, medical devices were not regulated in the U.S. But a series of high-profile safety problems in the 1970s — including deaths, miscarriages and injuries caused by a contraceptive implant — pushed Congress to intervene.

The laws that resulted are both more complex and less demanding than those governing drugs.

To win FDA approval, for example, most new prescription drugs undergo two large, rigorous clinical studies proving they benefit patients. But most new medical devices enter the market with no clinical trial testing.

Historically, more than 95 percent of FDA-reviewed devices on the market went through a streamlined process in which they need only show that they are "substantially equivalent" to a product already on the market. Typically, only devices considered high-risk, like heart pumps, must demonstrate safety and effectiveness in humans, but even those can sometimes rely on existing scientific data as opposed to new studies.

On Monday, the FDA proposed changes to the streamlined system that would push manufacturers to incorporate more up-to-date technology into their devices. But some of the major reforms could take years to implement.

Some experts have long argued that this fast-track pathway was never intended to be permanent. As framed by Congress in 1976, the system was originally meant to be a temporary way to grandfather in thousands of devices already on the market that weren't considered high-enough risk to require immediate review. But instead of being phased out, it became mainstream.

The industry contends that flexibility is critical to innovation, allowing manufacturers to quickly and cheaply experiment and improve. An FDA review under that process costs about $11,000, compared to $320,000, under the more rigorous standard.

The result, though, is that some medical products barely resemble the decades-old "predicates" they reference in applying for FDA clearance. And even when old devices have been linked to injuries or death, future products are allowed to reference them for approval because the FDA lacks explicit legal authority to swiftly intervene.

In more than four decades, the FDA has banned only two products — powdered surgical gloves, which caused allergic reactions in patients, and fake hair implants, which caused infections and didn't work. The agency says its ability to ban products is "bound by federal law" and is essentially limited to devices that are either deceptively marketed or unreasonably dangerous.

The U.S. device system is "basically set up to get things on the market, not to get things off the market," said Larry Kessler, a University of Washington professor and consultant who worked more than a decade in the FDA's device center.

___

A device used to treat childhood scoliosis illustrates how quickly manufacturers can win FDA approval with minimal clinical trial testing.

The MAGEC rod uses remote-controlled magnets to gradually extend titanium columns implanted in children's backs to correct debilitating spinal curvature. It is marketed as an alternative to traditional implants, which require frequent surgeries to manually extend the rods as a child grows.

Prior to clearing it for use in the United States, the FDA allowed the MAGEC rod's California-based manufacturer, Ellipse, to begin exporting its product overseas.

The company enlisted a Hong Kong surgeon to conduct its first human trials after winning European approval in 2009 following experiments in pigs. In a company-funded study published three years later — based on the results of just two patients — the surgeon concluded the MAGEC rod "improves quality of life and is more cost-effective." The rods were later implanted in patients in Australia, Israel, Korea and elsewhere.

The company had assumed it would need to conduct a large clinical study including American children to win FDA approval for use in the United States, Dr. Behrooz Akbarnia, a San Diego-based surgeon and company consultant, said in an interview.

But in early 2014, the FDA informed the company it could seek approval via the streamlined process, Akbarnia said. Ellipse claimed its device was "substantially equivalent" to a mechanical implant developed in the 1950s. It was cleared for use in the U.S. by the FDA in just 35 days.

"That was one of the things that surprised me," Akbarnia said, "because it was so fast."

The approval also "shocked the spine industry," according to an article by Ellipse's former vice president of engineering Tiger Buford, who did not respond to repeated requests for an interview.

More than 2,000 children have been implanted with MAGEC rods worldwide, according to company filings by Ellipse, which was purchased by Nuvasive in 2016 for roughly $400 million.

Anthony Wainess was 9 when he became the first U.S. child to have MAGEC rods implanted in 2013 under a "compassionate use" exemption by the FDA. The rods temporarily helped the boy's spine grow correctly, but began breaking within a year and were removed in 2016.

Anthony's doctors theorized his body might be having an allergic reaction to the metal rods, according to his father, Steven Wainess.

The FDA told the AP that the MAGEC rod was cleared based on laboratory testing, animal studies and a clinical study "to demonstrate the device is safe and effective."

The agency said it requires makers of all spinal implants to include warnings about potential risks, noting that the MAGEC rod's labeling warns that it can break, move, corrode, cause pain and should not be used by patients with metal allergies.

Researchers in Europe have identified cases of metallosis in children with the rods, the tissue around their spines stained black by titanium shards and debris.

The long-term effects of titanium metallosis are not yet known, but metal debris in patients with chrome and cobalt hip implants can cause bone and tissue damage. The all-metal hip implants, also cleared through the FDA's streamlined path to market, were implanted in an estimated 500,000 Americans before the FDA reclassified them as high-risk in 2016. Today, they have largely been recalled or phased out.

In a paper published in January in the medical journal, Spine, British orthopedic engineer Thomas Joyce said all 34 MAGEC rods examined by his lab at Newcastle University showed signs of metal wear, which could lead to debris spreading throughout children's bodies.

The level of metal debris from MAGEC rods is about 100 times the levels he'd previously seen with hip implants, "a shocking amount," he reported. Joyce has worked as an expert witness for lawyers suing metal hip makers. He donates his payment to his employer, per university rules.

Nuvasive said in a statement that its device has been shown to be effective in helping avoid the "pain, elevated complication rates, and psychological distress" of traditional spinal rods.

"While no technology in these patients is without risk, we have also seen MAGEC rebuild patient and family lives," the company said.

Joyce said Nuvasive initially cooperated with his research, providing materials to help with his tests. But after his research was published, he said the company sent a letter to spine doctors worldwide questioning its validity.

Joyce said he's simply trying to answer basic safety questions that haven't been addressed by the company or regulators: Why does the MAGEC rod cause metallosis, and what are the long-term effects on children?

A device that claims to treat depression by beaming rapid-fire bursts of magnetic energy into the brain's prefrontal cortex had a similarly smooth path to market, even though its benefits were unclear.

Between 2012 and 2016, former U.S. military members participated in a Department of Veterans Affairs study of the transcranial magnetic stimulation device, or TMS. As of 2018, the VA has spent more than $3.4 million acquiring dozens of the machines and related supplies, based on the FDA's approval.

The FDA cleared TMS technology for the U.S. market in 2008 even though the agency's own advisers said data submitted by the original manufacturer failed to establish its effectiveness. In fact, the advisers called its effect "marginal," ''borderline" and "questionable."

The experts did note that TMS therapy appeared "reasonably safe," producing only minor complications such as headaches and scalp pain. That compared favorably to older devices used for hard-to-treat depression, including electro-shock therapy.

The FDA eventually approved the device through a pathway reserved for "low to moderate" risk devices that are not equivalent to previously approved devices.

Under Shuren's tenure, six more TMS manufacturers have come on the market, mainly by piggy-backing off the original FDA clearance.

This June, when the VA published the findings of its study , they echoed the results of a decade earlier: TMS made almost no difference in patients' depression. The authors offered several explanations, including that veterans often have multiple psychiatric problems that complicate treatment.

The American Psychiatric Association's guidelines describe TMS as offering "relatively small to moderate benefits." And even when TMS treatment is successful, its long-term durability has not been established in rigorous patient studies.

Still, with persistent marketing from manufacturers, TMS has gradually won acceptance as an alternative to antidepressants. Some clinics also advertise unapproved uses of the device, including for autism, Alzheimer's and post-traumatic stress disorder.

More than 800 U.S. clinics have the devices, according to a filing from the original TMS manufacturer, Neuronetics Inc. The firm tells doctors they can recoup the cost of a machine by treating just 12 patients, with a typical course of treatment costing up to $10,000 for 30 or more sessions over four to six weeks.

"The clinics are proliferating, the insurance is reimbursing, but we still don't exactly know what kind of patients should be receiving this intervention," said Dr. Dost Ongur, a Harvard Medical School psychiatrist and editor of the journal that published the VA study.

TMS can be effective for certain patients, Ongur and other psychiatrists say, but identifying them can be challenging.

The FDA said it approved TMS after determining that its benefits outweighed its risks. The device's approval is limited to patients who have failed to respond to drug therapy with at least one antidepressant, the agency said.

Neuronetics said in a statement that its device has been proven effective in studies of more than 900 patients and is covered by more than 65 private insurers and the government's Medicare plan. And Magventure, which makes the device used in the VA study, said TMS' impact on the brain is "a well-established fact," though researchers are still exploring the "optimal way" to treat different patient types.

But skeptics remain. The Blue Cross Blue Shield network's unit for reviewing medical devices has assessed TMS three times, most recently concluding in 2014 that the studies "do not provide convincing evidence." The group is considered a pioneer in evaluating medical technology.

Foreman, the former FDA review chief, said the "least burdensome" requirements that bind FDA reviewers make it difficult to demand better evidence for devices like TMS. In such cases, the agency's position is generally "the device isn't going to hurt anybody so let's put it out there and let the consumer use it," she said.

But even ineffective treatments for depression can be harmful, according to Diana Zuckerman, a depression researcher and president of the nonprofit National Center for Health Research, which assesses the quality of outside research and conducts its own.

"If you are going five days a week for a month, spending all this money and you feel you're no better than when you started, you could end up more depressed," Zuckerman says.

A new analysis of the TMS literature by Zuckerman's group concludes that the treatment "is not shown to be beneficial compared to typical placebo effects."

___

One of the rationales FDA cites for accepting uncertainty in new device safety and effectiveness is "patient preference," which holds that the agency should consider patient opinions in its approval decisions.

Former FDA regulators say Shuren has repurposed that idea to justify putting even more devices on the market.

"Jeff tells wonderful stories in terms of 'We're doing this to make sure patients have this greatly improved technology,'" Foreman said. "But there's another side to it, too."

In recent years, patient preference information has been used to push approvals through the FDA's pathway for high-risk devices, even in a case where the manufacturer failed to meet its own study goal.

In early 2015, the FDA approved a first-of-a-kind obesity device — an implantable stimulator that shoots electricity through the nerves connecting the stomach and brain. But less than a year earlier, the Maestro Rechargeable System had received a mixed review from the agency's scientists and outside advisers.

To demonstrate effectiveness, the FDA and the manufacturer agreed Maestro patients would need to lose at least 10 percent more excess body weight than patients who received a sham treatment. But one-year data showed patients with the device lost only 8.5 percent more of their weight.

FDA scientists cautioned that long-term complications from removing and adjusting the device were not known. And some agency advisers said the demographic of study participants was unacceptable, since 93 percent were white and U.S. obesity rates are highest in African-Americans and Hispanics.

Still, the agency approved the device, citing a survey that showed patients were willing to accept the risks.

The patient survey, for which the FDA paid $280,000, is being used by regulators to "define minimum clinical effectiveness to evaluate new weight-loss devices," the agency said, adding, "The FDA recognized obesity as an area of unmet patient need."

The device manufacturer, ReShape Lifesciences, did not respond to requests for comment.

Earlier this year, Shuren addressed a conference of medical device industry executives, each of whom paid about $1,000 to attend.

Armed with dozens of PowerPoint slides, he explained how the FDA was approving more new devices in less time and credited his "north star" — the FDA's goal to be "first in the world" to approve new devices.

He highlighted the agency's new focus on "customer service," including removing "unnecessary burdens" for companies and streamlining clinical trials.

"We all know that premarket clinical trials can be very costly, very time-consuming and, in some respects, of limited value," Shuren said.

He explained that the FDA was now using easier-to-produce data to approve a variety of devices, including artery-opening stents, spinal implants and diagnostic tests.

Meanwhile, warning letters to device makers over safety, marketing and other issues have fallen to their lowest level in over a decade. The FDA says it has offset warnings with increased inspections and that companies continue to fix their violations at the same rate.

The stepped-up approvals and modified enforcement have the endorsement of President Donald Trump and his appointee, FDA Commissioner Dr. Scott Gottlieb, who has highlighted "acceptable uncertainty" as a key concept to "modernize" device regulation.

In September, the FDA began codifying that concept in draft guidelines for manufacturers, which would ease pre-market testing standards for certain devices, in exchange for companies conducting larger follow-up studies, even though the FDA's own data show that many studies are not completed until five or more years after approval.

The FDA said in a statement that all devices carry a level of uncertainty, even after extensive testing. It said its guidance focuses on "breakthrough" devices, where "it may be appropriate to accept a little more uncertainty," while still meeting FDA standards.

Lurie and other former regulators worry that the FDA is laying the groundwork for a "sliding scale" of medical evidence that will leave patients even more uncertain about the safety and effectiveness of devices.

"This guidance is basically a 'come hither' to industry, inviting them to ask FDA for the lower standards of evidence," he said.

Copyright Associated Press / NBC New York



Photo Credit: ASSOCIATED PRESS]]>
<![CDATA[AP Investigation: Insulin Pumps Have High Number of Injuries]]>Tue, 27 Nov 2018 14:40:13 -0500https://media.nbcnewyork.com/images/213*120/AP_18319556730528.jpg

When Polly Varnado's 9-year-old daughter was diagnosed with Type 1 diabetes, it didn't take long for the family to hear about insulin pumps.

In September 2012, the girl picked out a purple one — her favorite color.

Over the next seven months, she proceeded to be hospitalized four times in a McComb, Mississippi medical center with high blood sugar. But when Varnado asked about all her daughter's problems, she said, her doctor blamed user error.

"They said it wasn't the insulin pump, it was my daughter," said Varnado, who became a registered nurse so that she could better care for the girl.

When it comes to medical devices, none have had more reported problems over the last decade than insulin pumps, a product that's used by hundreds of thousands of diabetics around the world, many of them children.

Collectively, insulin pumps and their components are responsible for the highest overall number of malfunction, injury and death reports in the U.S. Food and Drug Administration's medical device database, according to an Associated Press analysis of reports since 2008.

In terms of injuries alone, insulin pumps were second only to metal hip replacements, whose problems with metal shavings in the body causing damage to bone and tissue and other issues, have been well-documented and widely reported.

By contrast, problems with insulin pumps largely have flown under the radar.

Medical device companies and many experts say insulin pumps are safe devices that can help diabetics lead more normal lives. They blame user error for most reported problems, noting that the pumps are complicated devices requiring special training for patients.

The FDA notes that "diabetes is a dangerous disease, and people with diabetes who rely on insulin are at higher risk." The agency said it "has played a critical role helping to identify and address safety concerns for devices ... including pushing manufacturers to improve the safety of their designs."

Over the last decade, insulin pumps and pump parts made by Medtronic Inc. were subject to 20 manufacturer recalls and about 100 lawsuits alleging pump malfunctions, according to a joint investigation by the AP and the International Consortium of Investigative Journalists.

In a statement, Medtronic said it monitors the safety of its products through clinical trials and observational studies, and that "data supports both the safety and efficacy of our insulin pumps, which have helped hundreds of thousands of patients manage their diabetes."

The company declined to answer more specific questions.

Varnado said she was unaware of problems with insulin pumps before receiving a notice in July 2013 that Medtronic was recalling some batches of parts for the model her daughter had used.

She reached a confidential settlement with the company in March 2017 after filing a federal lawsuit contending the device failed to properly deliver enough insulin. She remains convinced that the device harmed her child.

"Once she got off the pump, she never went back to the hospital," Varnado said.

Dr. Ben Wheeler, a leading pediatric diabetes researcher in Australia, told the AP that the use of insulin pumps "appears safe" and is "potentially safer" than insulin injections, the traditional method of treatment.

Still, a 2015 study he co-authored found that 40 percent of insulin pump users experienced problems, "with a minority, particularly in children, requiring hospital management."

The study also said "it is noteworthy that overall pump failure rates do not appear to be improving with technological advances."

___

Diabetes results when the pancreas fails to make enough insulin or the body can't respond normally to the insulin that is produced. Insulin is essential in regulating blood glucose, which is produced by food and is the main source of energy for the body's cells.

Insulin pumps are small, computerized devices that mimic a normal pancreas, and have two main components — the pump and the infusion set. In addition to maintaining the device, users also must monitor their diets and manually input information, such as the rate of insulin delivery.

Companies aggressively market the device to adults and children. For instance, Medtronic — which makes most of the pumps in use today — has a company mascot, "Lenny the Lion," for its estimated 250,000 children users.

But experts say not everyone is a good candidate for the device and that potential users should be carefully screened to ensure they're suitable.

"There is a sharp learning curve," said Dr. Desmond Schatz, medical director of the University of Florida's Diabetes Institute. "You've got to understand the pump. You've got to understand how it works.... You've got to understand how to change it. You have to understand settings."

The FDA's data offers no explanation for why the devices have so many adverse events. Many of the reports filed by doctors, manufacturers and patients lack critical information — a reporting failure the FDA acknowledges across all devices.

For example, medical device companies and health care providers are supposed to file an adverse event report whenever a device is suspected of malfunctioning or contributing to an injury or death. The report should include a device problem code and describe what happened, which can help pinpoint problems with a particular device.But an AP analysis of the FDA data found that Medtronic did not include a device problem code on virtually any of its more than 150,000 reports of deaths or injuries related to insulin pumps since 2008. The FDA said device makers should include a problem code, but don't have to if the information is unknown.

The company cited a specific problem in only 2 percent of the cases — most often "Device Displays Incorrect Message."

In addition, the AP found that Medtronic offered "no conclusion can be drawn at this time" as the cause in more than 80 percent of the reports. The second most common phrase: "Currently it is unknown whether or not the device may have caused or contributed to the event as no product has been returned."

Matt Harman, an Atlanta-based attorney who has filed numerous lawsuits involving medical devices, including insulin pumps,, said users also aren't told that data can be lost if batteries are removed from some pump models.

"I can't tell you how many times we've gotten a call from a distraught, devastated family member who had a loved one who passed away under suspicious circumstances," he said. "But when we try to find out what happened, we can't if we don't have the data."

The FDA said it was aware of that problem in older insulin pumps and has encouraged manufacturers to develop devices with memories that won't be erased when power is lost or have the capability to send data to a secure server for storage.

___

The FDA notes that the number of pump recalls has decreased over the last five years — from about eight annually over the previous 10 years to an average of three per year — which it credits to a 2010 initiative aimed at ramping up requirements for manufacturers and increasing user awareness.

But 2013's recalls included one on the most serious level concerning the Medtronic MiniMed Paradigm insulin infusion set, with the FDA noting that "under certain conditions, the infusion set may malfunction and deliver an incorrect volume of insulin."

Lawsuits related to insulin pumps often blame malfunctions for causing injuries or deaths.

One filed in February in federal court in Mississippi alleges that Debbie Davis, a 56-year-old bank loan officer, died two months after an insulin pump "delivered up to a week's worth of insulin at one time."

Her husband, Mike Davis, told the AP that his wife had been diabetic for about 10 years and easily managed her disease with injections, but decided to try a pump in 2016 after hearing how it could help.

One morning in January 2017, David said, he couldn't wake his wife after she had filled her insulin pump and gone to bed. She lingered in a coma for two months.

Seven months later, Davis said he received a Medtronic recall notice warning of the "potential over-delivery of insulin." ''I just knew right then it was what did it," he said.

In court records in the ongoing litigation, Medtronic denied the "devices malfunctioned, or that they were defective in any way."

Copyright Associated Press / NBC New York



Photo Credit: AP/Rogelio V. Solis]]>
<![CDATA[50K Women Killed by Partners, Family Last Year: UN Report]]>Tue, 27 Nov 2018 08:30:49 -0500https://media.nbcnewyork.com/images/213*120/AP_18329859688936-Elimination-of-Violence-Against-Women.jpg

The United Nations' Office on Drugs and Crime says about 50,000 women around the world were killed last year by their "intimate partner" or a member of their family, NBC News reported.

That means nearly six women were killed every hour, according to the UNODC report released Sunday, the U.N.'s International Day for the Elimination of Violence Against Women. Partners or family members were responsible for more than half of all the killings of women in 2017.

The findings didn't surprise Rachel Goldsmith, an official at U.S. victim's assistance organization Safe Horzion. She pointed to last week's shooting at a hospital in Chicago, in which a man fatally shot his former fiancee and two bystanders.

"This is happening all across the country where women who have made the decision to leave a relationship and their partners have decided to respond with firearms or violence," she said.



Photo Credit: Christian Palma/AP]]>
<![CDATA[CDC Confirms 116 Cases of Polio-Like Paralysis]]>Mon, 26 Nov 2018 16:26:47 -0500https://media.nbcnewyork.com/images/213*120/cdcGettyImages-456691988-%281%29.jpg

At least 116 people, mostly children, have been confirmed with the polio-like condition called acute flaccid myelitis, federal health officials said Monday.

The Centers for Disease Control and Prevention says it is investigating 286 cases of AFM, which puts 2018 on track to be a busy year for cases of the little-understood syndrome, NBC News reported.

“So far in 2018, there are 116 confirmed cases of AFM in 31 states,” the CDC said in its latest update.



Photo Credit: Getty Images]]>
<![CDATA[Gene-Edited Baby Claim by Chinese Scientist Sparks Outrage]]>Mon, 26 Nov 2018 16:51:30 -0500https://media.nbcnewyork.com/images/213*120/geneditedembryoAP_18330076340097.jpg

Scientists and bioethics experts reacted with shock, anger and alarm Monday to a Chinese researcher's claim that he helped make the world's first genetically edited babies.

He Jiankui of Southern University of Science and Technology of China said he altered the DNA of twin girls born earlier this month to try to help them resist possible future infection with the AIDS virus — a dubious goal, ethically and scientifically.

There is no independent confirmation of what He says he did, and it has not been published in a journal where other experts could review it. He revealed it Monday in Hong Kong where a gene editing conference is getting underway, and previously in exclusive interviews with The Associated Press.

Reaction to the claim was swift and harsh.

More than 100 scientists signed a petition calling for greater oversight on gene editing experiments.

The university where He is based said it will hire experts to investigate, saying the work "seriously violated academic ethics and standards."

A spokesman for He said he has been on leave from teaching since early this year but remains on the faculty and has a lab at the university.

Authorities in Shenzhen, the city where He's lab is situated, also launched an investigation.

And Rice University in the United States said it will investigate the involvement of physics professor Michael Deem. This sort of gene editing is banned in the U.S., though Deem said he worked with He on the project in China.

"Regardless of where it was conducted, this work as described in press reports violates scientific conduct guidelines and is inconsistent with ethical norms of the scientific community and Rice University," the school said in a statement.

Gene editing is a way to rewrite DNA, the code of life, to try to supply a missing gene that is needed or disable one that is causing problems. It has only recently been tried in adults to treat serious diseases.

Editing eggs, sperm or embryos is different, because it makes permanent changes that can pass to future generations. Its risks are unknown, and leading scientists have called for a moratorium on its use except in lab studies until more is learned.

They include Feng Zhang and Jennifer Doudna, inventors of a powerful but simple new tool called CRISPR-cas9 that reportedly was used on the Chinese babies during fertility treatments when they were conceived.

"Not only do I see this as risky, but I am also deeply concerned about the lack of transparency" around the work, Zhang, a scientist at MIT's Broad Institute, said in a statement. Medical advances need to be openly discussed with patients, doctors, scientists and society, he said.

Doudna, a scientist at the University of California, Berkeley and one of the Hong Kong conference organizers, said that He met with her Monday to tell her of his work, and that she and others plan to let him speak at the conference Wednesday as originally planned.

"None of the reported work has gone through the peer review process," and the conference is aimed at hashing out important issues such as whether and when gene editing is appropriate, she said.

Doudna is paid by the Howard Hughes Medical Institute and Zhang receives grant support from the organization, which also supports AP's Health & Science Department.

Another conference leader, Harvard Medical School dean Dr. George Daley, said he worries about other scientists trying this in the absence of regulations or a ban.

"I would be concerned if this initial report opened the floodgates to broader practice," Daley said.

Notre Dame Law School professor O. Carter Snead, a former presidential adviser on bioethics, called the report "deeply troubling, if true."

"No matter how well intentioned, this intervention is dangerous, unethical, and represents a perilous new moment in human history," he wrote in an email. "These children, and their children's children, have had their futures irrevocably changed without consent, ethical review or meaningful deliberation."

Concerns have been raised about how He says he proceeded, and whether participants truly understood the potential risks and benefits before signing up to attempt pregnancy with edited embryos. He says he began the work in 2017, but he only gave notice of it earlier this month on a Chinese registry of clinical trials.

The secrecy concerns have been compounded by lack of proof for his claims. He has said the parents involved declined to be identified or interviewed, and he would not say where they live or where the work was done.

One independent expert even questioned whether the claim could be a hoax. Deem, the Rice scientist who says he took part in the work, called that ridiculous.

"Of course the work occurred," Deem said. "I met the parents. I was there for the informed consent of the parents."

Copyright Associated Press / NBC New York



Photo Credit: Mark Schiefelbein/AP]]>
<![CDATA[Breast Implant Injuries Hidden as Patients' Questions Mount]]>Mon, 26 Nov 2018 12:57:17 -0500https://media.nbcnewyork.com/images/213*120/breast-implants.jpg

To all the world, it looked like breast implants were safe. From 2008 to 2015, the U.S. Food and Drug Administration publicly reported 200 or so complaints annually — a tiny fraction of the hundreds of thousands of implant surgeries performed each year.

Then last fall, something strange happened: Thousands of problems with breast implants flooded the FDA's system. More than 4,000 injury reports filed in the last half of 2017. Another 8,000 in the first six months of 2018.

Suddenly, women like Jamee Cook had evidence suggesting their suffering might be linked to their breast implants. An emergency room paramedic, Cook had quit her job because of a vague but persistent array of health problems that stretched over a decade, including exhaustion, migraines, trouble focusing and an autoimmune disorder diagnosis.

Why had it taken so long for complaints like hers to see the light of day?

Makers of breast implants were required to track patients and their health. But for more than a decade, manufacturers with high numbers of recurring problems — in the case of implants, ruptures that required surgery to remove — were allowed to report issues in bulk, with one report standing in for thousands of individual cases and no way for the public to discern the true volume of incidents.

That agreement stood even as the FDA began closely monitoring a rare type of cancer and acknowledged in 2011 that it might be linked to breast implants.

"It looked like these devices had become safer, but they hadn't," Cook told The Associated Press. "The data was hidden. It's a deceptive practice."

Once Cook's textured saline implants were removed, she said the majority of her symptoms disappeared. Her experiences prompted her to become a patient safety advocate, lobbying lawmakers and organizing groups of women online who have concerns about breast implants.

Public health advocates who've watched the debate over breast implant safety rage for nearly three decades say summary reporting is yet another way that information about the devices has been elusive for patients.

"They were told those devices were safe — the FDA would go back and say 'We only have this many reports,'" said Madris Tomes, a former FDA staffer who founded a company to analyze medical device reports. "But data was coming in another way that wasn't public. It leaves the patients demoralized — they don't understand how many other people are suffering."

The data came to light after the FDA instructed manufacturers in mid-2017 to go back and file individual reports in each case of patient injury, in response to a lawyer's discovery that reports from his clients weren't represented in the agency's data. Patient advocates took up the issue, complaining about a lack of transparency and voicing concerns about a host of autoimmune problems they believed stemmed from their implants.

But even as the FDA was dealing with the problems of how breast implant manufacturers had used summary reporting, the agency was moving to expand device makers' flexibility in how they report problems, saying it was trying to reduce the industry's paperwork requirements.

This August, the agency began allowing roughly 90 percent of all medical devices — including all breast implants and more than 160 types of other high-risk implanted devices like artificial hips and replacement heart valves — to report malfunctions in a quarterly tally, instead of individually. They will not be able to report cases involving deaths or injuries that way, however.

The FDA rejected claims that expanding summary reporting could harm public health by making problems with devices less transparent, saying the plan "will also yield benefits . such as helping FDA process malfunction reports more efficiently and helping both FDA and the public more readily identify malfunction trends."

FDA officials also said that the agency has closely monitored the breast implant industry in the past decade and issued updates about potential risks.

Two of the largest breast implant manufacturers, Mentor and Allergan, said they stood behind the safety of their products, citing years of studies that have led to inconclusive evidence that autoimmune problems are linked to breast implants.

"Our medical devices undergo extensive laboratory testing before they are submitted to government health experts for a science-based review," Mentor spokeswoman Mindy Tinsley said. "Many of our devices undergo careful reviews by not just one, but multiple regulatory bodies around the world."

Still, it can be hard for breast implant patients and advocates to track problems that do arise.

Insurance claims make no mention of the specific device or model implanted in a patient, and patients' electronic health records aren't required to record that either. In addition, products sold overseas can be renamed or carry a different model number, making international recalls or tracking across borders nearly impossible.

Meanwhile, the FDA's main database on medical device problems, which requires manufacturers to report patient deaths and serious injuries to the government within 30 days, relies on hand-typed entries from a variety of people — from patients to device manufacturers — to help track troubled products. That can lead to underreporting, along with missing and flawed data.

Tomes said accurate, complete and publicly accessible data is crucial to identifying problems quickly and making sure devices are safe. The FDA numbers, she said, offer the lowest possible count of reports about problems with breast implants.

"You can assume that the numbers are probably much, much higher," she said.

A Duke University report funded by the FDA in 2016 found that even though the agency collected data on device malfunctions for more than two decades, "reliably and efficiently tracking the medical device safety and effectiveness outcomes of most interest to patients remains a generally unfulfilled promise" that "significantly affects the public health."

Insurers, auto buyers and regulators all use a car's VIN number to track a vehicle's history, down to the line it was manufactured on at a specific factory, and the FDA's own pharmaceutical drug oversight works similarly. But medical devices didn't have a similar unique identifier until 2015, and many of the least-risky devices won't put an ID into use until 2020. On top of that, experts say it could be years before their use is required in patient records, on insurance claims and in the FDA's own data.

What are the most common makes and models of breast implants reported as having caused injury? The FDA's answer is still quite often "Unknown."

___

The FDA requires manufacturers and medical facilities to file a report when any kind of medical device causes serious injury, death or malfunctions.

The resulting database — called MAUDE, for Manufacturer and User Facility Device Experience — is available online to the public, so consumers can search for a device type, manufacturer, the details of an incident and the date on which it occurred. That is, if the forms are filled out properly.

But categories often are left blank, with no indication of the model or who submitted the report. And device names and manufacturers also are often misspelled, making it nearly impossible for users to find all the reports of problems with a specific device or company. For example, the data contains roughly 2,000 variations of the name Medtronic plc, one of the world's largest medical device manufacturers.

Overall, the MAUDE data contains reports of more than 1.7 million injuries and nearly 83,000 deaths over the past 10 years for all types of medical devices, according to an analysis of FDA data by the International Consortium of Investigative Journalists, which collaborated with the AP on a global investigation of medical device safety.

But in looking at problems with the MAUDE data, the investigation found an additional 2,100 cases in the past five years where people died but their deaths were misclassified as "malfunctions" or "injuries." Of those, 220 deaths could be directly linked to medical device failure; the other reports did not include enough information to determine conclusively if the device played a role.

Beyond the misclassified data, FDA inspections at 17 hospitals in 2015 and 2016 found that only a fraction of "adverse events" were even being reported anyway. The review —which included major facilities in Los Angeles, New York, Boston and Chicago — found more than half failed to report deaths of patients with medical devices, as required by the agency's rules. Jeffrey Shuren, the head of the FDA's device division, said at the time that underreporting problems from hospitals was widespread. The agency enhanced compliance training for hospital employees nationwide as a result.

Part of the problem, advocates say, is that the FDA's guidelines for reporting problem devices is vague — the agency states that reports are required from manufacturers within 30 days of an event when evidence "reasonably suggests" that a device was involved, allowing companies to make their own judgments.

S. Lori Brown, now a retired FDA senior researcher, used MAUDE for years in her studies of breast implants, ruptures and possible links to rare forms of cancer and a host of autoimmune disorders.

"It's a difficult database to use, because there's no good way to confirm what's reported, and there's no denominator — you don't know how many people have received breast implants," Brown said. "The MAUDE database was just not very helpful in finding out how frequently things happened or how severe the impact was."

Where it was helpful, she said, was in gathering patient stories and seeing general trends. In the 1990s, even as manufacturers claimed breast implants were durable enough to be run over by a car without breaking, MAUDE showed silicone implants leaking gel into thousands of women's bodies.

"As a signal, it was a burning bush, for sure," Brown said. "Because there were so many reports of ruptured implants from every manufacturer."

After the FDA removed silicone breast implants from the market in 1992, the public attention around ruptures and leaks resulted in a huge spike in the number reports about problems. During the 1990s, silicone implants represented the third-highest number of adverse events reports in MAUDE. At the time, the data show patients also complained about other symptoms, with hundreds of reports about chronic fatigue, headaches, autoimmune problems and fibromyalgia.

In 2006, silicone implants returned to the market, under the requirement that companies track patients for at least a decade. Although more than half the women dropped out of the studies within the first two years, researchers at the University of Texas MD Anderson Cancer Center in Houston released a study this September using the data the companies did collect and found that certain rare health problems — including immune system and connective tissue disorders — might be more common with silicone gel implants. The FDA, which mandated the original data collection, later criticized the study, citing "inconsistencies in the data."

Last year, the FDA did confirm a link between breast implants, particularly textured saline or silicone models, and anaplastic large cell lymphoma — a rare cancer documented in only a few hundred cases.

On its website, the FDA also noted more common problems with implants, such as ruptures, which can send silicone gel throughout the body. And the agency warned that implants "are not lifetime devices," but will likely need to be removed or replaced at some point.

The return of silicone implants, which advocates say feel more natural, has fueled a surge in surgeries. The American Society of Plastic Surgeons reported 400,000 procedures took place in 2017, up nearly 40 percent since 2000.

More than three-quarters of the implant surgeries were for cosmetic, not reconstructive, reasons. And there were about 20 percent fewer removals compared to 2000, the data show.

The increase in implants worries Diana Zuckerman, a medical researcher who was a congressional staffer during the earliest contentious House hearings on breast implant safety. She said poorly performed studies, research funded directly by manufacturers and the lack of data have left most women in the dark about the risks involved.

"Somehow, it's the most studied device and we have almost no useful information about it," said Zuckerman, the president of the National Center for Health Research, a nonprofit think tank that performs its own research, assesses the quality of others' research and works with patients.

Zuckerman's center reviewed more than 20 studies it says has been used by the industry to claim there is no evidence breast implants cause connective tissue problems and other long-term illnesses. She said almost all the studies were too small to detect rare diseases and conditions, only one required that participants have a medical exam and most didn't focus on patients who had implants long enough for problems to develop.

In September, Cook and 19 other breast implant patients-turned-health-advocates visited Washington to lobby the FDA for more stringent regulation, testing and reporting on breast implants. Among their requests — that all types of textured implants, which are more closely associated with lymphoma, be banned from the market, and that manufacturers be required to disclose the chemicals in silicone implants' shell and gel filling, which the makers claim is a trade secret.

The FDA has scheduled an advisory committee hearing for early 2019 on breast implant safety to address some of the U.S. group's concerns and determine whether additional actions are needed to protect public health. The agency did not rule out the possibility of including a "black box warning," the notification it puts on its most dangerous devices to draw attention to serious risks.

However, the FDA said in a statement: "The agency continues to believe that the weight of the currently available scientific evidence does not conclusively demonstrate an association between breast implants and connective tissue diseases."

Cook, who leads several breast implant groups on Facebook from her home near Dallas, said she chose to get her implants, but did so with almost no information on the potential dangers.

"If you had sat down with me and said 'this is the list of chemicals you're about to put in your body and you could get lymphoma,' no way in hell I would have done it," she said.

Her implants, a textured saline model made by Poly Implant Prothese of France, were used in the U.S. for four years before the FDA implemented more stringent standards for breast implant approval in 2000. Under the new rules, the FDA denied the company's application to sell implants in the U.S. after officials toured the company's French plant and cited 11 major deficiencies in quality control and manufacturing practices.

Poly Implant went bankrupt in 2010 after doctors in France noted abnormally high rupture rates of the implants, which were found to be filled with industrial-grade gel. The company's president was found guilty of aggravated fraud, and French authorities advised tens of thousands of women to get their implants removed as a precautionary measure.

Cook, 41, said she and others who already had the saline implants never were warned of the FDA's actions.

"I'm not going to sit back and be embarrassed about my decision when I can try to change the way that the future is going to occur for women younger than me," she said. "We need to make sure we're giving that patient the most safe device we possibly can. And above that, we need to make sure she understands what the risks are before she makes that choice."

___

The FDA may now require an identifying number on medical devices, but Zuckerman and other advocates note one big issue with the code associated with breast implants: The number is not actually stamped on the implant itself, but on the packaging.

"For the most part, these devices don't cause immediate problems — they cause problems later," Zuckerman said. "What good does it do to have these numbers if they're not in your medical records and they aren't on the implant itself?"

The unique device identifier, or UDI, is intended to help standardize device names and manufacturer information and make it easier to track devices to help in recall efforts and analyses of problems.

But that doesn't work if the codes aren't in the FDA's own database. Tomes, whose company Device Events analyzes MAUDE data, said UDIs are still rarely included in adverse event reports and, even when they are, often are removed from the public data so they can't be used to identify specific devices.

"The whole point of having a UDI is so that hospitals and providers and insurance companies and anyone else would be able to say 'I'm seeing a pattern, it's all this serial number,'" Tomes said. "But it's redacted."

Similarly, Tomes and others say the FDA's expansion of summary reporting and its use of device registries — databases funded and maintained by outside organizations to track a singular specific device — may ultimately make less data available to consumers.

This fall, the agency announced a breast implant registry run through the Plastic Surgery Foundation that will collect patient and device data — including UDI numbers for breast implants — and allow surgeons to track patients' medical history, complications and follow-up surgeries.

The participation of plastic surgeons in the registry is voluntary, and patients also can opt out. Doctors and researchers will have access to the collected data, but the public will not.

As the FDA weighed its expansion of the summary reporting program earlier this year, Cook and a dozen other patients with medical device problems, along with the patient-advocacy group Public Citizen, urged the agency to rethink its plan.

But the FDA sided with manufacturers and industry organizations, which had asked for easier reporting requirements for malfunctions, freeing them in some cases from filing tens of thousands of individual reports a year. Under the new rules now in place, roughly 90 percent of devices can report malfunctions quarterly.

"Thousands on thousands of consumers are harmed every single year by medical devices and we are discussing making it easier to hide the information that we need to make an informed decision," Cook wrote in her dissent to the plan.

"While the goal is not to 'hide' the data," she wrote, "in essence that is what is happening."

AP Health Writer Matthew Perrone contributed to this story. 

Copyright Associated Press / NBC New York



Photo Credit: Jose Luis Magana/AP]]>
<![CDATA[FDA Says It Will Overhaul Criticized Medical Device System]]>Mon, 26 Nov 2018 14:36:38 -0500https://media.nbcnewyork.com/images/213*120/medical-devices.jpg

U.S. health officials said Monday they plan to overhaul the nation's decades-old system for approving most medical devices, which has long been criticized by experts for failing to catch problems with risky implants and related products.

The Food and Drug Administration announced plans aimed at making sure new medical devices reflect up-to-date safety and effectiveness features. The system targeted by the actions generally allows manufacturers to launch new products based on similarities to decades-old products, not new clinical testing in patients.

The FDA's move came one day after the publication of a global investigation into medical device safety by more than 50 media organizations, including The Associated Press and NBC News. Led by the International Consortium of Investigative Journalists, the group found that more than 1.7 million injuries and nearly 83,000 deaths suspected of being linked to medical devices had been reported to the FDA over a 10-year period.

"We believe that it's time to fundamentally modernize an approach first adopted in 1976," FDA Commissioner Scott Gottlieb said in a statement, noting that the changes under consideration would push companies to compare their devices to more up-to-date technology.

On Twitter, he described the proposal as "the most significant modernization" of the medical device review process in a generation.

Some of the reforms proposed by the FDA could take years to implement and potentially include new guidelines and regulations for manufacturers, and the most substantive changes could require action by Congress.

Dr. David Challoner, a leading expert on the FDA's review system, said the changes would likely improve device safety, but worried that manufacturers could scuttle the reform effort.

"If the device industry comes back at this full bore with their lobbying efforts, this could all die a slow and painful death," he told the AP.

In 2011, Challoner led a government advisory panel that recommended the FDA's "flawed" review system be replaced. At the time, the FDA said it disagreed with the group's recommendations.

The FDA's framework for clearing more than 95 percent of devices on the U.S. market has long been criticized in reports from government watchdogs and independent medical experts. Unlike new pharmaceuticals — which are tested in patient studies — most medical devices only have to show that they are similar to devices already on the market. Only a handful of truly new devices must undergo extensive clinical testing to verify they are safe and effective.

Challoner's review panel had concluded that Congress originally intended for the streamlined pathway to be a temporary way to "grandfather" in thousands of low-to-moderate risk devices then on the market. But instead of being phased out it became the principal approval path.

Defective devices cleared through the streamlined system have included hip replacements that failed prematurely, surgical mesh linked to pain and bleeding, and a surgical instrument that inadvertently spread uterine cancer.

As generations of devices have been cleared via the FDA's main review process, medical products have become increasingly complex and often barely resemble the decades-old "predicates" they claim to reference. Devices cleared through this system, known as the 510(k), include imaging scanners, computerized drug pumps, artificial joints and spinal implants.

The FDA said it would consider phasing out some older devices so that new products could no longer reference them to enter the market. The agency noted that nearly 20 percent of devices cleared through its main review process are predicated on devices that are more than 10 years old.

The Advanced Medical Technology Association, the industry's chief lobbying group, said in a statement that it looked forward to learning more about the FDA's plans.

"While we believe the 510(k) pathway has proven its effectiveness over the years, we have always maintained that any process can be improved," the group said.

Copyright Associated Press / NBC New York



Photo Credit: AP]]>
<![CDATA[Spinal-Cord Stimulators Help Some Patients, Injure Others]]>Sun, 25 Nov 2018 22:42:00 -0500https://media.nbcnewyork.com/images/213*120/pain-deviceAP_18315045614367.jpg

Desperate for relief after years of agony, Jim Taft listened intently as his pain management doctor described a medical device that could change his life.

It wouldn't fix the nerve damage in his mangled right arm, Taft and his wife recalled the doctor saying, but a spinal-cord stimulator would cloak his pain, making him "good as new."

Taft's stimulator failed soon after it was surgically implanted. After an operation to repair it, he said, the device shocked him so many times that he couldn't sleep and even fell down a flight of stairs. Today, the 45-year-old Taft is virtually paralyzed, a prisoner in his own bed, barely able to get to the bathroom by himself.

"I thought I would have a wonderful life," Taft said. "But look at me."

For years, medical device companies and doctors have touted spinal-cord stimulators as a panacea for millions of patients suffering from a wide range of pain disorders, making them one of the fastest-growing products in the $400 billion medical device industry. Companies and doctors aggressively push them as a safe antidote to the deadly opioid crisis in the U.S. and as a treatment for an aging population in need of chronic pain relief.

But the stimulators — devices that use electrical currents to block pain signals before they reach the brain — are more dangerous than many patients know, an Associated Press investigation found. They account for the third-highest number of medical device injury reports to the U.S. Food and Drug Administration, with more than 80,000 incidents flagged since 2008.

Patients report that they have been shocked or burned or have suffered spinal-cord nerve damage ranging from muscle weakness to paraplegia, FDA data shows. Among the 4,000 types of devices tracked by the FDA, only metal hip replacements and insulin pumps have logged more injury reports.

The FDA data contains more than 500 reports of people with spinal-cord stimulators who died, but details are scant, making it difficult to determine if the deaths were related to the stimulator or implant surgery.

Medical device manufacturers insist spinal-cord stimulators are safe — some 60,000 are implanted annually — and doctors who specialize in these surgeries say they have helped reduce pain for many of their patients.

Most of these devices have been approved by the FDA with little clinical testing, however, and the agency's data shows that spinal-cord stimulators have a disproportionately higher number of injuries compared to hip implants, which are far more plentiful.

The AP reported on spinal stimulators as part of a nearly yearlong joint investigation of the global medical devices industry that included NBC, the International Consortium of Investigative Journalists and more than 50 other media partners around the world. Reporters collected and analyzed millions of medical records, recall notices and other product safety warnings, in addition to interviewing doctors, patients, researchers and company whistleblowers.

The media partners found that, across all types of medical devices, more than 1.7 million injuries and nearly 83,000 deaths were reported to the FDA over the last decade.

The investigation also found that the FDA — considered by other countries to be the gold standard in medical device oversight — puts people at risk by pushing devices through an abbreviated approval process, then responds slowly when it comes to forcing companies to correct sometimes life-threatening products.

Devices are rarely pulled from the market, even when major problems emerge. And the FDA does not disclose how many devices are implanted in the U.S. each year — critical information that could be used to calculate success and failure rates.

The FDA acknowledges its data has limitations, including mistakes, omissions and under-reporting that can make it difficult to determine whether a device directly caused an injury or death. But it rejects any suggestion of failed oversight.

"There are over 190,000 different devices on the U.S. market. We approve or clear about a dozen new or modified devices every single business day," Dr. Jeffrey Shuren, the FDA's medical device director said at an industry conference in May. "The few devices that get attention at any time in the press is fewer than the devices we may put on the market in a single business day. That to me doesn't say that the system is failing. It's remarkable that the system is working as it does."

In response to reporters' questions, the FDA said last week that it was taking new action to create "a more robust medical device safety net for patients through better data." ''Unfortunately, the FDA cannot always know the full extent of the benefits and risks of a device before it reaches the market," the agency said. In the last 50 years, the medical device industry has revolutionized treatment for some of the deadliest scourges of modern medicine, introducing devices to treat or diagnose heart disease, cancer and diabetes.

Pete Corby, who injured his back working as a movie stuntman, said a spinal-cord stimulator helped him deal with his constant pain and stop using the opioids he'd become dependent on.

"This is the greatest thing that saved my life, literally saved my life," said Corby, estimating that up to three-quarters of his original pain was alleviated by the stimulator.

Medical device companies have "invested countless resources — both capital and human — in developing leading-edge compliance programs," said Janet Trunzo, head of technology and regulatory affairs for AdvaMed, the industry's main trade association.

At the same time, medical device makers also have spent billions to try to influence regulators, hospitals and doctors.

In the U.S., where drug and device manufacturers are required to disclose payments to physicians, the 10 largest medical device companies paid nearly $600 million to doctors or their hospitals last year to cover consulting fees, research and travel and entertainment expenses, according to an AP and ICIJ analysis of data from the Centers for Medicare & Medicaid Services. This figure doesn't include payments from device manufacturers like Johnson & Johnson and Allergan, which also sell other products.

On top of that, lobbying records show that the top four spinal-cord stimulator manufacturers have spent more than $22 million combined since 2017 to try to influence legislation benefiting their overall business, which includes other devices.

Some companies have been fined for bribing physicians, illegally promoting products for unapproved uses and paying for studies that proclaim the safety and effectiveness of their products, according to the joint investigation.

In a 2016 case, Olympus Corp. of the Americas, the largest U.S. distributor of endoscopes and related medical equipment, agreed to pay $623.2 million "to resolve criminal charges and civil claims relating to a scheme to pay kickbacks to doctors and hospitals," according to the U.S. Justice Department. Olympus said that it "agreed to make various improvements to its compliance program."

In a case the previous year involving spinal-cord stimulators, Medtronic Inc. agreed to pay $2.8 million to settle Justice Department claims that the company had harmed patients and defrauded federal health care programs by providing physicians "powerful" financial inducements that turned them into "salesmen" for costly procedures. Medtronic denied wrongdoing. "As a matter of policy, Medtronic does not comment on specific litigation," the company said in a statement. "We do stand behind the safety and efficacy of our Spinal Cord Stimulators and the strong benefits this technology provides to patients, many of whom have tried all other therapy options to no benefit."

Some doctors enthusiastically promote spinal-cord stimulators without disclosing to patients they've received money from medical device manufacturers. Some experts say doctors are not legally required to disclose such payments, but they have an ethical obligation to do so. Sometimes the money goes to the doctors' hospitals, and not directly to them.

As for Taft, he said he just wanted to get better, but he has lost hope.

"This is my death sentence," Taft said, stretched out beneath his bed's wooden headboard on which he's carved the words "death row."

"I'll die here," he said.

A generation ago, tens of thousands of women were injured by the Dalkon Shield, an intrauterine device that caused life-threatening infections. Consumer advocates demanded testing and pre-market approval of medical devices to prevent deaths and injuries associated with defective products.

So in 1976, Congress passed the Medical Device Amendments, a law meant to assure Americans that devices recommended by their doctors would do good and not harm.

"Until today, the American consumer could not be sure that a medical device used by his physician, his hospital or himself was as safe and effective as it could or should be," President Gerald Ford said when he signed the bill into law.

Charged with carrying out the law, the FDA created three classes of medical devices. High-risk products like spinal-cord stimulators are designated to be held to the most rigorous clinical testing standards. But the vast majority of devices go through a less stringent review process that provides an easy path to market for devices deemed "substantially equivalent" to products already approved for use.

As designed by Congress, that process should have been phased out. Instead, it became the standard path to market for thousands of devices, including hip replacements implanted in tens of thousands of patients that would later be recalled because metal shavings from the devices made some people sick.

The AP found that the FDA has allowed some spinal-cord stimulators to reach the market without new clinical studies, approving them largely based on results from studies of earlier spinal stimulators.

Spinal stimulators are complex devices that send electrical currents through wires placed along the spine, using a battery implanted under the skin. An external remote controls the device.

The four biggest makers of spinal-cord stimulators are Boston Scientific Corp., based in Marlborough, Massachusetts; Medtronic, with headquarters in Ireland and the U.S.; Nevro, in Redwood City, California; and Illinois-based Abbott, which entered the market after its $23.6 billion purchase of St Jude Medical Inc.

St. Jude's application to go to market with its first spinal stimulator contained no original patient data and was based on clinical results from other studies, while Boston Scientific's application for its Precision spinal-cord stimulator was based largely on older data, though it did include a small, original study of 26 patients who were tracked for as little as two weeks.

Once approved, medical device companies can use countless supplementary requests to alter their products, even when the changes are substantial.

For example, there have been only six new spinal-cord stimulator devices approved since 1984, with 835 supplemental changes to those devices given the go-ahead through the middle of this year, the AP found. Medtronic alone has been granted 394 supplemental changes to its stimulator since 1984, covering everything from altering the sterilization process to updating the design.

"It's kind of the story of FDA's regulation of devices, where they're just putting stuff on the market," said Diana Zuckerman, president of the National Center for Health Research, who has studied medical devices for nearly 30 years.

Medical device manufacturers have cited multiple industry-funded studies showing the effectiveness of spinal-cord stimulation in the treatment of chronic pain. Experts say treatment is considered successful if pain is reduced by at least half, but not every patient experiences that much pain reduction.

A 2016 study looking at different stimulation systems found "significant evidence" that they were "a safe, clinical and cost-effective treatment for many chronic pain conditions."

But Zuckerman noted that the more extensive studies came after the devices were being widely used on people.

"These patients are guinea pigs," she said.

FDA said in a statement that it approves, clears or grants marketing authorization to an average of 12 devices per business day and its decisions are "based on valid scientific evidence" that the devices are safe and effective.

Dr. Walter J. Koroshetz, director at the neurological disorders and stroke division at the National Institutes of Health, said trials for medical devices like spinal-cord stimulators are generally small and industry-sponsored, with a "substantial" placebo effect.

"I don't know of anyone who is happy with spinal-cord technology as it stands," Koroshetz said. "I think everybody thinks it can be better."

Every time Jim Taft walked into his pain management doctor's office, he would glance at the brochures touting spinal-cord stimulators — the ones with pictures of people swimming, biking and fishing.

Inside the exam room, Taft said, his doctor told him the device had been successful for his other patients and would improve his quality of life.

On lifetime worker's compensation after his right arm was crushed as he was hauling materials for an architectural engineering company, Taft had been seeing the doctor for five years before he decided to get a stimulator in 2014. What finally swayed him, he said, was the doctor's plan to wean him off painkillers.

"I felt backed into a corner," said, Taft, who lives in West Columbia, South Carolina.

Taft said his pain management doctor praised the technology, saying stimulators had improved the quality of life for his patients. But four years later, Taft is unable to walk more than a few steps.

Taft is one of 40 patients interviewed by the AP who said they had problems with spinal-cord stimulators. The AP found them through online forums for people with medical devices. Twenty-eight of them said their spinal-cord stimulators not only failed to alleviate pain but left them worse off than before their surgeries.

Zuckerman, who has worked at the U.S. Department of Health and Human Services and as a senior policy adviser to then-first lady Hillary Rodham Clinton, said no doctor wants to think they're harming patients.

"But there's a tremendous financial incentive to downplay, ignore or forget bad patient experiences and just focus on how happy patients are," she said.

More than half the patients interviewed by the AP said they felt pressured to get stimulators because they feared their doctors would cut off their pain medications — the only thing helping them.

Stimulators are considered a treatment of "last resort" by insurance companies, as well as Medicare and Medicaid. That means doctors must follow a protocol before insurance will pay for the device and implantation.

Physicians must show that conservative treatments failed to help, and patients also undergo psychological assessments to evaluate the likelihood of success. They then typically undergo a trial period lasting three days to a week with thin electrodes inserted under the skin. If patients say they got relief from the external transmitter sending electrical pulses to the contacts near their spines, they have surgery to implant a permanent stimulator.

Taft said his three-day trial helped reduce his pain so, a few days before his surgery, he began preparing for a new life. He ordered lumber to refurbish a patio and deck for his wife, Renee, as thanks for her years of support.

In April 2014, Boston Scientific's Precision stimulator was implanted in Taft by Jason Highsmith, a Charleston, South Carolina, neurosurgeon who has received $181,000 from the company over the past five years in the form of consulting fees and payments for travel and entertainment. A Boston Scientific sales representative was in the operating room — a common practice, the AP found.

Highsmith would not comment on the payments. Other doctors have defended the practice, saying they do important work that helps the companies — and ultimately patients — and deserve to be compensated for their time.

From the time Taft was cut open and the device placed inside his body, he had nothing but problems, according to hundreds of pages of medical records reviewed by the AP. The device began randomly shocking him, and the battery burned his skin.

Taft and his wife complained repeatedly, but said his doctors and a Boston Scientific representative told them that spinal-cord stimulators don't cause the kind of problems he had.

That runs counter to Boston Scientific's own literature, which acknowledges that spinal stimulators and the procedures to implant them carry risks, such as the leads moving, overstimulation, paralysis and infections.

That also is not reflected in the AP's analysis of FDA injury reports, which found shocking and burning had been reported for all major models of spinal-cord stimulators. For Boston Scientific devices, infection was the most common complaint over the past decade, mentioned in more than 4,000 injury reports.

In response to questions, the company called infection "unfortunately a risk in any surgical procedure" that the company works hard to avoid. It added that the FDA's data "shouldn't be interpreted as a causal sign of a challenge with our device. In fact, many examples of reportable infections include those that were caused by the surgical procedure or post-operative care."

"In our internal quality assessments, over 95 percent of the injury reports were temporary or reversible in nature," the company added.

Taft said had he known the devices hurt so many people, he would have reconsidered getting one. A Boston Scientific sales representative tried reprogramming the device, he said, but nothing worked.

"I told them that it feels like the lead is moving up and down my spine," Taft said. "They said, 'It can't move.'" But in July 2014, X-rays revealed the lead indeed had moved — two inches on one side.

Highsmith told the AP the electrode broke from "vigorous activity," though Taft said that would not have been possible due to his condition. Taft said he was in such bad shape after his surgery that he was never able to redo the patio and deck for his wife or do anything else vigorous.

That October, Highsmith said, he operated on Taft to install a new lead, tested the battery and reinserted it.

Still, Taft's medical records show that he continued to report numbness, tingling and pain. During a January 2015 appointment, a physician assistant wrote that the device "seemed to make his pain worse."

The stimulator was surgically removed in August 2015. The following June, Taft got a second opinion from a clinic that specializes in spinal injuries, which said he had "significant axial and low back pain due to implantation and explantation" of the stimulator.

Highsmith said other doctors have documented severe arthritis in Taft and that, while he has not examined Taft in more than three years, it's "likely his current condition is the result of disease progression and other factors."

He did not answer questions about whether he informed Taft of the risks associated with stimulators.

The doctor said the overwhelming majority of his spinal-cord stimulator patients gain significant pain relief.

"Unfortunately, in spite of the major medical breakthroughs with devices like these, some patients still suffer from intractable pain," he said.

Renee Taft, a paralegal, reached out to Boston Scientific in 2017, but said the company refused to help because her husband's stimulator had been removed and blamed Taft for his problems, also saying he had engaged in "rigorous physical activity" after surgery.

In the letter from the company's legal department, Boston Scientific also noted that federal law shielded manufacturers from personal liability claims involving medical devices approved by the FDA.

In response to questions from the AP, Boston Scientific again blamed Taft's "activity level" but didn't elaborate. The company also said other factors could contribute to his problems such as "hyperalgesia, a phenomenon associated with long-term opioid use which results in patients becoming increasingly sensitive to some stimuli."

Brenda Simpson-Davis of Milton, Florida, said Boston Scientific also disregarded her complaints after her husband suffered a life-threatening infection following implant surgery.

George Davis, 57, had three Medtronic spinal-cord implants between 2003 and 2007 after a car accident mangled his back. They temporarily reduced some of his pain, but he said the non-rechargeable batteries that were supposed to last for years never did and he tired of multiple surgical removals.

In 2015, his pain management doctor urged him to try Boston Scientific's Precision Spectra, which he called the best on the market. Unlike Davis's old models, it had a rechargeable battery.

Within weeks of his surgery, Davis said, he started feeling pain shooting down his back and legs and a burning sensation at the implant site. After his skin started turning black, the doctor performed emergency surgery to remove the device.

Months later, Davis reluctantly agreed when his doctor urged him to try another Boston Scientific model but found that device even worse.

Over the next year, he spent more than 100 days in and out of hospitals battling a life-threatening infection. Today, Davis says he has trouble getting out of bed.

Boston Scientific said it never received the stimulators that were implanted in Taft and Davis so could not "conclusively identify" the causes of their problems. "Numerous factors can contribute to a patient's ongoing symptoms, from increased physical activity to the onset of pain in other areas," the company said.

Simpson-Davis said she spoke with attorneys around the country, who warned her about the high bar set for a lawsuit. Finally, she found a Texas lawyer who said he will consider taking the case if she can find another two dozen potential plaintiffs.

"To me, it's not about the money, It's about the people. It's about them knowing what they're getting themselves into," she said.

___

For years, Valerie McJunkin had been seeking relief from a rare neurological disorder that made her legs and feet feel like they were on fire. So when a medical device company sales representative and her West Virginia pain management doctor recommended what sounded to her like a "miracle device," she was all in.

They said a new kind of stimulator — one that targeted a bundle of sensory nerve cells in the lower back — was better than a spinal-cord device. She just needed to undergo a weeklong trial.

When McJunkin showed up at the pain clinic this January for the trial, the Abbott sales representative was there, along with her doctor and his staff. They explained every detail. This device wasn't for everyone, but she was the perfect candidate, she recalled them saying.

Over the next week, they called or texted her nearly every day to see if the stimulator was easing her torment. And since the trial did seem to help, she went ahead with the implant.

Within days, though, the device began randomly shocking her — a sharp pain that felt like a lightning bolt.

When McJunkin called her doctor and the Abbott representative, she said they suggested that she was at fault because "stimulators don't do that." It wasn't until she received a certified letter from Abbott in March that she learned it wasn't all in her head: The company said her device was being recalled due to a glitch that could cause patients some "discomfort."

Since 2005, there have been 50 recalls involving spinal stimulators, averaging about four per year in the last five years. Roughly half the recalls involved stimulators made by Medtronic, the world's largest device manufacturer, though none warned of a risk of serious injury or death.

In early September, McJunkin invited an AP reporter to accompany her when she met with her doctor and the company sales representative to request the device be removed.

The Abbott salesman and her doctor both suggested she get another stimulator, saying she had run out of options, especially since her doctor couldn't write prescriptions for opioids because of a government crackdown. If she didn't get another stimulator, he said, she faced a lifetime of pain. He did not suggest other options, such as steroid shots or continued physical therapy.

"I'm not trying to force your mind," the doctor said. "But for me, would I want to live my life like this?... If I get that new battery and it totally helps, that changes my life 180 degrees, right? But if I don't I already know what's going to happen to me: I'll be suffering for the rest of my life."

On the drive home to Martinsburg, West Virginia, McJunkin gripped the steering wheel of her car, her tattoo reading "persevere" visible on her forearm.

"You trust your doctor. You think he's going to do the right thing," she said. She paused, fighting back tears. "I just wanted to live without pain. But now that hope is gone."

In late October, her doctor removed the device.

The experience of nearly all the 40 patients interviewed by the AP mirrored McJunkin's: Their pain was reduced during the trial but returned once their stimulators were implanted.

Experts say the answer may be a placebo effect created when expectations are built up during the trial that only the stimulator can offer relief from pain, exacerbated by patients not wanting to disappoint family members, who often have been serving as their caregivers.

"If patients know this is a last resort, a last hope, of course they will respond well," said Dr. Michael Gofeld, a Toronto-based anesthesiologist and pain management specialist who has studied and implanted spinal-cord stimulators in both the U.S. and Canada.

By the time the trial ends, the patient is "flying high, the endorphin levels are high," Gofeld said.

Manufacturer representatives are heavily involved during the entire process. Along with often being in the operating room during surgery in case the physician has questions, they meet with patients to program the devices in the weeks following surgery.

Most of the patients interviewed by the AP said the adjustments to their devices were performed by sales representatives, often with no doctor or nurse present. That includes one patient who was billed for programming as if the doctor was in the room, though he was not.

"People who are selling the device should not be in charge of maintenance," Gofeld said. "It's totally unethical."

In a 2015 Texas case, a former Medtronic sales representative filed suit contending she was fired after complaining that the company trained employees to program neurostimulators without physicians present. She also claimed that a Medtronic supervisor snatched surgical gloves away from her when she refused to bandage a patient during a procedure, pushed her aside and then cleaned and dressed the patient's wound. Medtronic denied the allegations, and the case was settled on undisclosed terms.

In the Justice Department case involving Medtronic, a salesman who said he earned as much as $600,000 a year selling spinal-cord stimulators claimed sales representatives encouraged physicians to perform unnecessary procedures that drove up the costs for Medicare and other federal health programs.

"While there have been a few instances where individuals or affiliates did not comply with Medtronic's policies, we acted to remedy the situation in each case once discovered and to correct any misconduct," the company said.

Gofeld said he believes stimulators do work, but that many of the problems usually arise when doctors don't choose appropriate candidates. And he thinks the stimulators are used too often in the U.S.

Nevro, one of the four big manufacturers, has cited estimates that there are as many as 4,400 facilities in the U.S where spinal-stimulation devices are implanted by a variety of physicians, including neurosurgeons, psychiatrists and pain specialists.

It's a lucrative business. Analysts say stimulators and the surgery to implant them costs between $32,000 and $50,000, with the device itself constituting $20,000 to $25,000 of that amount. If surgery is performed in a hospital, the patient usually stays overnight, and the hospital charges a facility fee for obtaining the device. Costs are typically covered by insurance.

The AP found that doctors can make more money if they perform the surgery at physician-owned outpatient surgery centers, since the doctor buys the device, marks it up and adds on the facility fee.

In Canada, where Gofeld now works, he said the surgeries are done only by those who specialize in the procedures. He said spinal-cord stimulators should be used when pain starts and not after failed back surgeries.

"By then," he said, "it's too late."

While manufacturers and top FDA officials tout stimulators as a weapon in the battle against opioids, neurosurgeons like Steven Falowski are the front-line evangelists.

"Chronic pain is one of the largest health-care burdens we have in the U.S. It's more than heart disease, cancer and diabetes combined," Falowski said in an interview.

He referred AP to Corby, as one of his surgical patients who was helped by a spinal-cord stimulator.

Corby got the device more than two years ago and says that, after some initial adjustments, he hasn't had any further problems. He says he wouldn't trade the stimulator for opioids.

"I was actually buying them on the street ... a little like a druggie because I couldn't get them anymore" from his pain doctor, Corby said.

Falowski said opioids are good for acute pain, but were never meant to treat long-term chronic pain. For him, that's where spinal-cord stimulators come in.

If they're used early enough for pain, they can prevent people from going on opium-based pain killers, said Falowski, who speaks at neuromodulation conferences and teaches other doctors how to implant stimulators.

Since 2013, device manufacturers have paid Falowski — or St. Luke's University Health Network in Fountain Hill, Pennsylvania, where he works — nearly $863,000, including $611,000 from St. Jude or its new parent company, Abbott, according to the Centers for Medicare and Medicaid Services database. The payments range from consulting fees to travel and entertainment expenses.

Falowski said he has conducted research and done other work for manufacturers, adding, "The contracts with industry are with my hospital and not with me."

St. Luke's told the AP that it keeps the majority of the payments from device makers, but that Falowski "may receive a portion of these payments through his annual compensation."

Another of Falowski's patients was Lisa Snyder of Kempton, Pennsylvania, who was searching for relief from a painful nerve disorder. By the time she came to Falowski, she had cycled through three spinal-cord stimulators, which were removed for reasons ranging from infection to rejection.

"Not everybody could do it, but he was confident he could," she said.

After her fourth implant this March, "I complained about this battery right away. I knew it was positioned funny. It burned," Snyder said.

AP's analysis showed Abbott products were more likely than other major models to include reports of a hot or burning sensation near the site of the battery, with about 5,600 injury reports since 2008 referring to the words "heat" or "burn."

Abbott said that many of the "adverse events" reports in the FDA's data stemmed from a device that was voluntarily recalled in 2011. The company added that feeling a temperature increase at the implant site "is often a reality for rechargeable spinal-cord stimulation systems," which is why the company is now concentrating on devices that do not need to be recharged.

Snyder said she felt like Falowski's nurse and physician assistant downplayed the problems and that the reprogramming of her device was conducted by the Abbott sales representative, with no medical staff present. On at least one occasion, she was charged as if the medical staff was there, when she said they weren't, according to insurance bills reviewed by the AP.

Despite insisting nothing was wrong with the unit, Snyder said, Falowski called her one day out of the blue. "He said 'Under no circumstances are you to turn it on.' I asked him why and he wouldn't say," Snyder recalled.

Falowski then scheduled immediate surgery to remove the stimulator, she said.

Falowski called Snyder a difficult patient and said she was receiving "100 percent pain relief" when she had the stimulator removed, adding that she "remained very appreciative of her care." He added that programming is "performed under the direction of a physician."

"The physician is not present during the entire programming session, but provides oversight and direction....The only time programming sessions are billed is when the physician is actively seeing the patient during a visit which was the case with this patient," he said.

Snyder disputed the doctor's characterization of her and became angry after being told Falowski and his hospital received money from manufacturers.

"They need to be a little bit upfront," she said.

Falowski said doctors do important work for medical device companies, and he has been involved in device development, education, clinical trials and research.

"You're trying to help patients and you realize as a physician by yourself you're not going to generate $200 million to make the next best implant for a patient and it's going to take a company to do that," he said. "So I think the important part in that relationship is transparency and disclosures."

Experts interviewed by the AP said doctors are not legally required to tell their patients about financial relationships with medical device manufacturers, but that it would be the right thing to do.

"The patient should be fully informed before consenting to a procedure," said Genevieve P. Kanter, an assistant professor at the University of Pennsylvania who specializes in internal medicine, medical ethics and health policy.

All Snyder ever wanted was to feel better. Today, she often is immobilized by pain.

Before the latest stimulator, she could walk, stand and cook meals. Now, she finds it hard to get out of bed and rarely leaves her house. She says the device has ruined her life.

"My fear is I'll be like this forever," she said.

Associated Press reporters Meghan Hoyer and Matthew Perrone contributed to this report, as did video journalist P. Solomon Banda.

Copyright Associated Press / NBC New York



Photo Credit: Peter Banda/AP]]>
<![CDATA[First Gene-Edited Babies Claimed in China]]>Mon, 26 Nov 2018 10:17:21 -0500https://media.nbcnewyork.com/images/213*120/geneeditedAP_18330076461138.jpg

A Chinese researcher claims that he helped make the world's first genetically edited babies — twin girls born this month whose DNA he said he altered with a powerful new tool capable of rewriting the very blueprint of life.

If true, it would be a profound leap of science and ethics.

A U.S. scientist said he took part in the work in China, but this kind of gene editing is banned in the United States because the DNA changes can pass to future generations and it risks harming other genes.

Many mainstream scientists think it's too unsafe to try, and some denounced the Chinese report as human experimentation.

The researcher, He Jiankui of Shenzhen, said he altered embryos for seven couples during fertility treatments, with one pregnancy resulting thus far. He said his goal was not to cure or prevent an inherited disease, but to try to bestow a trait that few people naturally have — an ability to resist possible future infection with HIV, the AIDS virus.

He said the parents involved declined to be identified or interviewed, and he would not say where they live or where the work was done.

There is no independent confirmation of He's claim, and it has not been published in a journal, where it would be vetted by other experts. He revealed it Monday in Hong Kong to one of the organizers of an international conference on gene editing that is set to begin Tuesday, and earlier in exclusive interviews with The Associated Press.

"I feel a strong responsibility that it's not just to make a first, but also make it an example," He told the AP. "Society will decide what to do next" in terms of allowing or forbidding such science.

Some scientists were astounded to hear of the claim and strongly condemned it.

It's "unconscionable ... an experiment on human beings that is not morally or ethically defensible," said Dr. Kiran Musunuru, a University of Pennsylvania gene editing expert and editor of a genetics journal.

"This is far too premature," said Dr. Eric Topol, who heads the Scripps Research Translational Institute in California. "We're dealing with the operating instructions of a human being. It's a big deal."

However, one famed geneticist, Harvard University's George Church, defended attempting gene editing for HIV, which he called "a major and growing public health threat."

"I think this is justifiable," Church said of that goal.

In recent years scientists have discovered a relatively easy way to edit genes, the strands of DNA that govern the body. The tool, called CRISPR-cas9, makes it possible to operate on DNA to supply a needed gene or disable one that's causing problems.

It's only recently been tried in adults to treat deadly diseases, and the changes are confined to that person. Editing sperm, eggs or embryos is different — the changes can be inherited. In the U.S., it's not allowed except for lab research. China outlaws human cloning but not specifically gene editing.

He Jiankui (HEH JEE'-an-qway), who goes by "JK," studied at Rice and Stanford universities in the U.S. before returning to his homeland to open a lab at Southern University of Science and Technology of China in Shenzhen, where he also has two genetics companies. The university said He's work "seriously violated academic ethics and standards" and planned to investigate. A spokesman for He confirmed that he has been on leave from teaching since early this year, but he remains on the faculty and has a lab at the school.

The U.S. scientist who worked with him on this project after He returned to China was physics and bioengineering professor Michael Deem, who was his adviser at Rice in Houston. Deem also holds what he called "a small stake" in — and is on the scientific advisory boards of — He's two companies.

The Chinese researcher said he practiced editing mice, monkey and human embryos in the lab for several years and has applied for patents on his methods.

He said he chose embryo gene editing for HIV because these infections are a big problem in China. He sought to disable a gene called CCR5 that forms a protein doorway that allows HIV, the virus that causes AIDS, to enter a cell.

All of the men in the project had HIV and all of the women did not, but the gene editing was not aimed at preventing the small risk of transmission, He said. The fathers had their infections deeply suppressed by standard HIV medicines and there are simple ways to keep them from infecting offspring that do not involve altering genes.

Instead, the appeal was to offer couples affected by HIV a chance to have a child that might be protected from a similar fate.

He recruited couples through a Beijing-based AIDS advocacy group called Baihualin. Its leader, known by the pseudonym "Bai Hua," told the AP that it's not uncommon for people with HIV to lose jobs or have trouble getting medical care if their infections are revealed.

Here is how He described the work:

The gene editing occurred during IVF, or lab dish fertilization. First, sperm was "washed" to separate it from semen, the fluid where HIV can lurk. A single sperm was placed into a single egg to create an embryo. Then the gene editing tool was added.

When the embryos were 3 to 5 days old, a few cells were removed and checked for editing. Couples could choose whether to use edited or unedited embryos for pregnancy attempts. In all, 16 of 22 embryos were edited, and 11 embryos were used in six implant attempts before the twin pregnancy was achieved, He said.

Tests suggest that one twin had both copies of the intended gene altered and the other twin had just one altered, with no evidence of harm to other genes, He said. People with one copy of the gene can still get HIV, although some very limited research suggests their health might decline more slowly once they do.

Several scientists reviewed materials that He provided to the AP and said tests so far are insufficient to say the editing worked or to rule out harm.

They also noted evidence that the editing was incomplete and that at least one twin appears to be a patchwork of cells with various changes.

"It's almost like not editing at all" if only some of certain cells were altered, because HIV infection can still occur, Church said.

Church and Musunuru questioned the decision to allow one of the embryos to be used in a pregnancy attempt, because the Chinese researchers said they knew in advance that both copies of the intended gene had not been altered.

"In that child, there really was almost nothing to be gained in terms of protection against HIV and yet you're exposing that child to all the unknown safety risks," Musunuru said.

The use of that embryo suggests that the researchers' "main emphasis was on testing editing rather than avoiding this disease," Church said.

Even if editing worked perfectly, people without normal CCR5 genes face higher risks of getting certain other viruses, such as West Nile, and of dying from the flu. Since there are many ways to prevent HIV infection and it's very treatable if it occurs, those other medical risks are a concern, Musunuru said.

There also are questions about the way He said he proceeded. He gave official notice of his work long after he said he started it — on Nov. 8, on a Chinese registry of clinical trials.

It's unclear whether participants fully understood the purpose and potential risks and benefits. For example, consent forms called the project an "AIDS vaccine development" program.

The Rice scientist, Deem, said he was present in China when potential participants gave their consent and that he "absolutely" thinks they were able to understand the risks.

Deem said he worked with He on vaccine research at Rice and considers the gene editing similar to a vaccine.

"That might be a layman's way of describing it," he said.

Both men are physics experts with no experience running human clinical trials.

The Chinese scientist, He, said he personally made the goals clear and told participants that embryo gene editing has never been tried before and carries risks. He said he also would provide insurance coverage for any children conceived through the project and plans medical follow-up until the children are 18 and longer if they agree once they're adults.

Further pregnancy attempts are on hold until the safety of this one is analyzed and experts in the field weigh in, but participants were not told in advance that they might not have a chance to try what they signed up for once a "first" was achieved, He acknowledged. Free fertility treatment was part of the deal they were offered.

He sought and received approval for his project from Shenzhen Harmonicare Women's and Children's Hospital, which is not one of the four hospitals that He said provided embryos for his research or the pregnancy attempts.

Some staff at some of the other hospitals were kept in the dark about the nature of the research, which He and Deem said was done to keep some participants' HIV infection from being disclosed.

"We think this is ethical," said Lin Zhitong, a Harmonicare administrator who heads the ethics panel.

Any medical staff who handled samples that might contain HIV were aware, He said. An embryologist in He's lab, Qin Jinzhou, confirmed to the AP that he did sperm washing and injected the gene editing tool in some of the pregnancy attempts.

The study participants are not ethicists, He said, but "are as much authorities on what is correct and what is wrong because it's their life on the line."

"I believe this is going to help the families and their children," He said. If it causes unwanted side effects or harm, "I would feel the same pain as they do and it's going to be my own responsibility."

___

AP science writer Christina Larson, video journalist Emily Wang and researcher Fu Ting contributed to this report from Beijing and Shenzhen, China.

This Associated Press series was produced in partnership with the Howard Hughes Medical Institute's Department of Science Education. The AP is solely responsible for all content.

Copyright Associated Press / NBC New York



Photo Credit: Mark Schiefelbein/AP]]>
<![CDATA[Experts Study Long-Term Impact of Bad Air From Calif. Fires]]>Fri, 23 Nov 2018 09:07:39 -0500https://media.nbcnewyork.com/images/213*120/LAAP_18319814218322.jpg

Wind and rain arrived in Northern California this week, providing welcome relief to a region buffeted by the state's deadliest wildfire and then besieged for nearly two weeks by a dome of thick, noxious smoke, NBC News reported.

Forecasters expected 25 mph winds and rain to blow away the worst of the fallout by Friday. While that would improve air quality, the cleaner air does not mean that the health risks are over. Doctors in Berkeley said that they continued to see a slight uptick this week in emergency room visits, particularly from asthmatics, the elderly and children — groups most vulnerable to polluted air.

Longer-term impacts of such exposure, meanwhile, are little understood. Few studies have been conducted to track the health of people months, and years, after they have been exposed to high concentrations of “particulate” pollution. The emissions are similar to the toxic particles released with the burning of fossil fuels. But fire fumes could pose an additional risk, because they include chemicals released when homes and cars — and their attendant insulation, plastics and metals — burn.

Researchers at the University of California, Davis, began last year to recognize how little was known about longer-term impacts of smoke from wildfires. So they launched studies into the impacts of the 2017 Tubbs Fire in Sonoma County and other giant wine country blazes that killed more than 40 people. Scientists are also trying to better understand exactly what is in the smoke that comes from fires in the so-called "wildland-urban interface." When cars and homes burn, along with trees, it means the release of chemicals that went into paint, plastics, insulation and metal.



Photo Credit: Rich Pedroncelli/AP]]>
<![CDATA[Thanksgiving Is the Worst Day of the Year for Home Fires]]>Wed, 21 Nov 2018 08:56:14 -0500https://media.nbcnewyork.com/images/213*120/GettyImages-1002032730.jpg

Pay close attention while prepping your turkey and exercise extreme care when setting up your holiday decorations. Statistically, you'll be playing with fire.

There are more in-home fires during the holiday season than at any other time of the year, according to data from the National Fire Protection Association. Thanksgiving is the single worst day for fires, NBC News reported.

An estimated 2,090 home fires were reported to fire departments around the United States on Thanksgiving 2016, according to the association. That’s more than twice the daily average for the rest of the year. Of the Thanksgiving fires, three-quarters were cooking-related. On average, Thanksgiving fires killed five people, injured 25 and caused $19 million in property loss from 2014 to 2016, according to the U.S. Fire Administration. 

Distractions are the main cause of cooking fires, according to the NFPA, adding that hosts are inclined to talk to guests instead of managing the kitchen at all times. To stay safe during the holidays, experts suggest keeping combustible items like aprons and towels away from flames, installing or checking smoke and carbon monoxide detectors and paying attention while cooking.



Photo Credit: Getty Images]]>
<![CDATA[Do Not Eat Any Romaine Lettuce: Health Officials]]>Tue, 20 Nov 2018 16:39:12 -0500https://media.nbcnewyork.com/images/213*120/lettuce+thumb.jpg

Health officials in the U.S. and Canada are urging people to stay away from all romaine lettuce and products after 32 people in 11 states were sickened by an E. coli outbreak.]]>
<![CDATA[Limiting Screen Time for Kids Is Harder Than It Looks]]>Mon, 19 Nov 2018 12:02:28 -0500https://media.nbcnewyork.com/images/213*120/AP_18299067016337-Growing-Up-Digital-Sceen-Time.jpg

It is Saturday morning, and 10-year-old Henry Hailey is up at the crack of dawn. Still in PJs, his microphone-equipped headphones glowing blue in the dim basement, he fixates on the popular online game "Fortnite" on a large screen.

"What?! Right as I was about to finish it, I died," he calls out disappointedly to his friend Gus, a fellow fifth-grader playing the game from his home just a few blocks away. "Dude, I should NOT have died."

The digital battles resume, and Henry's enthusiasm never wanes. Would he play all day if his parents let him? "Probably," he concedes with a slight grin.

But they do not. Like many other parents, the Haileys are on a reinvigorated mission to limit screen time for Henry and his 15-year-old brother, Everett. For some parents, it feels like an exercise in futility. They are busy, overwhelmed and tired of the fight against increasingly omnipresent screens.

Getting Henry off screens has been a constant battle, his parents say. "Then once he's off, there's a lot of complaining and grumpiness for a while as we try to coax him to do something else," says his mom, Barb Hailey. "He's upset. Mom is a crank. What is it all for?"

The goal, experts say, should be to help kids learn to manage their own time as they get older and to stay physically active and socially connected as much offline as on. But parents in many American households are finding the power struggles — tantrums, withdrawal and, in some cases, even school and discipline problems — difficult, especially as more kids get access to screens at younger and younger ages.

A survey of 13- to 17-year-olds released this fall by the nonprofit Common Sense Media found that 95 percent of U.S. teens have their own mobile device. Seventy percent of them check social media several times a day, up from 34 percent in 2012. More than half say that their devices distract them from homework or the people they're with.

Some tech companies now at least acknowledge concerns about over-use and outright abuse of digital media. Apple instituted a "Screen Time" function in its latest iPhone software. It monitors app use and allows users — or their parents — to establish limits. Google For Families and Google Play, found on Android phones, and various independent apps also allow parents to monitor and set some restrictions.

But those features aren't enabled by default, so new limits can come as a shock to those on the receiving end.

That happened late this summer in the Hailey household on Chicago's North Side after dad, Allen Hailey, began watching the amount of time elder son Everett was spending on Wi-Fi. The teen was clocking more than four hours a day on sports videos, games and chats with friends on social media.

"I don't think he had any idea how much time he was spending online," says the father, who decided to block both boys from Wi-Fi during certain hours. He tested it out one night without warning.

One minute, Everett was talking to a friend on social media. "Then it went out," says the teen, who immediately complained aloud about the injustice of it all. Dad held firm and told him he needed to read a book or go outside to shoot hoops.

"I didn't do anything wrong to deserve that," Everett still insists. "If I get my work done, I think I should have my own time."

Researchers who study these trends generally refrain from using the word "addiction" when it comes to screens, as it's not an official diagnosis in the mental health world. But this summer, the World Health Organization added "gaming disorder" to its list of afflictions. That is gaming that severely interferes with relationships, school and work. The diagnosis is still under review by U.S. health authorities.

Sometimes, experts say, digital immersion exacerbates an existing condition, such as depression, anxiety or issues with body image. That's why teens who attend treatment at Newport Academy, a residential rehab and mental health program with sites across the country, must check their digital devices at the door when they arrive.

"Almost always, one of the symptoms is an excessive amount of time on smartphones," says Heather Senior Monroe, a Newport Academy administrator and licensed clinical social worker. "And it's usually a large symptom."

A small number of facilities have sprung up or added programs to specifically address the abuse of digital media. And in Washington state, a hub of high tech, there's a 12-step group called Internet & Tech Addiction Anonymous.

From Henry and Everett's perspective, the real problem is that their parents seem stricter than most.

Like a lot of teens, Everett often uses multiple screens in the evening. He saved his own money to buy himself an older-model iPhone — "to fit in," he says — and also uses a Chromebook laptop for homework. At his age, his mom says, his screen habits may be "a lost cause."

But she keeps working on limits for Henry. Games are not allowed on weekdays. And he gets screen time only if all his homework is done.

Experts say time limits can help but are sometimes a moot point given how deeply technology is "embedded in our daily life," says Sarah Domoff, a psychologist at Central Michigan University.

Instead she asks parents: How are your children doing in school? Are they active and physically healthy? Are they connecting with others in positive ways?

She does have a few basic rules, including limiting screen time for younger kids to the educational stuff. She also suggests making bedrooms "screen-free zones," even for teens. (Other experts, at the very least, advise keeping devices out of rooms overnight to avoid late-night shenanigans or other sleep interruptions.)

The Haileys sheepishly note that Everett routinely multitasks in his room with one eye on the Chromebook and often the other on his phone. "I think we're kind of wimps," Barb Hailey says. Henry doesn't have a phone — yet.

But phones and other screens are not allowed during meals — a limit both boys seem to appreciate. Everett says when they go out to eat, he happily leaves his phone in the car and marvels at the number of other families who are at the table with screens. "That just looks bad," he says.

Managing all this is no easy task, even for experts such as Sierra Filucci, executive editor of parenting content at Common Sense Media, an organization that helps families navigate the digital world.

Her own 12-year-old son, like Henry, is a fan of "Fortnite." She's witnessed the "bad attitude" when he's asked to get off the game and take out the garbage or find something to do that doesn't involve a screen. But she also sees the positives — connections he's made with new friends at school, for instance. For her, the question is: "How do we help him self-regulate?"

Some parents simply put off getting their kid a phone. Jacqui Koch, a college professor and mother in Wilmette, Illinois, had her sixth-grade daughter sign a pledge to wait until eighth grade for a smartphone — part of the national "Wait Until 8th " movement. Her daughter didn't put up much fuss, in part because mom has limited tech use for years.

"We are definitely not the norm of what we're surrounded by," Koch says, noting that she saw a "huge uptick" of kids with phones in fifth grade. Now some parents she knows are trying to backpedal, "and that's hard," she says.

The idea is that Wait Until 8th and events such as the National Day of Unplugging, an annual event in March, will make screen limits more socially acceptable and less like an adult-world imposition on kids.

Another key: Parents setting limits with their own devices.

When Allen Hailey is on his phone while watching a football game, Everett is quick to tell him that he's on his phone too much. "He gets really mad," Everett says.

When mom comes home, she says she tries to put down her phone, though it's hard not to check emails for work. "Let me just check in," she'll say — and before long finds herself on Instagram and Facebook.

"You can go down the rabbit hole so easily," Barb Hailey says. "Then you get it thrown back in your face."

It's not an easy balance to strike, but all the Haileys are trying. "We may not like it," Everett says, as his little brother nods. "But we know it's for the best."

Their dad still wants his boys to read 30 minutes a day. After he put the limits on the Wi-Fi, Everett went out and bought two books, then texted Dad photos of them to prove he'd done it.

The boys do regularly hang out with friends in person, and both play soccer. Everett plays the saxophone. Henry plays trumpet and recently took up the drums.

Mom laughs: "So when we say, 'Get off the screen' and he goes and plays the snare drum, we have to live with that decision."

Copyright Associated Press / NBC New York



Photo Credit: Martha Irvine/AP]]>
<![CDATA[Florida Sues Walgreens, CVS Over Opioid Sales]]>Mon, 19 Nov 2018 09:12:38 -0500https://media.nbcnewyork.com/images/213*120/cms1302.jpg

Florida is suing the nation's two largest drugstore chains, Walgreens and CVS, alleging they added to the state and national opioid crisis by overselling painkillers and not taking precautions to stop illegal sales.

Attorney General Pam Bondi announced late Friday that she has added the companies to a state-court lawsuit filed last spring against Purdue Pharma, the maker of OxyContin, and several opioid distributors.

Bondi said in a press release that CVS and Walgreens "played a role in creating the opioid crisis." She said the companies failed to stop "suspicious orders of opioids" and "dispensed unreasonable quantities of opioids from their pharmacies." On average, about 45 people die nationally each day because of opioid overdoses, according to the Centers for Disease Control and Prevention.

"We will continue to pursue those companies that played a role in creating the opioid crisis," said Bondi, who has been mentioned as a possible replacement by President Donald Trump for recently ousted U.S. Attorney General Jeff Sessions. "Thousands of Floridians have suffered as a result of the actions of the defendants."

CVS spokesman Mike DeAngelis called the lawsuit "without merit" in a statement Saturday. He said the company trains its pharmacists and their assistants about their responsibilities when dispensing controlled substances and gives them tools to detect potentially illegal sales.

"Over the past several years, CVS has taken numerous actions to strengthen our existing safeguards to help address the nation's opioid epidemic," DeAngelis said.

Walgreens said Saturday it doesn't comment on pending lawsuits.

Until a law enforcement crackdown at the beginning of the decade, Florida was known for its so-called pain mills. Drug dealers from throughout the country would send associates to store-front clinics where unscrupulous doctors would write opioid prescriptions for bogus injuries and illnesses. At one point, 90 of the nation's top 100 opioid prescribers were Florida doctors, according to federal officials.

After receiving the prescriptions, the phony patients would buy the pills from Florida pharmacies — state law says pharmacists must refuse to fill prescriptions they suspect are not for a valid purpose. Most of the opioids would then be taken out of state to be resold illegally at huge markups, creating a drug crisis in many communities throughout the Eastern United States.

According to the lawsuit, Walgreens has dispensed billions of opioid dosages from its Florida pharmacies since 2006. The Illinois-based chain is the nation's largest drugstore chain and has more than 13,200 stores globally.

The company distributed 2.2 million opioid tablets from its store in Hudson, a Tampa-area town of 12,000, and in one unidentified town of 3,000, sold 285,000 pills in a month, the lawsuit says. In some stores, its opioid sales jumped six-fold in two years. The company paid $80 million five years ago to resolve a federal investigation that centered on inadequate record keeping of its Florida opioid sales that allowed the pills to reach the black market.

Florida's accusations against CVS were more general, saying it sold 700 million opioid dosages between 2006 and 2014, including outsized sales in Hudson and two other nearby towns. The Rhode Island-based chain has more than 9,800 stores.

Copyright Associated Press / NBC New York



Photo Credit: Getty Images/Cultura RF]]>
<![CDATA[Why a Salmonella Outbreak Shouldn't Ruin Your Thanksgiving]]>Sun, 18 Nov 2018 13:44:48 -0500https://media.nbcnewyork.com/images/213*120/GettyImages-1034225338+%281%29.jpg

There's no reason to skip Thanksgiving dinner because of a salmonella outbreak linked to raw turkey.

That's according to health officials who've been monitoring the year-old outbreak. But they say it's a reminder to properly prepare your holiday bird. Cooking kills salmonella.

The ongoing outbreak and recall last week of ground turkey may nevertheless leave you with a few questions when reaching for a plate of turkey.

CAN MY TURKEY HAVE SALMONELLA?
Salmonella is considered widespread in poultry, and it's perfectly legal for supermarkets to sell raw turkey that has the bacteria. Part of the rationale for allowing salmonella is that people don't eat chicken medium rare, said Timothy Lytton, a Georgia State University law professor. In 1974, a court said that "American housewives and cooks normally are not ignorant and stupid" and that they know how to prepare food so people don't get sick.

Even though salmonella is not prohibited in raw meat or poultry, regulators check to make sure the number of samples at processing plants that test positive for the bacteria is within standards. Rules are tighter for whole turkeys, and the industry says the chances of finding salmonella in whole birds are "exceedingly low."

The turkey industry cites steps it takes to reduce risk, such as the use of antimicrobial rinses.

The rules differ for other products. For instance, salmonella is not allowed in packaged foods that aren't cooked to kill germs.

WHAT ABOUT THE OUTBREAK?
Since it began last year, the outbreak linked to raw turkey has caused one death and 164 reported illnesses in 35 states. Until last week, regulators hadn't been able to tie any cases to a specific product or supplier. That's even though investigators said 29 unidentified slaughtering and processing plants tested positive for the salmonella strain involved.

The recall could be confusing because federal regulations are contradictory. The U.S. Department of Agriculture doesn't prohibit salmonella but can ask companies to recall products once they are clearly shown to be responsible for illnesses. The USDA's Carmen Rottenberg said the agency can't take action until it has enough evidence.

According to the USDA, the people who got food poisoning reported eating different kinds of turkey products and brands. Cases also included people who handled raw turkey pet food or worked with live turkeys.

Salmonella spreads through animal feces. It is blamed for an estimated 1 million cases of food poisoning a year, with symptoms including diarrhea, vomiting and stomach cramps. Whether someone gets sick depends on the strength of the strain, the amount and the person's susceptibility, the USDA notes. But the agency says cooking should kill salmonella.

WHAT WAS RECALLED?
The USDA tied one illness in Arizona to Jennie-O ground turkey meat. The recall by Jennie-O was limited to turkey from a single day's production in September from a manufacturing line in Wisconsin. The packages had use-by dates of early October but could still be in freezers.

Regulators say more products from other companies could still be linked to the illnesses. Parent company Hormel Foods Corp. said it owns five of the 29 plants that tested positive for the germ.

The ongoing outbreak doesn't necessarily mean there's more food poisoning from salmonella. Improved detection might just be discovering outbreaks that in the past might have seemed like unrelated cases, said Sarah Sorscher of the Center for Science in the Public Interest.

"It's shedding a light on a longstanding problem," she said.

WHAT SHOULD COOKS DO?
Health officials say proper handling and cooking should kill any salmonella. A few points to remember:

— It seems counterintuitive, but don't rinse raw turkey — that can spread any germs.

— Clean hands and cooking surfaces that come into contact with raw turkey.

— Cook birds to an internal temperature of at least 165 degrees.

Hormel's Richard Carlson stressed salmonella in turkey is not unusual and that proper handling and cooking should get rid of it — even in the Jennie-O ground turkey recalled last week. Regulators, though, say to throw it out.

Copyright Associated Press / NBC New York



Photo Credit: Getty Images, File]]>
<![CDATA[FDA Announces Crackdown on Cigarettes]]>Fri, 16 Nov 2018 09:47:46 -0500https://media.nbcnewyork.com/images/213*120/NC_tobacco1115_1500x845.jpg

The Food and Drug Administration is making moves against the tobacco industry in an effort to crack down on smoking in teens, saying it is working to ban menthol and mint in all cigarettes, as well as flavored cigars. The agency also announced it will limit the sales of flavored e-cigarettes to youths, both in stores and online.]]>
<![CDATA[Smoke Spreading From California Fires Sparks Health Concerns]]>Fri, 16 Nov 2018 05:55:46 -0500https://media.nbcnewyork.com/images/213*120/LAAP_18319814218322.jpg

Smoke masks. Eye drops. No outdoor exercise. This is how Californians are trying to cope with wildfires choking the state, but experts say an increase in serious health problems may be almost inevitable for vulnerable residents as the disasters become more commonplace.

Research suggests children, the elderly and those with existing health problems are most at risk.

Short-term exposure to wildfire smoke can worsen existing asthma and lung disease, leading to emergency room treatment or hospitalization, studies have shown.

Increases in doctor visits or hospital treatment for respiratory infections, bronchitis and pneumonia in otherwise healthy people also have been found during and after wildfires.

Some studies also have found increases in ER visits for heart attacks and strokes in people with existing heart disease on heavy smoke days during previous California wildfires, echoing research on potential risks from urban air pollution.

For most healthy people, exposure to wildfire smoke is just an annoyance, causing burning eyes, scratchy throats or chest discomfort that all disappear when the smoke clears.

But doctors, scientists and public health officials are concerned that the changing face of wildfires will pose a much broader health hazard.

"Wildfire season used to be June to late September. Now it seems to be happening all year round. We need to be adapting to that," Dr. Wayne Cascio, a U.S. Environmental Protection Agency cardiologist, said this week.

In an overview published earlier this year, Cascio wrote that the increasing frequency of large wildland fires, urban expansion into wooded areas and an aging population are all increasing the number of people at risk for health problems from fires.

Wood smoke contains some of the same toxic chemicals as urban air pollution, along with tiny particles of vapor and soot 30 times thinner than a human hair. These can infiltrate the bloodstream, potentially causing inflammation and blood vessel damage even in healthy people, research on urban air pollution has shown. Studies have linked heart attacks and cancer with long-term exposure to air pollution.

Whether exposure to wildfire smoke carries the same risks is uncertain, and determining harm from smog versus wildfire smoke can be tricky, especially with wind-swept California wildfires spreading thick smoke hundreds of miles away into smoggy big cities.

"That is the big question," said Dr. John Balmes, a University of California, San Francisco, professor of medicine who studies air pollution.

"Very little is known about the long-term effects of wildfire smoke because it's hard to study populations years after a wildfire," Balmes said.

Decreased lung function has been found in healthy firefighters during fire season. They tend to recover but federal legislation signed this year will establish a U.S. registry tracking firefighters and potential risks for various cancers, including lung cancer. Some previous studies suggested a risk.

Balmes noted that increased lung cancer rates have been found in women in developing countries who spend every day cooking over wood fires.

That kind of extreme exposure doesn't typically happen with wildfires, but experts worry about the kinds of health damage that may emerge for firefighters and residents with these blazes occurring so often.

Whether that includes more cancer is unknown. "We're concerned about that," Balmes said.

Regular folks breathing in all that smoke worry about the risks too.

Smoke from the fire that decimated the Northern California city of Paradise darkened skies this week in San Francisco, nearly 200 miles southwest, and the air smelled "like you were camping," said Michael Northover, a contractor.

He and his 14-year-old son have first-time sinus infections that Northover blames on the smoke.

"We're all kind of feeling it," Northover said.

The smoke was so thick in San Francisco, the skyline was barely visible from across the Bay. The city's iconic open-air cable cars that are popular with tourists were pulled off the streets Thursday because of the bad air.

An Environmental Protection Agency website said air quality in Sacramento was "hazardous" Thursday and San Francisco's was "very unhealthy." Many people walking around the cities wore face masks.

Most schools in San Francisco, Sacramento, Oakland and Folsom said they would be closed Friday. At least six universities in Northern California canceled classes Thursday.

At Chico State University, 11 miles (18 kilometers) from Paradise, ash fell this week and classes were canceled until after Thanksgiving.

"It's kind of freaky to see your whole town wearing air masks and trying to get out of smoke," said freshman Mason West, 18. "You can see the particles. Obviously, it's probably not good to be breathing that stuff in."

West returned home this week to Santa Rosa, hard hit by last year's wine country fires, only to find it shrouded in smoke from the Paradise fire 100 miles (160 kilometers) away. West's family had to evacuate last year for a week, but their home was spared.

"It's as bad here as it was in Chico," West said. "It almost feels like you just can't get away from it."

Smoke has been so thick in Santa Rosa that researchers postponed a door-to-door survey there for a study of health effects of last year's fire.

"We didn't feel we could justify our volunteer interns going knocking on doors when all the air quality alerts were saying stay indoors," said Irva Hertz-Picciotto, a public health researcher at the University of California, Davis. The study includes an online survey of households affected by last year's fire, with responses from about 6,000 people so far.

Preliminary data show widespread respiratory problems, eye irritations, anxiety, depression and sleep problems around the time of the fire and months later.

"Conventional thinking is that these effects related to fires are transient. It's not entirely clear that's the case," Hertz-Picciotto said.

Researchers also will be analyzing cord blood and placentas collected from a few dozen women who were pregnant during the fire, seeking evidence of stress markers or exposure to smoke chemicals.

They hope to continue the study for years, seeking evidence of long-term physical and emotional harms to fire evacuees and their children.

Other studies have linked emotional stress in pregnant women to developmental problems in their children and "this was quite a stress," Hertz-Picciotto said.

It's a kind of stress that many people need to prepare for as the climate warms and wildfires proliferate, she said.

"Any of us could wake up tomorrow and lose everything we own," she said. "It's pretty scary."

Copyright Associated Press / NBC New York



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<![CDATA[FDA Restricts Most Flavored E-Cig Sales to Fight Teen Vaping]]>Thu, 15 Nov 2018 17:17:01 -0500https://media.nbcnewyork.com/images/213*120/844304082-E-Cigarette-fashion-week.jpg

The Food and Drug Administration will restrict sales of most flavored e-cigarettes to age-restricted stores and pursue bans on menthol cigarettes and flavored cigarettes as it tries to control what Commissioner Scott Gottlieb describes as an "astonishing" surge in teen e-cigarette use that is reversing years of progress in fighting youth tobacco addiction.

Gottlieb in a statement Thursday outlined a slew of policies and essentially threatened to pull products from the market if manufacturers do not follow them. He cited data from the Centers of Disease Control and Prevention's National Youth Tobacco Survey, expected to be released in its entirety later Thursday, showing that 3.6 million middle and high school students currently use e-cigarettes.

"These increases must stop," Gottlieb said in a statement. "And the bottom line is this: I will not allow a generation of children to become addicted to nicotine through e-cigarettes. We won't let this pool of kids, a pool of future potential smokers, of future disease and death, to continue to build. We'll take whatever action is necessary to stop these trends from continuing."

The announcement comes just over two months since Gottlieb ordered manufacturers to fix what he called "epidemic" levels of teens using e-cigarettes and specifically instructed five brands — Juul, British American Tobacco's Vuse, Altria's MarkTen, Imperial Brands' Blu E-cigs and Japan Tobacco's Logic — to submit plans detailing how they will prevent teens from using their products. He gave them 60 days, with the deadline passing on Sunday.

FDA targets fruity flavors
The FDA will require all types of flavored e-cigarettes, excluding menthol, to be sold by retailers that altogether prohibit people under the age of 18, the federal minimum age to buy tobacco products, or have a section of the store that bars minors. This policy effectively bans most flavored products from convenience stores and gas stations while permitting them in the roughly 10,000 tobacco and vape shops.

The agency will allow mint- and menthol-flavored e-cigarettes to continue to be sold at all retailers until it removes menthol cigarettes from the market. Officials worry that in removing menthol e-cigarettes from places where menthol cigarettes are sold, consumers might opt for conventional cigarettes. However, Gottlieb said the agency will reconsider the exemption if data show kids are using these products.

"America's youth are facing a public health crisis that threatens an entire generation: skyrocketing use of nicotine products, brought on by access to flavored products in particular," Health and Human Services Secretary Alex Azar said in a statement.

E-cigarette manufacturers that wish to sell flavored products more broadly in the future must first submit the products to the FDA to review and authorize. The FDA will require products that are found illegally being sold in stores to undergo review and would be pulled from the market until the agency completes the application process and clears it, which it may not. In the process, known as a premarket tobacco application, products must prove they deliver a net public health benefit.

All e-cigarettes currently on the market will eventually go through this process. Products that were on the market before Aug. 8, 2016, were supposed to start undergoing review this year until Gottlieb extended the deadline until Aug. 8, 2022, so manufacturers would have more time to file complete applications.

Companies who do not comply with new FDA-mandated age verification guidelines for online sales or are marketed to children, including by using popular children's cartoons or names of kid-favorite products like brands of candy or soda, would lose this extension and be required to undergo review.

Gottlieb said the FDA will explore how to accelerate the process for new technologies that prove they can keep kids from using them. Fontem Ventures, a unit of Imperial Brands and maker of blu e-cigarettes, and Juul have both said they plan to test new connected devices outside of the U.S.

Some manufacturers have already started taking action on flavors. Altria said it will voluntarily remove its MarkTen pod-based products from the market and will stop selling all flavors except for menthol or tobacco in its "cig-a-like" products until the FDA reviews and clears them.

Juul, the clear e-cigarette market leader, on Tuesday stopped accepting retail orders for its mango, fruit, creme and cucumber pods from the more than 90,000 convenience stores, vape shops and other retailers that sell them, CEO Kevin Burns said Tuesday in a blog post on the company's website. Juul plans to resume sales to retailers that are legally allowed to sell flavored e-cigarettes and adopt the company's new age restrictions and verification system, though it's unclear when sales could resume.

FDA to pursue ban on menthol cigarettes and flavored cigars
The FDA will also advance rules to ban menthol cigarettes and flavored cigars, Gottlieb said Thursday.

In 2009, the FDA banned certain flavors in cigarettes, but menthol was excluded, as were other tobacco products. Critics have begged the agency to reverse these exemptions in the years since.

This spring, the FDA took the first step toward implementing a new rule on flavors in tobacco products. The comment period closed in July. On menthol specifically, the FDA started the process of issuing a rule in 2013, which may allow the agency to speed up a process that can take years to finalize and implement.

More than half of youth smokers between the ages of 12 and 17 use menthol cigarettes, compared with less than one-third of adult smokers 35 and older, Gottlieb said. Among African-American youth, data show 7 out of 10 smoke menthol cigarettes, he said.

"Now, armed with the additional years of data, comments from the public – and with the perspective of our Comprehensive Plan and its implementation – the FDA will accelerate the proposed rulemaking process to ensure that our policies on flavored tobacco products protect public health across the continuum of risk," Gottlieb said.

Menthol cigarettes represent 35 percent of total industry volume, Wells Fargo analyst Bonnie Herzog wrote Monday in a note to clients. A ban on menthol cigarettes could slice into British American Tobacco, Imperial Brands and Altria sales.

Data Show Surge in Teens Using E-Cigarettes
More than 3.6 million middle and high school students reported being current e-cigarette users in 2018, according the CDC's National Youth Tobacco Survey.

The number of high school students who reported being current e-cigarette users, meaning they used the product within the past 30 days, increased 78 percent between 2017 and 2018. That equates to 3.05 million high school students, or 20.8 percent of this group. Among middle school students, current e-cigarette use increased 48 percent between 2017 and 2018, equaling 570,000, or 4.9 percent of middle school students.

"These data shock my conscience," Gottlieb said.

Of current high school e-cigarette users, 27.7 percent regularly used the product on 20 or more days in the past month, and 67.8 percent used flavored e-cigarettes, Gottlieb said, citing the survey data.

Researchers suggest the popularity of "certain types of e-cigarettes, such as JUUL" likely caused the surge in e-cigarette use.

"The markedly accelerating rate of e-cigarette use among U.S. youth within the past year is a cause for grave concern," CDC Director Robert Redfield said in a statement.

The spikes in e-cigarette use also cause overall tobacco product use to increase. Among high school students, 27.1 percent said they used any tobacco product, a 38 percent rise from the previous year. Among middle school students, 7.2 percent said they used one, a 29 percent year-over-year increase.

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<![CDATA[Record Number of Tick-Borne Diseases Reported in 2017: CDC]]>Wed, 14 Nov 2018 13:55:10 -0500https://media.nbcnewyork.com/images/213*120/957346856-Deer-Tick.jpg

U.S. health officials say a record number of tick-borne diseases were reported last year.

The 2017 tally of more than 59,000 cases is a 22 percent increase from the previous year. The Centers for Disease Control and Prevention released the numbers Wednesday.

Lyme disease accounted for nearly three-quarters of the illnesses. That's about 43,000 cases.

Traditionally about 30,000 cases of Lyme disease were reported to the government each year, but experts believed there was underreporting and thought the actual number was more like 300,000.

Experts say better reporting may be a reason for recent increases, but scientists have also discovered more diseases transmitted by ticks. Researchers also note that disease-spreading ticks have been seen over a wide range of states.

Copyright Associated Press / NBC New York



Photo Credit: John Ewing/Portland Press Herald via Getty Images, File]]>
<![CDATA[Neanderthal Life Not Especially Risky, Skull Analysis Shows]]>Wed, 14 Nov 2018 14:04:12 -0500https://media.nbcnewyork.com/images/213*120/neanderthal4.jpg

Life as a Neanderthal was no picnic, but a new analysis says it was no more dangerous than what our own species faced in ancient times.

That challenges what the authors call the prevailing view of our evolutionary cousins, that they lived risky, stressful lives. Some studies have suggested they had high injury rates, which have been blamed on things like social violence, attacks by carnivores, a hunting style that required getting close to large prey, and the hazards of extensive travel in environments full of snow and ice.

While it's true that their lives were probably riskier than those of people in today's industrial societies, the vastly different living conditions of those two groups mean comparing them isn't really appropriate, said Katerina Harvati of the University of Tuebingen in Germany.

A better question is whether Neanderthals faced more danger than our species did when we shared similar environments and comparable lifestyles of a mobile hunter-gatherer, she and study co-authors say in a paper released Wednesday by the journal Nature.

To study that, they focused on skull injuries. They reviewed prior studies of fossils from western Eurasia that ranged from about 80,000 to 20,000 years old. In all they assessed data on 295 skull samples from 114 individual Neanderthals, and 541 skull samples from 90 individuals of our own species, Homo sapiens.

Injury rates turned out to be about the same in both species.

That questions the idea that the behavior of Neanderthals created particularly high levels of danger, Marta Mirazon Lahr of Cambridge University wrote in an accompanying commentary.

But the new study is not the final word on Neanderthal trauma, she wrote. It didn't include injuries other than to the skull. And scientists still have plenty of work to do in seeking the likely cause of injuries and evidence of care for the injured, which could give insights into the behavior of both Neanderthals and ancient members of our species, she wrote.

___

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

Copyright Associated Press / NBC New York



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<![CDATA[Gene-Edited Food Is Coming, Regulatory Questions Remain]]>Wed, 14 Nov 2018 01:16:14 -0500https://media.nbcnewyork.com/images/213*120/geneeditedfoodAP_18317727243007.jpg

The next generation of biotech food is headed for the grocery aisles, and first up may be salad dressings or granola bars made with soybean oil genetically tweaked to be good for your heart.

By early next year, the first foods from plants or animals that had their DNA "edited" are expected to begin selling. It's a different technology than today's controversial "genetically modified" foods, more like faster breeding that promises to boost nutrition, spur crop growth, and make farm animals hardier and fruits and vegetables last longer.

The U.S. National Academy of Sciences has declared gene editing one of the breakthroughs needed to improve food production so the world can feed billions more people amid a changing climate. Yet governments are wrestling with how to regulate this powerful new tool. And after years of confusion and rancor, will shoppers accept gene-edited foods or view them as GMOs in disguise?

"If the consumer sees the benefit, I think they'll embrace the products and worry less about the technology," said Dan Voytas, a University of Minnesota professor and chief science officer for Calyxt Inc., which edited soybeans to make the oil heart-healthy.

Researchers are pursuing more ambitious changes: Wheat with triple the usual fiber, or that's low in gluten. Mushrooms that don't brown, and better-producing tomatoes. Drought-tolerant corn, and rice that no longer absorbs soil pollution as it grows. Dairy cows that don't need to undergo painful de-horning, and pigs immune to a dangerous virus that can sweep through herds.

Scientists even hope gene editing eventually could save species from being wiped out by devastating diseases like citrus greening, a so far unstoppable infection that's destroying Florida's famed oranges.

First they must find genes that could make a new generation of trees immune.

"If we can go in and edit the gene, change the DNA sequence ever so slightly by one or two letters, potentially we'd have a way to defeat this disease," said Fred Gmitter, a geneticist at the University of Florida Citrus Research and Education Center, as he examined diseased trees in a grove near Fort Meade.

GENETICALLY MODIFIED OR EDITED, WHAT'S THE DIFFERENCE?
Farmers have long genetically manipulated crops and animals by selectively breeding to get offspring with certain traits. It's time-consuming and can bring trade-offs. Modern tomatoes, for example, are larger than their pea-sized wild ancestor, but the generations of cross-breeding made them more fragile and altered their nutrients.

GMOs, or genetically modified organisms, are plants or animals that were mixed with another species' DNA to introduce a specific trait they're "transgenic." Best known are corn and soybeans mixed with bacterial genes for built-in resistance to pests or weed killers.

Despite international scientific consensus that GMOs are safe to eat, some people remain wary and there is concern they could spur herbicide-resistant weeds.

Now gene-editing tools, with names like CRISPR and TALENs, promise to alter foods more precisely, and cheaply without necessarily adding foreign DNA. Instead, they act like molecular scissors to alter the letters of an organism's own genetic alphabet.

The technology can insert new DNA, but most products in development so far switch off a gene, according to University of Missouri professor Nicholas Kalaitzandonakes.

Those new Calyxt soybeans? Voytas' team inactivated two genes so the beans produce oil with no heart-damaging trans fat and that shares the famed health profile of olive oil without its distinct taste.

The hornless calves? Most dairy Holsteins grow horns that are removed for the safety of farmers and other cows. Recombinetics Inc. swapped part of the gene that makes dairy cows grow horns with the DNA instructions from naturally hornless Angus beef cattle.

"Precision breeding," is how animal geneticist Alison Van Eenennaam of the University of California, Davis, explains it. "This isn't going to replace traditional breeding," but make it easier to add one more trait.

RULES AREN'T CLEAR
The Agriculture Department says extra rules aren't needed for "plants that could otherwise have been developed through traditional breeding," clearing the way for development of about two dozen gene-edited crops so far.

In contrast, the Food and Drug Administration in 2017 proposed tighter, drug-like restrictions on gene-edited animals. It promises guidance sometime next year on exactly how it will proceed.

Because of trade, international regulations are "the most important factor in whether genome editing technologies are commercialized," USDA's Paul Spencer told a meeting of agriculture economists.

Europe's highest court ruled last summer that existing European curbs on the sale of transgenic GMOs should apply to gene-edited foods, too.

But at the World Trade Organization this month, the U.S. joined 12 nations including Australia, Canada, Argentina and Brazil in urging other countries to adopt internationally consistent, science-based rules for gene-edited agriculture.

ARE THESE FOODS SAFE?
The biggest concern is what are called off-target edits, unintended changes to DNA that could affect a crop's nutritional value or an animal's health, said Jennifer Kuzma of the Genetic Engineering and Society Center at North Carolina State University.

Scientists are looking for any signs of problems. Take the hornless calves munching in a UC-Davis field. One is female and once it begins producing milk, Van Eenennaam will test how similar that milk's fat and protein composition is to milk from unaltered cows.

"We're kind of being overly cautious," she said, noting that if eating beef from naturally hornless Angus cattle is fine, milk from edited Holsteins should be, too.

But to Kuzma, companies will have to be up-front about how these new foods were made and the evidence that they're healthy. She wants regulators to decide case-by-case which changes are no big deal, and which might need more scrutiny.

"Most gene edited plants and animals are probably going to be just fine to eat. But you're only going to do yourself a disservice in the long run if you hide behind the terminology," Kuzma said.

AVOIDING A BACKLASH
Uncertainty about regulatory and consumer reaction is creating some strange bedfellows. An industry-backed group of food makers and farmers asked university researchers and consumer advocates to help craft guidelines for "responsible use" of gene editing in the food supply.

"Clearly this coalition is in existence because of some of the battle scars from the GMO debates, there's no question about that," said Greg Jaffe of the food-safety watchdog Center for Science in the Public Interest, who agreed to join the Center for Food Integrity's guidelines group. "There's clearly going to be questions raised about this technology."

SUSTAINABILITY OR HYPE?
Gene-editing can't do everything, cautioned Calyxt's Voytas. There are limitations to how much foods could be changed. Sure, scientists made wheat containing less gluten, but it's unlikely to ever be totally gluten-free for people who can't digest that protein, for example — or to make, say, allergy-free peanuts.

Nor is it clear how easily companies will be able to edit different kinds of food, key to their profit.

Despite her concerns about adequate regulation, Kuzma expects about 20 gene-edited crops to hit the U.S. market over five years — and she notes that scientists also are exploring changes to crops like cassava that important in the poorest countries.

"We think it's going to really revolutionize the industry," she said.

Copyright Associated Press / NBC New York



Photo Credit: Federica Narancio/AP]]>
<![CDATA[Juul Temporarily Suspends Retail Sales of Most Flavored E-Cigarettes]]>Tue, 13 Nov 2018 14:37:13 -0500https://media.nbcnewyork.com/images/213*120/juulGettyImages-1032883954.jpg

Juul said it will stop selling most of its flavored nicotine pods for its e-cigarettes in retail stores — though only temporarily — as it tries to appease federal regulators who have ordered the company to help reduce "epidemic" levels of teen use.

The company on Tuesday stopped accepting retail orders for its mango, fruit, creme and cucumber pods to the more than 90,000 convenience stores and other retail shops, CEO Kevin Burns said in a blog post on the company's website. Consumers will still be able to buy all of Juul's flavors on its website and its four tobacco and menthol-flavored pods in retail stores, Burns said.

The company plans to resume sales to retailers that adopt the company's new age restrictions and verification system. Juul is banning sales to anyone under 21, even in states where the legal age is lower.

The new policy doesn't go as far as expected. A person briefed on the company's plan told CNBC last week that Juul would stop all retail sales of flavored pods. There was no mention of resuming sales at any point. It's unclear when sales could resume.

Burns also said the company won't sell flavored pods to retailers that aren't legally allowed to sell them to the public, leaving the door open if federal regulators follow through on plans to restrict those sales to vape shops.

The Food and Drug Administration this week plans to restrict sales of cartridge-based flavored e-cigarettes to places like vape and tobacco shops, senior administration officials have told CNBC.

Retailers that want to sell the flavors will need to comply with Juul's new distribution system and age restrictions. Clerks must electronically scan IDs and verify consumers are older than 21, regardless of local laws. The sale quantity will also be limited to prevent bulk purchases.

Juul is already dominating the e-cigarette industry, just three years since its popular nicotine pods hit the market. The company, valued at $16 billion, captured 75 percent of the market in the period ended Nov. 3, according to Nielsen data compiled by Wells Fargo analyst Bonnie Herzog.

But the e-cigarette's appeal among teenagers has undermined Juul's success and threatened its future.

After months of parents and lawmakers begging the Food and Drug Administration to do something, Commissioner Dr. Scott Gottlieb in September ordered Juul and four other e-cigarette makers to fix what he labeled "epidemic" levels of teens using e-cigarettes. He said preliminary federal data show a more than 75 percent surge in high school students regularly using e-cigarettes.

That means roughly 3 million, or about 20 percent of high school kids, are using e-cigarettes, up from 1.73 million, or 11.7 percent in last year's National Youth Tobacco Survey. The complete data set is expected to be published this month.

"We're in alignment with [Gottlieb] that we need to take action and we need to get this category in a better position," Juul CEO Kevin Burns told CNBC in an October interview. The company declined to make Burns available for an interview Tuesday.

This week, the FDA will release its own proposal, which includes to restrict sales of cartridge-based flavored e-cigarettes to places like vape and tobacco shops that tend to enforce age restrictions better, senior FDA officials told CNBC last week. The agency also plans to ban online sales until manufacturers implement FDA-mandated guidelines for age verification, the FDA officials, who asked not to be named because the proposal is not yet public, said.

Some other e-cigarette makers have publicly shared their plans to the FDA. Altria said it will voluntarily remove its MarkTen pod-based products and will stop selling all flavors except for menthol or tobacco in its "cig-a-like" products until the FDA reviews and approves them. The company said it also supports federal legislation to make 21 the minimum age to buy tobacco products.

Fontem Ventures, a unit of tobacco company Imperial Brands and maker of blu e-cigarettes, said it will raise the minimum age requirements to buy pods on its website to 21 across the U.S. and review its packaging and product descriptions.

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<![CDATA[FDA Gives 2 Years to Purge Six Artificial Flavors From Food]]>Tue, 13 Nov 2018 12:53:27 -0500https://media.nbcnewyork.com/images/213*120/AP_18312850787176.jpg

Six artificial flavors are being ordered out of the food supply in a dispute over their safety, but good luck to anyone who wants to know which cookies, candies or drinks they're in.

The dispute highlights the complex rules that govern what goes in our food, how much the public knows about it, and a mysterious class of ingredients that has evolved over decades largely outside of public view.

On food packages, hundreds of ingredients are listed simply as natural flavor or artificial flavor. Even in minute amounts, they help make potato chips taste oniony or give fruit candy that twang.

"The food system we have is unimaginable without flavor additives," said Nadia Berenstein, a historian of flavor science based in New York.

The flavors are also at the center of a dispute over how ingredients should be regulated.

The U.S. Food and Drug Administration is giving companies two years to purge their products of six artificial flavors — even though the FDA made clear it believes the ingredients are safe in the trace amounts they are used.

The six artificial flavors in question, with names like methyl eugenol, benzophenone, ethyl acrylate and pyridine, are used to create cinnamon or spicy notes, fruity or minty flavors, or even hints of balsamic vinegar.

The FDA and the Flavor and Extract Manufacturers Association, an industry group, did not respond when asked for examples of products the six ingredients are used in. But they noted in statements that the compounds have natural counterparts in foods like basil, coffee, grapes and peppermint, and that the action does not affect the naturally derived versions.

The FDA said it had to order the artificial versions out of the food supply because of a lawsuit brought by consumer advocacy groups that cited a 60-year-old regulation known as the Delaney clause. The rule prohibits additives shown to have caused cancer in animals, even if tested at doses far higher than what a person would consume.

In a statement, the flavor industry group said the Delaney Clause doesn't allow regulators to assess an ingredient's risk based on modern scientific understanding, but that changing it would require an act of Congress. As far back as 1981, the Government Accountability Office issued a report saying the clause should be re-examined because of its inflexibility.

Christopher Kemp, a professor of cancer biology at the Fred Hutchinson Cancer Research Center, doesn't think the rule is necessarily too strict a threshold. He said animal studies provide the strongest evidence about cancer risk in humans, and that it is better to err on the side of caution.

Erik Olson of the Natural Resources Defense Council, one of the groups that sued over the six ingredients, said it's also unknown what effect they might have when used in combination with other ingredients. And since they're listed only as "artificial flavor," he said people don't know in what concentrations they're used in particular products.

"It's all secret. You can't pick up an ice cream or chewing gum or a baked good and have any idea what chemicals are in there," he said.

Berenstein, the flavor science historian, said the ingredients in flavors don't have to be specified in part because regulators decided long ago that listing the names of compounds on packages might just confuse people. And she stressed that flavors are used in infinitesimal amounts. In 2015, the flavor industry estimates just 40 pounds of one of the now banned artificial ingredients was produced.

But Bernstein said a more robust regulatory system might inspire greater public confidence about flavors.

In a separate but related lawsuit, the FDA is also facing a challenge over its oversight of the universe of ingredients companies can put into foods, including artificial flavors.

New flavors, sweeteners and other ingredients can go through an FDA petition process to be approved as food additives. But another option lets manufacturers deem their own ingredients to be "generally recognized as safe."

There's no clear rule for when ingredients should take one path or the other. The artificial sweetener Splenda is an approved food additive. Another sweetener, stevia, was declared GRAS by manufacturers.

The six artificial flavors in question were approved food additives, along with dozens of other synthetic flavors . The flavor industry group also regularly declares other ingredients like them to be GRAS, without formal review by the FDA.

Critics say GRAS determinations were meant for basic ingredients like salt and vinegar, not highly engineered ingredients. The advocacy groups suing the FDA say the GRAS option has turned into a loophole that lets companies approve all sorts of ingredients without public scrutiny, including artificial flavors.

In September, a judge allowed the legal challenge to move forward.

Copyright Associated Press / NBC New York



Photo Credit: Patrick Sison/AP]]>
<![CDATA[New Exercise Guidelines: Move More, Sit Less, Start Younger]]>Mon, 12 Nov 2018 09:34:48 -0500https://media.nbcnewyork.com/images/213*120/510751355-Kids-Exercising.jpg

Move more, sit less and get kids active as young as age 3, say new federal guidelines that stress that any amount and any type of exercise helps health.

The advice is the first update since the government's physical activity guidelines came out a decade ago. Since then, the list of benefits of exercise has grown, and there's more evidence to back things that were of unknown value before, such as short, high-intense workouts and taking the stairs instead of an elevator.

"Doing something is better than doing nothing, and doing more is better than doing something," said Dr. Donald Lloyd-Jones, a preventive medicine expert at Northwestern University in Chicago.

Only 20 percent of Americans get enough exercise now, and the childhood obesity problem has prompted the push to aim younger to prevent poor health later in life.

Highlights of the advice released Monday at an American Heart Association conference in Chicago and published in the Journal of the American Medical Association:

CHILDREN AND TEENS
The biggest change: Start young. Guidelines used to begin at age 6, but the new ones say preschoolers ages 3 through 5 should be encouraged to take part in active play throughout the day. They don't call for a certain amount but say a reasonable target may be three hours of various intensities. That's consistent with guidelines in many other countries and is the average amount of activity observed in kids this age.

From ages 6 through 17, at least an hour of moderate-to-vigorous activity throughout the day is recommended. Most of it should be aerobic, the kind that gets the heart rate up such as brisk walking, biking or running. At least three times a week, exercise should be vigorous and include muscle- and bone-strengthening activities like climbing on playground equipment or playing sports.

ADULTS
Duration stays the same — at least 2½ to 5 hours of moderate-intensity or 1 ¼ to 2 ½ hours of vigorous activity a week, plus at least two days that include muscle-strengthening exercise like pushups or lifting weights.

One key change: It used to be thought that aerobic activity had to be done for at least 10 minutes. Now even short times are known to help. Even a single episode of activity gives short-term benefits such as lowering blood pressure, reducing anxiety and improving sleep.

Sitting a lot is especially harmful.

The advice is similar for older adults, but activities should include things that promote balance to help avoid falls.

BROUGHT TO YOU BY THE LETTER E
Targeting young children is the goal of a project that Dr. Valentin Fuster, a cardiologist at New York's Mount Sinai Hospital, has worked on for years with the Heart Association and Sesame Workshop, producers of television's "Sesame Street."

At the heart conference, he gave results of an intensive four-month program to improve knowledge and attitudes about exercise and health among 562 kids ages 3 to 5 in Head Start preschools in Harlem.

"It was really successful," Fuster said. "Once they understand how the body works, they begin to understand physical activity" and its importance.

When brains are young, "it's the best opportunity" to set health habits that last, he said.

Copyright Associated Press / NBC New York



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<![CDATA[Big Studies Give Mixed News on Fish Oil, Vitamin D]]>Sat, 10 Nov 2018 20:02:10 -0500https://media.nbcnewyork.com/images/213*120/fishoilGettyImages-624914280.jpg

Taking fish oil or vitamin D? Big studies give long-awaited answers on who does and does not benefit from these popular nutrients.

Fish oil taken by healthy people, at a dose found in many supplements, showed no clear ability to lower heart or cancer risks. Same for vitamin D.

But higher amounts of a purified, prescription fish oil slashed heart problems and heart-related deaths among people with high triglycerides, a type of fat in the blood, and other risks for heart disease. Doctors cheered the results and said they could suggest a new treatment option for hundreds of thousands of patients like these.

Up to 10 percent of U.S. adults take fish oil. Even more take vitamin D, despite no major studies to support the many health claims made for it.

"Those who peddle it promote it as good for everything," but in this definitive test, vitamin D "showed a big nothing," said Dr. James Stein, a heart specialist at the University of Wisconsin-Madison. He had no role in the studies or ties to the companies involved.

Results were revealed Saturday at an American Heart Association conference in Chicago and published by the New England Journal of Medicine.

ABOUT FISH OIL
These oils, also called omega-3 fatty acids, are found in salmon, tuna and certain other fish. They reduce triglycerides and inflammation and may have other effects. There are different types, including EPA and DHA.

One study tested 4 grams a day of Amarin Corp.'s prescription Vascepa, which is concentrated EPA, in more than 8,000 patients with high triglycerides and a greater risk of heart problems for various reasons. All were already taking a statin such as Lipitor or Zocor to lower cholesterol. Half were given Vascepa and the rest, mineral oil capsules as a comparison.

After five years, about 17 percent of those on Vascepa had suffered one of these problems — a heart attack, stroke, heart-related death or clogged arteries requiring medical care — versus 22 percent of the others.

That worked out to a 25 percent reduction in risk. Looked at individually, heart attacks, heart-related deaths and strokes all were lower with Vascepa. Only 21 people would need to take Vascepa for five years to prevent one of the main problems studied — favorable odds, Stein said.

Side effects may be a concern: More people on Vascepa were hospitalized for an irregular heartbeat — 3 percent versus 2 percent of the comparison group. Doctors say that's puzzling because other research suggests fish oil lowers that risk.

The concern with the heart rhythm problem is that it can raise the risk of stroke, but there were fewer strokes among those on Vascepa, said study leader Dr. Deepak Bhatt of Brigham and Women's Hospital in Boston.

Vascepa costs around $280 a month; many insurers cover it. Amarin sponsored the study and some study leaders work or consult for the company.

A BROADER TEST
The other study tested a lower 1 gram daily dose of a different type of fish oil — an EPA/DHA combo sold as Lovaza or Omacor and in generic form — in 26,000 people with no prior heart problems or cancer.

After about five years, rates of a combined measure of heart attacks, strokes and other problems were similar for fish oil users and a comparison group. Cancer rates and deaths also were similar.

There were fewer heart attacks in the fish oil group — 145 versus 200 in the comparison group. The study leader, Dr. JoAnn Manson at Brigham and Women's, called that "a substantial benefit," but several independent experts disagreed because of the way the study was set up to track this and certain other results.

"These findings are speculative and would need to be confirmed in a separate trial," said the Cleveland Clinic's Dr. Steven Nissen.

FISHY COMPARISONS?
Both studies share a problem: the oils used for the comparison groups, which may not have been true placebos. The Vascepa study used mineral oil, which interferes with statin drugs, raises cholesterol, and might have made the comparison group fare worse and made Vascepa look better than it truly was.

The other study used olive oil, which might have helped that comparison group do better, possibly masking any benefit to the others from fish oil.

Leaders of both studies say any effect from the comparison oils isn't enough to alter the main results, and independent experts agreed. But Nissen, who is leading another fish oil study, is using corn oil as a comparison.

THE 'SUNSHINE' VITAMIN
Manson's study also tested vitamin D, which the skin makes from sun exposure. It's tough to get enough from foods like milk, eggs and oily fish, though many foods now are fortified with it. Some studies have found that people with lower levels of D are more likely to develop cancer, but it's not known if supplements alter that risk.

Study participants took 2,000 international units of D-3 (the most active form of vitamin D, also called cholecalciferol) or fake vitamin pills for five years.

Vitamin D did not affect the odds of having a heart attack or stroke or developing cancer. After excluding the first two years of use, researchers saw fewer cancer deaths among those on the vitamin — 112 versus 149 in the placebo group.

"Cancer can take years to develop" so a difference may not show up right away, Manson said. "This looks promising" and people will be studied longer to see if the trend holds up, she said.

Several other experts said these numbers just hint at a possible benefit that needs more study.

"These 'positive' results need to be interpreted with caution," Dr. Clifford Rosen of Maine Medical Center Research Institute and Dr. John Keaney Jr. of the University of Massachusetts wrote in a commentary in the medical journal.

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

Copyright Associated Press / NBC New York



Photo Credit: Charlotte Ball/PA Images via Getty Images]]>
<![CDATA[Medicare Expands Access to in-Home Support for Seniors]]>Fri, 09 Nov 2018 08:36:01 -0500https://media.nbcnewyork.com/images/213*120/AP_18312567718147-Medicare-Benefits-Book.jpg

In a harbinger of potentially big changes for Medicare, seniors in many states will be able to get additional services such as help with chores, safety devices and respite for caregivers next year through private "Medicare Advantage" insurance plans.

The shift reflects a growing recognition that simple help at home can have a meaningful impact on patients' well-being — and reduce some costs for taxpayers. A couple of hundred dollars to install grab bars in the shower can prevent a fall leading to a broken hip, a life-changing injury.

The newly covered services are similar to what people might need if they required long-term care, said Howard Gleckman, a senior researcher at the nonpartisan Urban Institute think tank. "It begins to break down the wall between long-term care and Medicare, which with very few exceptions, has never paid for long-term care."

Change is starting slowly. The services will be offered by some Medicare Advantage plans in about 20 states next year, expected to grow over time.

There has to be a health-related reason to qualify, and costs will vary among plans. In some plans, there's no added cost. But limits do apply. For example, a plan may cover one day per week at an adult day care center.

Nearly 23 million Medicare beneficiaries, or more than 1 in 3, are expected to be covered by a Medicare Advantage plan next year. The private plans generally offer lower out-of-pocket costs in exchange for limits on choice of doctors and hospitals and other restrictions such as prior authorization for services. It's a growing business for insurers.

Medicare Advantage open enrollment for 2019 ends Dec. 7. But it's not easy to use Medicare's online plan finder to search for plans with expanded benefits, so beneficiaries and their families will have to rely on promotional materials that insurers mail during open enrollment.

For years, Medicare has permitted private plans to offer supplemental benefits not covered by the traditional program. Think free gym memberships, transportation to medical appointments or home-delivered meals following a hospitalization.

The new benefits take that to a higher level, with Medicare's blessing.

"It is a big concept, in the sense that it is officially encouraging plans to get across the line into the many, many things that affect the health and well-being of beneficiaries," said Marc Russo, president of insurer Anthem's Medicare business. "I, for one, who have been in and around Medicare for decades, believe it pays."

Insurers under Anthem's corporate umbrella are offering different packages in 12 of 21 states they operate in. They can include alternative medicine, like acupuncture, or adult day care center visits or a personal helper at home.

Other major insurers like UnitedHealthcare and Humana are participating.

Still, Medicare's opening is no substitute for full long-term care coverage, which many people need for at least part of their lives and remains prohibitively expensive. Seniors trying to get long-term care through Medicaid — the program for low-income people — must spend down their life savings.

"Medicare policy has not kept up with the times," said Sen. Ron Wyden, D-Ore., one of the authors of bipartisan legislation seen as a catalyst for expanded services through Medicare Advantage.

Wyden said he's working to bring similar options to traditional Medicare, which is still the choice of 2 out of 3 seniors. "Clearly this is going to have to be an effort that is going to have to be built out," he added.

The changes represent a rare consensus at a time when health care issues are among the most politically divisive. Republican and Democratic lawmakers, as well as Seema Verma, the Trump administration's Medicare chief, are pulling in the same direction.

The idea of broader services through Medicare Advantage was embodied in a bipartisan Senate Finance Committee bill to improve care for chronically ill seniors. The legislation got spliced into a massive budget bill passed earlier this year. The Trump administration issued regulations in the spring trying to accelerate the changes.

According to Medicare, 12 insurers will be offering expanded supplemental benefits next year through 160 plans in 20 states. In four other states and Puerto Rico, such benefits may be available to seniors with certain health conditions.

"The guidance came out fairly late in the annual planning process, and that's one reason why some of these benefits may start out small," said Steve Warner, head of Medicare Advantage program development for UnitedHealthcare.

Medicare estimates that some 780,000 beneficiaries will have access to the new benefits next year. In-home helpers and support for caregivers are the most popular.

Consumer advocates recommend that seniors carefully weigh whether Medicare Advantage is best for them. If they don't like it, they can go back to traditional Medicare, but those with a pre-existing condition may not be able to buy a "Medigap" policy to help cover out-of-pocket costs. They can also switch to another Medicare Advantage plan.

Medicare doesn't pay the insurers more for offering added benefits. Under a complex formula, they're primarily financed out of the difference between bids submitted by insurers and Medicare's maximum payment to plans. If the companies bid below Medicare's rate, they can return some of that to beneficiaries in the form of added benefits. Costs for beneficiaries may vary. Some will face no added costs.

Copyright Associated Press / NBC New York



Photo Credit: Pablo Martinez Monsivais/AP]]>
<![CDATA[FDA Plans Limits on Sale of Flavored E-Cigarettes: Report]]>Fri, 09 Nov 2018 01:01:53 -0500https://media.nbcnewyork.com/images/213*120/ecigarettesAP_18313147982108.jpg

The U.S. Food and Drug Administration plans to require strict limits on the sale of most flavored e-cigarettes, including age verification controls for online sales, in an effort to curtail their use among children and teenagers.

FDA officials told The Wall Street Journal on Thursday the actions are expected to be announced as early as next week. The move is an attempt to curb what many are saying is an epidemic of underage vaping.

"What I can't tolerate is another year of this level of growth," FDA Commissioner Scott Gottlieb said in an interview Wednesday.

The new policy will apply to flavored cartridge-style vaping products like Juul that have become popular among youths, not the open tank-style systems sold in vape shops and mostly used by adults, officials said.

No retail outlets will be allowed to carry them unless it restricts minors from entering the store or creates an off-limits area.

Since 2017, FDA officials had discussed e-cigarettes as a potential tool to wean adult smokers off cigarettes, but in September the FDA reversed course and warned the industry to address the problem of surging teenage e-cigarette use or risk having their flavored products pulled off the market.

Gottlieb said then that the agency did not predict an "epidemic addiction" among youth, mainly driven by flavored products.

The FDA's new restrictions were earlier reported by The Washington Post.

Also Thursday, New York Gov. Andrew Cuomo's administration announced plans to ban the sale of flavored e-cigarettes as soon as next year, possibly making his state the first to prohibit such vaping products often marketed as a safer alternative to traditional cigarettes.

Copyright Associated Press / NBC New York



Photo Credit: Steven Senne/AP, File ]]>
<![CDATA[Surgeon Mistakes Woman's Kidney for Tumor During Back Surgery, Removes It]]>Wed, 07 Nov 2018 21:28:02 -0500https://media.nbcnewyork.com/images/213*120/110718+wellington+regional+medical+center.PNG

A Florida surgeon removed a woman's healthy kidney while she was undergoing back surgery because he believed the vital organ was a cancerous tumor.

The Palm Beach Post reported last week that Maureen Pacheco has sued Ramon Vazquez and two other surgeons for malpractice. Vazquez was responsible for cutting Pacheco open in 2016 so two orthopedic surgeons, Dr. John Britt and Dr. Jeffrey Kugler, could perform the back operation.

Pacheco's attorney, Donald J. Ward, says she didn't get a say in the removal. The lawsuit was settled in September. Vazquez's attorney Mark Mittelmark says the blame lies with Wellington Regional Medical Center, which didn't tell his client that Pacheco had a pelvic kidney.

The Florida Department of Health has filed an administrative complaint with the Board of Medicine against Vazquez.

Copyright Associated Press / NBC New York



Photo Credit: Google Earth]]>
<![CDATA[With Poo on a Pedestal, Bill Gates Talks Toilet Technology]]>Tue, 06 Nov 2018 08:28:41 -0500https://media.nbcnewyork.com/images/213*120/gates-poop.jpg

Placing a jar of feces on a pedestal next to him, billionaire philanthropist Bill Gates made a plea Tuesday for the safe disposal of human waste as he kicked off a "Reinvented Toilet" Expo in China.

"You might guess what's in this beaker — and you'd be right. Human feces," the former CEO of software giant Microsoft said. "This small amount of feces could contain as many as 200 trillion rotavirus cells, 20 billion Shigella bacteria, and 100,000 parasitic worm eggs."

He went on to say that pathogens like these cause diseases that kill nearly 500,000 children under the age of 5 every year.

More than 20 companies and academic institutions are exhibiting new toilet technologies at the three-day expo in Beijing, from self-contained toilets to a small-scale, self-powered waste treatment plant called the Omni Processor.

The Bill and Melinda Gates Foundation that Gates co-founded with his wife has spent more than $200 million since 2011 to stimulate research and development of safe sanitation technology.

"The technologies you'll see here are the most significant advances in sanitation in nearly 200 years," he said, according to a text of his prepared remarks.

UNICEF estimates that 4.5 billion people worldwide do not have access to safely managed sanitation, and that 480,000 children under 5 die every year from diarrhea, primarily in South Asia and sub-Saharan Africa. There is an economic cost too: Poor sanitation cost the world nearly $223 billion in 2015, according to a study by Oxford Economics and Japanese toilet maker Lixil.

Gates left the feces on display for about 10 minutes before removing it, his point made.

Copyright Associated Press / NBC New York



Photo Credit: Mark Schiefelbein/AP]]>
<![CDATA[Don't Spank: Pediatricians Warn Parents of Long-Term Harms]]>Mon, 05 Nov 2018 15:55:36 -0500https://media.nbcnewyork.com/images/213*120/babycryingGettyImages-53312738.jpg

The nation's leading pediatricians' group has strengthened its advice against spanking and other physical punishment because of the potential for long-term harm. 

In an updated policy released Monday, the American Academy of Pediatrics says that can include aggression, brain changes, substance abuse and suicidal behavior in adulthood. 

The academy says research since its 1998 discipline policy led to the update. It says spanking is falling out of favor among parents, especially those with young children. While some parents still believe it can lead to short-term improvements in behavior, studies show spanking is no more effective than non-physical punishment, including timeouts, setting firm limits and establishing unwanted consequences. 

The group also suggests putting favorite toys away or reducing screen time. 

"Although many children who were spanked become happy, healthy adults, current evidence suggests that spanking is not necessary and may result in long-term harm,'' the academy advises. 

Studies published in the past two decades have bolstered evidence that spanking can make young kids more aggressive and defiant. 

Other studies have linked physical punishment in childhood with later brain changes in young adults including reduced gray matter and elevated levels of stress hormones. Suicidal behavior, substance abuse and anger are among other potential long-term consequences of spanking, studies have suggested. 

The academy also warns against harsh verbal abuse including shaming kids, citing research linking it with depression and behavior problems in teens.

Copyright Associated Press / NBC New York



Photo Credit: David Silverman/Getty Images, File]]>
<![CDATA[Earth's Ozone Layer Is Healing, UN Report Says]]>Mon, 05 Nov 2018 07:48:33 -0500https://media.nbcnewyork.com/images/213*120/ozone.jpg

Earth's protective ozone layer is finally healing from damage caused by aerosol sprays and coolants, a new United Nations report said.

The ozone layer had been thinning since the late 1970s. Scientist raised the alarm and ozone-depleting chemicals were phased out worldwide.

As a result, the upper ozone layer above the Northern Hemisphere should be completely repaired in the 2030s and the gaping Antarctic ozone hole should disappear in the 2060s, according to a scientific assessment released Monday at a conference in Quito, Ecuador. The Southern Hemisphere lags a bit and its ozone layer should be healed by mid-century.

"It's really good news," said report co-chairman Paul Newman, chief Earth scientist at NASA's Goddard Space Flight Center. "If ozone-depleting substances had continued to increase, we would have seen huge effects. We stopped that."

High in the atmosphere, ozone shields Earth from ultraviolet rays that cause skin cancer, crop damage and other problems. Use of man-made chemicals called chlorofluorocarbons (CFCs), which release chlorine and bromine, began eating away at the ozone. In 1987, countries around the world agreed in the Montreal Protocol to phase out CFCs and businesses came up with replacements for spray cans and other uses.

At its worst in the late 1990s, about 10 percent of the upper ozone layer was depleted, said Newman. Since 2000, it has increased by about 1 to 3 percent per decade, the report said.

This year, the ozone hole over the South Pole peaked at nearly 9.6 million square miles (24.8 million square kilometers). That's about 16 percent smaller than the biggest hole recorded — 11.4 million square miles (29.6 million square kilometers) in 2006.

The hole reaches its peak in September and October and disappears by late December until the next Southern Hemisphere spring, Newman said.

The ozone layer starts at about 6 miles (10 kilometers) above Earth and stretches for nearly 25 miles (40 kilometers); ozone is a colorless combination of three oxygen atoms.

If nothing had been done to stop the thinning, the world would have destroyed two-thirds of its ozone layer by 2065, Newman said.

But it's not a complete success yet, said University of Colorado's Brian Toon, who wasn't part of the report.

"We are only at a point where recovery may have started," Toon said, pointing to some ozone measurements that haven't increased yet.

Another problem is that new technology has found an increase in emissions of a banned CFC out of East Asia, the report noted.

And the replacements now being used to cool cars and refrigerators need to be replaced themselves with chemicals that don't worsen global warming, Newman said. An amendment to the Montreal Protocol that goes into effect next year would cut use of some of those gases.

"I don't think we can do a victory lap until 2060," Newman said. "That will be for our grandchildren to do."

___

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

Copyright Associated Press / NBC New York



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<![CDATA[Heroin, Fentanyl Remain Biggest Drug Threat to US, Feds Say]]>Fri, 02 Nov 2018 11:47:51 -0500https://media.nbcnewyork.com/images/213*120/AP_180237383992511.jpg

Drug overdose deaths hit the highest level ever recorded in the United States last year, with an estimated 200 people dying per day, according to a report by the U.S. Drug Enforcement Administration. Most of that was the result of a record number of opioid-related deaths.

Preliminary figures show more than 72,000 people died in 2017 from drug overdoses across the country. About a week ago, U.S. Health and Human Services Secretary Alex Azar said overdose deaths, while still slowly rising, were beginning to level off, citing figures from late last year and early this year.

The DEA's National Drug Threat Assessment, which was released Friday, shows that heroin, fentanyl and other opioids continue to be the highest drug threat in the nation. But federal officials are concerned that methamphetamine and cocaine are being seen at much higher levels in areas that haven't historically been hotspots for those drugs. The DEA is also worried that people are exploiting marijuana legalization to traffic cannabis into the illicit market or to states that don't have medicinal or recreational-use marijuana laws, according to the report.

The preliminary data also showed 49,060 people died from opioid-related overdose deaths, a rise from the reported 42,249 opioid overdose deaths in 2016.

President Donald Trump has declared the U.S. opioid crisis as a "public health emergency" and just last week pledged to put an "extremely big dent" in the scourge of drug addiction.

Fatal heroin overdoses rose nationwide between 2015 and 2016, with a nearly 25 percent increase in the Northeast and more than 22 percent in the South. Most of the heroin sold in the U.S. is being trafficked from Mexico, and U.S. Customs and Border Protection officers seize the most amount of heroin along the Mexico border, near San Diego, California, the report said.

Fentanyl and other related opioids, which tend to be cheaper and much more potent than heroin, remain one of the biggest concerns for federal drug agents.

The DEA has said China is a main source of fentanyl and other synthetic opioids that have been flooding the U.S. market. China has pushed back against the characterization, and U.S. officials have stressed they work closely with their Chinese counterparts as they try to stem the flow of drugs.

Legislation that Trump signed last week will add treatment options and force the U.S. Postal Service to screen overseas packages for fentanyl.

Azar said in a speech last week that toward the end of 2017 and through the beginning of this year the number of drug overdose deaths "has begun to plateau." However, he was not indicating that deaths were going down, but that they appear to be rising at a slower rate than previously seen.

Last month, the Centers for Disease Control and Prevention released preliminary figures that appear to show a slowdown in overdose deaths from December to March. In that period, the figures show that the pace of the increase over the previous 12 months has slowed from 10 percent to 3 percent, according to the preliminary CDC figures.

Even if a slowdown is underway, no one is questioning the fact that the nation is dealing with the deadliest drug overdose epidemic in its history. While prescription opioid and heroin deaths appear to be leveling off, deaths involving fentanyl, cocaine and methamphetamines are on the rise, according to CDC data.

The DEA's report also noted that methamphetamine is making its way into communities where the drug normally wasn't heavily used, the report said. Chronic use of meth, a highly addictive stimulant, can cause paranoia, visual and auditory hallucinations and delusions, studies have shown.

As the government enacted laws that limited access to cold medicines containing pseudoephedrine — the ingredient used to cook meth with other household chemicals — or required the medications to be placed behind pharmacy counters, officials discovered the number of meth labs began to drop.

But the DEA has found the gap is being filled by Mexican and Latin American drug cartels that had primarily dabbled in heroin and cocaine trafficking. A saturated market on the West Coast is now driving the cartels to peddle methamphetamine into the Northeast, using the same routes they use for heroin and other drugs.

Officials also warn that because of more cocaine production in South American countries including Colombia, they expect to see larger shipments at the Mexican border.

Copyright Associated Press / NBC New York



Photo Credit: Matt Rourke/AP, File]]>
<![CDATA[Federal Health Care Website Up and Running After Slow Start]]>Thu, 01 Nov 2018 11:24:46 -0500https://media.nbcnewyork.com/images/213*120/AP_18304546448456.jpg

The federal website where consumers can get health insurance under the Affordable Care Act was up and running Thursday after a slow start as sign-up season for 2019 opened days before the midterm elections.

During early morning hours, people accessing the site were directed to a screen that said work was underway. A recording at the HealthCare.gov call center conveyed a similar message. Things seemed to be running normally by about 9 a.m. EDT.

With health care a major issue in Tuesday's elections, this sign-up season under the Trump administration is getting close scrutiny.

In earlier years, technical problems with the site created major headaches for the Obama administration. Some Democrats cited HealthCare.gov's meltdown after its 2013 debut as one of the reasons they lost control of the Senate the following year.

Since those initial problems were fixed, the website serving people in 39 states has worked fairly smoothly, first under President Barack Obama and now under Donald Trump. The rest of the states and the District of Columbia run their own sign-ups.

A spokesperson for the Centers for Medicare and Medicaid Services said Thursday morning that HealthCare.gov was open for business.

Before the site went live for sign-ups at the start of a new coverage year, technicians had to load up details on thousands of changes in plans and premiums.

"Prior to every open enrollment, final preparations must take place ahead of the start of the open enrollment period to ensure the website runs smoothly for consumers," said a statement from the agency. The statement said the agency's commitment had been that the site would be ready "in the morning."

The health law's sixth sign-up season began with stabilizing premiums and more choice for consumers.

Nationally, average premiums are going up only by low single-digit percentages for 2019. In some states, and for some types of plans, premiums will decline. Fewer areas will see increases. Insurers also are expanding their participation.

But Republicans have not backed off their pledge to fully repeal the health law, despite failing to do so in Trump's first year. Still, other changes by the GOP-run Congress and the administration for next year may result in fewer people signing up.

Congress did get rid of the unpopular requirement that most people carry health insurance or risk fines, starting Jan. 1. The administration has opened the way for insurers to offer alternatives to the law's comprehensive coverage, including plans that don't have to cover pre-existing conditions.

Democrats have made maintaining protections for pre-existing conditions a major issue in the elections, forcing Republicans on the defensive. They also accuse Trump of trying to "sabotage" the health law, and a core group of former Obama administration officials has kept close tabs on sign-up season.

Despite all the political drama, enrollment has remained remarkably stable.

About 10 million people have private policies through HealthCare.gov and state-run insurance markets, with roughly 9 in 10 getting taxpayer-financed help to pay their premiums. An estimated 12 million more are covered through the law's Medicaid expansion, aimed at low-income adults.

Income-based subsidies that protect consumers from high premiums remain available for next year, as has been the case since the overhaul went into effect. Open enrollment ends Dec. 15 for coverage starting Jan. 1.

Copyright Associated Press / NBC New York



Photo Credit: AP Photo/Pablo Martinez Monsivais]]>
<![CDATA[Studies: Appendix Removal Linked to Lower Parkinson's Risk]]>Wed, 31 Oct 2018 13:17:17 -0500https://media.nbcnewyork.com/images/213*120/AP_18303758160613.jpg

Scientists have found a new clue that Parkinson's disease may get its start not in the brain but in the gut — maybe in the appendix.

People who had their appendix removed early in life had a lower risk of getting the tremor-inducing brain disease decades later, researchers reported Wednesday.

Why? A peek at surgically removed appendix tissue shows this tiny organ, often considered useless, seems to be a storage depot for an abnormal protein — one that, if it somehow makes its way into the brain, becomes a hallmark of Parkinson's.

The big surprise, according to studies published in the journal Science Translational Medicine: Lots of people may harbor clumps of that worrisome protein in their appendix — young and old, people with healthy brains and those with Parkinson's.

But don't look for a surgeon just yet.

"We're not saying to go out and get an appendectomy," stressed Viviane Labrie of Michigan's Van Andel Research Institute, a neuroscientist and geneticist who led the research team.

After all, there are plenty of people who have no appendix yet still develop Parkinson's. And plenty of others harbor the culprit protein but never get sick, according to her research.

THE GUT CONNECTION
Doctors and patients have long known there's some connection between the gastrointestinal tract and Parkinson's. Constipation and other GI troubles are very common years before patients experience tremors and movement difficulty that lead to a Parkinson's diagnosis.

Wednesday's research promises to re-energize work to find out why, and learn who's really at risk.

"This is a great piece of the puzzle. It's a fundamental clue," said Dr. Allison Willis, a Parkinson's specialist at the University of Pennsylvania who wasn't involved in the new studies but says her patients regularly ask about the gut link.

Parkinson's Foundation chief scientific officer James Beck, who also wasn't involved, agreed that "there's a lot of tantalizing potential connections."

He noted that despite its reputation, the appendix appears to play a role in immunity that may influence gut inflammation. The type of bacteria that live in the gut also may affect Parkinson's.

But if it really is common to harbor that Parkinson's-linked protein, "what we don't know is what starts it, what gets this whole ball rolling," Beck said.

For years, scientists have hypothesized about what might cause the gut-Parkinson's connection. One main theory: Maybe bad "alpha-synuclein" protein can travel from nerve fibers in the GI tract up the vagus nerve, which connects the body's major organs to the brain. Abnormal alpha-synuclein is toxic to brain cells involved with movement.

There have been prior clues. People who decades ago had the vagus nerve cut as part of a now-abandoned therapy had a reduced risk of Parkinson's. Some smaller studies have suggested appendectomies, too, might be protective — but the results were conflicting.

Labrie's team set out to find stronger evidence.

First, the researchers analyzed Sweden's huge national health database, examining medical records of nearly 1.7 million people tracked since 1964. The risk of developing Parkinson's was 19 percent lower among those who had their appendix surgically removed decades earlier.

One puzzling caveat: People living in rural areas appeared to get the benefit. Labrie said it's possible that the appendix plays a role in environmental risk factors for Parkinson's, such as pesticide exposure.

Further analysis suggested people who developed Parkinson's despite an early-in-life appendectomy tended to have symptoms appear a few years later than similarly aged patients.

A COMMON PROTEIN
That kind of study doesn't prove that removing the appendix is what reduces the risk, cautioned Dr. Andrew Feigin, executive director of the Parkinson's institute at NYU Langone Health, who wasn't involved in Wednesday's research.

So next, Labrie's team examined appendix tissue from 48 Parkinson's-free people. In 46 of them, the appendix harbored the abnormal Parkinson's-linked protein. So did some Parkinson's patients. Whether the appendix was inflamed or not also didn't matter.

That's a crucial finding because it means merely harboring the protein in the gut isn't enough to trigger Parkinson's, Labrie said. There has to be another step that makes it dangerous only for certain people.

"The difference we think is how you manage this pathology," she said — how the body handles the buildup.

Her team plans additional studies to try to tell.

The reservoir finding is compelling, Feigin said, but another key question is if the abnormal protein also collects in healthy people's intestines.

And Penn's Willis adds another caution: There are other unrelated risks for Parkinson's disease, such as suffering a traumatic brain injury.

"This could be one of many avenues that lead to Parkinson's disease, but it's a very exciting one," she said.

Copyright Associated Press / NBC New York



Photo Credit: Van Andel Research Institute via AP]]>
<![CDATA[US Steps Up Scrutiny of Funds for Asbestos Exposure Victims]]>Wed, 31 Oct 2018 01:00:15 -0500https://media.nbcnewyork.com/images/213*120/dojAP_18303858528439.jpg

The Trump administration has stepped up scrutiny of asbestos trust funds, concerned that the pots of money intended to help people exposed to the hazardous substance are being depleted by fraudulent claims, harming victims, businesses and the government.

The Justice Department in the last two months has demanded trust documents as part of a civil investigation, opposed the creation of another trust it said lacked sufficient safeguards, and argued against the appointment of a lawyer it said was too conflicted to represent victims.

The actions take aim at a system that over decades has paid out billions of dollars to the sick and cancer-stricken, but that critics say is opaque and prone to fraud and manipulation by well-connected lawyers. The government's intervention aligns it with business groups who have long complained about the process.

"We have an interest in fraud and consumer protection, so if there is fraud happening out there that is cognizable under federal law, that's the type of thing the Justice Department tends to get interested in," acting Associate Attorney General Jesse Panuccio said in an interview.

But plaintiffs' lawyers and asbestos victims' advocates say there's scant proof of widespread fraud, particularly for a system that has accommodated millions of claims. And University at Buffalo law professor S. Todd Brown said the additional government oversight, while not a bad idea, "could lead to money going to complying with this oversight rather than going to the victims."

The trusts started emerging in the 1980s, formed by makers of asbestos-containing products who sought bankruptcy protection in the face of lawsuits from people who feared they had been exposed. The maneuvering enabled the companies to shield themselves from lawsuits while setting aside money to pay pending and future claims for asbestos, an environmental hazard once found in everyday products that can lead to the deadly mesothelioma cancer and other illnesses.

The model flourished. A 2011 Government Accountability Office report identified 60 trusts formed between 1988 and 2010 that it said had paid about 3.3 million claims valued at more than $17 billion.

Lawyers for asbestos victims say the process enables people to obtain compensation for catastrophic illness without drawn-out lawsuits.

"There is incredible irony in the fact that an industry that covered up the dangers of a known carcinogen for decades, leading to the ongoing deaths of 15,000 Americans a year, is now claiming that its victims are committing systemic fraud against the trusts — even though no court has ever found evidence of such fraud," Peter Knudsen, spokesman for the plaintiffs' lawyers group American Association for Justice, said in a statement.

Business groups and defense lawyers contend otherwise.

They say weak oversight allows people to collect payments with minimal evidence they were harmed by a particular company's product, and for illnesses far less serious than mesothelioma and lung cancer. They argue trust overseers are often tied to well-connected plaintiffs' firms, raising concerns of favoritism and cronyism.

And they say the meager amount of publicly available information makes it hard to know how decisions on payments are made, how much a given individual is receiving or whether the exposure evidence submitted to one trust is consistent with what's submitted to others.

In 2014, a judge in the bankruptcy case of an asbestos gasket maker described a "startling pattern of misrepresentation" by alleged victims and their lawyers. The judge found that plaintiffs repeatedly told Garlock Sealing Technologies that it was responsible for their exposure and struck large settlement agreements with the company, only to later file claims with multiple other trusts over injuries and exposures they hadn't previously disclosed.

Plaintiffs' lawyers say asbestos victims are routinely sickened by multiple companies, often making it hard to pinpoint precisely who's to blame and leaving them with no choice but to seek compensation from anyone who may have harmed them.

The Justice Department stepped up its oversight in the last few months.

In September, it challenged the creation of a new trust it said lacked details about how it would guard against fraud and abuse. The department said in a letter to state attorneys general that "it would object to plans for asbestos trusts that fail to include critical information on how asbestos claims will be evaluated, paid and reported" or that don't do enough to prevent fraud.

It later challenged a different trust, Duro Dyne, over the appointment of a lawyer it said was too conflicted to represent interests of people who may later become ill. A judge rejected that request, and Jeffrey Prol, an attorney for the trust, said he was taken aback by what he called the department's effort to make "this bankruptcy case a referendum on the asbestos trust system."

At least one trust, DII Industries, has disclosed receiving an administrative subpoena, to produce records of settlements as part of an investigation into whether Medicare is being properly reimbursed for trust payments. A trust spokesman said it was complying.

Harold Kim, executive vice president of the U.S. Chamber Institute for Legal Reform, a pro-business legal organization, said the system has long been "broken."

"Having more oversight and taking a closer look in terms of how these trusts operate and whether they're violating federal law will hopefully keep these trusts honest." 

Copyright Associated Press / NBC New York



Photo Credit: J. David Ake/AP, File ]]>
<![CDATA[Halloween Can Be Deadly for Pedestrians, Traffic Study Says]]>Wed, 31 Oct 2018 07:10:23 -0500https://media.nbcnewyork.com/images/213*120/childwitchGettyImages-1616984.jpg

Trick-or-treaters beware: Halloween can be deadly for pedestrians and children face the greatest danger.

Research published Tuesday found a 43 percent higher risk of pedestrian deaths on Halloween night than on other nights near that date.

The study was based on four decades of U.S. traffic data, including 608 pedestrian deaths on 42 Halloweens.

Canadian traffic researchers launched the study after noticing advertisements for Halloween parties posted to lampposts in their country. That got them thinking about a dangerous witches' brew: holiday revelers driving away from bars mixed with "legions of kids roaming the streets" in costume, said lead author Dr. John Staples of the University of British Columbia.

Canada celebrates Halloween, too, but U.S. traffic data is remarkably complete, so Staples and colleagues focused their analysis south of their border. The study appears in JAMA Pediatrics.

Using National Highway Traffic Safety Administration data, the researchers compared pedestrian deaths on Halloween nights with deaths on two evenings the week before and the week after. They found car-pedestrian accidents kill four more people on average on Halloween than on other days.

The findings echo a U.S. Centers for Disease Control and Prevention analysis of 1975-1996 data from the traffic safety agency.

Kids aged 4 to 8 faced the highest risks in the new study: There were 55 Halloween deaths in this age range compared with just 11 on control days.

"That age group is maybe particularly excited about Halloween and maybe in the midst of that excitement loses track of the very real danger that vehicles pose," Staples said. "They may be unaware that drivers aren't able to see them."

Deaths peaked near dusk, around 6 p.m.

Dr. Donald Redelmeier, a study co-author, works at Canada's largest trauma hospital and recalls treating a pedestrian injured on one Halloween.

Staples offered some common sense advice: Attach reflective patches to costumes, carry a flashlight or glow stick to be more visible, make sure masks don't obstruct vision, and look both ways before crossing the street.

Copyright Associated Press / NBC New York



Photo Credit: Mark Wilson/Getty Images]]>
<![CDATA[Gum, Bottled Water, Pizza Bagels want to be Called 'Healthy']]>Tue, 30 Oct 2018 12:12:46 -0500https://media.nbcnewyork.com/images/213*120/AP_18300856495582.jpg

Pizza bagels, chewing gum and bottled water want to play a starring new role in our diets: Foods that can be called healthy.

The U.S. Food and Drug Administration is revamping its definition of healthy to reflect our changing understanding of nutrition science. The push is fueling debate about eating habits and what the new standard should say.

Frozen food-makers are seeking special rules for "mini meals," citing little pizza bagels and dumplings as examples that might qualify. Chewing gum and bottled water companies say they should no longer be shut out from using the term just because their products don't provide nutrients. Advocacy groups and health professionals are also weighing in, raising concerns about ingredients like sugar.

Some say the word healthy is inherently misleading when applied to a single product instead of an overall diet.

"The problem is that healthy is relative," said Bruce Y. Lee, a professor of international health at Johns Hopkins. Subsisting on broccoli alone, for instance, wouldn't be healthy.

The federal standards for use of the word "healthy" on labels was established in 1994 and set limits on total fat and cholesterol.

Susan Mayne, who heads the FDA's food labeling division, said the definition reflects decades-old understanding of nutrition and needs to be updated.

With the revamp, she said people will be able to trust the word "healthy" is based in science, unlike many other terms on packages.

"This is one that the federal agencies will stand behind," she said.

NUTTY HEALTH

The government's dusty definition of healthy came under scrutiny in late 2015, when the FDA warned Kind that its snack bars had too much fat to use the term. Kind pushed back, saying the fat came from nuts.

Since the rule was established more than two decades ago, nutrition experts have drawn a greater distinction between "good fats" like those found in nuts and "bad fats" like the trans fats in oils that are partially hydrogenated, an industrial process that gives foods a longer shelf life.

The link between dietary cholesterol and heart disease is also no longer clear.

Separate U.S. dietary guidelines , which are updated every five years, no longer set limits on total fat or cholesterol. They still recommend avoiding trans fats and limiting saturated fats, such as those found in meat and milk. But even the link between saturated fats and heart disease is now questioned .

Now sugar has become more of a concern, with some health experts saying our past fear of fat led to people gobbling up low-fat products high in sugar.

The shifting views reflect the pitfalls of nutrition science. Most food studies are based on links between what people say they eat and their health, which leaves the door open for flawed conclusions . Pinning down cause-and-effect relationships is harder.

It's why the effort to redefine "healthy" invites such debate. After launching the push in late 2016, the FDA received more than 1,140 public comments on the matter.

The next step is for the FDA to propose a new definition, which would be subject to another round of public comment. The agency won't say when it expects to establish a final rule with the new definition.

LIKE MOMMA USED TO MAKE

"Healthy" was once just another generic marketing term, like "wholesome" or "like momma used to make," said Xaq Frohlich, a professor of food history at Auburn University.

After a proliferation of products making claims about health and disease, the FDA set ground rules for the word.

"The reason why 'healthy' is getting attention is because a broad part of the American public really wants their food to be healthy," Frohlich said.

But beyond the regulatory definition, what people consider healthy varies. Among the notable dietary tribes today: Adherents of paleo, gluten-free, organic and vegan diets. Some of their views are reflected in comments to the FDA last year.

The Sierra Club wants "healthy" to exclude foods made with genetically engineered and artificial ingredients. The National Pasta Association wants to the option to call gluten-free pasta healthy. Right now, it says some gluten-free pastas fall shy of nutrient requirements.

In addition to limiting fat and cholesterol, the current standard requires the presence of a nutrient like calcium, fiber, iron or vitamin C. It's partly why bottled water and sugar-free gum companies say they're unfairly excluded from using the term.

Richard Mann, a lawyer for the International Chewing Gum Association, said sugar-free gum doesn't have any of the nutrients people are supposed to limit.

"It doesn't have fat. It doesn't have sugar. It has virtually no calories," he said.

Some question whether an updated definition will make a difference. The American Academy of Pediatrics says companies will likely just reformulate snacks to meet the new rules.

Companies may have added incentive to do so: The FDA is also considering a symbol that would make it easier for people to identify products that meet the new definition.

Copyright Associated Press / NBC New York



Photo Credit: AP/ Mark Lennihan]]>
<![CDATA[Trump: New Proposal Will Lower Some US Drug Prices]]>Thu, 25 Oct 2018 23:22:03 -0500https://media.nbcnewyork.com/images/213*120/trumpAP_18298685465135.jpg

Less than two weeks before the midterm elections, President Donald Trump on Thursday announced a plan to lower prices for some prescription drugs, saying it would stop unfair practices that force Americans to pay much more than people in other countries for the same medications.

"We are taking aim at the global freeloading that forces American consumers to subsidize lower prices in foreign countries through higher prices in our country," Trump said in a speech at the Department of Health and Human Services.

"Same company. Same box. Same pill. Made in the exact same location, and you would go to some countries and it would be 20 percent of the cost of what we pay," said Trump, who predicted the plan will save Americans billions. "We're fixing it."

But consumers take note:

  • The plan would not apply to medicines people buy at the pharmacy, just ones administered in a doctor's office, as are many cancer medications and drugs for immune system problems. Physician-administered drugs can be very expensive, but pharmacy drugs account for the vast majority of what consumers buy.
  • Don't expect immediate rollbacks. Officials said the complex proposal could take more than a year to put into effect.

In another twist, the plan is structured as an experiment through a Medicare innovation center empowered to seek savings by the Affordable Care Act. That's the law also known as "Obamacare," which Trump is committed to repealing.

Trump has long promised sweeping action to attack drug prices, both as president and when he was running for the White House. He made his latest announcement just ahead of the Nov. 6 elections, with health care high among voters' concerns.

Under the plan, Medicare payment for drugs administered in doctors' offices would gradually shift to a level based on international prices. Prices in other countries are lower because governments directly negotiate with manufacturers.

Drugmakers immediately pushed back, arguing the plan amounts to government price-setting.

"The administration is imposing foreign price controls from countries with socialized health care systems that deny their citizens access and discourage innovation," Stephen Ubl, president of the Pharmaceutical Research and Manufacturers of America, said in a statement. "These proposals are to the detriment of American patients."

Trump is linking the prices Americans complain about to one of his longstanding grievances: foreign countries the president says are taking advantage of U.S. research breakthroughs.

Drug pricing expert Peter Bach of Memorial Sloan Kettering's Center for Health Policy and Outcomes called the plan "a pretty substantive proposal" but one that faces "serious political challenges."

"The rhetoric about finally dealing with foreign freeloading suggests that we are going to take steps to get other countries to pay their fair share for innovation," Bach added. But that's "quite literally the opposite of what is being proposed. What is being proposed is that we freeload off of other countries' ability to negotiate more effectively."

Democratic leaders on Capitol Hill were dismissive. House Minority Leader Nancy Pelosi of California said if Trump wants to save seniors money he should seek congressional approval for Medicare to negotiate prices for its main prescription drug program, "Part D." Senate Democratic Leader Chuck Schumer of New York said "it's hard to take the Trump administration and Republicans seriously about reducing health care costs for seniors two weeks before the election."

The health insurance industry, at odds with drugmakers over prices, was pleased with the administration's action.

Matt Eyles, president and CEO of America's Health Insurance Plans, said: "Drug prices are out of control, and we commend the Administration for its continued commitment to reduce drug prices."

As an experiment, the proposal would apply to half the country. Officials said they're seeking input on how to select the areas that will take part in the new pricing system. HHS Secretary Alex Azar said politics would have nothing to do with it.

In advance of Trump's speech, HHS released a report that found U.S. prices for the top drugs administered in doctors' offices are nearly twice as high as in foreign countries. The list includes many cancer drugs. Medicare pays directly for them under its "Part B" coverage for outpatient care.

Physician-administered drugs cost Medicare $27 billion in 2016. HHS says the plan would save Medicare $17.2 billion over five years. Beneficiaries would save an estimated $3.4 billion through lower cost-sharing.

The plan could meet resistance not only from drugmakers but from doctors, now paid a percentage of the cost of the medications they administer. However, HHS officials said the plan is designed so it would not cut into doctors' reimbursements.

Azar said more plans are being developed on drug costs.

"This is not the end of the road, the end of the journey," he said. "There is more coming."

Trump has harshly criticized the pharmaceutical industry, once asserting that the companies were "getting away with murder." But it's largely been business as usual for drugmakers even as Trump has predicted "massive" voluntary price cuts.

A recent Associated Press analysis of prices for brand-name drugs found far more increases than cuts in the first seven months of this year. The analysis found 96 price hikes for every price cut. The number of increases slowed somewhat and they were not quite as steep as in past years, the AP found.

The Trump administration proposal is open for public comment for 60 days.

Copyright Associated Press / NBC New York



Photo Credit: Susan Walsh/AP]]>
<![CDATA[US Approves First New Type of Flu Drug in 2 Decades]]>Wed, 24 Oct 2018 19:54:01 -0500https://media.nbcnewyork.com/images/213*120/GettyImages-72494366+edited.jpg

U.S. health regulators have approved the first new type of flu drug in two decades.

Wednesday's approval of Xofluza for people age 12 and older comes ahead of the brunt of this winter's flu season.

Xofluza is a pill that can reduce severity and shorten duration of flu symptoms after one just dose. It was developed by the Roche Group and Shionogi & Co.

It works about as well as Tamiflu, Roche's older flu treatment, which is also available in cheaper generic versions. Tamiflu is taken twice daily for five days.

Health officials have said an estimated 80,000 Americans died of flu and its complications last winter, the disease's highest death toll in at least four decades. The severe flu season increased demand for Tamiflu and led to spot shortages.

Roche's Genentech unit plans to launch Xofluza within a few weeks. It will cost $150 without insurance.

The need for only one dose is an advantage since patients don't always take all their medicine, said Dr. Mark Eisner, Genentech's head of development of infectious disease medicines.

Each year, flu typically kills about 12,000 to 56,000 Americans and up to 650,000 people worldwide.

"With thousands of people getting the flu every year, and many people becoming seriously ill, having safe and effective treatment alternatives is critical. This novel drug provides an important, additional treatment option," said U.S. Food and Drug Administration Commissioner Dr. Scott Gottlieb said in a statement.

In company testing on 1,064 people, Xofluza ended coughing, sneezing and fever, or greatly reduced symptoms, in just over two days on average. A comparison group given Tamiflu fared similarly. While Xofluza didn't work faster than Tamiflu, it did reduce the level of the virus in patients' nose and throat quicker.

Further testing is planned to determine whether Xofluza is better than Tamiflu for preventing spread of the flu to others and for treating patients at high risk for hospitalization and pneumonia, such as people with diabetes or lung disease, pregnant women, young children and the elderly.

"We think this can be important for patients, important for public health," Eisner said.

Xofluza side effects were mild -- diarrhea, nausea, headaches and bronchitis -- and occurred at about the same rate as study participants given Tamiflu or placebo pills.

Flu treatments generally work best if taken within 48 hours of symptoms beginning, and health officials encourage vaccination, preferably by the end of October. Relenza inhalers and Rapivab injections also are available for treating flu.

Xofluza, also known as baloxavir marboxil, worked against both Type A and B flu strains. The pill was initially developed by Shionogi of Japan, where it's already approved. Roche has the rights to market Xofluza everywhere but Japan and Taiwan.

Copyright Associated Press / NBC New York



Photo Credit: Getty Images (File)]]>
<![CDATA[Young People Back Single-Payer Health Care, Poll Finds]]>Wed, 24 Oct 2018 07:32:17 -0500https://media.nbcnewyork.com/images/213*120/health-care-photo.jpg

Large majorities of young Americans want to see an expansion of government services, including a single-payer health care program, according to a new poll by The Associated Press-NORC Center for Public Affairs Research and MTV.

According to the poll, 69 percent of young Americans between the ages of 15 and 34 favor a national health plan, known as a single-payer program. Eighty-eight percent of young Democrats and 40 percent of young Republicans favor a government-run health insurance program, according to the poll. Roughly two-thirds of young independents are in favor.

Young Americans called health care a very important issue in deciding how to vote. Sixty-two percent of those who will be old enough to vote in the midterms rated it as such. That's the most who said the same of any issue in the poll, including immigration and the economy.

Thirty-three-year-old Jasmine Miller, of Detroit, said that she pays $800 a month for health insurance to cover herself and her son. Miller, who describes herself as a humanitarian, said that health care is among the issues she cares about most.

"It should be a universal standard for health care," said Miller, who prefers Democrats. "If we do have to pay deductibles, at least let our premiums be lower."

Christopher Edwards, 28, of Columbia, Missouri, said health care was among the most important issues for him as he looks ahead to the midterms.

"People sometimes get sick, and sometimes medicine is what they need," said Edwards, who described himself as a moderate Democrat.

Majorities of young Americans also favor other types of expansion of government service, including free public college and trade school. Sixty-six percent of young Americans say they support free public college tuition. Seventy-nine percent of young Democrats and 39 percent of young Republicans are in favor. Among independents, 72 percent said they supported free tuition.

Younger people typically do not turn out for midterm elections in great numbers. According to the new poll, more than half of young voters say voting in the upcoming midterms is very important, but just 32 percent of those who will be old enough say they're certain to cast a ballot.

Jannette Ramirez, 27, of Winter Haven, Florida, said she would "probably" vote in November's elections, but she was unsure how much impact her vote would have.

"I can vote all day long, every day, 30 times a day and still my opinion wouldn't matter," said Ramirez, who described herself as a political moderate.

Liberal Democrats are more excited than other young people about participating in the political process, according to the poll. Seventy-six percent said they are reading and watching news about November's elections, compared with 58 percent of young Americans overall. Similarly, 71 percent of liberal young Democrats called voting in the midterms very important, compared with 54 percent of young Americans overall.

Miller, who is a tax preparer, said that while she will absolutely vote in November's election, she's frustrated by the tone of politics today.

"It's more like a big high school argument," she said.

___

The AP-NORC and MTV poll of 1,052 young Americans age 15-34 was conducted Sept. 20 to Oct. 8, 2018. The poll was conducted using NORC's probability-based AmeriSpeak panel, designed to be representative of the U.S. population. The margin of sampling error for all respondents is plus or minus 4.3 percentage points.

Copyright Associated Press / NBC New York



Photo Credit: AP]]>
<![CDATA[Health Care Prices Vary Widely Across US, Study Finds]]>Thu, 25 Oct 2018 13:15:17 -0500https://media.nbcnewyork.com/images/213*120/emergency2.jpg

A patient receiving health care services in one part of the United States could pay twice as much as a patient living elsewhere, according to a new study.

Prices were highest in San Jose and lowest in Baltimore in 2016 for privately insured patients, the Health Care Cost Institute found.

The Washington-based nonprofit group analyzed nearly 1.8 billion health insurance claims filed between 2012 and 2016. It then calculated a nationwide average for health care prices and ranked 112 metros against that average.

Although prices generally were well above average on the West Coast and the Northeast, regional patterns broke down elsewhere.

Across the Midwest, prices were below the national average in most cities, including Chicago, Indianapolis and Cleveland. But Milwaukee and Green Bay, Wis., were the fourth and fifth most expensive areas nationwide, just behind San Francisco and ahead of San Diego.

“It reinforces this idea that all health care is local,” said Bill Johnson, a senior health researcher with the institute.

There is little logic to health care prices within regions. Metros with professional fees near the national average sometimes have very high hospital prices and vice versa.

In Los Angeles, professional fees are 5 percent below the national average while prices for inpatient (hospital) stays and outpatient services (emergency room and procedures such as colonoscopies) are 28 percent and 30 percent above the national average respectively.

Green Bay has the fifth highest health costs in the nation — 14 percent above the national average. But it’s too simple to say that health care is expensive in Green Bay. Inpatient and outpatient costs are below the national average there while professional fees are 43 percent above the national average.

Kevin Kennedy, a researcher at the institute, said that examples like this “help direct attention to what the right question is to ask.”

For example, in Dayton, Ohio (health care costs 11 percent below the national average), inpatient charges are 18 percent above average. In Boston (health care costs 3 percent above the national average), professional fees are 22 percent above average. In San Jose (health care costs 65 percent above the national average), outpatient charges are a whopping 117 percent above average.

“It seems like there’s a different reason (for high costs) for every area,” Kennedy said.

“Health care isn’t one big problem,” Johnson said. “It’s a series of little problems.”

The institute plans additional reports to see how usage and competition affect the price of health care.

The group analyzed health claims data from four major insurers — Aetna, Humana, UnitedHealthcare and Kaiser Permanente — representing more than 50 million individuals.



Photo Credit: jdoms - stock.adobe.com]]>
<![CDATA[6 Kids Dead, 12 Sick in 'Severe' Viral Outbreak at NJ Center]]>Tue, 23 Oct 2018 23:45:08 -0500https://media.nbcnewyork.com/images/213*120/adenovirus+nj.png

Six children at a long-term care medical facility in New Jersey have died after a “severe outbreak” of adenovirus, a family of viruses that can cause mild illness, while 12 others have been infected, according to the state's Department of Health.

New Jersey Department of Health officials said children were recently infected with adenovirus at the Wanaque Center for Nursing and Rehabilitation in Haskell, Passaic County. The medical institution houses the Pediatric Center.

The facility has been instructed not to admit any new patients until the outbreak ends and they are in full compliance, the DOH says.

Adenoviruses are common viruses that can cause a range of illnesses, according to the Centers for Disease Control and Prevention. The viruses cause cold-like symptoms, sore throat, bronchitis, pneumonia, diarrhea, and pink eye. Adenoviruses can pose serious complications to certain people, particularly those with weakened immune systems, respiratory issues and cardiac disease.

That is the case at the Wanaque Center, health officials said. 

"Unfortunately, the particular strain of adenovirus (#7) in this outbreak is affecting medically fragile children with severely compromised immune systems," the New Jersey Department of Health in a statement. "This strain has been particularly associated with disease in communal living facilities."

According to the CDC, adenoviruses are typically spread from an infected person to others through: close personal contact such touching or shaking hands; through the air by coughing and sneezing; or by touching an object or surface with adenoviruses on it, then touching your mouth, nose, or eyes before washing your hands.

Health investigators visited the facility over the weekend as part of their probe, officials said.

The state Department of Health further said that it is monitoring the situation “very closely” and has been in contact with the staff at the center “providing guidance on infection control and cleaning procedures.”

The Wanaque Center is a for-profit facility that, according to its website, works with "with medically fragile children" from newborn to 22 years of age. The center also serves as an adult nursing home and rehabilitation center for short- and long-term care.

A spokesperson for the Wanaque Center did not respond to repeated request for comment.

New Jersey Gov. Phil Murphy issued a statement on the adenovirus outbreak saying that he is "heartbroken by the news that several children have lost their lives."

"I have been briefed by [Commissioner of Health] Dr. [Shereef] Elnahal, who has assured me that the Department of Health has recommended vital measures to enhance protections against the further spread of infection and will continue its active on-site surveillance," Murphy says in his statement. "I am confident that the steps being taken by state and local officials will minimize the impact to all those who remain at the facility, including patients and employees.”

The cause of the outbreak remains unclear.



Photo Credit: News 4 NY]]>
<![CDATA[GoFundMe Means Big Bucks for Dubious Care, Study Finds]]>Tue, 23 Oct 2018 11:44:50 -0500https://media.nbcnewyork.com/images/213*120/AP_18292524650791-Cancer-Cure-GoFundme-Video.jpg

People seeking dubious, potentially harmful treatment for cancer and other ailments raised nearly $7 million over two years from crowdfunding sites, a study found.

Echoing recent research on campaigns for stem cell therapies, the findings raise more questions about an increasingly popular way to help pay for costly, and sometimes unproven, medical care.

Soliciting money on GoFundMe and other sites eliminates doctors, hospitals, insurance companies and other "gatekeepers" that can be a barrier to expensive treatment, said lead author Dr. Ford Vox, an ethicist and brain injury expert at Shepherd Center rehabilitation hospital in Atlanta. He calls it "the democratization of economic power through social media" but says it can pose an ethical dilemma.

Online fundraising "has a big bright side" when it helps patients pay for legitimate care, he said. "Communities are really being able to rally around people in rough times. That's fantastic, but there is this very clear dark side" when treatments sought are worthless or even dangerous.

His study was published Tuesday in the Journal of the American Medical Association.

GoFundMe says campaigns for medical care are increasing and are among the most numerous on its site. They include solicitations for conventional treatment and for unproven alternative therapies.

"We always encourage people to fully research whatever it is they are raising money for and to be absolutely transparent on their GoFundMe page, so donors can make an informed decision on what they're donating to," GoFundMe said in an emailed statement.

The researchers examined campaigns posted from November 2015 through mid-December 2017, mostly on GoFundMe. They focused on five treatments sought in about 1,000 campaigns: homeopathy or naturopathy for cancer; hyperbaric oxygen for brain injuries; stem cells for brain or spinal cord injuries; and long-term antibiotics for persistent Lyme disease.

While some patients swear they've benefited from some of the treatments, there is no rigorous scientific evidence that any of them work for the conditions involved, the researchers said.

The most numerous were solicitations for homeopathy or naturopathy for cancer — 474 requests seeking more than $12 million. About one-quarter of that was raised.

Homeopathic products typically contain heavily diluted drugs, vitamins or minerals said to promote healing, although some have been found to contain toxic amounts. Naturopathy, another alternative medicine practice, sometimes uses homeopathic products, herbs and dietary supplements or body cleanses.

Michelle Drapeau has raised about $7,000 on GoFundMe for homeopathy and other alternative remedies since being diagnosed with advanced stomach cancer in February 2017. The 45-year-old investment banker from West Palm Beach, Florida, credits them with keeping her alive since she stopped chemotherapy over a year ago.

"I wanted to make sure I explored every and all options," Drapeau said. "It's vital for everyone to have that opportunity."

Dr. Leonard Lichtenfeld, the American Cancer Society's deputy chief medical officer, said it's important to consider what may drive some patients to turn to unproven remedies. U.S. health care costs are exorbitant and many patients run out of money trying to pay them.

And despite considerable progress against cancer and other illnesses, conventional treatment can't cure every patient, he noted.

"We should not be judgmental and come out and say this is terrible," Lichtenfeld said.

"No one wants to hear, 'You have cancer,' and especially no one wants to hear that there's no treatment available that can help you," he said. "You begin to understand why people may turn to unproven treatments and you can understand why others reach out to try to support them."

"What we need to do is to better inform, even better care for our patients and their families, so they don't feel this is what they need to do."

Copyright Associated Press / NBC New York



Photo Credit: Michelle Drapeau via AP]]>
<![CDATA[Honey Smacks Returns to Shelves With New Recipe After Recall]]>Tue, 23 Oct 2018 08:42:17 -0500https://media.nbcnewyork.com/images/213*120/honey-smacks.jpg

Kellogg's Honey Smacks is returning to shelves following a voluntarily recall after salmonella infected 100 people in 33 states.

The company announced on Monday the cereal will return next month in limited quantities with "a simpler, updated recipe." The company says production was moved to a "trusted and tested Kellogg-owned facility that has been reliably producing cereal for decades."

The recall was issued in June. The Centers for Disease Control and Prevention said at least 30 of the people infected in the outbreak were hospitalized.

Salmonella usually causes fever, diarrhea, nausea, vomiting and abdominal pain.

Copyright Associated Press / NBC New York



Photo Credit: Gene J. Puskar/AP, File]]>
<![CDATA[CDC Probes More Cases of Polio-Like Syndrome AFM]]>Tue, 23 Oct 2018 06:56:02 -0500https://media.nbcnewyork.com/images/213*120/GettyImages-460492806+%281%29+edited.jpg

Federal health officials now have reports of 155 possible cases of acute flaccid myelitis, a polio-like syndrome that mostly affects children and that causes muscle weakness and paralysis, federal health officials said on Monday.

The latest update from the Centers for Disease Control and Prevention shows no change in the number of confirmed cases — 62 cases in 22 states, NBC News reported. But state health departments have reported another 28 suspected cases.

The CDC urges parents to get kids to an emergency room quickly if a child has the following symptoms: difficulty moving the eyes or drooping eyelids, facial droop or weakness, difficulty with swallowing or slurred speech, or sudden arm or leg weakness.



Photo Credit: Getty Images
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<![CDATA['Obamacare' Shapes Opioid Grant Spending: Analysis]]>Mon, 22 Oct 2018 06:30:08 -0500https://media.nbcnewyork.com/images/213*120/AP_18276774517702-Opioid-Epidemic-Treatment-Dollars.jpg

With Republicans and Democrats joining forces again in a bipartisan effort to target the U.S. opioid crisis, an Associated Press analysis of the first wave of emergency money from Congress finds that states are taking very different approaches to spending it.

To a large extent, the differences depend on whether states participated in one of the most divisive issues in recent American politics: the health overhaul known as "Obamacare."

The AP analysis found states that expanded Medicaid under President Barack Obama's health overhaul reported spending their allocations more slowly than states that didn't expand the health insurance program to poor, childless adults.

Why? In states that expanded Medicaid, the insurance program already covers addiction treatment for nearly everyone who is poor and needs it.

Medicaid allows states to go beyond the basics with the grant money, while non-expansion states have to fill in for basic needs with fewer dollars, said Brendan Saloner, an addiction researcher at Johns Hopkins Bloomberg School of Public Health. In effect, Medicaid expansion states had a running start on the opioid crisis, while states without the extra Medicaid funding hastened to catch up.

"Non-expansion states are dealing with populations more likely to be uninsured and more likely to need coverage for addiction treatment," Saloner said. In contrast, states with Medicaid expansion can use the grants to create new infrastructure, "asking providers to take risks by investing in new personnel, new systems and new ways of doing things," Saloner said. "The puzzle is how to keep momentum going after the funds are gone."

The Medicaid insurance expansion gives states a head start because they have "a coordinated, reliable and consistent source of coverage" for a demographic group hit hard by addiction, said Trish Riley, executive director of the National Academy for State Health Policy. "It's not grant funded. It's not stopgap," Riley said.

"Coverage matters, period," Riley said.

Thirty-three states have expanded Medicaid, receiving enhanced federal funding to cover poor adults. Historically, Medicaid has covered a large share of all addiction treatment in the U.S., more than all private insurance combined. Medicaid covers 4 out of 10 adults under age 65 with opioid addiction.

On Election Day, voters in Idaho, Nebraska and Utah will decide whether their states should expand Medicaid. Montana voters will decide on maintaining that state's expansion.

The emergency money from Congress was part of a two-year, nearly $1 billion grant program. It was distributed according to a formula favoring states with more overdose deaths and treatment needs. California received nearly $45 million. Texas got $27.6 million. Florida got $27.2 million.

States spent the money at different paces and on different services, the AP found. In total, states used the money to provide treatment to nearly 119,000 people with opioid addiction, including nearly 3,000 pregnant women. More than 33,000 people received recovery services, such as training and housing.

In Massachusetts, with Medicaid expansion already paying for treatment, the grant goes largely toward such recovery services. Phillip Oliver, a 48-year-old who has struggled with addiction since his early teens, is training to work in the restaurant industry; his tuition is covered by the grant.

Michael Robinson, who is in recovery from heroin addiction, got a care services coordinator, a $500 benefit and a six-week training program in construction. Two months ago, the 25-year-old became a union carpenter and has been working on building projects across the Boston area since.

"It's a great thing they're doing," Robinson said. "The reason a lot of people stay getting high is they have nothing to look forward to. They don't have the jobs skills and the streets are all they know."

Tennessee, which has not expanded Medicaid, is spending its grant at a quicker pace than most other states, filling empty slots at treatment facilities that were instantly ready for more clients. One is Buffalo Valley Inc. with 14 locations around the state.

Thanks to the federal grant, Buffalo Valley is treating an additional 1,000 people a year with opioid addiction and without insurance. People like Tim Nolen, 36, of Nashville.

"I see it as a blessing," said Nolen, who after years addicted to pain pills is making progress with medication and counseling. "The biggest thing for me was, not having insurance, I could still get help and I didn't have to go bankrupt to get it."

The AP obtained the spending data via a Freedom of Information Act request filed with federal health officials.

The 12 months of spending totaled $270 million, a portion of the $1 billion Congress approved in 2016 to address opioid addiction under the 21st Century Cures Act.

To compare states, AP obtained year-end reports and analyzed actual expenditures from May 2017 through April 2018. States were required to report on money actually spent, not what they intended to spend.

In some states, structural delays — choosing contractors through competitive bidding, for example — led to less time for invoices to be submitted and paid by the end of the period. California officials said such processes and a deliberate effort to build an entirely new treatment structure explain why the state still had $41 million of its grant left after the first 12 months.

The AP analysis found:

—States that did not expand Medicaid spent $2,645 per patient on opioid addiction treatment on average. Expansion states spent $1,581 per patient for treatment.

—States that did not expand Medicaid spent $1,170 per person served on recovery support services. Expansion states spent $446 per person served on recovery.

—States that did not expand Medicaid spent 71 percent of their grant money in the first year. Expansion states spent 59 percent of their grant money. States can get permission to carry over unspent money into the next year.

Virginia and Maine were counted as non-expansion states in AP's analysis because neither state's expansion was implemented in time to affect grant spending.

Federal officials said states had some leeway in how they categorized money spent but also got some guidance. For instance, states were instructed to categorize the opioid overdose drug naloxone under the "treatment" category.

It's too early to pinpoint whether the spending may be helping solve the crisis. The Trump administration has said a recent survey shows efforts are working. Fewer people used heroin in 2017 for the first time than the previous year. Fewer were misusing or addicted to prescription opioid painkillers. And more people were getting treatment for heroin and opioid addiction. The Centers for Disease Control and Prevention has released preliminary figures that appear to show a leveling off in overdose deaths.

In the shadow of the bitter fight over Brett Kavanaugh's Supreme Court confirmation, Congress passed the bipartisan Support for Patients and Communities Act, which includes multiple provisions to address the opioid crisis and reauthorizes the Cures Act grants through 2021. President Donald Trump is expected to sign the measure.

Debbie Hillin of Buffalo Valley in Tennessee said she worries Congress won't continue the grants beyond that.

"It's an overwhelming concern. I still got people calling every day that I can't get into treatment services," Hillin said.

Associated Press writer Philip Marcelo contributed to this report.

Copyright Associated Press / NBC New York



Photo Credit: Steven Senne/AP]]>
<![CDATA[2.4M Pounds of Taquitos Recalled Over Salmonella Concern]]>Sun, 21 Oct 2018 16:46:23 -0500https://media.nbcnewyork.com/images/213*120/GettyImages-1005726022.jpg

More than 2.4 million pounds of ready-to-eat taquitos have been recalled due to possible contamination with salmonella and listeria, the Food Safety and Inspection Service announced.

The recall includes meat and poultry taquitos produced between July 1 and Oct. 10, 2018, by Ruiz Food Products, according to a Friday press release from the FSIS. The affected products are 4.5-pound cases of Go-Go Taquitos in “Beef Taco & Cheese Taquitos," “Buffalo Style Cooked Glazed Chicken Taquitos" and “Chipotle Chicken Wrapped in A Battered Flour Tortilla." The items were shipped nationwide.

There have been no confirmed reports of illness from customers eating the food. But the FSIS said people should not eat taquitos already purchased and to throw them away. The agency encouraged people to contact their healthcare providers if they are concerned.

Ruiz Food was notified on Oct. 16, 2018, that the diced onions used in the taquitos were being recalled by their supplier because of possible contamination.

Salmonella can cause diarrhea, fever and abdominal cramps. Diagnosing the illness requires a blood or stool sample, as other illnesses cause similar symptoms.

Listeria can cause diarrhea, fever and other similar foodborne illness symptoms.



Photo Credit: Getty Images/iStockphoto]]>
<![CDATA[Medicaid Expansion Becomes Key Issue in GOP-Leaning States]]>Sun, 21 Oct 2018 13:09:53 -0500https://media.nbcnewyork.com/images/213*120/AP_18290648140559.jpg

For nearly a decade, opposition to former President Barack Obama's health care law has been a winning message for Nebraska Republicans.

It's helped them win every statewide office, control the Legislature and hold all the state's congressional seats. So it was something of a surprise for Bob Tatum when he set out to ask his fellow Nebraskans if they would back a ballot initiative to expand Medicaid, one of the pillars of Obama's health overhaul.

"There seems to be a lot more support than I anticipated," said Tatum, who lives in a remote town near the Colorado border.

It took him little more than a week to gather over 100 petition signatures in Perkins County, where roughly 70 percent of the 1,963 registered voters are Republicans. Tatum, 66, also is a Republican but differs from most of his party's elected officials. He supports the Medicaid expansion because his job as an ambulance driver brings him into frequent contact with working people who can't afford insurance but earn too much to qualify for regular Medicaid.

"When I was circulating petitions, pretty much everyone signed it without objection," Tatum said. "I didn't expect that to be the case in rural Nebraska."

Nebraska isn't the only conservative state where residents are bypassing a legislature that has refused to expand Medicaid.

Voters in two other Republican-dominated states, Idaho and Utah, also will decide in November whether to expand the health insurance program to more lower-income Americans. Another ballot initiative, in Montana, seeks to raise a tobacco tax to keep funding a Medicaid expansion that is set to expire.

It also has become a focal point in numerous governor's races.

The election-year push in conservative-leaning states for one of the main aspects of Obama's health care law has surprised many Republican lawmakers after they spent years attacking it.

Most GOP lawmakers in Idaho staunchly opposed expansion efforts there and cast it as a welfare program that would deepen the state's reliance on the federal government. Supporters responded by gathering more than 75,000 petition signatures, far exceeding the minimum threshold to qualify for the ballot.

Expansion advocates launched a petition drive in Utah after continued resistance from the Republican-dominated Legislature. Utah lawmakers did expand coverage to about 6,000 of the state's neediest residents last year and approved another expansion measure with work requirements, but the federal government hasn't yet accepted that plan. Expansion advocates say it still leaves tens of thousands of people without insurance.

Other states have seen Medicaid expansion become a top issue in their governor's race, with Democratic candidates forcing Republicans to defend their opposition.

In Tennessee, Democratic contender Karl Dean argues that the state already has lost out on $4 billion in federal money by refusing to participate.

"That money is being spent in other states," Dean said in a recent debate. "We need to get our Medicaid dollars back here."

His Republican opponent, Bill Lee, noted that Tennessee had expanded its Medicaid program long before Obama was even in office, but rolled it back in 2003 to balance the budget.

"We expanded Medicaid before, and it ended up failing and it almost broke the state," he said.

Democrat Stacey Abrams is promoting expansion as a way to improve health care access in rural parts of Georgia where hospitals have closed, partly due to the expense of caring for the uninsured. Republican Brian Kemp said Abrams wants to "double down on big government programs that cost too much and fail to deliver."

Medicaid expansion also has been in the spotlight in the Florida, Kansas and Wisconsin governor's races.

About 12 million Americans have gained coverage under the expansion in the 33 states that opted for it under the Obama health care reforms. The program extends Medicaid to cover more low-income adults, including those with no children at home, and the federal government picks up most of the cost.

A government report released this past week found that lower-income people in states that did not broaden access to Medicaid were much more likely to skip needed medical care than people in states that did.

In Nebraska, Amanda Gershon is among those who went without.

As a single, childless adult, she wasn't eligible for regular Medicaid after a series of autoimmune disorders in 2013 rendered her too sick to work. The Lincoln resident remained uninsured for two years before she qualified for Social Security disability benefits that allowed her to receive coverage. Even then, the enrollment process took nine months.

Without the prescription drugs, tests and surgeries that could have helped her earlier, Gershon said she suffered needlessly and wasn't able to hold a job.

A co-sponsor of the petition drive to qualify the initiative, she said she grew frustrated with lawmakers who opposed the Medicaid expansion because none of them proposed alternatives that would have helped her.

"It's hard to understand," said Gershon, now 36. "They are there to represent the people, and it does seem like a majority of people see this as a good thing."

Kathy Campbell is among the few Republicans who were not surprised by the citizen effort to circumvent the Legislature. As a state lawmaker, she had pushed repeatedly for Medicaid expansion before being termed out of office last year.

"People want good health care policy," she said. "They're much more informed about it than you might think. I think that's why you had so many people sign the petition."

Politicians who steadfastly opposed the Medicaid expansion in Nebraska say the initiative's supporters don't understand the consequences.

"I don't believe anybody (in the Legislature) who voted against it is really opposed to helping people," said Sen. Mark Kolterman, a Republican. "But how are we going to pay for it?"

The estimated annual cost of expanding the program in Nebraska is $40 million to $69 million, roughly 1 percent of the state budget.

State Sen. John Stinner, a Republican who heads a budget committee, cited voter frustration that so many people lack health care as a driving force behind the initiative.

"Believe me, I'm frustrated with it, too," he said. "I don't want to be insensitive to people out there in that Medicaid expansion group. I just don't think this is sustainable."

If passed, the measure would add about 90,000 Nebraskans to the Medicaid rolls. Organizers with Insure the Good Life, a Nebraska group formed to back the expansion, said many of those people work in jobs with no health benefits, such as in hotels, restaurants and construction.

"Almost every single person in Nebraska probably knows somebody who's directly affected by the unaffordability of health care," said Meg Mandy, campaign manager for Insure the Good Life.

___

Associated Press writers Rebecca Boone in Boise, Idaho, Kimberlee Kruesi in Nashville, Tennessee, and Lindsay Whitehurst in Salt Lake City contributed to this article. Mulvihill reported from Cherry Hill, New Jersey.

Copyright Associated Press / NBC New York



Photo Credit: AP Photo/Nati Harnik]]>
<![CDATA[Breakfast Club Helps Former NFL Players Get Healthy Together]]>Fri, 19 Oct 2018 07:05:09 -0500https://media.nbcnewyork.com/images/213*120/Breakfast-Club-Football.jpg

Kevin Mawae played 16 seasons in the NFL, earning eight Pro Bowls and three All-Pro honors. Yet the former offensive lineman found himself struggling to walk in the summer of 2017.

With each step came stabbing pains because of severe plantar fasciitis.

The Breakfast Club came to his rescue by figuring out what caused his pain instead of focusing only on the symptoms.

"I started through the program, and it turns out for me I just got to stretch and take care of my body instead of being complacent in that area," Mawae said.

The Breakfast Club is a free six-week program for former players with at least two credited seasons at EXOS workout facilities or YMCAs, bringing them together for three workouts a week, along with physical therapy and a nutritionist. The club started in February 2015 in Arizona through The Trust, which developed out of the 2011 labor agreement following a lengthy lockout. The Trust was created to help players transition to non-football lives once their careers end.

Mawae, a former president of the NFL Players Association, joined such former players as Pittsburgh linebacker Levon Kirkland and long snapper Jason Kyle, who played for four teams, in the club session in Scottsdale, Arizona. Mawae also spent four weeks with the club this summer before reporting for fall practice in August in his new job as a quality control analyst at Arizona State for coach Herm Edwards.

The man who played center his final 14 years in the NFL had a simple issue: He never stretched.

"So to finally get from where I could barely touch my shins to where I can put my hands on the ground now in a straight-legged stretch, that's a huge accomplishment for me," Mawae said.

A nutritionist also helps each player with an individual eating plan and teaches them how to pick healthy foods when shopping. They also get a cookbook developed to assist with making better choices.

Support comes from The Trust, which assists former players with career counseling, finances and education. Connecting former players and helping them take care of their bodies is where the Breakfast Club comes in. Bahati Van Pelt, executive director of The Trust, credits former player Aaron Taylor for creating the group workout concept by asking if EXOS could provide a workout plan if he got 10 players together in San Diego.

The concept quickly grew from a couple groups to five a year, then 12, and now through expansion with about 400 former players have taken part.

The Breakfast Club has been in the Dallas area; Miami; Tampa; Birmingham, Alabama; Jacksonville, Florida; Brentwood, Tennessee; Kansas City, Missouri; and New Orleans. Van Pelt said they went to New Orleans last year because several former players reached out to Tulane, a medical partner of The Trust, when they had a large enough group for a Breakfast Club.

"Anytime we can have a player-driven, organized community that players are willing to buy into and incorporate and be active in, a part of that's a no-brainer for us," Van Pelt said.

With so many former NFL players in the Atlanta region, The Trust needed another gym option in areas without EXOS facilities. That led to the YMCA, where a free one-year membership is renewable and keeps former players working out once the club's six-week sessions end.

Former players only have to register with The Trust, which is identifying more cities to host future Breakfast Clubs. The current club started Oct. 8 in Carlsbad, California, near San Diego, with players including former offensive tackle Vaughn Parker, now 47 who played 10 of his 11 NFL seasons with the Chargers.

The biggest benefit may be recreating the locker room vibe that disappears after football. Van Pelt said they've had former players ask when the club is coming back to their towns.

"It brought back that feeling of being in the locker room, of having a workout in your position group and having an accountability partner with your wellness," Van Pelt said. "So if I don't come work out on a Monday and Wednesday, I have teammates that are going to check in on me and find out what's going on and make sure I'm there on Friday."

Getting moving again with a routine matters most for players accustomed to living by practice and meeting schedules through high school, college and the NFL.

But Mawae said no former player wants to be a statistic, and the club can help men live longer, healthier lives.

"It doesn't mean you can't have a drink every now and then, you can't indulge in sweets or candies or whatever, you can't just relax for a week. That just means you don't live a sedentary lifestyle where all your previous injuries can pile up and debilitate you," Mawae said.

"And unfortunately for a lot of the players that retire, that's exactly what happens."

Copyright Associated Press / NBC New York



Photo Credit: Gregory Bull/AP]]>
<![CDATA[Dieting Is Out, Posing a Problem as Weight Watchers Rebrands]]>Thu, 18 Oct 2018 10:16:29 -0500https://media.nbcnewyork.com/images/213*120/GettyImages-512022306.jpg

Traces of the name "Weight Watchers" have been scrubbed from the company's headquarters on Manhattan's Avenue of the Americas.

Purple letters — WW — now hang from the lobby announcing the $4.6 billion diet giant's new name that it unveiled in September along with its purpose: "We inspire healthy habits for real life. For people, families, communities, the world — for everyone."

The cosmetic changes are the final touches on the 55-year-old company's new plan: Sell wellness instead of weight loss to its 4.5 million subscribers.

CEO Mindy Grossman, who took the helm last summer, is tasked with maintaining a balance between WW's status as a weight-loss leader while trying to attract new subscribers who don't want to lose weight. She also has to persuade existing members to stay after reaching their goal.

Weight Watchers had weathered threats over the decades from the likes of Jenny Craig, Nutrisystem and fad diets like Atkins. But its biggest competition in recent years hasn't been from any of its rivals, and it was coming from all directions.

Free apps like MyFitnessPal allowed consumers to track their calories without committing to a diet. People started to give up processed foods and grains in favor of cleaner, gluten-free options. Members stopped coming to meetings. Its revenue, which climbed almost every year since its 2001 IPO, peaked in 2012 at $1.83 billion, according to data compiled by FactSet. Its sales hit decade-lows of about $1.16 billion in 2015 and 2016 before starting to rebound under Grossman's watch last year.

Investors lost confidence in 2015 after its membership, which accounts for about 80 percent of its annual revenue, slid almost 20 percent during the post-Thanksgiving period, its biggest diet season of the year. Its first-quarter numbers in 2015 showed that it lost about 700,000 members over the year, from 3.6 million in the beginning of 2014 to 2.9 million. Its stock hit $3.67 a share, an all-time intraday low, on July 7, 2015.

People wanted to eat healthier but didn't want to diet. For a company named Weight Watchers, that posed a problem.

Weight Watchers tapped Oprah Winfrey in 2015 as an advisor. It added flexible meal plans and overhauled its digital app, among other changes. Last spring, it hired Grossman. A "friend of Oprah," she had proven she could modernize a legacy brand at the Home Shopping Network. She also had successful runs as a top executive at Ralph Lauren and Nike.

Wellness cruises

The company already had been inching closer toward becoming a lifestyle brand over the previous few years.

But the 61-year-old Grossman is extending its new wellness mantra into everything the company does: wellness-themed Caribbean cruises, cookware and removing artificial sweeteners from its line of snacks. It's adding a rewards system with WW swag and prizes from trendy names like Rent the Runway and ClassPass to keep people engaged.

So far, these changes are paying off. More people are subscribing to WW now than ever before and they're staying with the program longer. Wall Street has rewarded the company, sending its stock price to a record intraday high of $105.73 on June 20. Its shares have tumbled to $68 a share since then, but the stock is still up by more than 50 percent this year, and the company has a market value of $4.5 billion.

"Everything we try and do, I try to look through the lens of we need to be surprising yet familiar," Grossman told CNBC in an interview this month at WW's headquarters. "We will never not celebrate and believe that our heritage and everything we do is important. So we're not going to take a sharp left, but we have to be relevant. We have to understand that people need different things."

Executives are targeting $2 billion in annual revenue by the end of 2020. Last year, revenue reached $1.31 billion, up 12.2 percent from $1.16 billion in 2016. They want to add new members and improve retention to fuel the growth.

WW needs to keep the momentum alive to convince shareholders it can achieve these goals.

Investors quickly soured in August when the company said the number of subscribers slipped to 4.5 million at the end of June from 4.6 million three months before. The company's shares fell nearly 15 percent. Some members want Weight Watchers to stick to weight-loss programs.

Keeping it off

Few companies have changed so many lives in such profound ways as Weight Watchers.

It's hard to pinpoint how many members the company has served since Jean Nidetch founded it in 1963 because millions of people have cycled in and out of the program.

The points system has made it easy for people to evaluate how nutritious foods are since being formally introduced in 1997 as the "1-2-3 Success Plan." The company has tweaked the system over the years as science has evolved and consumers have demanded more flexibility, but it's still the cornerstone of the program.

So is the sense of community that Nidetch built Weight Watchers on. Members can attend in-person meetings where they weigh themselves and discuss problem issues, such as strategies for handling the food-temptation-filled holidays like Thanksgiving. Members can also opt for the online-only program where they can track foods on the app and connect with other members there, too.

One of Weight Watchers' struggles has been that while people lose weight on the program, they tend to gain it back.

"This is a universal challenge that people generally speaking are much more successful in achieving initial weight loss than maintaining weight loss," said Dr. Kevin Volpp, a professor of medicine at the University of Pennsylvania and director of the Center for Health Incentives and Behavioral Economics. "I think a lot of people get frustrated and move on to something else."

Michael Schildt, 48, has tried Weight Watchers five or six times over the past 20 years. He said he would lose weight, the most being 125 pounds in 1998, then get bored.

First he would become less vigilant in monitoring what foods he was eating. Then the portion sizes. Then he would stop losing weight. Then he would gain a pound or 2, a dreaded experience that would cause him and countless other members to skip in-person meetings so they would not have to step on the scale.

Earlier this year, Schildt rejoined WW. Now about eight weeks in, he said he's lost 57 pounds, down to 434.5 pounds from 491.5 pounds. This time, he's determined to stick with the program.

"People take it for granted to just go to the supermarket," he said. "I need two knee replacements, and seven weeks ago, I couldn't walk into the grocery store. I would walk 20 feet, and I was in so much pain I had to turn around. I went into Whole Foods just now to buy some fruit, and I can actually go into stores and walk around."

WW wants Schildt and its millions of other members to stay around this time. A key component of the company's new strategy is to become a lifetime health partner rather than a diet.

WellnessWins

Turnover can be costly to the business. WW has improved its member retention to "well over nine months," a 15 percent increase from three years ago, Chief Financial Officer Nicholas Hotchkin told analysts on a call discussing its second-quarter earnings results. Grossman wants that to one day be measured in years, not months.

WW recently introduced WellnessWins, a program that rewards members for engaging with the app, whether that's tracking the food they eat or the activity they've completed.

"To be able to do that, we have to keep providing more and more value, more and more tools, more and more community and support so people feel that we are a really key component in having what they consider their success to be. We don't dictate that. They do," Grossman said.

Since joining the WW board in 2015, Winfrey has appeared in ads promoting WW as a lifestyle, not a diet. It's a striking shift for the company and Winfrey, who has publicly struggled with her weight for years.

"Healthy is the new skinny," Winfrey, spokeswoman and investor, proclaimed on stage at a WW event unveiling its new vision in February.

With WW's new tagline, "wellness that works" the company is pinning weight loss to overall health, not dress size. Grossman says WW will never abdicate its status as the leader in weight loss, but it wants to be more than that.

WW is adding meditation content from Headspace to its own app. Members can access free fitness activities like entry to rock 'n' roll marathons and fitness classes from ClassPass as part of the new WellnessWins program.

Artificial sweeteners, flavors, colors and preservatives will be removed from WW's meal replacements and snacks.

Workshops over meetings

Even meetings, the bedrock of WW, are changing. They'll now be called workshops. Leaders are coaches. Receptionists are guides. The actual content will change, too. Executives declined to describe what those changes will look like, but they hinted at making them more interactive and to focus on other aspects of health in addition to weight.

One Saturday morning in October, Schildt attended a workshop where the group discussed tai chi and other breathing exercises. That was new to him. He said meetings typically had focused on weight loss or exercise.

"In general, the weight-loss industry has gone toward a more holistic approach to weight loss," said Linda Bolton Weiser, an analyst at D.A. Davidson & Co. "My theory is this is positive for the industry because it gives women permission to spend money on a weight-loss brand."

More people are signing up for less expensive digital memberships, which Bolton Weiser said may dampen the revenue but has helped WW improve its gross margin.

Of the total 4.5 million current subscribers, 1.6 million attend in-person meetings for about $45 a month while 2.9 million have access only to online features for about $20 a month. But it costs less to run an app than the meetings, and the savings have shown up in its profit margins. Last year, WW's gross profit margin increased to 53 percent, up from 50.3 percent in 2016.

Partying WW style

A group of women snapped pictures holding pillows flecked with white, gold and purple sequins spelling the letters WW at a party in Brooklyn on Oct. 4. More women took turns posing for photos in front of a wall of red, orange, yellow and white lights pointing to a bright circle surrounding the letters WW.

If someone had unknowingly walked in, they might not realize this party was for Weight Watchers — at least until they saw servers carrying hors d'oeuvres with signs displaying their point values. A slice of avocado toast with watermelon, radish, lime, cilantro and 12-grain toast equaled 4 points. A vodka and tonic from the bar? Six points.

Here at the Barclays Center in Brooklyn, executives were celebrating Weight Watchers' transformation into WW. The party was built for Instagram. Bruno Mars, the night's headliner, was the ideal person to celebrate a 55-year-old company trying to balance decades of history with its quest to attract newer, younger members.

Grossman recognizes the challenge. She joined the company after helping turn around the Home Shopping Network. Similar to Weight Watchers, the channel shortened its name to HSN.

It's too early to tell whether the company can convince people this brand is different than the one they tried decades ago or the one they grew up watching their parents use.

"They have to do physical things that show this is something deeper than a name change," said Oliver Hahl, assistant professor of organizational theory and strategy at Carnegie Mellon University's Tepper School of Business. "Will this be enough to fully embrace weight as wellness and not just weight for weight's sake?"

Some members aren't entirely sold.

Wayne Muhlstein has been a Weight Watchers member since 1968. Then 13, his parents sent him to a meeting because they didn't want him looking "chubby" in his bar mitzvah pictures. In 1984, he became a leader and taught for "31 wonderful years" before retiring in 2015.

Muhlstein praises the company for enduring all these years but cautions WW against moving too far away from weight loss.

"If I want yoga, I go to my yoga studio," he said. "If I want a massage, I go to a massage therapist. If I need a shrink, I go to a shrink. If I want to lose weight, I go to Weight Watchers. And there's nothing wrong with that."

At the party, Grossman put on a captain's hat and smiled for pictures in front of a green screen promoting WW cruises. She sat and watched celebrity chef Cat Cora tell the crowd about creating a menu for the new cafe.

Grossman admired the wall behind Cora decorated with posters of WW spokespeople, including Winfrey. She smiled softly and turned her attention back to the moment.

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

 



Photo Credit: Michael Nagle/Bloomberg via Getty Images, File
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<![CDATA[Despite the Science, Cities Are Removing Fluoride From Water]]>Wed, 17 Oct 2018 06:36:50 -0500https://media.nbcnewyork.com/images/214*120/140806786-Faucet-bathroom.jpg

Fluoride prevents cavities and tooth decay, something confirmed by numerous studies, yet a small but vocal minority has gotten dozens of cities to remove the naturally occurring compound from the water supply, NBC News reported.

"Anti-fluoridationists" blame fluoride for lower IQs and diseases, despite long-established science. The American Dental Association says that 74 cities have voted to remove fluoride from their drinking water in the last five years, and proposed bans are on the ballot in two more cities this November.

"You cannot tailor public health to the whims of a small group of people," said Dr. Johnny Johnson, a retired pediatric dentist who leads the nonprofit American Fluoridation Society. "If you are doing that, you are harming a large group of people."

While nearly 75 percent of the United States gets fluoridated water, more than 80 percent of New Jersey residents do not, and the Texas Republican Party now opposes water fluoridation as well.



Photo Credit: Getty Images/iStockphoto, File]]>
<![CDATA[Cases of Mysterious Paralyzing Illness Reported in 22 States]]>Tue, 16 Oct 2018 17:57:55 -0500https://media.nbcnewyork.com/images/213*120/generic-doctor1.jpg

U.S. health officials on Tuesday reported a jump in cases of a rare paralyzing illness in children, and said it seems to be following an every-other-year pattern.

At least 62 cases have been confirmed in 22 states this year, and at least 65 additional illnesses in those states are being investigated, according to the Centers for Disease Control and Prevention. Similar waves of the same illness occurred in 2014 and 2016.

NBC News did its own unofficial survey of state health officials, finding 87 confirmed or suspected cases in 26 states. 

CDC officials say they haven't found the cause. Some possible suspects, such as polio and West Nile virus, have been ruled out. Another kind of virus is suspected, but it's been found in only some of the cases.

"This is a mystery so far," the CDC's Dr. Nancy Messonnier said in a call Tuesday with reporters.

About 90 percent of the cases are children who have suffered muscle weakness or paralysis, including in the face, neck, back or limbs. The symptoms tend to occur about a week after they had a fever and respiratory illness.

It is "a pretty dramatic disease," but fortunately most kids recover, Messonnier said.

Health officials call the condition acute flaccid myelitis. The CDC would not release a list of the states reporting probable or confirmed cases. But some states have previously announced clusters, including Minnesota, Illinois, Colorado, New York and Washington.

The cases in 2014 and 2016 were partly attributed to particular strains of respiratory germs called enteroviruses, which spread the most in the summer and fall.

Most people infected with enteroviruses suffer only minor symptoms like cough and runny nose. And though enteroviruses have been detected in some paralysis cases, it hasn't been found in others, CDC officials say.

Lacking an established cause, health officials confirm cases through a review of brain scans and symptoms.

About 120 confirmed cases were reported in 2014. Another 149 were reported in 2016. In 2015 and 2017, the counts of reported illnesses were far lower.

The cases this year seem to be spread across much of the country, as were the earlier two waves. But mysteriously no other country has reported the emerging every-two-years pattern seen in the U.S., Messonnier said.

___

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

Copyright Associated Press / NBC New York



Photo Credit: AP]]>
<![CDATA[Miami Police to Offer Opioid Addicts Rehab Instead of Jail]]>Tue, 16 Oct 2018 11:49:33 -0500https://media.nbcnewyork.com/images/213*120/cms1302.jpg

Officials in Miami are hoping police officers will be able to steer opioid addicts into to treatment rather than jail.

A plan announced Monday will offer addicts an opportunity to go into rehabilitation. The Miami Herald reports Miami police will use $1.6 million in federal grants to develop a pre-arrest diversion program where people with small amounts of opioids can enter a one-year outpatient treatment program.

They are working with Jackson Behavioral Health Hospital, the South Florida Behavioral Health Network, the University of Miami Health system and other agencies to develop the program.

The plan includes anti-addiction medication, social services, mental health counseling and general medical care.

Dr. Patricia Ares-Romero of the Behavioral Health Hospital says the program could treat about 100 people over the three-year life of the grant.

"This will serve as a potentially life-saving resource for those who need it most," City of Miami Mayor Francis Suarez wrote in a tweet announcing the program.

The U.S. Centers for Disease Control and Prevention estimated that drug overdoses killed a record 72,300 Americans in 2017, about 10 percent more than in 2016. The majority of the deaths involved opioids. But a growing number of them are from illicit synthetic drugs, including fentanyl, rather than prescription opioids such as OxyContin or Vicodin.

A Florida Department of Law Enforcement report found opioids were identified as either the cause of death or were present in the decedent's system in 3,037 cases between January and June in 2017, a 20 percent increase from the same time period in 2016. The figures for the second half of 2017 are still being compiled.

Copyright Associated Press / NBC New York



Photo Credit: Getty Images/Cultura RF]]>
<![CDATA['Patients Deserve to Know': US Wants Drug Prices in TV Ads]]>Tue, 16 Oct 2018 03:42:59 -0500https://media.nbcnewyork.com/images/213*120/drugpricesAP_18288613969544.jpg

The federal government said Monday that it wants to force drugmakers to disclose prices for prescription medicines in their TV commercials.

The drug industry's main trade group said drug companies are only willing to disclose the prices on their websites, not in commercials, and they'll start doing that next spring.

Health and Human Services Secretary Alex Azar unveiled a proposal that would apply to all brand-name drugs covered by the Medicare and Medicaid programs, which is most medicines.

"Patients deserve to know what a given drug could cost when they're being told about the benefits and risks it may have," Azar said in prepared remarks. "They deserve to know if the drug company has pushed their prices to abusive levels. And they deserve to know this every time they see a drug advertised to them on TV."

Most Americans don't pay the full price for prescriptions — one reason drugmakers have opposed disclosing the list prices, arguing that would just confuse the public. But insurance plans base their copayments on the list price set by drugmakers. And patients with high-deductibles plans or no insurance sometimes pay full price.

President Trump has long promised to bring down drug prices, and in May, his administration released a "blueprint" with vague proposals for doing so, including exploring listing prices in TV commercials.

Hours before Azar's announcement, the trade group Pharmaceutical Research and Manufacturers of America, known as PhRMA, said its 33 member companies agreed to include in commercials a website that would give the drug's list price, the range of likely out-of-pocket costs and any available financial assistance. The group also plans its own website, where patients could look up drugs by name and find similar information.

"We appreciate their effort," Azar said. "But placing information on a website is not the same as putting it right in an ad."

PhRMA CEO Stephen J. Ubl and others in the trade group said they believe requiring list prices in ads would violate the companies' First Amendment free speech rights. But Azar, speaking at a National Academy of Medicine conference, said there is precedence for such a move, pointing out that federal law requires automakers to disclose sticker prices for cars.

Direct-to-consumer advertising of drugs has been allowed in the U.S. for two decades. Ads are required to list side effects but not prices.

Many details of the proposed rule still must be worked out, including whether it should be expanded to cover radio, print or internet ads. According to the proposal, TV commercials would have to state in legible type the list price set by the manufacturer for all drugs costing more than $35 per month or for a standard course of treatment, such as for an antibiotic.

If the rule is adopted after a 60-day public comment period, Azar's department plans to publicize the names of drugmakers that don't comply and could take legal action against them.

Drugmakers generally can charge as much as the U.S. market will bear because the government doesn't regulate medicine prices, unlike most other developed countries.

List prices have long been closely guarded, and those prices are the starting point for drugmakers' price negotiations with middlemen, such as insurance companies and prescription benefit managers.

According to the government, the list prices for the top 10 prescription medicines advertised on TV range from $535 to $11,000 for a month or course of treatment.

Pfizer's heavily advertised nerve pain drug Lyrica has a monthly list price of $669. Humira, AbbVie's treatment for immune system disorders like rheumatoid arthritis, has a list price of $4,872 per monthly injection. Both have nearly doubled in four years.

Patients for Affordable Drugs, an advocacy group funded by foundations, called PhRMA's website choice "a transparent attempt to pre-empt full disclosure of list prices in ads," adding that it doesn't think disclosing list prices will reduce patients' costs. 

Copyright Associated Press / NBC New York



Photo Credit: Julio Cortez/AP, File ]]>
<![CDATA[Virtual Reality Simulation Shows What It's Like to Die]]>Sat, 13 Oct 2018 03:36:05 -0500https://media.nbcnewyork.com/images/213*120/BOST_000000018887814.JPG

A new virtual reality simulation is helping hospice workers and medical students see what it's like to die.

An end-of-life simulation by Embodied Labs is now educating staff and students at the Gosnell Memorial Hospice House in Scarborough, Maine. It's also a required experience for medical students at the University of New England. Grant money awarded to UNE paid for the simulation technology.

"It was amazing," said Hospice of Southern Maine CEO Daryl Cady. "I was pretty skeptical in the beginning. It's very unique and very emotional as it's happening."

The simulation lasts about 30 minutes and follows a cancer patient named Clay. The participant sees how Clay is struggling to have conversations with his family, suffers a fall and ends up in the E.R., and eventually transitions into hospice care. The experience shows how his skin changes and senses dull.

"His eye sight gets really dim as the end of life process is coming to a close," said hospice nurse Kate Henderson. "That was a little bit surreal."

Second-year UNE medical student Victoria Nguyen thought the simulation was very moving.

"Just seeing the family hit hard," she said. "It's definitely really emotional." She now wants to study old age with gerontology and thinks she may want to work in the hospice field.

"Everyone dies," she said. "I think making it easier is what is going to help the most."

Cady said the module will help staff empathize with their patients, and provide emotional support for their family members. When they build a new facility, Hospice of Southern Maine plans to have a simulation center where more staff and members of the community can experience the virtual reality.

"It's difficult to have conversations about end of life," Cady said. "This is an opportunity to learn about it before they really need us."



Photo Credit: necn]]>
<![CDATA[Texas Child Hospitalized After Venomous Caterpillar Sting]]>Sat, 13 Oct 2018 02:22:52 -0500https://media.nbcnewyork.com/images/213*120/caterpiller-kid-new.jpg

Lauren Chambers didn’t know what to think when she received a call from her daughters’ daycare that 5-year-old Adrie couldn’t move her arm after getting stung by a caterpillar.

“They said that she had been stung by the most poisonous caterpillar in the United States,” said Chambers.

Daycare workers believe the woolly looking caterpillar fell from a tree above Adrie as she was playing outside.

“It was burning,” said Adrie.

After she told them it felt like it was stuck in her arm, they did a quick search to learn it was a Southern Flannel Moth Caterpillar or an asp with venomous spines buried beneath its hair.

“How does that happen? We have those here in Texas? I mean I never even heard of those before yesterday,” said Chambers.

Michael Merchant, an entomologist with Texas A&M University says they’ve received more calls about the bugs this year though they don’t know why.

“They’re common on a lot of trees and plants we have in North Texas… on oaks, yaupons, even rose bushes,” said Michael Merchant.

He said it’s a series of spines hidden below the caterpillar’s distinctive hair that are filled with venom and responsible for the painful sting that can last up to 12 hours.

“Different people react in different ways, feeling pain in different parts of the body. I had one friend who actually felt like he was having some heart trouble or something after he got stung. So it’s not a pleasant experience,” said Merchant.

Adrie’s bite led to pain, swelling and an upset stomach. But had her teachers not thought to quickly remove the spines from her arm with tape, doctors tell Chambers it could’ve been much worse.

“They said if that had not happened it could actually cause her whole body to go numb and start shutting down,” said Chambers.

According to Merchant, the caterpillars should start to disappear in the next couple of weeks as they prepare their cocoons for winter. Once they hatch as moths in the spring, he says they’re no longer have their harmful spines.



Photo Credit: NBC 5 News]]>
<![CDATA[NBC New York and Hackensack Meridian Health Launch the Health Hub]]>Wed, 17 Oct 2018 10:40:00 -0500https://media.nbcnewyork.com/images/213*120/announcement-hackensack.jpg

The following content is created in consultation with Hackensack Meridian Health. It does not reflect the work or opinions of NBC New York’s editorial staff. Click here to learn about Hackensack Meridian Health.

In the coming months, Hackensack Meridian Health experts will be sharing exclusive health and wellness tips as featured guests on NBC programming including Sports Final and New York Live. You will also have a chance to hear from Hackensack Meridian Health experts during Facebook Live sessions covering important health topics for you and your family.

Hackensack Meridian Health is committed to providing our community with a range of resources to keep you on a GamePlan for Health. Please click here to download your personalized GamePlan containing recommended health screenings, exercise regimens, nutritional tips and more.

Hackensack Meridian Health’s Health Hub offers the latest health and wellness news from expert physicians throughout our health network. The Health Hub is continuously updated with helpful wellness tips, nutritional advice, testimonials and other resources to keep you on your health journey.

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<![CDATA[NYC Hospital Creates Life-Saving Spotify Playlist ]]>Thu, 11 Oct 2018 12:09:30 -0500https://media.nbcnewyork.com/images/213*120/CPR+training.jpg

Perhaps you’re familiar with the rumor that humming “Stayin’ Alive” while doing chest compressions is the best way to perform CPR on someone. Some of you might even remember when Michael Scott memorably sang the Bee Gees’ hit when learning CPR with his co-workers on "The Office."

While chaos ensued in the rest of that episode, this CPR secret can still be beneficial to incorporate in everyday life, and New York-Presbyterian Hospital is here to help you do that.

The top-ranked NYPH created a Spotify playlist and shared it via Twitter to help raise awareness about effective CPR, and help everyday individuals easily remember how to time chest compressions.

"Only about 46 percent of cardiac arrest victims receive bystander intervention before EMS arrives and women are even less likely to receive intervention," Lauren Browdy, a spokesperson from NYPH, says. "But for every minute without CPR, the survival rate decreases by 10 percent."

Although released last March as part of a #HandsOnlyCPR campaign, the playlist has recently gained traction and has been increasingly shared throughout Twitter within the last few days. The NYPH staff, and specifically Dr. Holly Andersen, a cardiologist, have worked hard to raise more awareness on bystander CPR, and believe this playlist helps make situations like that less scary so that bystanders are more likely, and able to jump in and help.

"Dr. Holly Anderson has been advocating for everyone to learn Hands Only CPR with three easy steps: Check, Call, Compress," Browdy says. "Her goal is to teach everyone to not be afraid to jump in.'

Comprised of 40 songs at 100 BPM, each track consists of the optimum beat to time CPR compressions, so that 100 chest compressions are done per minute.

With songs like “Dancing Queen” by ABBA and “Spirit In The Sky” by Norman Greenbaum, to current hits like “Sorry” by Justin Bieber and “Closer” by The Chainsmokers, there’s a song for everyone to learn how to effectively and simply save a life in a time of need.

Check out the rest of the tracks here, and check out more about the Hands Only CPR campaign here, which has instructional videos so you can learn at home.



Photo Credit: Getty Images]]>
<![CDATA[Toxic Metal Cadmium Found in National Chain Stores' Jewelry]]>Thu, 11 Oct 2018 09:48:39 -0500https://media.nbcnewyork.com/images/213*120/jewelryAP_18268701424191.jpg

Jewelry with the toxic metal cadmium is showing up on the shelves of national retailers including Ross, Nordstrom Rack and Papaya, according to newly released test results.

Analysis done for the nonprofit Center for Environmental Health revealed some jewelry sold with women's dresses and shirts was nearly pure cadmium, which can cause cancer and reproductive harm after prolonged exposure.

Consumer advocates were hopeful cadmium had disappeared from the U.S. jewelry market following changes prompted by a 2010 Associated Press investigation that found Chinese manufacturers were using the metal to make kids' jewelry. States including California outlawed cadmium in children's jewelry, and testing by the center found the chemical had virtually disappeared from jewelry by 2012.

No laws address cadmium in adult jewelry, however, and last year the center decided to check those products. Lab testing found 31 adult jewelry items purchased from retail stores were at least 40 percent cadmium, and most were more than 90 percent, according to results shared exclusively with the AP.

California's law allows no more than 0.03 percent cadmium in children's jewelry. The precise health risk from the tested jewelry is unclear because researchers did not assess whether small amounts shed when the jewelry is handled and worn.

Over time, cadmium accumulates in the body and can damage the kidneys and bones. Most exposure happens by ingesting small amounts or by breathing it, most commonly through tobacco, which can contain cadmium. Researchers also have documented some absorption through skin contact, though the phenomenon is not well-studied.

Michael Harbut, a practicing doctor who as a university professor has researched cadmium's cancer-causing properties, noted that contact can trigger skin rashes including psoriasis.

"Cadmium is bad," said Harbut, who teaches at Michigan State University's College of Human Medicine. "Given a choice between wearing something with cadmium in it, or wearing something without cadmium in it, I would take the product without cadmium."

The Oakland-based nonprofit bought all the test samples in the San Francisco Bay Area this year or last. The extent to which contaminated jewelry is in stores elsewhere isn't clear, though a national retailer would not typically limit a product to just one region.

The center said the problem should not be underestimated because of the limited market sampling.

"If you're the person that buys and is wearing that jewelry, you don't really care whether it's a common problem or a rare problem," said Caroline Cox, senior scientist at the center. "You have a problem."

Brent Cleaveland, executive director of the Fashion Jewelry and Accessories Trade Association, said he does not believe the test results suggest a larger problem. Most major retailers have a stringent system for testing and analyzing what they sell, he said.

Most of the tainted items were sold at Ross, which operates more than 1,400 stores in 38 states. One pendant from a necklace chain was 100 percent cadmium, according to the testing.

In a written statement, Ross said it is committed to protecting its customers and has "addressed this issue with our supplier." The retailer would not say whether it pulled suspect jewelry from stores.

The brands found with high cadmium levels in Ross stores include Tacera and Vibe Sportswear.

Xinwei Xie, chief executive officer at Trend Textile Inc., which owns Tacera, declined to comment when reached by phone. The Skate Group Inc., which owns Vibe Sportswear, did not respond to multiple requests for comment.

Papaya said it considers cadmium in its products a serious problem. It operates more than 100 retail locations nationwide.

Steven Kim, an attorney representing Papaya, said the company has recalled the products where contamination was found and stopped buying from the manufacturer in China.

"Our manufacturers are required to represent and warrant that their products are in legal compliance," Kim said. "Papaya is very strict and stops doing business with any manufacturer which fails to comply."

Nordstrom spokeswoman Emily Sterken said the company is "reaching out to these vendors to make them aware of the situation and get more information on these items."

The Center for Environmental Health has long used California law to force companies to reduce levels of harmful materials in consumer products, including cadmium and lead in jewelry.

Under the state's Proposition 65, businesses must inform consumers about significant exposures to chemicals that cause cancer or other reproductive harm. The nonprofit has settled Proposition 65 claims against 36 companies, including Gap Inc. and Target Corp., which agreed to not sell jewelry with more than 0.03 percent cadmium.

That limit for children's jewelry took effect after the AP reported in 2010 that some Chinese jewelry manufacturers were substituting cadmium for lead, the use of which Congress clamped down on following a string of imported-product safety scandals.

The jewelry industry helped write voluntary U.S. standards following the AP investigation, but the U.S. Consumer Product Safety Commission did not mandate any cadmium limits.

Associated Press writer Justin Pritchard contributed to this report.

Copyright Associated Press / NBC New York



Photo Credit: Center for Environmental Health via AP]]>
<![CDATA[When Pumpkin Spice is Not So Nice]]>Wed, 10 Oct 2018 13:44:34 -0500https://media.nbcnewyork.com/images/213*120/When_Pumpkin_Spice_is_Not_So_Nice_OUT-153919065893900002.jpg

An expert warns that pumpkin spice flavoring is nowhere near as healthy as pumpkin itself.]]>
<![CDATA[DOJ Approves $69B CVS Health-Aetna Merger, With Conditions]]>Wed, 10 Oct 2018 10:33:23 -0500https://media.nbcnewyork.com/images/213*120/AP_Aetna_18283545667050.jpg

The proposed $69 billion merger between CVS Health and Aetna is getting a greenlight from the Department of Justice, with some conditions.

The Justice Department on Wednesday approved the deal on the condition that Aetna moves ahead with its plan to sell its Medicare Part D prescription drug plan business, resolving some anti-monopoly issues.

Aetna announced last month it'd sell the business for an undisclosed amount.

CVS announced plans to buy Hartford, Connecticut's Aetna late last year. The deal is expected to give the Woonsocket, Rhode Island, drugstore chain a bigger role in health care, with the companies combining to manage care through CVS stores, clinics and prescription drugs.

Copyright Associated Press / NBC New York



Photo Credit: Bill Sikes/AP, File]]>
<![CDATA[Texas Baby Who Underwent Surgery While in Womb Is Doing 'Great': Mom]]>Wed, 10 Oct 2018 17:37:54 -0500https://media.nbcnewyork.com/images/213*120/Fetal+Surgery+100818.jpg

At 19 weeks pregnant, Sarah Prowell learned her unborn son had spina bifida. 

Spina bifida is a birth defect caused when the spine and spinal cord do not form properly, in many cases leaving a portion of the spine exposed. 

Without medical intervention, the condition causes differing levels of disability, which can include paralysis and lifelong bladder issues.

The Terrell mom was referred to Dr. Timothy Crombleholme, director of the newly opened Fetal Care Center at Medical City Children's Hospital in Dallas.

"The open fetal surgery opens up the opportunity for us to intervene at a time when things are not irreparable. We can intervene and save the baby's life or prevent unknown injury to the baby's organs," Crombleholme said.

Prior to Crombleholme's arrival to North Texas earlier this year, families of babies diagnosed with the most common and severe form of spina bifida, called myelomeningocele, had to travel elsewhere for open fetal surgery.

Because spinal cord damage is progressive during gestation, prenatal repair of myelomeningocele may prevent further damage.

"A few years ago, if they came to our practice with this spina bifida problem, they would have had to travel to the east coast, Houston or the west coast to have this surgery," said Dr. Kevin Magee, maternal and fetal medicine at Medical City Children's Hospital.

Crombleholme is one of only a handful of surgeons nationwide qualified to perform open fetal surgery and he is widely recognized for his skill and successful surgical outcomes. 

Baby Uriah became his first North Texas patient on June 25, 2018. Now, at almost two months old, Uriah is kicking his legs, signaling early success from leading-edge surgery for spina bifida. 

"He will have lifelong difficulties, but it's not going to slow him down," Uriah's father, Sean Kirby, said.

"He's doing so good, better than we thought he'd be," Sarah Prowell said. "I think he'll be very determined. I think he will impress us and everyone else, like he has so far."

You can follow his progress here.

Fetal surgery for spina bifida is not a cure, but studies show that it repair can lead to better results than traditional repair surgery after a child is born. 

The surgery greatly reduces the need to divert fluid from the brain, improves mobility and improves the chances that a child will be able to walk independently, doctors said.



Photo Credit: NBC 5 News]]>
<![CDATA[Rare, Polio-Like Condition Appears in US Again]]>Tue, 09 Oct 2018 18:20:10 -0500https://media.nbcnewyork.com/images/213*120/GettyImages-685025333.jpg

A puzzling condition that causes partial paralysis in children is back on the uptick in parts of the U.S., with six cases under investigation in Minnesota and 14 reported in Colorado, health officials said Monday.

The children have acute flaccid myelitis or AFM, a weakening of the nerves that resembles polio. It was first widely recognized in 2014, when 120 children were diagnosed, NBC News reported.

So far this year, the Centers for Disease Control and Prevention says there have been 38 confirmed cases of the polio-like condition across 16 states.



Photo Credit: Kateryna Kon/Getty Images/Science Photo Libra]]>
<![CDATA[LaCroix Faces Suit Alleging It's Mislabeled as 'Natural']]>Sat, 06 Oct 2018 12:06:17 -0500https://media.nbcnewyork.com/images/213*120/lacroixGettyImages-614915466.jpg

Popular sparkling water company LaCroix is facing a lawsuit that alleges its products are mislabeled as "all-natural," and the allegations are weighing on the shares of its parent company National Beverage.

The lawsuit, filed in a Cook County, Illinois, circuit court, claims that LaCroix contains ethyl butanoate, limonene, linalool and linalool propionate — ingredients it says are non-natural and synthetic compounds. Linalool is an aromatic oil often found in cockroach insecticide, and many of the reports about the suit have touted this fact.

The suit also says limonene is known to cause kidney toxicity and tumors, while linalool propionate is used to treat cancer.

However, a report in Popular Science raises doubts about the claims that the chemicals technically qualify as synthetic or dangerous. The report says limonene is a "naturally occurring chemical" and a "major component of oil extracted from citrus peels." It is commonly used to give food a lemony flavor and fragrance, according to Popular Science.

Linalool and linalool propionate (also known as linalyl propionate) are also naturally occurring and derived from plants. Although linalool is used in insecticides, that doesn't mean it's poisonous to humans, according to Popular Science. Their report claims the only real risk to humans is a mild skin or eye irritation, mostly from the chemical's use in aerosol forms. Additionally, the report claims that linalool and linalyl propionate may help fight cancer.

Shares of National Beverage, LaCroix's parent company, were trading down nearly 3 percent on Friday.

On Monday, National Beverage posted first-quarter earnings for the 2019 fiscal year, which showed that revenue grew 12.6 percent, largely driven by the growth of LaCroix. The sparkling-water brand has benefited from a consumer shift away from traditional cola drinks to drinks perceived to be more healthy.

The lawsuit was brought on behalf of plaintiff Lenora Rice, by the law firm Beaumont Costales in Chicago. It said, "Thousands of consumers purchase Defendant's water under the mistaken belief that it conforms with the representations made by Defendant on LaCroix's packaging and advertisements, i.e., it is 'all natural' and/or '100% natural.'"

The lawsuit does not explain how the product was tested for the presence of these chemicals.

National Beverage said it "categorically denies all allegations in a lawsuit filed [Monday] without basis in fact or law regarding the natural composition of its LaCroix Sparkling Water."

"Natural flavors in LaCroix are derived from the natural essence oils from the named fruit used in each of the flavors. There are no sugars or artificial ingredients contained in, nor added to, those extracted flavors," the company said in a statement.

National Beverage declined our request for further comment. Lawyers at Beaumont Costales couldn't be immediately reached for comment.

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



Photo Credit: Randy Shropshire/Getty Images
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<![CDATA[Therapy Dogs Can Spread Superbugs to Kids, Hospital Finds]]>Fri, 05 Oct 2018 13:33:44 -0500https://media.nbcnewyork.com/images/213*120/AP_18277512893965.jpg

Therapy dogs can bring more than joy and comfort to hospitalized kids. They can also bring stubborn germs.

Doctors at Johns Hopkins Hospital in Baltimore were suspicious that the dogs might pose an infection risk to patients with weakened immune systems. So they conducted some tests when Pippi, Poppy, Badger and Winnie visited 45 children getting cancer treatment.

They discovered that kids who spent more time with the dogs had a 6 times greater chance of coming away with superbug bacteria than kids who spent less time with the animals. But the study also found that washing the dogs before visits and using special wipes while they're in the hospital took away the risk of spreading that bacteria.

The results of the unpublished study were released Friday at a scientific meeting in San Francisco.

One U.S. health official said the findings add to the growing understanding that while interactions with pets and therapy animals can be beneficial, they can also carry risk.

"Whether covered in fur, feathers or scales, animals have the potential to carry germs that make people sick," said Casey Barton Behravesh of the Centers for Disease Control and Prevention.

Pet therapy can help people recover from a range of health problems. Past studies have shown dogs or other animals can ease anxiety and sadness, lower blood pressure and even reduce the amount of medications some patients need.

But there have been episodes of the superbug MRSA riding around on healthy-looking therapy dogs.

MRSA, or methicillin-resistant Staphylococcus aureus bacteria, often live on the skin without causing symptoms. But they can become more dangerous if they enter the bloodstream, destroying heart valves or causing other damage. Health officials have tied MRSA to as many as 11,000 U.S. deaths a year.

The bacteria can spread in daycares, locker rooms and military barracks, but public health efforts have focused on hospitals and nursing homes.

The Baltimore study looked at 45 children who interacted with the four dogs — petting, hugging, feeding or playing with them — over 13 visits in 2016 and 2017.

Among kids who had no MRSA, the researchers found the superbug on about 10 percent of the samples taken from those kids after the dog visits. They also found MRSA on nearly 40 percent of the samples from the dogs. The researchers also determined that the more time someone spent with the animals, the greater the chance of ending up with the bacteria.

The researchers think the dogs were generally clean of MRSA when they first came to the hospital, but picked it up from patients or others while they were there, said one of the authors, Meghan Davis.

"Our hypothesis is it's really person-to-person transmission, but it happened through contact with the fur," said Davis, a Johns Hopkins public health researcher and veterinarian.

Under hospital protocols, therapy dogs must be bathed within a day of a visit and are checked for wounds or other health problems. Children who see them are supposed to use hand sanitizer "but that wasn't strictly enforced," said Kathryn Dalton, another one of the researchers.

Later in the study, the researchers asked the dogs' owners to bathe the animals with a special shampoo before the visits. They also had the dogs patted down every five to 10 minutes with disinfecting wipes at the hospital.

Those steps dramatically decreased the bacteria level on the dogs, Dalton said.

She hopes further study will show that such cleanings can reduce any risk of superbug infection.

"I really had the opportunity to see how important these dogs were to the patients," Dalton said. After the sessions with the dogs, the kids "would say how much this made their day."

Copyright Associated Press / NBC New York



Photo Credit: Meghan Davis/Johns Hopkins University via AP]]>
<![CDATA[US Military's Bug Gene-Altering Program: Boon or Bioweapon?]]>Fri, 05 Oct 2018 07:10:00 -0500https://media.nbcnewyork.com/images/213*120/AP_18277661309243-Corn-Aphids-Insect-Allies-Military.jpg

A research arm of the U.S. military is exploring the possibility of deploying insects to make plants more resilient by altering their genes. Some experts say the work may be seen as a potential biological weapon.

In an opinion paper published Thursday in the journal Science, the authors say the U.S. needs to provide greater justification for the peace-time purpose of its Insect Allies project to avoid being perceived as hostile to other countries. Other experts expressed ethical and security concerns with the research, which seeks to transmit protective traits to crops already growing in the field.

That would mark a departure from the current widely used procedure of genetically modifying seeds for crops such as corn and soy, before they grow into plants.

The military research agency behind the project says its goal is to protect the nation's food supply from threats like drought, crop disease and bioterrorism by using insects to infect plants with viruses that protect against such dangers.

"Food security is national security," said Blake Bextine, who heads the 2-year-old project at the Defense Advanced Research Projects Agency, or DARPA, an arm of the U.S. Department of Defense.

The State Department said the project is for peaceful purposes and does not violate the Biological Weapons Convention. The U.S. Department of Agriculture said its scientists are part of the research, which is being conducted in contained labs.

The technology could work in different ways. In the first phase, aphids — tiny bugs that feed by sucking sap from plants — infected plants with a virus that temporarily brought about a trait. But researchers are also trying to see if viruses can alter the plant's genes themselves to be resistant to dangers throughout the plant's life.

Still, the research is raising concerns.

"They're talking about massive release of genetic modification by means of insects," said Gregory Kaebnick, an ethicist at the Hastings Center bioethics research institute in Garrison, N.Y., who has studied genetic modification. He wasn't part of the Science paper but said Insect Allies technology could end up being destructive.

Kaebnick questioned how well the viruses and insects carrying them could be controlled. "When you are talking about very small things — insects and microbes — it might be impossible to remove them" once they are introduced into farmers' fields, he said.

Dr. David Relman, a professor of medicine and microbiology at Stanford who has advised the Obama administration on bio-defense but is not part of the DARPA research, said the project could play into longstanding fears among countries that enemies might try to harm their crops.

Still, Relman said the technology could potentially help farmers fight a "bad plant virus moving across the plains" or protect crops from bioterrorism. Since insects often spread crop diseases, Relman said DARPA is trying to use the bugs' own biology to "recruit them as allies" in spreading protective traits.

Though it's not a household name, DARPA helped develop the Internet and its mission is to research potentially pivotal new technologies. The agency announced the Insect Allies project in 2016.

Guy Reeves, a co-author of the Science paper and a biologist at the Max Planck Institute for Evolutionary Biology in Germany, says the technology is more feasible as a weapon — to kill plants — than as an agricultural tool. As a result, he said DARPA could be sending an alarming message regardless of its intentions.

"It's really about how it's perceived," he said.

The papers' European authors say the mere announcement of the program may have motivated other countries to develop their own capabilities in the arena. They say the project also underscores the need for greater discussion of the regulatory and ethical concerns of such developing technologies.

Todd Kuiken, a senior research scholar at North Carolina State University, said he doesn't think the military intends to attack another country with insects. But he said it looks bad that DARPA is funding the project.

"The pure fact that this is a military program would naturally raise these sorts of questions," said Kuiken, who last year raised concerns similar to those published in Science.

Tom Inglesby, a professor of environmental health and engineering at Johns Hopkins, said the technology is being developed specifically to protect crops. But he acknowledged it could be misused.

Concerns that a new technology could be weaponized are to be expected, even if that's not the intention, said Paul Thompson, a professor of agriculture and ethics at Michigan State University who is on an advisory board for DARPA.

"Once you make those kinds of breakthroughs, you are in a new world. It's a morally ambiguous place. You wonder, 'Is this something that we should never do?'" he said.

Some experts have questioned whether the project's ambitious goals are even achievable.

North Carolina State University entomologist Fred Gould, who chaired a National Academy of Sciences panel on genetically modified food and is not part of the DARPA research, said too many biological interactions would need to be perfectly manipulated, so the chance of it working is "pretty close to zero."

It may not ever work, but Relman said that's DARPA's role: Exploring the "bleeding edge of challenging work" to anticipate future threats.

Copyright Associated Press / NBC New York



Photo Credit: Meena Haribal/Boyce Thompson Institute via AP]]>
<![CDATA[1 in 3 US Adults Eat Fast Food Each Day, Study Says]]>Wed, 03 Oct 2018 07:39:58 -0500https://media.nbcnewyork.com/images/213*120/GettyImages-921741316.jpg

A government study has found that 1 in 3 U.S. adults eat fast food on any given day. That's about 85 million people.

It's the first federal study to look at how often adults eat fast food. An earlier study found a similar proportion of children and adolescents ate it on any given day.

The Centers for Disease Control and Prevention released the numbers Wednesday. It's based on a survey of about 10,000 adults over four years.

The study did not find a difference between men and women. But higher-income families ate fast food more often than lower-income families, and blacks ate it more than other racial or ethnic groups.

Health officials say too much high-calorie fast food can lead to obesity, diabetes, heart disease and other health problems.

Copyright Associated Press / NBC New York



Photo Credit: Matt Cardy/Getty Images]]>
<![CDATA[Two Studies Look to Prevent Alzheimer's Before Symptoms Show]]>Tue, 02 Oct 2018 17:56:48 -0500https://media.nbcnewyork.com/images/213*120/AP_18256018577029.jpg

It may be too late to stop Alzheimer's in people who already have some mental decline. But what if a treatment could target the very earliest brain changes while memory and thinking skills are still intact, in hope of preventing the disease? Two big studies are going all out to try.

Clinics throughout the United States and some other countries are signing up participants — the only studies of this type enrolling healthy older people.

"The excitement in the Alzheimer's field right now is prevention," said Dr. Eric Reiman, executive director of the Banner Alzheimer's Institute in Phoenix, which is leading the work.

Science so far has failed to find a drug that can alter the progression of Alzheimer's, the most common form of dementia; 146 attempts have failed over the last decade, a recent industry report found. Even drugs that help remove the sticky plaques that clog the brains of people with the disease have not yet proved able to stave off mental decline.

It may be that they were tried too late, like lowering cholesterol after someone has suffered a heart attack whose damage can't be undone, Reiman said.

"What we have been learning, painfully, is that if we really want to come up with therapies that will modify the disease, we need to start very, very, very early," said Dr. Eliezer Masliah, neuroscience chief at the National Institute on Aging.

His agency is funding the prevention studies with the Alzheimer's Association, several foundations, and Novartis and Amgen, makers of two experimental drugs being tested.

The goal is to try to block the earliest steps of plaque formation in healthy people who show no symptoms of dementia but are at higher risk for it because of age and a gene that makes it more likely.

To participate, people must first join GeneMatch, a confidential registry of folks interested in volunteering for various Alzheimer's studies who are ages 55 to 75 and have not been diagnosed with any mental decline.

They are checked for the APOE4 gene, which doesn't destine someone to develop Alzheimer's but raises that risk. About one in four people have one copy of the gene and about 2 percent have two copies, one from each parent.

More than 70,000 people have signed up since the registry began three years ago, said Jessica Langbaum, one of the Banner study leaders.

"Most of them have been touched by the disease personally," either by having a family member or close friend with it, she said.

Langbaum's 67-year-old mother, Ivy Segal, gave a DNA sample through a cheek swab and joined the registry in August. Her father was a patient at Banner and died of Alzheimer's in 2011 at age 87. Watching him go from a mild-mannered man whose smile could light up a room to what he was like when he died was devastating, she said.

Being in GeneMatch doesn't necessarily mean you'll find out if you have the gene — folks with and without it may be contacted about various studies. But to be in one of the two prevention studies, people must agree to learn their APOE4 status and have at least one copy of the gene.

Participants get periodic brain scans and memory and thinking tests every six months. They are given experimental drugs or placebo versions of them for several years.

One study is enrolling people with two copies of the gene. They are given either shots every few months of a drug intended to help the immune system clear plaque from the brain or daily pills of a drug intended to prevent first steps of plaque formation, or placebo versions of these experimental treatments.

The other study is in people who either have two copies of APOE4 or one copy of the gene plus evidence on brain scans of plaque starting to build. They will get one of two doses of the drug to prevent plaque formation or placebo pills.

Larry Rebenack, 71, of the Phoenix suburb of Surprise, Arizona, joined GeneMatch in August.

"I have a lot of friends and acquaintances I've seen deteriorate," including one who started blowing through stop signs on a route to a golf course they had safely traveled for years, and another who forgot not only where he had parked his car but even what kind of car it was, Rebenack said. "It's a disease that takes a little part of you away each day."

Rebenack has decided to learn whether he has the gene if researchers give him the chance to find out.

"It's like any other piece of information. It helps you plan your life and you owe it to all your loved ones, too."

Copyright Associated Press / NBC New York



Photo Credit: Matt York/AP, File ]]>
<![CDATA[EPA Radiation Rollback Proposal Veers From Mainstream View]]>Tue, 02 Oct 2018 12:24:23 -0500https://media.nbcnewyork.com/images/213*120/radiation.jpg

The Trump administration is quietly moving to weaken U.S. radiation regulations, turning to scientific outliers who argue that a bit of radiation damage is actually good for you — like a little bit of sunlight.

The government's current, decades-old guidance says that any exposure to harmful radiation is a cancer risk. And critics say the proposed change could lead to higher levels of exposure for workers at nuclear installations and oil and gas drilling sites, medical workers doing X-rays and CT scans, people living next to Superfund sites and any members of the public who one day might find themselves exposed to a radiation release.

The Trump administration already has targeted a range of other regulations on toxins and pollutants, including coal power plant emissions and car exhaust, that it sees as costly and burdensome for businesses. Supporters of the EPA's new proposal argue the government's current no-tolerance rule for radiation damage forces unnecessary spending for handling exposure in accidents, at nuclear plants, in medical centers and at other sites.

"This would have a positive effect on human health as well as save billions and billions and billions of dollars," said Edward Calabrese, a toxicologist at the University of Massachusetts who is to be the lead witness at a congressional hearing Wednesday on EPA's proposal.

Calabrese, who made those remarks in a 2016 interview with a California nonprofit, was quoted by EPA in its announcement of the proposed rule in April. He declined repeated requests for an interview with The Associated Press. The EPA declined to make an official with its radiation-protection program available.

The regulation change is now out for public comment, with no specific date for adoption.

Radiation is everywhere, from potassium in bananas to the microwaves popping our popcorn. Most of it is benign. But what's of concern is the higher-energy, shorter-wave radiation, like X-rays, that can penetrate and disrupt living cells, sometimes causing cancer.

As recently as this March, the EPA's online guidelines for radiation effects advised: "Current science suggests there is some cancer risk from any exposure to radiation."

"Even exposures below 100 millisieverts" — an amount roughly equivalent to 25 chest X-rays or about 14 CT chest scans — "slightly increase the risk of getting cancer in the future," the agency's guidance said.

But that online guidance — separate from the rule-change proposal — was edited in July to add a section emphasizing the low individual odds of cancer: "According to radiation safety experts, radiation exposures of ...100 millisieverts usually result in no harmful health effects, because radiation below these levels is a minor contributor to our overall cancer risk," the revised policy says.

Calabrese and his supporters argue that smaller exposures of cell-damaging radiation and other carcinogens can serve as stressors that activate the body's repair mechanisms and can make people healthier. They compare it to physical exercise or sunlight.

Mainstream scientific consensus on radiation is based on deceptive science, says Calabrese, who argued in a 2014 essay for "righting the past deceptions and correcting the ongoing errors in environmental regulation."

EPA spokesman John Konkus said in an email that the proposed rule change is about "increasing transparency on assumptions" about how the body responds to different doses of dangerous substances and that the agency "acknowledges uncertainty regarding health effects at low doses" and supports more research on that.

The radiation regulation is supported by Steven Milloy, a Trump transition team member for the EPA who is known for challenging widely accepted ideas about manmade climate change and the health risks of tobacco. He has been promoting Calabrese's theory of healthy radiation on his blog.

But Jan Beyea, a physicist whose work includes research with the National Academies of Science on the 2011 Fukushima nuclear power plant accident, said the EPA proposal on radiation and other health threats represents voices "generally dismissed by the great bulk of scientists."

The EPA proposal would lead to "increases in chemical and radiation exposures in the workplace, home and outdoor environment, including the vicinity of Superfund sites," Beyea wrote.

At the level the EPA website talks about, any one person's risk of cancer from radiation exposure is perhaps 1 percent, Beyea said.

"The individual risk will likely be low, but not the cumulative social risk," Beyea said.

"If they even look at that — no, no, no," said Terrie Barrie, a resident of Craig, Colorado, and an advocate for her husband and other workers at the now-closed Rocky Flats nuclear-weapons plant, where the U.S. government is compensating certain cancer victims regardless of their history of exposure.

"There's no reason not to protect people as much as possible," said Barrie.

U.S. agencies for decades have followed a policy that there is no threshold of radiation exposure that is risk-free.

The National Council on Radiation Protection and Measurements reaffirmed that principle this year after a review of 29 public health studies on cancer rates among people exposed to low-dose radiation, via the U.S. atomic bombing of Japan in World War II, leak-prone Soviet nuclear installations, medical treatments and other sources.

Twenty of the 29 studies directly support the principle that even low-dose exposures cause a significant increase in cancer rates, said Roy Shore, chief of research at the Radiation Effects Research Foundation, a joint project of the United States and Japan. Scientists found most of the other studies were inconclusive and decided one was flawed.

None supported the theory there is some safe threshold for radiation, said Shore, who chaired the review.

If there were a threshold that it's safe to go below, "those who profess that would have to come up with some data," Shore said in an interview.

"Certainly the evidence did not point that way," he said.

The U.S. Food and Drug Administration, which regulates electronic devices that emit radiation, advises, broadly, that a single CT scan with a dose of 10 millisieverts may increase risks of a fatal cancer by about 1 chance in 2,000.

The EPA tucked its proposed relaxation of radiation guidelines into its "transparency in science" proposal in April. The proposal would require regulators to consider "various threshold models across the exposure range" when it comes to dangerous substances.

While the EPA rule change doesn't specify that it's addressing radiation and chemicals, the EPA's official press release announcing the change does.

Supporters of the proposal say it's time to rethink radiation regulation.

"Right now we spend an enormous effort trying to minimize low doses" at nuclear power plants, for example, said Brant Ulsh, a physicist with the California-based consulting firm M.H. Chew and Associates. "Instead, let's spend the resources on minimizing the effect of a really big event."

Copyright Associated Press / NBC New York



Photo Credit: AP]]>
<![CDATA[FDA Makes Surprise Inspection of E-Cigarette Maker Juul]]>Tue, 02 Oct 2018 10:52:23 -0500https://media.nbcnewyork.com/images/213*120/890546208-juul-ecig-vape.jpg

The Food and Drug Administration seized "thousands of pages of documents" in a surprise inspection of e-cigarette maker Juul's San Francisco headquarters last week, the agency said Tuesday.

The FDA is looking into the company's marketing practices as Commissioner Scott Gottlieb calls teen use of nicotine vaping devices an "epidemic."

It builds on the agency's request in April for company materials related to how Juul products appeal to kids. The most recent inspection, conducted Friday, "sought further documentation related to Juul's sales and marketing practices, among other things," FDA said in a statement.

Juul did not immediately have comment.

The inspection comes weeks after the FDA announced a crackdown that requires e-cig manufacturers, including Juul, to submit plans to address youth use of their products within 60 days. The agency also threatened to ban some flavored nicotine liquids, which critics say attract kids to e-cigarettes.

Juul has been at the center of the FDA's attention this year as e-cigarette use soars among teens.

Over the past year, the number of high school students who have used e-cigarettes in the past 30 days has skyrocketed by about 75 percent, preliminary data from the Centers for Disease Control and Prevention's annual National Youth Tobacco Survey show, according to people familiar with the data. They asked not to be identified because the report isn't yet public.

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

 



Photo Credit: Brianna Soukup/Portland Press Herald via Getty Images, File
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<![CDATA[Trump Emissions Rule Would Cause More Illness, Death: Study]]>Tue, 02 Oct 2018 01:50:44 -0500https://media.nbcnewyork.com/images/213*120/emissionsAP_18264674993328.jpg

An official environmental analysis by the government found that as many as 299 premature deaths annually by mid-century would be the result of President Donald Trump's weakening of pollution and fuel-efficiency standards for new cars, NBC News reported

Additionally, the proposed change in standards, which rolled out in August, would cost Americans nearly 17,000 days of work a year, due to increased illnesses.  The emissions rule would do nothing to rein in the potentially catastrophic global warming either, according to the analysis by the National Highway Traffic Safety Administration.

The likely negative health impacts from allowing more pollution are outlined in a chart deep in the NHTSA’s environmental impact statement. It predicts 199 additional cases of acute bronchitis a year, 62 added emergency room visits from respiratory distress annually and a total of 16,819 missed work days per year. The premature death total of 299 annually would come under one predictive model, while another model suggests premature deaths would top out at 134 a year.

The Environmental Protection Agency did not immediately respond to a request for comment. 



Photo Credit: Eric Risberg/AP, File ]]>
<![CDATA[80,000 People Died of Flu Last Winter in US, CDC Says]]>Wed, 26 Sep 2018 14:58:35 -0500https://media.nbcnewyork.com/images/213*120/AP_18040559764205.jpg

The U.S. government estimates that 80,000 Americans died of flu and its complications last winter — the disease's highest death toll in at least four decades.

The director of the Centers for Disease Control and Prevention, Dr. Robert Redfield, revealed the total in an interview Tuesday night with The Associated Press.

Flu experts knew it was a very bad season, but at least one found size of the estimate surprising.

"That's huge," said Dr. William Schaffner, a Vanderbilt University vaccine expert. The tally was nearly twice as much as what health officials previously considered a bad year, he said.

In recent years, flu-related deaths have ranged from about 12,000 to — in the worst year — 56,000, according to the CDC.

Last fall and winter, the U.S. went through one of the most severe flu seasons in recent memory. It was driven by a kind of flu that tends to put more people in the hospital and cause more deaths, particularly among young children and the elderly.

The season peaked in early February. It was mostly over by the end of March, although some flu continued to circulate.

Making a bad year worse, the flu vaccine didn't work very well. Experts nevertheless say vaccination is still worth it, because it makes illnesses less severe and save lives.

"I'd like to see more people get vaccinated," Redfield told the AP at an event in New York. "We lost 80,000 people last year to the flu."

CDC officials do not have exact counts of how many people die from flu each year. Flu is so common that not all flu cases are reported, and flu is not always listed on death certificates. So the CDC uses statistical models, which are periodically revised, to make estimates.

CDC officials called the 80,000 figure preliminary, and it can be slightly revised. But they said it is not expected to go down.

It eclipses the estimates for every flu season going back to the winter of 1976-1977. Estimates for many earlier seasons were not readily available.

Last winter was not the worst flu season on record, however. The 1918 flu pandemic, which lasted nearly two years, killed more than 500,000 Americans, historians estimate.

Copyright Associated Press / NBC New York



Photo Credit: AP Photo/David Goldman,File]]>
<![CDATA[Number of Babies Born With Syphilis Has Hit a 20-Year High]]>Tue, 25 Sep 2018 16:13:36 -0500https://media.nbcnewyork.com/images/213*120/OB-office.jpg

The number of babies born with syphilis has doubled since 2013 and is at a 20-year high, federal health officials said Tuesday.

More than 900 U.S. babies were born infected with syphilis in 2017, the Centers for Disease Control and Prevention reported.

It’s easy to cure a syphilis infection with antibiotics, but the sexually transmitted infection often does not cause immediate symptoms and people may not know they have it, NBC News reported.

It can kill babies, however. The CDC says 40 percent of babies infected with syphilis are stillborn or die soon after they are born. Others are born prematurely.

Those who survive can develop deformed bones, severe anemia, meningitis, blindness and deafness.



Photo Credit: Teresa Crawford/AP, File ]]>
<![CDATA[Pills for Appendicitis? Surgery Often Not Needed, Study Says]]>Tue, 25 Sep 2018 13:05:07 -0500https://media.nbcnewyork.com/images/213*120/appendicitis.jpg

When emergency tests showed the telltale right-sided pain in Heather VanDusen's abdomen was appendicitis, she figured she'd be quickly wheeled into surgery. But doctors offered her the option of antibiotics instead.

A new study from Finland shows her choice is a reasonable alternative for most patients with appendicitis. Five years after treatment with antibiotics, almost two-thirds of patients hadn't had another attack.

It's a substantial change in thinking about how to treat an inflamed appendix. For decades, appendicitis has been considered a medical emergency requiring immediate surgery to remove the appendix because of fears it could burst, which can be life-threatening.

But advances in imaging tests, mainly CT scans, have made it easier to determine if an appendix might burst, or if patients could be safely treated without surgery.

The results suggest that nearly two-thirds of appendicitis patients don't face that risk and may be good candidates for antibiotics instead.

"It's a feasible, viable and a safe option," said Dr. Paulina Salminen, the study's lead author and a surgeon at Turku University Hospital in Finland.

Her study in adults is the longest follow-up to date of patients treated with drugs instead of surgery for appendicitis and the results confirm one-year findings reported three years ago.

Research has also shown antibiotics may work for some children with appendicitis.

The Finnish results were published Tuesday in the Journal of the American Medical Association.

A journal editorial says "it's a new era of appendicitis treatment."

Appendix removal is the most common emergency surgery worldwide, with about 300,000 performed each year in the United States alone, said Salminen. She said the results from her study suggest many of those surgeries could be avoided.

U.S. doctors have started offering antibiotics instead of surgery and Salminen says she occasionally does too. The journal editorial says appropriate patients should be given that option.

The study involved about 500 Finnish adults who had CT scans to rule out severe cases.

Half were treated with antibiotics; the others had surgery.

Among the antibiotics patients, 100 ended up having surgery within five years of treatment — most for a suspected recurrence of appendicitis in the first year. Seven of them did not have appendicitis and likely could have avoided surgery. The results suggest the success rate for antibiotic treatment was almost 64 percent, the authors said.

About 1 in 4 surgery patients had complications, including infections around the incision, abdominal pain and hernias, compared with only 7 percent of antibiotics patients. Antibiotic patients had 11 fewer sick days on average than the surgery group. In the first year, their treatment costs were about 60 percent lower. A cost analysis for the full five years wasn't included in the published results.

Surgery patients in the Finnish study all had conventional incisions rather than the less invasive "keyhole" surgeries that are more common for appendix removal in the United States. The non-surgery patients received three days of IV antibiotics in the hospital, followed by seven days of pills at home.

Dr. Giana Davidson, a University of Washington surgeon, is involved in a similarly designed multicenter U.S. study that may answer whether similar benefits would be seen for antibiotics versus "keyhole" surgery.

Davidson called the Finnish study "a critical piece to the puzzle but I don't think it answers all of the questions."

Heather VanDusen was treated at the University of Washington in 2016. She said she chose antibiotic treatment partly to avoid surgery scars, and now offers advice to patients for Davidson's study.

"I knew the worst case scenario was ending up back in the hospital so why not try antibiotics first," said VanDusen, who works in university communications.

She said she has done well since her treatment, but that the biggest drawback "is wondering, with every episode of stomach or bad gas, if it could happen again."

___

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

Copyright Associated Press / NBC New York



Photo Credit: UIG via Getty Images, File]]>
<![CDATA[Drug Prices Going Up Despite Trump Promise of 'Massive' Cuts]]>Tue, 25 Sep 2018 08:08:44 -0500https://media.nbcnewyork.com/images/213*120/cms1302.jpg

President Donald Trump made reducing drug prices a key promise during his election campaign, repeatedly accusing drugmakers of "getting away with murder." At the end of May, he promised that drug companies would be announcing "massive" voluntary drug price cuts within two weeks.

That hasn't happened, and an Associated Press analysis of brand-name prescription drug prices shows it's been business as usual for drugmakers, with far more price hikes than cuts. The number of increases slowed somewhat and were not quite as steep as in past years, the AP found.

Over the first seven months of the year, there were 96 price hikes for every price cut, the AP found. Health and Human Services Secretary Alex Azar, the administration's point person for efforts to lower drug prices, conceded in a recent AP interview that it will be a while before drug prices fall. He noted the complexity of the medicine market and its incentives for drugmakers to boost prices so they and middlemen make bigger profits.

"I am not counting on the altruism of pharma companies lowering their prices," said Azar, who was a senior executive in Eli Lilly & Co.'s U.S. business for a decade when it dramatically raised prices for its insulin products.

The AP analyzed 26,176 U.S. list price changes for brand-name prescription drugs from Jan. 1 through July 31 in the years 2015 through 2018, using data supplied by health information analytics firm Elsevier. The AP focused its analysis on the first seven months of each year because of the seasonality of price changes and to make meaningful year-to-year comparisons.

The data included more than 97 percent of price changes during those periods and, for many drugs, several dosages and drugs forms, such as pills, liquids and injectable drugs. (In the 3 percent of cases not analyzed, the AP couldn't determine how the new price compared with the previous one or whether it was for a product new on the market.)

Among the AP's findings:

—There were fewer price increases this year from January through July than in comparable prior-year periods, but companies still hiked prices far more often than they cut them. This year through the end of July, there were 4,412 brand-name drug price increases and 46 price cuts, a ratio of 96-to-1.

—In June and July, right after Trump's price cut prediction, there were 395 price increases and 24 decreases. The two dozen cuts were up from the 15 decreases in those same two months last year, but increases still outpaced decreases by a ratio of 16.5-to-1.

—The median price increase, meaning half were higher and half lower, was 5.2 percent in June and July of 2018, down from 8 percent in that period in 2017.

—The median price cut this June and July was 11 percent, much smaller than in comparable periods in prior years.

The AP also asked 24 large drug companies this summer if they planned to cut drug prices. None said they did, though some didn't answer. Drugmakers typically say they need to keep raising prices of existing drugs to pay for costly, lengthy research to develop new medicines, though industry critics dispute that.

Dr. Peter Bach, who heads the Center for Health Policy and Outcomes at Memorial Sloan Kettering Cancer Center in New York, said the AP's analysis shows there's been no big move to decrease prices.

"We have a broken pricing system," he said.

In the U.S., drug pricing is far from transparent. Manufacturers typically set high list prices but then negotiate rebates and discounts with middlemen, such as prescription benefit managers, to get preferential insurance coverage for their products. Many consumers never see the list price, though rising drug prices generally put pressure on insurers to raise rates. Patients with high-deductible or no insurance often get stuck being charged the full list price.

Elsevier drug pricing expert Kay Morgan said the data indicate companies are being more cautious about price increases, but Trump's criticisms are just one factor.

"It's everyone saying, 'This has got to stop,'" Morgan said.

She cited frequent media coverage, patients and their advocacy groups pressuring members of Congress to fight high drug prices, and Congress holding hearings on huge price increases. Those include hikes for EpiPen emergency allergy shots and the actions of disgraced former pharma executive Martin Shkreli, who hiked the price of an old infection treatment from $13.50 to $750 per pill overnight.

"The rate of increases has slowed down, but prices haven't decreased," said Stephen Schondelmeyer, a University of Minnesota professor of pharmaceutical economics who runs its research program on drug prices and public policy. He noted such temporary pricing restraint occurs periodically, around elections and other times when the issue is hot, but then companies go back to raising drug prices.

Edward Jones drug analyst Ashtyn Evans said, "companies are self-policing more." She noted many firms are now taking one price hike near 10 percent once a year, instead of two or three smaller hikes each year.

"That started before Trump was even elected," she said.

Pfizer, the biggest U.S. drugmaker, angered Trump by raising prices on July 1 for 40 medicines and vaccines, totaling more than 100 products, with some increases hitting 9 percent. Pfizer had already hiked list prices in January for all but two of those medicines, most by 9 percent to 9.5 percent, according to Elsevier's data.

"Pfizer & others should be ashamed that they have raised drug prices for no reason. ... We will respond!" Trump tweeted . After a call with Trump, Pfizer executives reversed those price hikes until January at the latest.

Seven other major drugmakers, perhaps hoping to avoid their own Twitter spanking by Trump, have since said they wouldn't increase prices for the rest of the year. All of them had already taken price hikes on many of their products in January.

Meanwhile, 77 percent of Americans consider U.S. prescription drug costs "unreasonable" and fewer than a quarter approve of how Trump is addressing the problem, according to a mid-August national poll of 1,002 adults from West Health Institute, a nonpartisan health care research group.

Just this month, a fresh controversy over price hikes erupted, triggering criticism of Nostrum Laboratories. The tiny Kansas City, Missouri-based generic drug company posted a 404 percent increase, to $2,392.32 per bottle, for its generic version of a 65-year-old liquid antibiotic for bladder infections, nitrofurantoin.

Nostrum's product and competitors had been off the market since January after federal regulators required that they be reformulated. Nostrum now is relaunching its version amid limited competition. Chief executive Nirmal Mulye told the AP that the maker of the brand-name version, Casper Pharma, hiked its price to $2,800, so Nostrum was "obligated" to maximize its own profit to keep the company afloat after years of losing money.

Experts don't expect drugmakers to slash prices soon, if ever.

Trump's "blueprint" for reducing drug prices, released on May 10, has no provisions for reducing prices of the costliest new brand-name drugs, which won't face competition for years, Bach said.

Schondelmeyer predicts drugmakers "will wait to see if this blueprint is going to do anything." If it doesn't bring substantive policy changes, they won't alter their pricing strategy, he said.

Azar acknowledged there's no "overnight solution," but he said the administration is making progress on blueprint proposals like increasing generic competition for old drugs and giving government prescription programs more negotiating power.

 

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

Copyright Associated Press / NBC New York



Photo Credit: Getty Images/Cultura RF]]>
<![CDATA[2 Die as Human West Nile Cases Reach Record Highs in NJ]]>Mon, 24 Sep 2018 13:31:14 -0500https://media.nbcnewyork.com/images/213*120/Hospital_generic_shutterstock_104336624.jpg

Nearly three dozen human cases of West Nile virus, two of them fatal, have been reported in New Jersey so far this year, authorities said Monday. 

Both victims who died -- a 62-year-old man and an elderly woman -- were from Bergen County and died this month. New Jersey reported two West Nile-related deaths in 2017, two in 2016 and three in 2015. None of those were in Bergen County. In total, the state has seen 31 cases in 2018, up from just eight human cases in 2017 -- a spike health officials attribute at least in part to the hot and wet summer weather being prime conditions for mosquitos. 

"The number of human West Nile Virus cases is the highest we’ve seen since 2012, and the season is not over yet,” New Jersey Health Commissioner Dr. Shereef Elnahal said in a statement.

West Nile is most commonly spread to humans through bites from infected mosquitoes. The most common times for transmission to humans are the summer through fall, and there are no vaccines or medications to treat it when contracted by humans. 

According to the Centers for Disease Control, about one in five people who are infected develop a fever or mild symptoms like body aches and heache. Roughly one in 150 people develop a serious, sometimes deadly illness; severe symptoms could include high fever and brain swelling that may lead to coma and convulsion. Most infected people, though, show no symptoms at all. The CDC recommends using bug repellent and wearing long-sleeved shirts and pants when outside at dawn and dusk, when mosquitoes.

Elnahal says Bergen County officials have been proactive in spraying the highest-risk areas; he added that the health department is working with local agencies statewide who "monitor and initiate rsponses as appropriate." 

]]>
<![CDATA[Flea, Tick Pills Can Cause Nerve Reactions in Pets: FDA]]>Thu, 20 Sep 2018 18:52:19 -0500https://media.nbcnewyork.com/images/213*120/GettyImages-175854393.jpg

Chewable products that protect dogs and cats against fleas can cause neurological problems such as stumbling or seizures, and pet owners need more warning, the Food and Drug Administration said Thursday.

The FDA issued an alert to owners and veterinarians and said it was requiring clearer labels on the products, NBC News reported.

The flea pills and chews all contain a pesticide called isoxazoline, the FDA said. They include products sold under the brand names Bravecto, Nexgard and Simparica.

"Another product in this class, Credelio, recently received FDA approval. These products are approved for the treatment and prevention of flea infestations, and the treatment and control of tick infestations," the FDA said in a statement.



Photo Credit: Getty Images/iStockphoto]]>
<![CDATA[New FDA Campaign Hopes to Scare Teens Away From E-Cigarettes]]>Wed, 19 Sep 2018 06:07:07 -0500https://media.nbcnewyork.com/images/213*120/AP_18260466488784-Vaping-Teens.jpg

The federal government is hoping it can scare American teens away from e-cigarette use.

The Food and Drug Administration is rolling out a new campaign of videos aimed at graphically illustrating the dangers of e-cigarettes and so-called “vaping.”

Teen e-cigarette use rose to 12 percent in 2017, according to the Centers for Disease Control and Prevention, which found that more than 2 million middle and high school students used the devices that year, making them the most popular cigarette problem in the group for the fourth straight year.

The campaign, called "The Real Cost," will feature posters in school bathrooms and advertisements on social media sites popular among children, like YouTube and Facebook. The FDA's Kathy Crosby said it would be "snarky and irreverent," with messages like, "Strangely enough, some kids come here to put crap into their bodies," according to NBC News.

The JUUL brand e-cigarettes have grown especially popular among teens, in part because of the easy to hide design and fruit-flavored liquid nicotine. That popularity led to a nationwide blitz by the FDA on retailers who sell to teens. The agency issues monetary penalties and sent warning letters to more than 1,300 retailers nationwide who sold to children, including eight in Connecticut.

Wolcott mom Christy Bisaillon says she’s encouraged her teen daughters not to try vaping, despite what their classmates are doing and the misconception among some teens that vaping is less harmful than traditional cigarettes.

“Say no just like a regular drug. It’s still nicotine no matter what it is” said Bisaillon. “They think it's not addicting. They think it's not ruining their health. I’m just hoping they stay away from it.”

Even as this anti-vaping campaign rolls out, the clock is still ticking for the makers of e-cigarettes. Last week the FDA gave the five major manufacturers of e-cigarettes two months to come up with a plan to keep their products away from kids.



Photo Credit: Steven Senne/AP, File]]>
<![CDATA[Scared of Heights? Spiders? Virtual Reality Therapy May Help]]>Tue, 18 Sep 2018 08:43:43 -0500https://media.nbcnewyork.com/images/213*120/AP_18248608330021-Virtual-Reality-Phobias.jpg

Dick Tracey didn't have to visit a tall building to get over his fear of heights. He put on a virtual reality headset.

Through VR, he rode an elevator to a high-rise atrium that looked so real he fell to his knees.

"I needed to search with my hand for something solid around me," he said.

He told himself, "I must look stupid. Let's just stand up. Nothing's going to happen."

Virtual reality therapy can help people like Tracey by exposing them gradually to their greatest terrors. The technology is just now reaching the mainstream after 20 years of research. Equipment is lighter and more affordable, with tech advances spilling over from the gaming industry to help people fight disabling fears of flying, heights, spiders or dogs.

And the surge in products is bringing VR to more therapists' offices. Experts predict people with mild phobias will treat themselves successfully at home.

Research shows VR therapy can lead to real-world gains for people with phobias, and works as well as traditional exposure therapy, which slowly subjects patients to what causes anxiety for them.

For Denver librarian Nick Harrell, VR was a booster shot after traditional therapy for fear of flying. Panic drove him off a flight to Paris two years ago, forcing him to abandon a vacation with his girlfriend.

"I don't like being locked in the metal tube," Harrell explained. "I couldn't breathe. My chest was pounding."

With help from a therapist, Harrell first faced his fears through exposure therapy. Elevators, buses and trains were good practice for airplanes.

"Within a matter of months, I was flying again," Harrell said.

With VR recently added to his therapy, Harrell keeps fears in check. His health insurance covers the cost with a small copay.

But few people with phobias seek treatment. Too embarrassed to get help, many plan their lives around avoiding their fears.

Tracey of Oxfordshire, England, avoided heights, from ladders to breathtaking vistas. Escalators gave the 62-year-old retiree heart palpitations. His wife walked between him and steep slopes.

Tracey's VR therapy was part of a study. He was one of the first to try a VR world with an animated virtual coach. University of Oxford psychology professor Daniel Freeman developed the program for an Oxford spin-off with support from the National Health Service.

Freeman's team is now at work on a VR world where people with schizophrenia can practice being in a cafe, elevator or store.

"Many of our patients are withdrawn from the world," Freeman said. The fear-of-heights VR program shows you can automate treatment.

What is VR? Put on a headset and look around. You'll see a simulation of an interactive, three-dimensional environment. Look up and you'll see the sky; look down and your own hands and feet may come into view.

With exposure therapy, a therapist can accompany a person who's afraid of heights to a tall building. With VR, a patient learns to feel safe on a virtual high-rise balcony, without leaving the therapist's office.

Exposure works by gradually taking the oomph out of panic. Sweaty palms and pounding hearts ease. Fears shrink to manageable levels. By riding it out, a person learns the feelings are survivable.

The best studies on VR exposure therapy have been small with fewer than 100 patients. Increasingly VR therapy will be delivered at home via the internet, a still largely unstudied area, said Katharina Meyerbroker, a researcher at Utrecht University in the Netherlands, who has published reviews of research done in the field.

Harrell's therapist is helping field-test VR content for a company called Limbix, an arrangement between the company and the National Mental Health Innovation Center at University of Colorado's medical school.

Such ties are important for VR companies, which need scientific credibility to sell their products to therapists. Researchers gain too.

"We've all been piggybacking on this technology that was initially developed for video gaming," said Hunter Hoffman, a research scientist at the University of Washington in Seattle who developed an early VR therapy called Spider World two decades ago. He didn't license his arachnophobia project like other early researchers who've teamed up with companies to sell VR platforms and content.

Children may someday use VR to learn to cope with anxiety, said Stephen Whiteside, director of the Mayo Clinic Pediatric Anxiety Disorders Clinic, where a study targets kids with schoolwork anxieties.

In the VR scenario, a classroom teacher hands back a school paper with a bad grade.

"You hear the voices of other kids laughing and saying you didn't do so well," Whiteside said. "When I first watched it, I had a visceral response myself. It made you nervous."

The Mayo researchers say children prefer the VR experience to traditional exposure therapy. Next they'll test whether it works as well.

Whiteside said VR researchers everywhere must demonstrate benefits that outweigh treatment costs, which can reach $200 per session in some specialty clinics.

"The cheaper and more accessible it gets," Whiteside said, "the easier that will be."

VR therapy made life simpler for Tracey. After seven VR sessions, he now easily parks his car atop a multi-story garage. He stood on the flat roof of his house to clean his carport.

"I would never have dreamed of doing that before," he said. "I now know how much the fear of heights restricted my everyday life."

Copyright Associated Press / NBC New York



Photo Credit: Oxford VR via AP]]>
<![CDATA[2 Million US Teens Are Vaping Marijuana, Survey Finds]]>Mon, 17 Sep 2018 11:05:37 -0500https://media.nbcnewyork.com/images/213*120/AP_18260466488784-Vaping-Teens.jpg

A school-based survey shows nearly 1 in 11 U.S. students have used marijuana in electronic cigarettes, heightening concern about the new popularity of vaping among teens.

E-cigarettes typically contain nicotine, but results published Monday mean 2.1 million middle and high school students have used them to get high.

The devices are generally considered a less dangerous alternative to regular cigarettes, despite little research on their long-term effects including whether they help smokers quit.

The rise in teenagers using them has alarmed health officials. Last week, the Food and Drug Administration gave the five largest e-cigarette makers 60 days to produce plans to stop underage use of their products.

Nearly 9 percent of students surveyed in 2016 said they used an e-cigarette device with marijuana, according to Monday's report in the journal JAMA Pediatrics. That included one-third of those who ever used e-cigarettes.

The number is worrying "because cannabis use among youth can adversely affect learning and memory and may impair later academic achievement and education," said lead researcher Katrina Trivers of the Centers for Disease Control and Prevention.

Students who said they lived with a tobacco user were more likely than others to report vaping marijuana.

It's unclear whether marijuana vaping is increasing among teens or holding steady. The devices have grown into a multi-billion industry, but they are relatively new.

It was the first time a question about marijuana vaping was asked on this particular survey, which uses a nationally representative sample of students in public and private schools. More than 20,000 students took the survey in 2016.

A different survey from the University of Michigan in December found similar results when it asked for the first time about marijuana vaping. In that study, 8 percent of 10th graders said they vaped marijuana in the past year.

"The health risks of vaping reside not only in the vaping devices, but in the social environment that comes with it," said University of Michigan researcher Richard Miech. Kids who vape are more likely to become known as drug users and make friends with drug users, he said, adding that "hanging out with drug users is a substantial risk factor for future drug use."

Copyright Associated Press / NBC New York



Photo Credit: Steven Senne/AP, File]]>
<![CDATA[Watchdog: Foster Kids Are Overprescribed Psych Drugs]]>Mon, 17 Sep 2018 11:38:07 -0500https://media.nbcnewyork.com/images/213*120/drugs10.jpg

Thousands of foster children may be getting powerful psychiatric drugs prescribed to them without basic safeguards, says a federal watchdog agency that found a failure to care for youngsters whose lives have already been disrupted.

A report released Monday by the Health and Human Services inspector general's office found that about 1 in 3 foster kids from a sample of states were prescribed psychiatric drugs without treatment plans or follow-up, standard steps in sound medical care.

Kids getting mood-altering drugs they don't need is only part of the problem. Investigators also said children who need medication to help them function at school or get along in social settings may be going untreated.

The drugs include medications for attention deficit disorder, anxiety, PTSD, depression, bipolar disorder and schizophrenia. Foster kids are much more likely to get psychiatric drugs than children overall.

"We are worried about the gap in compliance because it has an immediate, real-world impact on children's lives," said Ann Maxwell, an assistant inspector general.

Among the situations investigators encountered was the case of a 6-year-old boy diagnosed with ADHD, learning and speech disorders, outbursts of temper and defiance, and hair-pulling disorder. He had been put on four psychiatric drugs.

But a medication review questioned the need for some of the medications. Of the four, two were discontinued and one was reduced in dosage, investigators said. Two different medications were prescribed.

Investigators found no evidence that a treatment plan for the boy had been developed in the first place, before starting him on medication.

In another case, an 11-year-old boy had been put on two medications after being diagnosed with ADHD, anxiety and behavior problems. But over a three-month period his foster mother had problems getting prescription refills. By the fourth month, the boy's life was out of control. His decline included stealing, lying, bullying and an in-school suspension.

Investigators found there was no requirement in that state for case workers to follow up with foster parents about medications. The lack of effective follow-up contributed to the boy's downward spiral.

"These children are at greater risk of not getting the medications they need, but equally important, they are at risk of getting powerful medications that they do not need," Maxwell said.

The inspector general is recommending that the HHS Administration for Children and Families develop a strategy to help states meet their existing requirements for prescribing psychiatric drugs to foster children, and to generally raise standards for case-by-case oversight.

In a formal response to the report the children's agency said it may need additional legal authority. The agency also said it is committed to making sure foster children get psychiatric medications only when medically appropriate. Officials noted that the inspector general's findings covered just five states.

Foster children come into the mental health system with added complications. Their most basic connections in life have been stressed or severed. They may have suffered neglect or abandonment. They may have witnessed or been a victim of abusive behavior or violence.

A 2010 study from the Tufts Clinical and Translational Science Institute found that estimated rates of psychiatric drug use among youth in foster care are much higher (13 percent to 52 percent) than among youth overall (4 percent).

Compounding the challenge for foster children is the fact that responsibility for their well-being is often divided among foster parents, birth parents, relatives and case workers. That can increase chances for miscommunication and conflict, not to mention everyday problems going unaddressed until they escalate.

Caring for foster kids is a shared responsibility of state, local and federal agencies. The federal government provides grants to state programs and also covers health care for foster children through Medicaid, which spends hundreds of millions of dollars annually on psychiatric drugs. Nationally, it's been estimated that about 120,000 children in foster care take at least one such medication.

The inspector general scrutinized a sample of 125 cases from each of five states with the highest overall percentages of foster children treated with psychiatric drugs. Those states were Iowa, Maine, New Hampshire, North Dakota and Virginia. The cases covered the period from October 2014 through March 2015. Investigators looked at each state's compliance with its own particular requirements for treatment planning and follow-up.

Maxwell said the finding that 34 percent of children did not have either treatment plans or follow-up monitoring translates to about 4,500 children in the five states examined. She said the national number would certainly be higher but the design of the inspector general's review did not allow for a simple extrapolation. Even among the five states cited there were wide differences.

Copyright Associated Press / NBC New York



Photo Credit: sharky1 - stock.adobe.com]]>
<![CDATA[Puerto Rican Government Abandons Bottled Water, Citing Taste]]>Wed, 19 Sep 2018 09:37:11 -0500Telemundo Puerto Rico shows what appears to be hundreds of boxes of water abandoned on a naval runway in Ceiba, Puerto Rico. The water delivery, which was a surplus from FEMA, allegedly stalled due to complaints of the smell and taste. ]]>Telemundo Puerto Rico shows what appears to be hundreds of boxes of water abandoned on a naval runway in Ceiba, Puerto Rico. The water delivery, which was a surplus from FEMA, allegedly stalled due to complaints of the smell and taste. ]]>https://media.nbcnewyork.com/images/213*120/pr_waterbottles.jpg

Puerto Rican government officials resorted to mass finger-pointing after CBS News recently reported that thousands of water bottles were abandoned on the taxiway of a naval base in Ceiba, Puerto Rico.

In a Facebook post written in Spanish, Thomas Rivera Schatz, Puerto Rico’s Senate president, called out Wanda Vázquez, the island’s secretary of the Department of Justice.  

"The discovery of a shipment of boxes containing potable water going to waste out in the open on Ceiba’s naval base possibly did not even provoke an investigation from the Department of Justice,” Rivera Schatz wrote on his Facebook page.

The Senate president also said it's necessary for someone to file a complaint regarding the incident.

"We are waiting for the great explanation ‘someone’ will offer, in some moment, that will justify everything,” he continued.

Viral images on social media show hundreds of boxes of water abandoned outside at the naval base Roosevelt Roads in Ceiba.

Following Hurricane Maria’s landfall last September, many residents were left without clean drinking water for weeks.

After falsely counting the death toll in the wake of the hurricane as 64, the government has since acknowledged the storm caused the deaths of almost 3,000 people on the island.

Clinicians linked 26 of those deaths to leptospirosis, a bacterial illness spread through contaminated water and soil, according to an investigative piece by CNN and the Centro de Periodismo Investigativo. That’s double the amount of deaths the illness caused in Puerto Rico in 2016.

As peak hurricane season approaches, Rivera Schatz said Puerto Ricans are once again preparing for the worst.

“This week, the people have massively resorted to buying potable water before the possible passage of a tropical storm that could become a hurricane, while there [on the naval base] waste thousand and thousands of bottles of water," the Senator leader added. "It is a real shame that this is occurring."

Puerto Rico’s Administrator of the General Services Administration, Ottmar Chávez, and Secretary of the Department of Public Safety Héctor Pesquera offered explanations about the situation.

“The Federal Agency for Emergency Management reported that it had an excess of bottled water in April 2018, and GSA made an application to take custody that was approved and executed upon in May 2018 through the U.S. GSA Surplus Property program,” Chávez explained during a press conference.  

In total, the administration requested about 20,000 pallets of the undistributed excess water, according to a press release written by a spokesperson for the Puerto Rican government.

“GSA took control of the inventory in May 2018 before I took over the agency's functions,” Chávez added. “Deliveries to two municipalities and the Public Broadcasting Corporation of Puerto Rico began that same month and continued through August 2018.”

Chávez said that after his agency delivered more than 700 pallets, recipients from the municipality of Barceloneta and the Corporation for Public Dissemination began sending complaints regarding the water’s smell and taste.

“Based on those complaints, we contacted FEMA to return the water to the federal GSA inventory,” the GSA administrator continued. “The secretary of the [Department of Public Safety] specified that, based on the compiled documentation, in no moment during the digital communication about the surplus water was it evident that the bottled water was spoiled.”

The DPS secretary further highlighted the island government’s lack of information regarding how FEMA stored and distributed the water.

“When GSA performed its merchandise survey, U.S. GSA photographs appeared to show bottled water in a warehouse,” Pesquera said. “We do not know when FEMA moved the inventory to the Roosevelt Roads Base in Ceiba.”

The secretary of DPS further explained that “the Government of Puerto Rico never received the water from FEMA for distribution during the emergency, and it was not until April 2018 that we were notified of its availability.”

Chávez has ordered an administrative investigation to analyze the internal processes associated with this matter and to discuss possible follow-up measures.

In a Facebook Live video, Puerto Rico Gov. Ricardo Rossello also questioned FEMA’s handling of the water and the distribution delay.

“If we had the water supply available since January, why was it not declared until months later, when the bottles of water could possibly be contaminated due to having them exposed outside of a warehouse for so long?” he asked. “The question is should these containers have been kept in some sort of warehouse or storage facility and if they distributed potentially contaminated water?”

Ultimately, the governor believes FEMA is responsible for causing the water to possibly spoil.

“I demand answers from FEMA, because the evidence establishes that this was water that belonged to FEMA, and they left out in the open for so long and did not make it available to those who needed it until a few months later,” Rosselo said. “I guarantee to the public of Puerto Rico that we are in a constant investigation of these events and there will be significant consequences.”

FEMA Spokesperson Lenisha Smith responded to Rosselo’s claims by saying the decision to store the water at the naval base aligned with the agency’s goal of providing “the maximum support to disaster survivors, while also being mindful of our responsibility as stewards of taxpayer dollars.”

Smith claimed placing the water on the tarmac resulted in “millions of dollars of savings.”

“FEMA announced that the water would be available to any agency that needed it, and placed the water at the taxiway of Roosevelt Roads where it could be stored in an area that was free and secure,” Smith wrote in the statement. “The P.R. General Services Administration showed interest in this inventory and requested that it be transferred. Once the transfer of water took place, the water became property of the government of Puerto Rico.”



Photo Credit: Telemundo Puerto Rico]]>
<![CDATA[Active Shooter Study: Semi-Automatic Rifles Deadlier ]]>Tue, 11 Sep 2018 11:14:55 -0500https://media.nbcnewyork.com/images/213*120/AP_18249701961288-Active-Shooter-Study.jpg

Active shooters with semi-automatic rifles wound and kill twice as many people as those using non-automatic weapons, although chances of dying if hit in either type of assault are the same, a new analysis shows.

Researchers examined FBI data on nearly 250 active shooter incidents in the United States since 2000. Almost 900 people were wounded and 718 were killed.

One in four of these attacks involved semi-automatic rifles. These weapons automatically load each bullet after firing although firing requires pulling the trigger for each round.

Recent attacks involving semi-automatics include the shootings at Parkland High School, Orlando's Pulse night club and Sandy Hook Elementary School.

Semi-automatics, which include some assault weapons, often are thought of as being more lethal. Since they can fire rapidly, chances of being hit in those circumstances are high, the study shows.

But in active shooter attacks, which tend to occur in confined spaces and with an intent to kill, the results suggest all types of guns can be equally deadly, said lead researcher Dr. Adil Haider, a trauma surgeon at Brigham and Women's Hospital in Boston.

Overall, 44 percent of people hit in active shooter attacks involving semi-automatic weapons died, the same as those wounded in non-automatic weapon attacks, showing that "the death rate if you got hit by a bullet was the same," Haider said.

"Active shooters are hell-bent on killing people," he said. "The big difference — and this is not such a big surprise — is if you give them a semi-automatic, they're able to shoot twice the number of people."

The average number of people wounded in semi-automatic attacks totaled nearly six, versus about three in attacks with a non-automatic weapon. Roughly four people were killed on average in semi-automatic attacks, compared with about two in other attacks, the study found.

The results were published Tuesday in the Journal of the American Medical Association.

Haider said the study highlights a need to better track details on types of weapons used in active shooter attacks; FBI figures do not detail whether weapons used were semi-automatic so the researchers got that information from court and police documents and news media reports.

Semi-automatic rifles cause more deaths and injuries, but "firearms in general, regardless of the type, are extraordinarily lethal weapons," said Dr. Cassandra Crifasi, deputy director of the Johns Hopkins Center for Gun Policy and Research, who was not involved in the research.

A longtime gun owner and sports shooting enthusiast, Crifasi said her understanding of gun culture brings a different perspective to gun research and safety. "The main thing is that there are gun owners like me ... who support common sense solutions to reducing gun violence," she said.

Copyright Associated Press / NBC New York



Photo Credit: Keith Srakocic/AP]]>
<![CDATA[Doctors Gave No Reason for 1/3 of Opioid Prescriptions: Study]]>Tue, 11 Sep 2018 09:20:26 -0500https://media.nbcnewyork.com/images/213*120/cms1251.jpg

New research shows that about one-third of doctors who prescribed opioids in the buildup to the opioid overdose epidemic gave no reason for doing so, according to NBC News.

In 29 percent of cases between 2006 and 2015, doctors's opioid prescriptions had no explanation for why they were written, a team from Harvard Medical School and the Rand Corp. reported Monday.

"Whatever the reasons, lack of robust documentation undermines our efforts to understand physician prescribing patterns and curtails our ability to stem overprescribing," said Dr. Tisamarie Sherry, who worked on the study, in a statement.

Federal agencies have said that inappropriate prescribing practices contributed to the crisis that saw 42,000 people die in 2016 alone. The Centers for Disease Control and Prevention has been encouraging doctors to prescribe opioids only when necessary.



Photo Credit: Getty Images/Cultura RF, File]]>
<![CDATA[GOP Lacks Votes — and Appetite — to End 'Obamacare']]>Tue, 11 Sep 2018 01:37:58 -0500https://media.nbcnewyork.com/images/213*120/jkAP_18253844547904.jpg

Arizona's new senator says he'd vote to repeal the nation's health care law. That's one additional Republican ready to obliterate the statute because his predecessor, the late Sen. John McCain, helped derail the party's drive with his fabled thumbs-down vote last year.

It could well be too little, too late.

After years of trying to demolish former President Barack Obama's prized law, GOP leaders still lack the votes to succeed. Along with the law's growing popularity and easing premium increases, that's left top Republicans showing no appetite to quickly refight the repeal battle.

"I'm not going to be asking for another vote on that this year," No. 2 Senate GOP leader John Cornyn of Texas said last week when asked if he favored reopening the issue in a postelection lame duck session. No. 3 House leader Steve Scalise, R-La., said, "We need to win this election and then get more seats next year." Each is their party's chief vote counter.

That means any serious push to annul the statute would almost certainly hinge on Republicans retaining House control and adding Senate seats in November's elections, neither of which is assured. If either goal eludes them on Election Day, President Donald Trump's ability to deliver on one of his top campaign promises would have to wait for a second term, if he gets one.

Republicans seemed to gain ground last week when Sen. Jon Kyl replaced McCain, who died in August from brain cancer. Kyl said in a brief interview that he would have backed the measure that McCain opposed, a pivotal vote that would have sustained the repeal drive.

"It seems to me that would have been a useful thing to do," Kyl said.

That bill failed 51-49. A "yes" from McCain would have meant a 50-50 tie that Vice President Mike Pence could have broken by casting his own vote.

Yet the two other GOP senators who also voted no, Maine's Susan Collins and Lisa Murkowski of Alaska, haven't relented. With Republicans controlling the Senate 51-49, the GOP remains short of the 50 votes they'd need.

"I would still oppose outright repeal," Collins said in a short interview last week. In a written statement, aides said Murkowski "is not interested in another rushed, partisan process in the absence of a quality, comprehensive replacement" for the law.

Republicans have one fewer seat this year because Alabama Democrat Doug Jones defeated Republican Roy Moore in a December special election. Moore had defeated incumbent GOP Sen. Luther Strange in a party primary.

Senate Majority Leader Mitch McConnell, R-Ky., has ruled out revisiting the health care fight before November's midterm elections, citing the crush of spending and other bills facing Congress. He's displayed little desire to revisit the issue, which many Democrats are using in their election campaigns because Obama's law is widely accepted, especially provisions like requiring insurers to cover people with pre-existing medical conditions.

Returning to the health care fight is a decision "I don't have to reach anytime soon and don't have time to facilitate, even if I was so inclined," McConnell told reporters last week. He has said he doesn't want to resume the fight unless he can win, and his House counterpart is also showing his focus is elsewhere.

"I haven't even thought about it," said House Speaker Paul Ryan, R-Wis.

A lame-duck session would last barely over a month and likely be absorbed with lingering budget disputes and picking the new Congress' leaders.

That would leave scant time for health care work, such as resolving intractable disputes about what a replacement bill would look like.

Then they'd need an official cost estimate of any bill from the nonpartisan Congressional Budget Office, which could take weeks. They'd also have to take procedural steps to protect their bill from a Senate Democratic filibuster, which would otherwise essentially kill the measure by requiring Republicans to garner 60 votes to succeed.

"There's still a process that we have to go through, and people have to be aware of it," said Sen. Bill Cassidy, R-La., who opposes the health care program. "You don't just drop it from heaven like manna."

Explaining the diminished urgency, Cornyn cited Congress' repeal last December of the tax penalty on people who don't buy individual insurance. That requirement, aimed at prodding healthier people to buy coverage and stabilize health markets, was one of the law's least popular provisions.

Cornyn also mentioned Trump administration rules making it easier for people to buy short-term health care policies or association plans offered by groups of small businesses or self-employed people. Such packages could offer lower premiums but cover fewer benefits, and Democrats criticize them as undermining the consumer protections Obama's law was designed to enshrine.

Also easing pressure on Republicans to act are indications that insurance premiums, a major vexation for voters, are growing more slowly.

An analysis by the consulting firm Avalere Health and The Associated Press last week found a 3.3 percent average increase in proposed or approved premiums across 47 states and Washington, D.C., for 2019. The average increase nationally this year was about 30 percent.

Meanwhile, the House plans to vote this week on a bill easing requirements the law imposed on employers. The measure would make it easier for companies to provide health insurance for fewer workers, refund tax penalties firms paid for not covering employees and postpone a levy on expensive policies companies provide workers.

Further underscoring the effort's lack of traction, that measure seems certain never to emerge from Congress.

Copyright Associated Press / NBC New York



Photo Credit: Cliff Owen/AP, File ]]>
<![CDATA[Nutritionist-Approved Frozen Meals]]>Mon, 10 Sep 2018 12:49:11 -0500https://media.nbcnewyork.com/images/213*120/stirfryGettyImages-112856093.jpg

If you're picking up a frozen meal from the grocery store, there are a few things you want to look for before stocking up, according to NBC News.

A meal that has less than 500 calories and no more than 600 milligrams of sodium is your best option. It should also have at least 10 grams of protein and 3 grams of fiber. This will ensure you stay full longer and won't be looking to snack a few hours later. 

Read the ingredients list. The first ingredient should be a whole food, for example, a protein like chicken, a fruit or vegetable or a whole grain. Avoid trans fats.

Here are seven nutritionist-picked meals to consider:

 

  • Sweet Earth Curry Tiger Bowl
  • Luvo Chicken Harissa Chickpeas
  • Evol Vegetable Enchiladas
  • Amy's Kitchen Brown Rice & Vegetables Bowl
  • Caulipower Margherita Pizza
  • Trader Joe's Wild Salmon
  • Gardein Asian Style Chick'n Fried Rice



Photo Credit: Bill Hogan/Chicago Tribune/MCT via Getty Images]]>
<![CDATA[Doctors Explore Lifting Barriers to Living Organ Donation]]>Mon, 10 Sep 2018 06:53:22 -0500https://media.nbcnewyork.com/images/213*120/AP_18250590512164-Living-Organ-Donors.jpg

Surgeons turned down Terra Goudge for the liver transplant that was her only shot at surviving a rare cancer. Her tumor was too advanced, they said — even though Goudge had a friend ready to donate, no matter those odds.

"I have a living donor — I'm not taking away from anyone. I'm trying to save my own life," she pleaded. Finally, the Los Angeles woman found a hospital on the other side of the country that let the pair try.

People lucky enough to receive a kidney or part of a liver from a living donor not only cut years off their wait for a transplant, but those organs also tend to survive longer. Yet living donors make up a fraction of transplants, and their numbers have plateaued amid barriers that can block otherwise willing people from giving. Among them: varying hospital policies on who qualifies and the surprising financial costs that some donors bear.

Now researchers are exploring ways to lift those barriers and ease the nation's organ shortage.

"We just want people to be given the chance to at least entertain this as a possibility," said Dr. Abhinav Humar, transplant chief at the University of Pittsburgh Medical Center, where Goudge ultimately received part of friend Amy Aleck's liver.

Thousands of people die each year waiting for an organ transplant. Nearly 14,000 are on the waiting list for a liver transplant. Of 8,082 transplants last year, just 367 were from living donors, according to the United Network for Organ Sharing, or UNOS, which oversees the nation's transplant system. Living kidney donations are more common but still not enough to meet the need. About 95,000 people are on the kidney waiting list. Of 19,849 transplants last year, 5,811 were from living donors.

Also troubling, black and Hispanic patients are less likely than whites to receive a kidney from a living donor, and a study in the Journal of the American Medical Association earlier this year found the disparity is growing.

One hurdle is economic. The transplant recipient's insurance pays the donor's medical bills. But donors are out of work for weeks recuperating. The U.S. Labor Department last month made clear that a donor's job can be protected under the Family Medical Leave Act. But that's unpaid leave — and donors lose income if their employer doesn't allow some form of paid time off. They also may have other expenses such as travel and hotel bills for visits to a far-away transplant center.

One study found more than a third of living kidney donors reported lost wages in the first year following donation. The median amount was $2,712, particularly difficult if asking economically disadvantaged friends or family for an organ.

"It's a strange thing to tell you that donors have to pay for the privilege of donating their kidneys. I think most of us would agree that's just fundamentally wrong," said Dr. Paige Porrett, a surgeon with the University of Pennsylvania.

Penn is one of half a dozen transplant centers testing whether reimbursing a donor's lost income could shorten the wait for a kidney.

"The community's in a real bind about how we can help them," Porrett said. "It's a fine line that it doesn't get misconstrued that we're paying people for their organs."

Another challenge: Living donation too often is considered as a last resort rather than a first choice, said Pittsburgh's Humar — especially for liver transplants. His hospital is trying to change that and last year performed more adult liver transplants from living donors than deceased ones, a milestone.

The liver is unique, able to regenerate a few months after donors give a piece. But it is a larger and riskier operation than donating a kidney.

And that sparks an ethical debate: Many people with failing livers aren't allowed onto the national waiting list for organs from deceased donors. That's because the scarce supply is rationed, given only to those with the best survival chances. But what if patients who don't qualify find a living donor? Should the donor be allowed to undergo a risky surgery if the recipient's predicted survival isn't quite as good?

Goudge, the California patient, had been fighting a rare condition called fibrolamellar hepatocellular carcinoma since 2001. A variety of treatments kept her cancer in check for years but eventually it overwhelmed her liver. While Goudge's condition isn't as aggressive as typical liver cancer, it was more advanced than transplant waiting list rules allow — and the first surgeons she consulted said living donation wasn't an option either.

Then she stumbled onto Pitt's program. Humar says living donation could allow transplants for many patients who otherwise would never get one — either because too many people are ahead of them on the waiting list or because they weren't listed. After extensive evaluation of both patient and would-be donor, Humar decided Goudge had a good enough shot at prolonged survival to justify the risk to her friend. In April, his team replaced Goudge's liver with a healthy piece of Aleck's. Both recovered well.

"She is truly a walking miracle for me," Goudge said.

Copyright Associated Press / NBC New York



Photo Credit: Family Photo via AP]]>
<![CDATA[Calif. Mom Shares Warning After Finding Glass Shards in Kid's Burrito]]>Tue, 11 Sep 2018 10:54:31 -0500https://media.nbcnewyork.com/images/213*120/Santee_Mom_Claims_Glass_Found_in_Burrito.jpg

A Santee, California, mother is warning people about a potential hazard after finding glass shards in her daughter's frozen burrito.

Tracey Brintle's daughter, Kayla, was eating a Tina's Beef and Bean Burrito that she bought from a local 99ȼ Only Stores about two weeks ago when she suddenly heard a crunching noise.

"It's a beef and bean burrito so you shouldn't be hearing anything," Brintle said. "And I saw what's left on her plate and I saw that there was glass."

Brintle immediately rushed her daughter to the emergency room, but her daughter was OK. Brintle reached out to both 99ȼ Only Stores in Santee, where she bought the burritos, as well as the maker of the burritos.

A representative from Tina's Burritos had told Brintle the company would send her a box to ship the burrito back to the company so it could test the food. The company has not sent the box since that conversation, though the company did call her again Friday to say a box was on its way.

Brintle said she wants to warn parents about the potential hazard because she doesn't want what happened to her daughter to happen to another child. She said she doesn't want to wait for the company to complete its testing before deciding to pull the batch from shelves.

"I'm sure that batch is still available in stores because I only bought it in the middle of August," Brintle said. "And it needs to be pulled off the shelves."

A spokesperson for Tina's said Brintle's incident was their only known complaint. 

"The matter has been escalated to the highest levels of our company. We are currently engaged in the process of a full and detailed investigation which we conduct in the case of receiving feedback of this nature," Customer Service Manager Lee Ann Vasquez said. 

The company's testing process includes both the burrito in question, once retrieved from the consumer, and other burritos in the same production run, Vasquez said. So far, their testing has not found any other problems. 

In addition to 99ȼ Only Stores, Tina's Burritos is also available at other grocery store chains, such as Smart & Finals, Food 4 Less and Vons.

The 99ȼ Only Stores in Santee said it's started the recall process but the company. Tina's has not recalled any burritos. 

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<![CDATA[Convenience Shops Go Healthy as Millennials Choose Wellness]]>Sun, 09 Sep 2018 09:36:24 -0500https://media.nbcnewyork.com/images/213*120/AP_18226715867958.jpg

In convenience stores spawned by the wellness wave, kombucha slushies take the place of corn-syrupy treats infused with red dye, tortilla chips are made of cassava flour instead of corn and there are vegan ice cream bars and a dizzying selection of organic produce and craft beer on tap.

Traditional corner markets have been notching up their healthier options in recent years, selling pre-made salads, nut milks and organic yogurts.

But a new crop of niche stores aimed at millennials who can afford to pay more have completely overhauled the shelves, making gluten-free and organic products their staples, not just the side dish, along with compostable straws and on-demand delivery. These shoppers also like to see their stores support what they consider worthy causes.

"We think of our stores as a human recharging station as opposed to the traditional convenience store, which tears down your health," said Lisa Sedlar, who's about to open her fourth Green Zebra Grocery in Portland, Oregon.

The store sells so much kombucha that it recently launched its own line of kombucha slushies with flavors including pineapple ginger and marionberry mint. It also offers itself as a pickup spot for customers who have pre-ordered weekly boxes of fresh produce from local farms.

There's even a store on Portland State University campus to satisfy late-night dorm cravings. That store attracts about 1,500 visits a day with coconut sugar and gluten-free flour in bulk bins, and other health-oriented goods.

Analysts say millennials, who are willing to pay a premium for higher-quality ingredients and want to support companies in line with their values, are a driving force behind the trend for stores that are popping up around the country from Los Angeles to Philadelphia.

A 2018 report from EuroMonitor says convenience stores are changing their image to appeal to a more health-conscious generation, stocking up on gluten-free, grass-fed and organic products.

While "portability and grab-and-go convenience remain critical, millennial dietary habits stand to revolutionize a channel that has been anything but health-conscious in the past," the report says.

At least 200 stores fall into this category in the United States, said Jeff Lenard, a vice president with Advancing Convenience & Fuel Retailing. And while that's still a small segment of the 154,000 convenience stores in the U.S., he said it's likely to grow.

Everything at The Goods Mart in Silver Lake, California, is free of artificial flavors and dyes, nitrates and genetically modified ingredients. Customers choose from healthy snacks, $4 breakfast burritos and ugly fruit provided through a partnership with a local farmer, including avocados that cost only 50 cents.

There are no single-serve plastic bottles or plastic straws. Instead the coffee and slushies come in recycled paper cups with compostable paper straws, although many customers buy metal or glass straws at the cash register.

Customers can also donate up to 5 percent of their bill to charity, including a local homeless mission, says founder Rachel Krupa.

Experts predict those layered missions will give green convenience stores staying power.

"I don't believe it's a passing fad," said David Portalatin, food industry adviser for trend group NPD. "People bring the same demand for convenience but with a whole new set of food values to go along with it."

Choice Market in Denver even created its own delivery app for consumers who want their gourmet sandwich, organic produce and craft beer on demand. About 30 percent of the store's sales are delivery.

"It's such a big piece of our target market and how they shop," said CEO Mike Fogarty, who donates leftovers to a local food bank.

The response has been so strong that construction has started on two additional stores, including one in partnership with the Denver Housing Authority to service low-income neighborhoods lacking nearby grocery stores with healthier foods and fresh produce and to hire at-risk youth.

The checkout counter at Mendez Fuel in Miami is filled with the expected cigarettes, lottery tickets and mini bottles of whiskey, but there's also a large selection of high-end dark chocolate. Behind the cafe counter sits a massive prep bowl of leafy greens next to a woman pouring filling into handmade vegan empanadas.

A large line has formed waiting for orders off a menu that includes smoothies with algae, bee pollen, matcha and other superfoods. They also serve house-made, organic, cold-pressed juices and have a vast selection of craft beer.

Jay Mayorga, a 25-year-old barber who works nearby and follows a paleo diet, stops in about four times a week for a green smoothie or acai bowl and he usually grabs some jerky or a protein bar.

"Paleo is hard to find so I like that," he said.

The store has a large selection of vegan, paleo, keto and other healthy snacks including specialty nut butters, non-dairy cheeze puffs and grain-free tortilla chips.

Mendez Fuel owner Michael Mendez made an effort to stock the shelves with hard-to-find specialty diet items, including a $15 jar of dairy-free yogurt with 400 billion live probiotic cultures, $19 jars of high-end nut butters and $4 collagen protein bars.

"We're becoming a destination," Mendez said. "People are going out of their way to come to us because we have products that they can't find anywhere else."

Copyright Associated Press / NBC New York



Photo Credit: AP Photo/Lynne Sladky]]>
<![CDATA[Modest Premium Hikes as 'Obamacare' Stabilizes, Data Show]]>Fri, 07 Sep 2018 10:39:56 -0500https://media.nbcnewyork.com/images/213*120/Healthcare.gov-website.jpg

Millions of people covered under the Affordable Care Act will see only modest premium increases next year, and some will get price cuts. That's the conclusion from an exclusive analysis of the besieged but resilient program, which still sparks deep divisions heading into this year's midterm elections.

The Associated Press and the consulting firm Avalere Health crunched available state data and found that "Obamacare's" health insurance marketplaces seem to be stabilizing after two years of sharp premium hikes. And the exodus of insurers from the program has halted, even reversed somewhat, with more consumer choices for 2019.

The analysis found a 3.6 percent average increase in proposed or approved premiums across 47 states and Washington, D.C., for next year. This year the average increase nationally was about 30 percent. The average total premium for an individual covered under the health law is now close to $600 a month before subsidies.

For next year, premiums are expected either to drop or increase by less than 10 percent in 41 states with about 9 million customers. Eleven of those states are expected to see a drop in average premiums. In six other states, plus Washington, D.C., premiums are projected to rise between 10 percent and 18 percent.

Insurers also are starting to come back. Nineteen states will either see new insurers enter or current ones expand into more areas. There are no bare counties lacking a willing insurer.

Even so, Chris Sloan, an Avalere director, says, "This is still a market that's unaffordable for many people who aren't eligible for subsidies."

Nearly 9 in 10 ACA customers get government subsidies based on income, shielding most from premium increases. But people with higher incomes, who don't qualify for financial aid, have dropped out in droves.

It's too early to say if the ACA's turnabout will be fleeting or a more permanent shift. Either way, next year's numbers are at odds with the political rhetoric around the ACA, still heated even after President Donald Trump and congressional Republicans failed to repeal the law last year.

Trump regularly calls "Obamacare" a "disaster" and time again has declared it "dead." The GOP tax-cut bill repealed the ACA requirement that Americans have health insurance or risk fines, effective next year. But other key elements remain, including subsidies and protection for people with pre-existing conditions. Democrats, meanwhile, accuse Trump of "sabotage," driving up premiums and threatening coverage.

The moderating market trend "takes the issue away from Republican candidates" in the midterm elections, said Mark Hall, a health law and policy expert at Wake Forest University in North Carolina. "Part of the mess is now their fault, and the facts really don't support the narrative that things are getting worse."

Market stability also appears to undercut Democrats' charge that Trump is undermining the program. But Democrats disagree, saying the ACA is in danger while Republicans control Washington, and that premiums would have been even lower but for the administration's hostility.

"Voters won't think that the Trump threat to the ACA has passed at all, unless Democrats get at least the House in 2018," said Bill Carrick, a strategist for Sen. Dianne Feinstein, D-Calif., whose re-election ads emphasize her support for the health law.

As if seconding Democrats' argument, the Trump administration has said it won't defend the ACA's protections for pre-existing conditions in a federal case in Texas that could go to the Supreme Court. A new Kaiser Family Foundation poll found that Americans regardless of partisan identification said those protections should remain the law of the land.

In solidly Republican Arkansas, Democratic state legislator and cancer survivor Clarke Tucker is using the ACA in his campaign to try to flip a U.S. House seat from red to blue. Tucker, 37, says part of what made him want to run is the House vote to repeal the ACA last year and images of Trump and GOP lawmakers celebrating at the White House.

Business analysts say the relatively good news for 2019 is partly the result of previous premium increases, which allowed insurers to return to profitability after losing hundreds of millions of dollars.

"They can price better, and they can manage this population better, which is why they can actually make some money," said Deep Banerjee of Standard & Poor's.

Repeal of the ACA's requirement to carry insurance doesn't seem to have had a major impact yet, but Banerjee said there's "a cloud of uncertainty" around the Trump administration's potential policy shifts. Yet some administration actions have also helped settle the markets, such as continuing a premium stabilization program.

April Box of Spokane Valley, Washington, lives in a state where premiums could rise substantially since insurers have proposed an 18 percent increase. In states expecting double-digit increases, the reasons reflect local market conditions. Proposed increases may ultimately get revised downward.

Box is self-employed as a personal advocate helping patients navigate the health care system. She has an ACA plan, but even with a subsidy her premiums are expensive and a high deductible means she's essentially covered only for catastrophic illness.

"I'm choosing not to go to the doctor, and I'm saying to myself I'm not sick enough to go to the doctors," Box said. "We need to figure out how to make it better and lower the price."

Now in her 50s, Box was born with dislocated hips. She worries she could be uninsurable if insurers are allowed to go back to denying coverage for pre-existing conditions. She might need another hip surgery.

"It needs to be a level playing field for everybody," said Box. "We need to have universal coverage — that is really the only answer."

Tennessee is a prime example of the ACA's flipped fortunes.

Last year, the state struggled to secure at least one insurer in every county. But approved rates for 2019 reflect an 11 percent average decrease. Two new insurers — Bright Health and Celtic— have entered its marketplace, and two others —Cigna and Oscar— will expand into new counties.

Tennessee Republican Sen. Lamar Alexander called that a "welcome step," but argued rates could have been even lower if congressional Democrats had supported a market stabilization bill. Democrats blame Republicans for the failure.

To calculate premium changes, Avalere and The Associated Press used proposed overall individual marketplace rate filings for 34 states and D.C., and final rates for 13 states that have already approved them. Data was not available for Massachusetts, Maryland and Alabama. The average rate change calculations include both on-exchange and off-exchange plans that comply with ACA requirements. The government isn't expected to release final national figures until later this fall.

Copyright Associated Press / NBC New York



Photo Credit: Healthcare.gov]]>
<![CDATA[Hospital Groups Launch Own Company to Make Generic Drugs]]>Thu, 06 Sep 2018 05:17:24 -0500https://media.nbcnewyork.com/images/213*120/civicaGettyImages-730138169.jpg

Several major hospital groups Thursday launched their own generic drug company to tackle chronic shortages and high prices.

The new company, Civica Rx, plans to start with 14 widely used hospital drugs long in short supply. The company isn't disclosing the drugs' names for competitive reasons, but they include a mix of generic pills, patches and injectable drugs for treating infections, pain and heart conditions, board chairman Dan Liljenquist said.

"The mission of Civica is to make sure these drugs remain in the public domain, that they're available and affordable to everyone," he said.

Drug shortages have been widespread for more than a decade, particularly for inexpensive generic drugs, due to manufacturers consolidating, stopping production of low-profit medicines and having to fix manufacturing problems.

Hospitals are particularly hard hit and frequently must scramble to find scarce medicines, often at huge price markups, or come up with workarounds that may not be as effective or safe for patients.

Besides creating a reliable supply for its 500 hospitals, Civica aims to reduce drug prices by about 20 percent. The drugs will be sold to nonmember hospitals as well, at slightly higher prices, Liljenquist said.

The company, based in the Salt Lake City area, plans to make some of the generics itself and hire companies to produce others, he said. It is aiming to get its first medicines on the market by mid- to late 2019.

Civica was founded and funded by three health foundations and seven hospital groups, among them Intermountain Healthcare, a 23-hospital system based in Salt Lake City where Liljenquist is chief strategy officer. Veterans Affairs and the American Hospital Association also are participating.

Chief executive of the not-for-profit company will be Martin VanTrieste, the retired head of manufacturing quality at biotech drugmaker Amgen.

Copyright Associated Press / NBC New York



Photo Credit: Getty Images/Tetra images RF, File ]]>
<![CDATA[Fact Check: Kavanaugh on the Affordable Care Act]]>Wed, 05 Sep 2018 20:10:25 -0500https://media.nbcnewyork.com/images/213*120/AP_18247564205902-Kavanaugh-Hearing.jpg

Several Democratic senators have claimed that Judge Brett M. Kavanaugh’s history shows he would be a danger on the court to the Affordable Care Act. Senate Minority Leader Chuck Schumer said on Aug. 28 on the Senate floor: “Judge Kavanaugh has written opinions skeptical of our health care law, reproductive rights, and even the contraception coverage requirement.”

The criticisms have focused on two dissents Kavanaugh wrote in cases challenging the constitutionality of the individual mandate, and a third dissent in a case challenging the ACA’s contraception coverage accommodations for certain religious organizations. Also, Democrats have repeatedly stressed that a case in District Court in Texas could reach the Supreme Court and affect preexisting condition protections in the health care law. We’ll look at the facts.

THE ACA's CONSTITUTIONALITY
What Democrats are saying: "There’s a Texas case where that’s being challenged right now, that’s moving up, it could likely go before the Supreme Court. Well knowing your record, it is right that these Americans, so many of them with preexisting conditions are asking whether the Supreme Court will be an institution that affirms and protects the rights of people with access to healthcare,” Sen. Cory Booker said during the first day of the confirmation hearings on Sept. 4. “We all know too many people who have set aside prescription drugs because they’re too high, because of what corporations are doing there. People who have put off going to see the doctor because a visit is too expensive, that is in the balance with this nomination.”

“Judge Kavanaugh, you wrote, for example, in Seven-Sky v. Holder that a president can disregard a law passed by Congress if he deems it to be unconstitutional, even if a court has upheld it,” Sen. Amy Klobuchar said in the Sept. 4 hearing.

Senate Minority Leader Chuck Schumer said in a July 9 tweet: “Judge Kavanaugh’s own writings make clear that … he would welcome challenges to the constitutionality of the Affordable Care Act.”

Also in a July 9 tweet, Sen. Elizabeth Warren described Kavanaugh as being “hostile to health care for millions.”

What Kavanaugh’s record shows: As an appellate judge on the U.S. Court of Appeals for the District of Columbia Circuit, Kavanaugh issued dissents in two cases that challenged the constitutionality of the Affordable Care Act’s individual mandate, which requires most people to have health insurance or pay a penalty on their tax returns. (The Republican tax law signed in December 2017 eliminated the tax penalty, effective for the 2019 tax year.)

Seven-Sky v. Holder, 2011. The appeals court rejected this challenge to the ACA’s individual mandate. Kavanaugh dissented, but his objection concerned the jurisdiction of the court, not the constitutionality of the health care law.

Kavanaugh wrote that the court shouldn’t have heard the case because the Anti-Injunction Act said a tax must be assessed and collected before a suit against it could be decided. (The individual mandate didn’t go into effect until the 2014 tax year.)

He argued that what the law referred to as “penalties” were to be “assessed and collected in the same manner as taxes.” And he said he would “leave these momentous constitutional issues for another day – a day that may never come.”

Kavanaugh dissent, Seven-Sky v. Holder, 2011: Between now and 2015, Congress might keep the mandate as is and the President may enforce it as is. If that happens, the federal courts would resolve the resulting constitutional case by our best lights and would not shy away from a necessary constitutional decision. But history tells us to cross that bridge only if and when we need to. Unlike the majority opinion, I would adhere to the text of the Anti-Injunction Act and leave these momentous constitutional issues for another day – a day that may never come.

There are differing views on what Kavanaugh’s lengthy dissent may say about his stance on the ACA.

The Federalist, a conservative online publication, published opposing takes in early July.

One commentator called it a “roadmap to save Obamacare,” noting that Kavanaugh wrote that “this case could disappear by 2015 because, by then, Congress may fix the alleged constitutional shortcoming and ensure that the Affordable Care Act’s individual mandate provision fits comfortably within Congress’ Taxing Clause power.” In fact, the Supreme Court in 2012 in NFIB v. Sebelius upheld the constitutionality of the individual mandate under the taxing clause.

But on July 3, The Federalist published a second analysis that said the “roadmap” claim was “nonsense.” Justin Walker, a former law clerk for Justice Anthony Kennedy and Kavanaugh, and an assistant professor at the University of Louisville Brandeis School of Law, wrote in that piece that Kavanaugh’s dissent was actually a “roadmap” for the Supreme Court dissenters in the NFIB v. Sebelius case.

Another former clerk for Kavanaugh, Sarah E. Pitlyk, wrote in the National Review that Kavanaugh said in his dissent that the taxing clause “has not traditionally authorized a legal prohibition or mandate.” And while “he ultimately determined that a challenge to Obamacare had to be brought later,” she said, “he left no doubt about where he stood.”

But Timothy S. Jost, an emeritus professor at the Washington and Lee University School of Law and an expert on health care, wrote in a July 16 analysis of Kavanaugh’s record for the Commonwealth Fund that the Supreme Court nominee didn’t show “strong opposition” to the health care law in this case, or the one we’ll examine next.

“After a long discussion of the Tax Anti-Injunction Act in Seven-Sky, Kavanaugh concluded his opinion by musing about the possible invalidity of the mandate under Congress’s commerce power,” Jost wrote. “On the one hand, he entertained arguments that the mandate encroached on state authority and individual rights, but on the other, he suggested that it was a novel approach to providing safety-net services through the private sector. Seeing both sides of the argument, he concluded that the court should avoid a constitutional ruling until the case was properly before it.”

Klobuchar, and other Democrats, have highlighted one line in particular from Kavanaugh’s dissent, where he says: “Or the President might not enforce the individual mandate provision if the President concludes that enforcing it would be unconstitutional.” In a footnote, Kavanaugh says: “Under the Constitution, the President may decline to enforce a statute that regulates private individuals when the President deems the statute unconstitutional, even if a court has held or would hold the statute constitutional.”

Klobuchar framed this as an executive power issue, not explicitly a health care issue.

Jost told us in a phone interview that it’s “not unprecedented” for a president to take the position that a law is unconstitutional, but it is “very controversial” to hold that a president can refuse to enforce a statute after a court has upheld its constitutionality.

Our fact-checking colleagues at PolitiFact.com spoke with several legal experts about this issue, finding: “Experts generally agree that a president is not bound by a lower court’s decision when deciding a law is unconstitutional but diverge on whether the Supreme Court has the final say.”

Abbe R. Gluck, a professor of law and the faculty director of the Solomon Center for Health Law and Policy at Yale Law School, told us in an email: “[T]hat is indeed a very controversial position to take, one that embraces what I would say is a dangerously broad view of presidential power, especially in the case where a court has upheld the law in question.” But Kavanaugh’s statement doesn’t reveal much about his views on the ACA, she said, noting that “the footnote was dropped in the very same case in which Judge Kavanaugh actually rejected an early major constitutional challenge to the ACA.”

Sissel v. HHS, 2015. Schumer’s July tweet included a graphic that cited this case, saying: “Judge Kavanaugh argued that the D.C. Circuit Court should consider a claim that the ACA was unconstitutional. His fellow judges described it as a ‘flawed’ ‘misread’ of SCOTUS precedent.”

In Sissel v. HHS, an Iowa artist named Matt Sissel argued that the Affordable Care Act was unconstitutional because it violated the origination clause of Article 1, which says that legislation that raises revenue must originate in the House of Representatives. The three-judge panel for the District of Columbia Circuit ruled against Sissel, and he requested the court reconsider the case en banc, meaning the full court would hear the case.

The appeals court again rejected the claim, saying, “The purpose of the ACA was to overhaul the national healthcare system, not to raise revenue.”

Kavanaugh dissented, joined by three other judges. He said the ACA was indeed “a revenue-raising bill subject to the Origination Clause.” But, he said, the ACA complied with the clause. “Although the original House bill was amended and its language replaced in the Senate, such Senate amendments are permissible under the Clause’s text and precedent,” Kavanaugh wrote.

He said he would grant the en banc hearing — so, Schumer is technically correct that Kavanaugh “argued that the D.C. Circuit Court should consider a claim that the ACA was unconstitutional.” But that ignores the fact that Kavanaugh went on to argue that the court should “rule for the Government on the ground that the Affordable Care Act originated in the House and thereby complied with the Origination Clause.”

The court’s opinion also did say that Kavanaugh’s reading of Supreme Court precedent was “flawed” — but Kavanaugh, along with his fellow dissenters, described the panel opinion as “flawed” as well. The disagreement was over whether the origination clause applied in the case, not whether the ACA was constitutional.

Kavanaugh argued that not ruling on the case would raise constitutional questions about the origination clause and the balance of power between the House and the Senate.

The Harvard Law Review wrote of the case: “Sissel sends a very strong message regarding the constitutionality of the ACA under the Origination Clause. Even the four dissenting judges reached the conclusion that the ACA is constitutional, likely indicating unanimity across the D.C. Circuit.”

The Texas case and preexisting conditions. As we wrote this summer, in their opposition to Kavanaugh’s nomination, Democrats have highlighted a case filed in District Court in Texas, and the Trump administration’s decision to not defend the federal government in that case.

The Texas suit, filed by that state and 19 others, points to the Supreme Court’s 2012 decision that the ACA’s individual mandate to have health insurance was lawful under Congress’ power to tax. Since Congress has now eliminated the tax penalty associated with the individual mandate (starting in tax year 2019), the suit argues, the mandate itself is unconstitutional. Without the mandate, the suit says, “the remainder of the ACA must also fall.”

The Department of Justice has sided with the plaintiffs, but disagrees that the entire health care law must be eliminated. Instead, the DOJ said a finding that the mandate were unconstitutional would mean ACA preexisting condition provisions — provisions guaranteeing that those with medical conditions won’t be denied coverage or charged more based on health status — would have to be eliminated as well.

The case has a long way to go before the Supreme Court would have any potential impact. It would need to make its way through the District Court in Texas, which began hearing oral arguments on Sept. 5, then through an appeals court and then to the Supreme Court.

CONTRACEPTION
What Democrats are saying: “And he would not uphold the Affordable Care Act’s contraception mandate,” Sen. Bernie Sanders claimed this summer.

What Kavanaugh’s record shows: Kavanaugh sided with religious organizations in a case challenging the ACA’s requirement that insurance policies include coverage of birth control. There’s some nuance, though, to this dissent as well.

Priests for Life v. HHS, 2015. The plaintiff — a Catholic anti-abortion rights group — challenged the Obama administration’s accommodation to the ACA’s contraception mandate for religious employers. That accommodation, which pertained to nonprofits with religious affiliations and closely-held for-profit companies, said that women working for those groups could get contraception coverage paid for by the insurers, instead of their employers, if the employers notified the insurance companies or the Department of Health and Human Services of their religious objections.

The appeals court rejected the plaintiffs’ request for a rehearing en banc. Kavanaugh dissented, saying he would “rule for the plaintiff religious organizations.” But he also said that the Supreme Court ruling in the 2014 Hobby Lobby case “strongly suggests that the Government has a compelling interest in facilitating access to contraception for the employees of these religious organizations.” However, Kavanaugh said, the accommodation for the religious groups “is not the Government’s least restrictive means of furthering its interest.”

Jost, writing for the Commonwealth Fund, said that Kavanaugh acknowledged this “compelling interest” and “argued only that the government could have fulfilled that interest through an approach less restrictive of the rights of religious organizations.”

In addition to these cases, Jost includes one on abortion and another on Medicare coverage in his full analysis, finding that “[i]n none of these cases did Kavanaugh stake out a strong ideological position, for example, opposing abortion or the ACA. … This is not to say, however, that as a Supreme Court justice Kavanaugh might not effectuate major changes in law affecting controversial health policy issues.”



Photo Credit: Andrew Harnik/AP]]>
<![CDATA[Major Opioid Maker to Pay for Overdose-Antidote Development]]>Wed, 05 Sep 2018 14:26:43 -0500https://media.nbcnewyork.com/images/213*120/cms1251.jpg

A company whose prescription opioid marketing practices are being blamed for sparking the addiction and overdose crisis says it's helping to fund an effort to make a lower-cost overdose antidote.

OxyContin maker Purdue Pharma announced Wednesday that it's making a $3.4 million grant to Harm Reduction Therapeutics, a Pittsburgh-based nonprofit, to help develop a low-cost naloxone nasal spray.

The announcement comes as lawsuits from local governments blaming Purdue, based in Stamford, Connecticut, and other companies in the drug industry for using deceptive marketing practices to encourage heavy prescribing of the powerful and addictive painkillers. Last week, the number of lawsuits against the industry being overseen by a federal judge topped 1,000.

The Cleveland-based judge, Dan Polster, is pushing the industry to settle with the plaintiffs — mostly local governments and Native American tribes — and with state governments, most of which have sued in state court or are conducting a joint investigation. Hundreds of other local governments are also suing in state courts across the country.

The sides have had regular settlement discussions, but it's not clear when a deal might be struck in the case, which is complicated by the number of parties and questions on how to assign blame.

The U.S. Centers for Disease Control and Prevention estimated that drug overdoses killed a record 72,000 Americans last year, about 10 percent more than in 2016. The majority of the deaths involved opioids. But a growing number of them are from illicit synthetic drugs, including fentanyl, rather than prescription opioids such as OxyContin or Vicodin.

Governments are asking for changes in how opioids are marketed, and for help paying for treatment and the costs of ambulance runs, child welfare systems, jails and other expenses associated with the opioid crisis.

Polster is expected to rule in coming weeks on motions from drugmakers, distributors and pharmacies to dismiss the claims. Trials in some of the cases — being used to test issues common to many of them — are now scheduled to begin in September 2019.

Purdue agreed to pay $634 million in fines back in 2007 to settle charges that the company downplayed the risk of addiction and abuse of its blockbuster painkiller OxyContin starting in the 1990s.

It's facing similar accusations again.

Earlier this year, the privately held company stopped marketing OxyContin to doctors.

The naloxone grant is a way the company can show it's trying to help stem the damage done by opioids. "This grant is one example of the meaningful steps Purdue is taking to help address opioid abuse in our communities," Purdue President and CEO Craig Landau said in a statement.

Paul Hanly, one of the lead lawyers for plaintiffs in the lawsuits, said having more access to an overdose antidote would be good, but he questioned Purdue's motives.

"I think it's just a strategic move on their part to curry favor with the judge, and the public," he said.

Naloxone is seen as one major piece in overdose prevention strategies. Over the past several years, most states have eased access to the antidote for laypeople. First responders, drug users and others have taken to carrying naloxone to reverse overdoses. But the price of the drug has been a problem for state and local governments.

Pittsburgh-based Harm Reduction Therapeutics says it is trying to get its version to the market within two years.

"Combatting the ongoing crisis of opioid addiction will require innovative approaches to both prevention and medication-assisted treatment," Harm Reduction co-founder and CEO Michael Hufford said in a statement, "but it all starts with making sure lives are not lost from overdose."

Copyright Associated Press / NBC New York



Photo Credit: Getty Images/Cultura RF]]>
<![CDATA[Pediatricians Recommend Flu Shot Versus Nasal Spray]]>Tue, 04 Sep 2018 18:11:28 -0500https://media.nbcnewyork.com/images/213*120/fluvaccineGettyImages-92811553.jpg

The American Academy of Pediatrics recommends flu shots for children of all ages, citing higher effectiveness of the shot versus nasal spray. But for children who refuse needles, FluMist nasal spray is available. 

Additionally, some evidence suggests Flucelvax and FluBlok, the only two egg-free vaccines on the market, may work better than the older vaccines grown in eggs. Dr. Richard Zimmerman, who advises the University of Pittsburgh Medical Center's Influenza Committee, said the major hospital group will only be buying egg-free formulations this year.

"The egg-free vaccines appear to have perhaps a 10 percent higher effectiveness over the traditional egg-based vaccines,” Zimmerman said in an interview with NBC News. 

Centers for Disease Control and Prevention recommend everyone over the age of six months get a flu vaccine but they "do not recommend one flu vaccine over another."



Photo Credit: Justin Sullivan/Getty Images]]>
<![CDATA[More Sick in Honey Smacks Salmonella Outbreak: CDC]]>Tue, 04 Sep 2018 16:36:49 -0500https://media.nbcnewyork.com/images/213*120/honeysmacks.jpg

Another 30 people have been reported sick due to an outbreak of salmonella linked to Honey Smacks cereal, and federal health officials said Tuesday that some stores are still selling the recalled product, NBC News reported.

No one should be buying or selling any form of Honey Smacks, the Centers for Disease Control and Prevention said. Consumers should check their homes and throw away any Honey Smacks cereal, the FDA reiterated.

“Since the last update on July 12, 2018, 30 more illnesses have been reported, bringing the total to 130 cases from 36 states,” the CDC said in a statement.

Thirty-four were sick enough to be hospitalized, although no deaths have been reported. Three more states have been added to the list of places where cases have been reported: Delaware, Maine and Minnesota.

In July the Food and Drug Administration said despite the wide-ranging recall, some boxes were still sitting on store shelves.

Kellogg's, who produces Honey Smacks, issued a voluntary recall in June for the cereal that was distributed across the U.S.

After the CDC found salmonella in Honey Smacks samples, customers were warned that they should avoid all Honey Smacks. The CDC tweeted, "Do not eat this cereal." The agency advised people to stop eating the cereal and throw it out, regardless of its package size or expiration date. It also advised retailers to stop selling and serving all Honey Smacks.

Salmonella is a common cause of food poisoning and it can live and grow even on dry foods such as breakfast cereal.

People usually get sick 12 hours to three days after they eat something contaminated. Symptoms include diarrhea, fever and stomach cramps.

Consumers seeking more information, including images of these products, can visit kelloggs.com/honeysmacksrecall or call 1-800-962-1413 from Monday – Friday, from 9 a.m. to 6 p.m. ET as well as Saturday and Sunday from 10 a.m. – 4 p.m. ET.

To report adverse reactions or other problems with FDA-regulated products, contact the FDA Consumer Complaint Coordinator for the state in which you reside. Please Note: There is not a Consumer Complaint Coordinator in each state. Please visit the FDA site for more information.

Copyright Associated Press / NBC New York



Photo Credit: FDA]]>
<![CDATA[Trump's Pollution Rules Rollback to Hit Coal Country Hard]]>Mon, 03 Sep 2018 09:30:14 -0500https://media.nbcnewyork.com/images/213*120/AP_18225531605518-coal-fired-power-plant.jpg

It's coal people like miner Steve Knotts, 62, who make West Virginia Trump Country.

So it was no surprise that President Donald Trump picked the state to announce his plan to roll back Obama-era pollution controls on coal-fired power plants.

Trump left one thing out of his remarks, though: northern West Virginia coal country will be ground zero for increased deaths and illnesses from the rollback on regulation of harmful emission from the nation's coal power plants.

An analysis done by his own Environmental Protection Agency concludes that the plan would lead to a greater number of people here dying prematurely, and suffering health problems that they otherwise would not have, than elsewhere in the country, when compared to health impacts of the Obama plan.

In Grant Town, Knotts, a coal miner for 35 years, isn't fazed when he hears that warning, a couple of days after Trump's West Virginia rally. He says the last thing people in coal country want is the government slapping down more controls on coal — and the air here in the remote West Virginia mountains seems fine to him.

"People here have had it with other people telling us what we need. We know what we need. We need a job," Knotts said at lunch hour at a Circle K in a tiny town between two coal mines, and 9 miles down the road from a coal power plant, the Grant Town plant.

The sky around Grant Town is bright blue. The mountains are a dazzling green. Paw Paw Creek gurgles past the town.

Clean-air controls since the 1980s largely turned off the columns of black soot that used to rise from coal smokestacks. The regulations slashed the national death rates from coal-fired power plants substantially.

These days pollutants rise from smoke stacks as gases, before solidifying into fine particles — still invisible — small enough to pass through lungs and into bloodstreams.

An EPA analysis says those pollutants would increase under Trump's plan, when compared to what would happen under the Obama plan. And that, it says, would lead to thousands more heart attacks, asthma problems and other illnesses that would not have occurred.

Nationally, the EPA says, 350 to 1,500 more people would die each year under Trump's plan. But it's northern two-thirds of West Virginia and the neighboring part of Pennsylvania that would be hit hardest, by far, according to Trump's EPA.

Trump's rollback would kill an extra 1.4 to 2.4 people a year for every 100,000 people in those hardest-hit areas, compared to under the Obama plan, according to the EPA analysis. For West Virginia's 1.8 million people, that would be equal to at least a couple dozen additional deaths a year.

Trump's acting EPA administrator, Andrew Wheeler, a former coal lobbyist whose grandfather worked in the coal camps of West Virginia, headed to coal states this week and last to promote Trump's rollback. The federal government's retreat on regulating pollution from coal power plants was "good news," Wheeler told crowds there.

In Washington, EPA spokesman Michael Abboud said Trump's plan still would result in "dramatic reductions" in emissions, deaths and illness compared to the status quo, instead of to the Obama plan. Obama's Clean Power Plan targeted climate-changing carbon dioxide, but since coal is the largest source of carbon dioxide from fossil fuels, the Obama plan would have curbed other harmful emissions from the coal-fired power plants as well.

About 160 miles to the south of Grant Town, near the state capital of Charleston, shop owner Doris Keller figures that if Trump thinks something's for the best, that's good enough for her.

"I just know this. I like Donald Trump and I think that he's doing the right thing," said Keller, who turned out to support Trump Aug. 21 when he promoted his rollback proposal. She lives five miles from the 2,900-megawatt John Amos coal-fired power plant.

"I think he has the best interests of the regular common people at the forefront," Keller says.

Trump's Affordable Clean Energy program would dismantle President Barack Obama's 2015 Clean Power Plan, which has been caught up in court battles without yet being implemented.

The Obama plan targeted climate-changing emissions from power plants, especially coal. It would have increased federal regulation of emissions from the nation's electrical grid and broadly promoted natural gas, solar power and other cleaner energy.

Trump's plan would cede much of the federal oversight of existing coal-fired power plants and drop official promotion of cleaner energy. Individual states largely would decide how much to regulate coal power plants in their borders. The plan is open for public review, ahead of any final White House decision.

"I'm getting rid of some of these ridiculous rules and regulations, which are killing our companies ... and our jobs," Trump said at the rally.

There was no mention of the "small increases" in harmful emissions that would result, compared to the Obama plan, or the health risks.

EPA charts put numbers on just how many more people would die each year because of those increased coal emissions.

Abboud and spokeswoman Ashley Bourke of the National Mining Association, which supports Trump's proposed regulatory rollback on coal emissions, said other federal programs already regulate harmful emissions from coal power plants. Bourke also argued that the health studies the EPA used in its death projections date as far back as the 1970s, when coal plants burned dirtier.

In response, Conrad Schneider of the environmental nonprofit Clean Air Task Force said the EPA's mortality estimates had taken into account existing regulation of plant emissions.

Additionally, health studies used by the EPA looked at specific levels of exposure to pollutants and their impact on human health, so remain constant over time, said Schneider, whose group analyzes the EPA projections.

With competition from natural gas and other cleaner energy helping to kill off more than a third of coal jobs over the last decade, political leaders in coal states are in no position to be the ones charged with enforcing public-health protections on surviving coal-fired power plants, said Vivian Stockman of the Ohio Valley Environmental Coalition.

"Our state is beholden to coal. Our politicians are beholden to coal," Stockman said outside Trump's West Virginia rally, where she was protesting. "Meanwhile, our people are being poisoned."

And when it comes to coal power plants and harm, Schneider said, "when you're at Grant Town, you're at Ground Zero."

Retired coal miner Jim Haley, living 4 miles from the town's coal-fired power plant, has trouble telling from the smokestack when the plant is even operating.

"They've got steam coming out of the chimneys. That's all they have coming out of it," Haley said.

Parked near the Grant Town post office, where another resident was rolling down the quiet main street on a tractor, James Perkins listened to word of the EPA's health warnings. He cast a look into the rear-view mirror into the backseat of his pickup truck, at his 3-year-old grandson, sitting in the back.

"They need to make that safe," said Perkins, a health-care worker who had opted not to follow his father into the coal mines. "People got little kids."

AP Science Writer Seth Borenstein contributed from Washington.

Copyright Associated Press / NBC New York



Photo Credit: J. David Ake/AP, File]]>
<![CDATA[Amid Opioid Crisis, Researchers Aim to Put Pot to the Test]]>Mon, 03 Sep 2018 03:45:51 -0500https://media.nbcnewyork.com/images/213*120/GettyImages-99037655+%281%29+weed+edited.jpg

Despite anecdotal and historical accounts of pot’s painkilling properties, scientific evidence that it works better than traditional painkillers is hard to come by. But Dr. Jeffrey Chen, director of UCLA's Cannabis Research Initiative, wants to change that, NBC News reported

The United States classifies marijuana as a Schedule 1 drug with no medical use, like heroin and cocaine. And as a 2015 article in the journal Current Pain and Headache Reports points out, high-quality clinical studies of pot’s effectiveness are limited. 

"The public consumption of cannabis has already far outpaced our scientific understanding," Chen said. “We really desperately need to catch up.”

Now, with one of the first academic programs in the world dedicated to the study of cannabis, researchers hope to conduct a high-quality study using opioid patients. The study aims to find out which combination “produces the most good,” according to Edythe London, a distinguished professor of psychiatry and pharmacology at the UCLA school of medicine who designed the study.



Photo Credit: Kevork Djansezian/Getty Images, File ]]>
<![CDATA[1 in 10 Kids Diagnosed With ADHD: Study]]>Fri, 31 Aug 2018 17:35:27 -0500https://media.nbcnewyork.com/images/213*120/anonymous-kid-toy-trucks.jpg

More than 10 percent of U.S. kids have been diagnosed with attention-deficit/hyperactivity disorder (ADHD), up from 6 percent 20 years ago, researchers reported Friday.

It’s not clear why, but it’s startling, said Dr. Wei Bao of the University of Iowa, who helped lead the study.

“It is very common now – one in 10 kids,” Bao told NBC News.

The team used surveys covering more than 180,000 children aged 4 to 17 between 1997 and 2016. The surveys were in-person with a parent or guardian and asked whether the child had ever been diagnosed with ADHD.

“Over the 20-year period from 1997 to 2016, we found a significant increase in the prevalence of diagnosed ADHD from 1997-1998 to 2015-2016,” they wrote in the Journal of the American Medical Association’s JAMA Open Network.



Photo Credit: Getty Images (File)]]>
<![CDATA[Pediatricians Change Guidelines for Babies in Car Seats]]>Fri, 31 Aug 2018 16:39:32 -0500https://media.nbcnewyork.com/images/213*120/carseatGettyImages-127238301.jpg

The American Academy of Pediatrics issued new guidelines for young children in car seats: They should remain rear-facing until they reach the maximum height and weight allowed by the car seat manufacturer.

The update is a departure from the previous recommendation that babies remain rear facing until the age of 2. Because the new guidelines are now based on the size of the child, some children will remain rear facing even after turning 2.

The AAP said all infants and toddlers should ride in rear-facing car seats for "as long as possible, until they reach the highest weight or height allowed" by the seat's manufacturer.

While there is new research on car safety for children, the guideline that has not changed is rear facing is safer. 



Photo Credit: The Washington Post/Getty Images]]>
<![CDATA[Ominous FDA Update on Blood Pressure, Heart Drug Recalls]]>Fri, 31 Aug 2018 11:05:27 -0500https://media.nbcnewyork.com/images/213*120/080618bloodpressire.jpg

The head of the U.S. Food and Drug Administration says the agency has launched a "major operation to investigate and address" the "troubling" finding of a cancer-causing agent that may be contaminating a growing number of medications used to treat high blood pressure and heart failure.

In a joint statement Thursday, FDA Commissioner Scott Gottlieb and Dr. Janet Woodcock, director of the Center for Drug Evaluation and Research (CDER), said they have developed a multidisciplinary task force to investigate trace amounts of N-nitrosodimethylamine (NDMA), a "probable human carcinogen," detected in some generic versions of the medication valsartan.

The initial recall in July has now been expanded to include five manufacturers and other companies who repackage the affected valsartan products under a different name, and officials warned Thursday more products may need to be recalled. A third-party supplied the valsartan contained in the recall. The FDA recently updated the list of products affected and the list of those unaffected

"At the same time, the FDA is working to make certain that patients have access to the treatment that they need," the joint statement said. "Currently, more than half of all valsartan products on the market are being recalled. But prescribers can find a similar replacement product within the same class to substitute for patients who require this medication."

The FDA said it is working with companies to take "swift action" to pull any products found with unacceptable amounts of NDMA from the U.S. market. The agency also said manufacturers would not have been testing for NDMA in valsartan because there was no anticipation such levels would be evident. 

"Recognizing these risks is based on a deep understanding of the chemistry involved in drug manufacturing, and the theoretical risk that an impurity could be a by-product of an essential step used in the manufacture of an active ingredient," the statement said. "When these impurities are identified, there are ways to re-engineer manufacturing processes to find pathways that don’t create these by-products."

It continued: "As we develop a better understanding of the root cause of NDMA formation, and develop a way to detect NDMA in valsartan or other ARBs, we can ensure that appropriate testing is performed in the future."

The FDA also said that while millions of Americans take blood pressure medication, the risk of many of them developing cancer because of the NDMA exposure is fairly low. CDER toxicologists and chemists estimated that if 8,000 people took the highest valsartan dose from NDMA-affected medicines every day for four years, which is the period of time officials believe the affected products have been on the U.S. market, there may be one extra case of cancer beyond the regular average cancer rate of Americans. 

Patients are urged to look at the drug name and company name on the label of their prescription bottles to determine whether a specific product has been recalled. If the information is not on the bottle, patients should contact the pharmacy that dispensed the medicine to find out the company name.

If a patient is taking one of the recalled medicines, they should follow the recall instructions each specific company provided, which are available on the FDA’s website.

If a patient's medicine is included in the recall, he or she should contact his or her health care professional to discuss treatment options, which may include another valsartan product this recall doesn't affect or an alternative option.

The agency encourages patients and health care professionals to report any adverse reaction to the FDA’s MedWatch program.

In the meantime, the FDA said it will continue to improve its procedures for guarding against such impurity risks. 

"We will use the information that we learn from our investigation into valsartan to strengthen our oversight," the statement said. 

Read more about the agency's probe and NDMA here. 



Photo Credit: Joe Raedle/Getty Images]]>
<![CDATA[Cheese and Yogurt Help Protect Against Dying, Study Finds]]>Fri, 31 Aug 2018 06:28:46 -0500https://media.nbcnewyork.com/images/213*120/910571610-Yogurt-Cheese.jpg

Eating dairy products, especially cheese and yogurt, is linked with a lower mortality rate, according to a new study reviewed by NBC News.

Consuming any dairy was associated a 2 percent lower risk of death by any cause, while dairy diets of mostly cheese was associated with an 9 percent lower risk, according to the research presented Tuesday at a meeting of the European Society of Cardiology. Dairy consumption also slightly lowered the risk of death by stroke.

The researchers reviewed data from U.S. federal health and nutrition surveys conducted between 1999 and 2010.

"This was a study of an eating pattern — which is really what we need to be focusing on, eating patterns as opposed to individual foods or food groups," said University of Alabama at Birmingham nutrition science professor Beth Kitchin in an email. She was not affiliated with the study.



Photo Credit: Getty Images/Johner RF]]>
<![CDATA[Texas Nurse Fired Over Post About Young Measles Patient]]>Thu, 30 Aug 2018 15:24:39 -0500https://media.nbcnewyork.com/images/213*120/measles-vaccine.jpg

A Houston nurse who posted protected health information about a young patient with measles to a Facebook page related to the anti-vaccine movement is no longer employed at Texas Children’s Hospital, the facility said in a statement Thursday.

The nurse, who has not been identified, posted to the page that despite the fact that the young patient was “super sick,” was admitted to the ICU and "looked miserable," the nurse was still opposed to vaccines, NBC News reported.

The nurse was investigated and ultimately dismissed for privacy violations, but her anti-vaccine stance concerns others in the medical field.

Dr. David Persse, director of the Houston Health Department, was dismayed that a medical professional would be opposed to childhood vaccinations. "She is one of the few people who has seen firsthand how devastating these diseases can be, and she has still taken this position against vaccines," Persse said in an interview.

Measles has been eliminated in the United States through vaccination, but every year, cases are imported from other countries. People who are not vaccinated or who are incompletely vaccinated can become infected and carry the virus with them. It will spread if there are pockets of other unvaccinated people.



Photo Credit: Leo Correa/AP (File)]]>
<![CDATA[Hundreds of Nasal Products for Kids, Adults Recalled]]>Thu, 30 Aug 2018 10:09:53 -0500https://media.nbcnewyork.com/images/213*120/ucm616192.jpg

An over-the-counter health and beauty product manufacturer supplying medicines to retailers across the country has expanded its voluntary nasal product recall to include all nasal products and baby oral gels -- amounting to hundreds of items -- over concerns of microbial contamination that could pose life-threatening infection risk for vulnerable users.

Product Quest, which first announced a recall of some bottles of CVS Health's 12 Hour Sinus Relief Nasal Mist, said this week it was pulling all lots of nasal treatments and baby oral gels made in its Florida facility. The recall amounts to hundreds of nasal allergy and congestion treatments used by both children and adults.See the full 65-page list of recalled items here.  

Product Quest recalled the items as a precaution after finding Pseudomonas aeruginosa, a kind of bacteria, in some of its CVS products. Frequent use of the contaminated product could result in infections, which could be life-threatening for users with cystic fibrosis or people who are immuno-compromised, according to the FDA.

Product Quest said there is no known microbial contamination associated with the nasal products and gels added to the recall, but it was pulling them out "an abundance of caution" and said retailers who shelve the products should dump them as well. There have been no reports of illnesses connected to the recall, "to the best" of the manufacturer's knowledge, a statement said. 

Product Quest says it is notifying its customers by oral and written communication and is arranging for return and or replacement of all recalled products. Consumers/distributors/retailers that have a recalled product should stop using it immediately and return it to the place of purchase. 

Consumers with questions can contact Product Quest Manufacturing LLC at 704-939-4342, Monday through Friday from 8 a.m. to 4 p.m., EST. Consumers should contact their physicians or health care providers if they have experienced any problems that may be related to taking or using these drug products.



Photo Credit: Food and Drug Administration ]]>
<![CDATA[Rubber Critter Toys Recalled for Excessive Lead Paint Levels]]>Thu, 30 Aug 2018 09:54:35 -0500https://media.nbcnewyork.com/images/213*120/rubber-critters-recall.jpg

Tens of thousands of rubber critter toys in the shapes of animals are being recalled for excessive lead levels in their orange and yellow paint. 

BSN Sports sold the 31,200 recalled units nationally through catalogues and online at Amazon.com, Athleticconnection.com, Bsnsports.com, Esportsonline.com and Usgames.com from February 2017 to June 2018, according to a recall notice posted Wednesday by the U.S. Consumer Product Safety Commission. 

The toys, which the notice says are "primarily used to play physical education tossing games," are shaped like an octopus, alligator, chicken, frog, pig, penguin or cow.

"Consumers should immediately take the recalled rubber critter toys away from children," the recall notice said.

Lead is especially dangerous to children because their bodies absorb the toxic element more than adults' bodies do, and a child's nervous system is also more sensitive to lead's effects, according to the Environmental Protection Agency.

The toys, which were made in China and imported and distributed by BSN Sports, sold for about $10 for an individual rubber critter or up to $145 for a set, according to recallrt.com/rubbercritters. Sets ranged from two to 24 critters. 

BSN Sports said it was contacting all known purchasers directly but those who bought the critters can also request a merchandise credit by calling 1-888-847-8816 between 7 a.m. and 6 p.m. CT on weekdays. Those who want refunds can also register at recallrtr.com/rubbercritters.



Photo Credit: BSN Sports]]>
<![CDATA[Legal Marijuana Industry Tries to Shake 'Stoner' Stereotypes]]>Wed, 29 Aug 2018 10:05:23 -0500https://media.nbcnewyork.com/images/213*120/AP_18239772786553.jpg

Michelle Janikian, who writes about marijuana for publications like Herb, Playboy and Rolling Stone, says after she tells someone what she does for a living, she usually spends the rest of the conversation "trying to act so friendly and mainstream" so they don't think she's stoned.

Adam Salcido relates that after he went to work a couple of years ago for a Southern California company that helps organize weed-infused events like Hempfest and Cannabis Cup, he had to reassure his family he wouldn't turn into a drug addict.

Stoner stereotypes die hard.

But with a multibillion-dollar industry beginning to flower — marijuana is now legal in some form in 30 states — cannabis advocates are pushing to dispel the idea that people who toke up still live on the couches in their parents' basements and spend their waking hours eating Cheetos and playing video games.

MedMen, a flashy, upscale chain of dispensaries that brands itself as the Apple store of pot shops, recently rolled out a $2 million ad campaign that, for lack of a better description, might be called the "anti-stoner offensive."

Photos of 17 people — including a white-haired grandmother, a schoolteacher, a business executive, a former pro football player and a nurse — are being splashed across billboards, buses and the web by the company that has dispensaries in Los Angeles, Las Vegas and New York. Each photo has the word "stoner" crossed out and in its place a description of their job.

People can find their biographies on the website www.forgetstoner.com, where they can also learn why they use weed. Reasons range from treatment of medical conditions like migraines and anxiety to simply enjoying the high.

"What we're saying is the very definition of a stereotype is defining a person by one bad mention," says Daniel Yi, MedMen's senior vice president of communications and a former Los Angeles Times reporter. "They're also a grandmother. They're also a father, a son, a brother."

Judd Weiss, CEO and founder of cannabis company Lit.Club, believes the industry needs to do still more. He suggests marketing products in a way that makes them look more than just respectable, but as the herbal equivalent of a fine bourbon or scotch.

Thus, he says, Lit.Club's vape pens are packaged in a way "that won't embarrass you at the opera." They look sleek and stylish, with inspirational phrases like "Light A Path" printed on each one. He compares the aroma and flavor of his company's pre-rolled joints to something similar to a fine brandy.

"Very much like the Tesla, we want to be seen as luxury quality but affordable," he said.

The website Leafly, which is sometimes called a Yelp for discerning potheads, has taken out ads in The New York Times and staged promotional events at gatherings like the South by Southwest Festival in Austin, Texas, to extol the virtues of marijuana. Better sex and better health are two claims it focuses on.

Still there is pushback from some who believe realities about pot are being glossed over by slick marketing.

"It is not a controversial claim to say that marijuana could be addictive for some people, that it could produce mental illness, that it's tied to impaired driving, that it makes you not motivated, that you're more likely to drop out of school if you're a kid using," said Kevin Sabet, president of the group Smart Approaches to Marijuana and a former drug policy adviser to presidents Clinton, Obama and George W. Bush.

Sabet accuses the cannabis industry of enticing children with edibles and cookies in an attempt to become another "Big Tobacco," although he also acknowledges there is evidence that marijuana has some medicinal value.

It was edibles that brought Cindy Paul of Billings, Montana, to a Portland, Oregon, pot shop a few weeks ago to sample marijuana for the first time in 25 years. A casual if closeted smoker during her school days, Paul, 55, said she decided to indulge again while vacationing with her daughter in a state where it's legal and where she can acquire it in a form she doesn't have to inhale.

"I do think it has medicinal qualities," she said, adding, "I'm not using it for that. I'm using it to have a good time. I don't think it's any different than having a beer."

To bring more people like Paul into the fold, branding expert Robert Miner says the marijuana industry needs to use movies and TV shows to change negative perceptions.

Those lovable stoners Cheech and Chong were fine back in the day when it came to rebuffing the idea that anybody who smoked pot was headed for Reefer Madness. But the mainstreaming of marijuana, he said, demands a new message.

"For that larger portion of the cannabis-consuming population, that same silly bumbling stereotype that led to a wider acceptance is now an impediment to their being open about their cannabis consumption," said Miner, whose firm, Miner & Co. Studio, works with TV networks and other media in image building.

One show that presents a more modern take on marijuana is HBO's "High Maintenance." It features a bicycle-riding pot dealer who interacts with a variety of average New Yorkers, from empty-nesting Boomers to workaholic Millennials. The only thing any have in common is they buy marijuana from him and, as they do, pull him into their daily lives.

It's one of Janikian's favorite shows, and she'd like to see more like it. But for now the writer who divides her time between New York and Mexico will continue to remain circumspect about her marijuana use.

She sometimes uses a topical cream to curb anxiety and after a hard day's work she likes to smoke a joint to unwind like any "random normal person" would have a glass of wine.

But she knows those random normal people are often skeptical.

"It's like, 'Oh, you just want to smoke weed,' " she says, laughing. " 'Stop lying.'"

Copyright Associated Press / NBC New York



Photo Credit: Chris Pizzello/AP]]>
<![CDATA[STDs Set New Record, Continuing Rapid Rise in US, CDC Says]]>Tue, 28 Aug 2018 12:35:24 -0500https://media.nbcnewyork.com/images/213*120/475150913-Condom-Safe-Sex.jpg

Nearly 2.3 million cases of chlamydia, gonorrhea and syphilis were diagnosed in the United States last year, far more than the STD record set in 2016, NBC News reported.

The new data come from the Centers for Disease Control and Prevention, which said Tuesday that the number of cases in 2017 surpassed the previous record by more than 200,000.

There have been recent increases in STDs among heterosexual men and women and among pregnant women and their babies, said Dr. Gail Bolan, head of the CDC's Division of STD Prevention.

"Usually there are ebbs and flows, but this sustained increase is very concerning," Bolan said. She and others suspect that newer drugs that made HIV less lethal and infectious may have contributed to declining condom use.



Photo Credit: Getty Images/Cultura RF]]>
<![CDATA[50 Adult Meds Added to National Recall With 32 Kids' Items]]>Tue, 28 Aug 2018 10:27:53 -0500https://media.nbcnewyork.com/images/213*120/Dr+King+Bio+Recall.jpg

King Bio has announced it is pulling all of its water-based products across all brands, amounting to more than 50 products intended to treat virtually every ailment from migraines to allergies, amid a national recall over concerns about possible purity issues.

The company's founder, Frank King, announced the expanded recall in a statement on the website Monday. Nearly three dozen children's medicines have already been recalled over the microbial contamination fears. 

King Bio, a North Carolina-based company that makes homeopathic drugs, first said last week that a small percentage of its products produced between Aug. 1, 2017 and April 2018 tested positive for the microbial contamination.

The company said use of the medicines could result in increased or life-threatening infections. There have been no reports of illnesses, according to the FDA, and King Bio issued the recall "out of an abundance of caution."

There were still no reported illnesses as of Monday, and King Bio said it was notifying its distributors and customers by letter to arrange for return and/or replacement of all the affected medicines.

The recalled products are used to treat dozens of conditions, including allergies, migraine, anxiety, bed wetting, chicken pox, common colds, nosebleeds, sore throat and teething. Products meant for use on pets are also being recalled. They were sold nationwide between August 2017 and July 2018.

"We are truly sorry for the inconvenience or concern our recall may have caused, but we felt this was the right thing to do to maintain your trust," King said in a statement. "Thank you for your continued loyalty and confidence in our King Bio products."

Customers are urged to stop using the affected products immediately and contact King Bio by email at recall@kingbio.com or call the company at 866-298-2740, Monday through Friday from 8:30 a.m. ET to 3:30 p.m. ET. Consumers who believe they may have been sickened by one of the recalled products should contact their physician or healthcare provider. 

See a list of 32 the affected kids' medicines below. For a complete list of UPC and Lot numbers click here. Find all the recalled adult medicines here.

• DK Attention & Learning Enh.
• Chicken Pox Symptom Relief
• Children's Appetite & Weight
• Children's Appetite Enhance
• Children's Cough Relief
• Children's Fever Reliever
• Children's Growth & Development
• DK Newborn Tonic
• DK Nosebleed Relief
• TonsilPlex
• Children's Ear Relief Formula
• DK Teething
• DK Colic Relief
• Tummy Aches
• Kids Multi-Strain Flu Relief
• Kids Stress & Anxiety
• Kids Sleep Aid
• Kids Bed Wetting (NP)
• Kids Candida - 4-ounce bottle
• Kids Attention & Learning (SCRX)
• Bed Wetting Prevention (SCRX)
• Chicken Pox Symptom Relief (SCRX)
• Childrens Cough (SCRX)
• Children’s Ear Formula (SCRX)
• Children’s Fever Reliever (SCRX)
• Children’s Growth & Development (SCRX)
• Colic Relief (SCRX)
• Newborn Tonic (SCRX)
• Teething (SCRX)
• Tummy Aches (SCRX)
• Children’s Apetite & Weight (SCRX)
• Children’s Appetite Enhancer (SCRX) 



Photo Credit: Dr. King's by King Bio]]>
<![CDATA[Cigarette Butts Are Biggest Source of Ocean Trash: Advocates]]>Mon, 27 Aug 2018 08:07:59 -0500https://media.nbcnewyork.com/images/213*120/680792025-cigarette-butts-beach.jpg

As coastal cities ban plastic straws and California and Hawaii consider following suit, activists are trying to raise awareness about cigarette butts, a much greater source of ocean pollution, NBC News reported.

The filters have been the most-collected item on the world's beaches for 32 consecutive years of the Ocean Conservancy's annual beach cleanup, more than plastic wrappers, eating utensils, bottles and containers combined.

Among those arguing that cigarette butts should be banned are the international Surfrider Foundation, a California lawmaker and leading tobacco industry academic Thomas Novotny.

"It's pretty clear there is no health benefit from filters. They are just a marketing tool," said Novotny, a professor of public health at San Diego State University. "It's also a major contaminant, with all that plastic waste. It seems like a no-brainer to me that we can't continue to allow this."



Photo Credit: Getty Images/Science Photo Libra, File]]>
<![CDATA[Aspirin Disappoints for Avoiding First Heart Attack, Stroke: Study]]>Mon, 27 Aug 2018 06:56:00 -0500https://media.nbcnewyork.com/images/213*120/689227195-Aspirin-.jpg

Taking a low-dose aspirin every day has long been known to cut the chances of another heart attack, stroke or other heart problem in people who already have had one, but the risks don't outweigh the benefits for most other folks, major new research finds.

Although it's been used for more than a century, aspirin's value in many situations is still unclear. The latest studies are some of the largest and longest to test this pennies-a-day blood thinner in people who don't yet have heart disease or a blood vessel-related problem.

One found that aspirin did not help prevent first strokes or heart attacks in people at moderate risk for one because they had several health threats such as smoking, high blood pressure or high cholesterol.

Another tested aspirin in people with diabetes, who are more likely to develop or die from heart problems, and found that the modest benefit it gave was offset by a greater risk of serious bleeding.

Aspirin did not help prevent cancer as had been hoped.

And fish oil supplements, also tested in the study of people with diabetes, failed to help.

"There's been a lot of uncertainty among doctors around the world about prescribing aspirin" beyond those for whom it's now recommended, said one study leader, Dr. Jane Armitage of the University of Oxford in England. "If you're healthy, it's probably not worth taking it."

The research was discussed Sunday at the European Society of Cardiology meeting in Munich. The aspirin studies used 100 milligrams a day, more than the 81-milligram pills commonly sold in the United States but still considered low dose. Adult strength is 325 milligrams.

WHO'S REALLY AT RISK?
A Boston-led study gave aspirin or dummy pills to 12,546 people who were thought to have a moderate risk of suffering a heart attack or stroke within a decade because of other health issues.

After five years, 4 percent of each group had suffered a heart problem — far fewer than expected, suggesting these people were actually at low risk, not moderate. Other medicines they were taking to lower blood pressure and cholesterol may have cut their heart risk so much that aspirin had little chance of helping more, said the study leader, Dr. J. Michael Gaziano of Brigham and Women's Hospital.

One percent of aspirin takers had stomach or intestinal bleeding, mostly mild— twice as many as those on dummy pills. Aspirin users also had more nosebleeds, indigestion, reflux or belly pain.

Bayer sponsored the study, and many researchers consult for the aspirin maker. Results were published by the journal Lancet.

ASPIRIN FOR PEOPLE WITH DIABETES?
People with diabetes have a higher risk of heart problems and strokes from a blood clot, but also a higher risk of bleeding. Guidelines vary on which of them should consider aspirin.

Oxford researchers randomly assigned 15,480 adults with Type 1 or 2 diabetes but otherwise in good health and with no history of heart problems to take either aspirin, 1 gram of fish oil, both substances, or dummy pills every day.

After seven and a half years, there were fewer heart problems among aspirin users but more cases of serious bleeding, so they largely traded one risk for another.

FISH OIL RESULTS
The same study also tested omega-3 fatty acids, the good oils found in salmon, tuna and other fish. Supplement takers fared no better than those given dummy capsules — 9 percent of each group suffered a heart problem.

"We feel very confident that there doesn't seem to be a role for fish oil supplements for preventing heart disease," said study leader Dr. Louise Bowman of the University of Oxford.

The British Heart Foundation was the study's main sponsor. Bayer and Mylan provided aspirin and fish oil, respectively. Results were published by the New England Journal of Medicine.

Other studies are testing different amounts and prescription versions of fish oil, "but I can't tell people go spend your money on it; we think it's probably better to eat fish," said Dr. Holly Andersen, a heart disease prevention specialist at New York-Presbyterian/Weill Cornell who was not involved in the study.

The new research doesn't alter guidelines on aspirin or fish oil, said Dr. Nieca Goldberg, a cardiologist at NYU Langone Medical Center and an American Heart Association spokeswoman. They recommend fish oil only for certain heart failure patients and say it's reasonable to consider for people who have already suffered a heart attack.

Copyright Associated Press / NBC New York



Photo Credit: Peter Dazeley/Getty Images]]>
<![CDATA[THC Found in Breast Milk Up to 6 Days After Pot Use: Study]]>Mon, 27 Aug 2018 08:55:18 -0500https://media.nbcnewyork.com/images/213*120/marijuanaAP_18235522395657.jpg

Marijuana's main mind-altering ingredient was detected in nursing mothers' breast milk in a small study that comes amid evidence that more U.S. women are using pot during pregnancy and afterward.

Experts say the ingredient, THC, has chemical properties that could allow it to disrupt brain development and potentially cause harm, although solid evidence of that is lacking.

The new study involved 50 nursing mothers who were using pot and provided breast milk samples to researchers at the University of California, San Diego. Lab testing found small amounts of THC, the psychoactive chemical that causes marijuana's "high," in 34 of 54 samples up to six days after they were provided. Another form of THC and cannabidiol, a pot chemical touted by some as a health aid, were detected in five samples.

The study authors said "it is reasonable to speculate" that exposing infants to THC or cannabidiol "could influence normal brain development," depending on dose and timing.

The results echo findings in case reports from years ago, when pot was less potent than what's available today, said study co-author Christina Chambers, a pediatrics professor. It's not known if the amounts detected pose any risk, but she said her research team is studying children whose moms' were involved to try to answer that question.

Two small studies from the 1980s had conflicting results on whether pot use affects breastfed infants. One found no evidence of growth delays; the other found slight developmental delays in breastfed infants, but their mothers had used pot during pregnancy too.

Most pediatricians encourage breastfeeding and its health benefits for infants, but "they're stuck with a dilemma" with infants whose mothers use pot, Chambers said.

A new American Academy of Pediatrics report recommending against pot use while pregnant or nursing acknowledges that challenge.

"We still support women breastfeeding even if using marijuana but would encourage them to cut down and quit," said Dr. Seth Ammerman, a report co-author and Stanford University pediatrics professor.

"In counseling patients about this, it's important to be nonjudgmental but to educate patients about the potential risks and benefits," Ammerman said, to ensure "a healthy outcome for themselves and their baby."

The study and report were published Monday in the journal Pediatrics.

The American College of Obstetricians and Gynecologists has similar advice.

The academy report says its advice is based on theoretical risks to developing brains, but it acknowledges conflicting evidence and a dearth of research. Some studies have linked pot use during pregnancy with lower birth weights or preterm birth, along with developmental delays and learning difficulties in older children. But additional factors including women's use of other drugs during pregnancy complicated the results, the report says.

Marijuana is legal for recreational use in nine states and Washington, D.C., and for medical use in 31 states, according to the National Conference of State Legislatures.

As more states legalize marijuana, its use is increasing along with the "false impression" that it is safe, the academy's report says. Ammerman said caution makes sense, given the uncertainties.

According to U.S. government data, about 1 in 20 women report using marijuana during pregnancy. Estimates for use among breastfeeding mothers vary, but a study in Colorado, where recreational marijuana is legal, put the number at almost 20 percent among women in a government supplemental food program.

The report, study and a journal editorial all said more research is needed.

Last year, a federal advisory panel said lack of scientific information about marijuana poses a public health risk.

Research has been hampered by federal government restrictions based on its view that marijuana is an illegal drug.

That has contributed to a stigma and shaded doctors' views, said Keira Sumimoto, an Irvine, California, mother who used marijuana briefly for medical reasons while pregnant and breastfeeding. She said smoking a joint daily helped her gain weight when she was sick before learning she was pregnant, and eased childbirth-related pain, but that she quit because of backlash from marijuana opponents.

She said her daughter, now 8 months old, is healthy and advanced for her age.

Sumimoto runs @cannabisandmotherhood, an Instagram account that she says aims to present truthful information about marijuana so women can make their own choices.

She said she agrees with advice to be cautious, but that the academy's stance is "is just a little too much."

"The fear is taking over and the need and want to understand this plant is being ignored by the stigma," Sumimoto said. 

Copyright Associated Press / NBC New York



Photo Credit: Steven Senne/AP, File ]]>
<![CDATA[Weight-Loss Drug Seems Safe for Heart, Study Finds]]>Sun, 26 Aug 2018 10:13:11 -0500https://media.nbcnewyork.com/images/213*120/WeightAP_18093712630899.jpg

For the first time, a drug has been shown to help people lose weight and keep it off for several years without raising their risk for heart problems — a safety milestone that may encourage wider use to help curb the obesity epidemic.

The drug, Belviq, has been sold in the United States since 2013 and is the first of several new weight-loss medicines to complete a long-term heart safety study now required by federal regulators to stay on the market.

"Patients and their doctors have been nervous about using drugs to treat obesity and for good reason. There's a history of these drugs having serious complications," said study leader Dr. Erin Bohula of Brigham and Women's Hospital in Boston.

With this study, Belviq has been convincingly shown safe for the heart, she said.

Although Belviq did not raise heart risks, it didn't lower them either, as many had hoped it would. The weight loss it produced was fairly modest — after 40 months, Belviq users had shed 9 pounds (4 kilograms), twice as much as those on dummy pills.

It may be that weight loss alone is not enough to lower heart risks, or that there needs to be more to do that, some doctors said.

Results were discussed Sunday at a European Society of Cardiology meeting in Munich and published by the New England Journal of Medicine. Belviq's maker, Eisai Inc., sponsored the study and many of the researchers consult or work for the company.

Worldwide, 13 percent of adults are obese and 39 percent are overweight, raising their risk for a host of health problems. Diet and exercise are the first steps doctors recommend, but medicines also can be considered for people with dangerously high weight who cannot drop enough pounds by other means.

Several popular diet medicines were previously withdrawn from sale after they were found to raise the risk for heart valve damage, suicidal thoughts or other problems, prompting the new requirement for heart safety studies.

Belviq is an appetite suppressant that works by stimulating brain chemicals to give a feeling of fullness. It costs roughly $220 to $290 a month in the United States.

Researchers tested it in a study of 12,000 people who were either obese or overweight with heart disease risk factors such as high blood pressure or cholesterol. They were given Belviq or dummy pills to take twice a day and offered lifestyle and diet advice.

At one year, 39 percent on Belviq and 17 percent on dummy pills had lost at least 5 percent of their starting weight. Several previous studies also found the drug effective for weight loss.

After about three years, 6 percent of each group had suffered a heart-related problem or death.

Fewer people on Belviq developed diabetes — 8.5 percent versus 10.3 percent on dummy pills.

Serious side effects were similar, but more on Belviq stopped taking their pills because of them — 7 percent versus 4 percent. Common side effects included dizziness, fatigue, headache and nausea.

Dangerously low blood sugar happened in 13 people on Belviq versus four in the other group; all but one case involved people also taking diabetes medicines, which lower blood sugar.

Tests for heart valve damage were done on 3,270 participants but no big differences in rates were seen. Suicidal thoughts or behavior were reported in 21 people on Belviq versus 11 on dummy pills, but more on the drug had a history of depression and the difference was so small it could have been due to chance, Bohula said.

In a commentary, two of the journal's editors, Drs. Julie Inglefinger and Clifford Rosen, said there might be alternatives to Belviq. Liraglutide, when used to treat diabetes, also causes weight loss and lowers heart risks, though it hasn't been tested for cardiac safety at the dose used for weight loss.

For now, Belviq "may be best used on a cautious basis, according to the needs of individual patients," they write.

___

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

Copyright Associated Press / NBC New York



Photo Credit: AP Photo/Patrick Sison]]>
<![CDATA[Have Food Poisoning? Here's When to See a Doctor]]>Fri, 24 Aug 2018 14:13:50 -0500https://media.nbcnewyork.com/images/213*120/FOODPOINSONING.jpg

If you eat contaminated food, symptoms may not show up for hours or days. Here's when you should go see a doctor.]]>
<![CDATA[No Amount of Alcohol Is Safe, Health Experts Warn]]>Fri, 24 Aug 2018 10:19:34 -0500https://media.nbcnewyork.com/images/183*120/GettyImages-719519832.jpg

So much for a glass of wine a day for your health's sake — all alcohol consumption is bad for you, according to a damning report. 

The global study, which claims to be the most comprehensive of its kind, pours cold water on previous reports that espouse the protective effects of alcohol under some conditions. 

While researchers acknowledged that moderate drinking can protect against heart disease and diabetes, they said that the risks of cancer and other illnesses outweigh those benefits and have called for a change in medical guidance. 

"The widely held view of the health benefits of alcohol needs revising," said the report published in The Lancet medical journal. 

The majority of national guidelines suggest that one or two glasses of wine or beer per day are safe for an adult's health. However, the report's authors said, "Our results show that the safest level of drinking is none." 

The study, which was carried out by researchers at the Institute of Health Metrics and Evaluation in Seattle, looked at levels of alcohol use and its health effects on those aged between 15 and 95 in 195 countries between 1990 and 2016. 

It found that alcohol led to 2.8 million deaths in 2016 and was the leading risk factor for premature mortality and disability among those aged 15 to 49, accounting for 10 percent of all deaths. 

The greatest proportion of alcohol-related deaths among young people were tuberculosis, road injuries and self-harm, the report found. Meanwhile, for those aged over-50, the biggest killer was cancer, particularly among women.

Current drinking habits pose "dire ramifications for future population health," the reports authors said, urging people to rethink their approach to drinking alcohol.

The study claims to go beyond prior research because of the range of factors considered, including insights from 592 studies and 28 million people worldwide. 

It forms part of a wider Global Burden of Diseases study, a research project based at the University of Washington that compiles data on the causes of illness and death in the world.

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



Photo Credit: Justin Sullivan/Getty Images, File
This story uses functionality that may not work in our app. Click here to open the story in your web browser.]]>
<![CDATA[23andMe Will No Longer Let App Developers Read Your DNA Data]]>Fri, 24 Aug 2018 09:33:27 -0500https://media.nbcnewyork.com/images/213*120/23andme.jpg

23andMe, which provides DNA testing kits for consumers, is telling outside app developers that they'll no longer have access to the company's raw genomic data. 

Developers of health apps, weight loss services and quantified self tests have been able to use 23andMe's anonymized data sets since 2012, when the company announced the opening of its application programming interface (API). The idea was to "allow authorized developers to build a broad range of new applications and tools for the 23andMe community," the company said at the time

But on Thursday, 23andMe sent an email to developers, informing them that the API was being disabled in two weeks and that apps will only be able to use reports generated by the company and not the hard data. 

"We're updating our API program to focus on apps that build on the interpretations and results we provide to our customers," 23andMe said in the email, which was viewed by CNBC. 

23andMe is one of the largest makers of at-home DNA tests, which start at $199. More than five million people have sent in a spit sample in exchange for information about their ancestry, as well as some personalized health reports, like whether they're at greater risk of developing breast cancer. 

The company works with pharmaceutical developers aiming to use genetic information to identify new drugs, and with academic researchers on genetics studies. 

The API is currently being used by dozens of developers, said a person familiar with the matter, who asked not to be named because the information is confidential. It's caused controversy for 23andMe in the past. In 2015, Wired reported on an application that was using the API to block people from websites and apps based on personal characteristics like their gender and ancestry. 

Developers will now be much more limited in how they access 23andMe's rich data and potentially in the services they can offer consumers. The company acknowledged changes to the program in an email to CNBC. 

"Moving forward, we will only partner with developers building applications that leverage the data based on 23andMe reports," the company said. "Our hope is to bring added value to customers' overall experience. We're notifying existing developers and any impacted customers now in order to help them prepare for the changes to our program." 

Raw data will still be available to research partners. 

Privacy concerns
23andMe hasn't said if the move is designed to retain control over its data or in response to concerns about user privacy. The company had plans several years ago to launch an app store, according to two people familiar with the matter, but opted not to move forward with the project because of challenges with vetting third-party developers. 

At-home DNA testing companies have been at the center of a privacy firestorm in recent months. 

Earlier this year, police arrested a suspect in the decades-old Golden State Killer case based on genetic information, when investigators used an open-source service called GEDmatch to look for potential matches to DNA samples from the crime scene. The case involves 12 deaths and at least 50 rapes in California between 1974 and 1986. 

23andMe customers can still choose to upload their genetic information to a service like GEDmatch and share it online or with a particular developer.

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



Photo Credit: AP, File
This story uses functionality that may not work in our app. Click here to open the story in your web browser.]]>
<![CDATA[Fertility Doctor Who Used Own Sperm Surrenders License]]>Fri, 24 Aug 2018 07:32:45 -0500https://media.nbcnewyork.com/images/213*120/AP_18051840147764.jpg

A retired Indianapolis fertility doctor who lied about using his own sperm to impregnate possibly dozens of women surrendered his medical license Thursday to a state board that also barred him from ever seeking its reinstatement.

After an attorney for Dr. Donald Cline surrendered his expired license to the Indiana Medical Licensing Board, the 7-member panel voted to prohibit the 79-year-old Cline from ever applying for a license in Indiana again.

Indiana's supervising deputy attorney general, Laura Iosue, asked the board before the vote to consider the impact of Cline's actions.

"It's particularly egregious. The important thing is that Dr. Cline doesn't practice anymore," she said.

Cline, who retired from practice in 2009, was given a one-year suspended sentence in December after pleading guilty to two counts of obstruction of justice. He'd used his own sperm to impregnate as possibly dozens of women after telling them the donors were anonymous.

No other charges were filed against Cline because Indiana law doesn't specifically prohibit fertility doctors from using their own sperm.

Cline was charged after lying to investigators, and he had faced up to three years in prison on each count. The charges stemmed from two confirmed cases of paternity, but children of women treated by Cline have said DNA tests show he's likely the biological father of as many as 20 of them .

Cline apologized "for the pain my actions have caused" during his December sentencing, although he didn't specify how often he used his own sperm in procedures. But court documents state that he told one of his biological daughters, Jacoba Ballard, that he had done so about 50 times in the 1970s and 1980s.

Ballard said at Thursday's hearing that Cline's actions have "affected me in every possible way."

"He's portrayed as this man that's remorseful," she said.

A total of 10 people who believe Cline is their biological father attended Thursday's hearing with their mothers.

Many of Cline's former patients and their children are now focusing on persuading Indiana lawmakers to pass a measure that would deem a fertility doctor's use of his own sperm as a crime.

Matt White, who learned as an adult that the "anonymous" sperm donor who impregnated his mother was actually Cline, called the surrender of Cline's already expired license "a slap on the wrist." But he said he appreciated the board barring Cline from ever seeking to seek reinstatement of his license.

"That was a small victory," he said.

Copyright Associated Press / NBC New York



Photo Credit: Marion County, Ind. via AP, File]]>
<![CDATA[Friday Night Lights Start to Dim on High School Football]]>Fri, 24 Aug 2018 08:30:16 -0500https://media.nbcnewyork.com/images/213*120/849343576-High-School-Football.jpg

Fewer high school students are joining football teams, even though more students are playing high school sports on the whole, NBC News reported.

Participation in football has declined 7 percent since the 2009-2010 school year, after the dangers of concussions started to be reported, and the decline has accelerated in recent years, according to new data from the National Federation of State High School Associations.

Even in Texas, where high school football stadiums can dwarf other states' college stadiums, parents are having doubts about their kids playing the game, and enrollment is down slightly from its peak seven years ago.

"When you sit there and the doctor's doing the test and he's having a hard time repeating back basic numbers," said the father of a boy who quit the team at Carroll High School near Dallas, "I mean, that's certainly eye-opening as a parent."



Photo Credit: The Washington Post/Getty Images]]>
<![CDATA[Russians Pushed Divisive Content Over Vaccines: Researchers]]>Thu, 23 Aug 2018 16:54:14 -0500https://media.nbcnewyork.com/images/213*120/VaccineRussia.jpg

Russian trolls weren’t just trying to cause division in U.S. politics. A new study shows they were also trying to sow discord in one of the country's most heated debates around public health: vaccinations.

NBC News reports Russia-linked social media bots pushed divisive rhetoric and misinformation on Twitter on both sides of the vaccine debate, according to research led by George Washington University and published Thursday in the American Journal of Public Health.

"These trolls seem to be using vaccination as a wedge issue, promoting discord in American society," the study's authors said.



Photo Credit: AP/Carolyn Kaster, File]]>
<![CDATA[Pot Vs. Pills for Pain Relief ]]>Thu, 23 Aug 2018 12:34:14 -0500https://media.nbcnewyork.com/images/213*120/NC_potpain0823_1500x845.jpg

Medical marijuana could be the answer to overcoming the nation's opioid epidemic, but so far the only evidence cannabis can relieve pain comes from patients. That's because the federal government considers marijuana a Schedule 1 drug, highly restricting research. ]]>
<![CDATA[32 Children's Medicines Recalled Over Contamination Concerns]]>Thu, 23 Aug 2018 14:48:49 -0500https://media.nbcnewyork.com/images/213*120/King+Bio+Recall.jpg

King Bio is recalling 32 children's medicines due to a possible microbial contamination.

The North Carolina-based company, which makes homeopathic drugs, announced Wednesday that a small percentage of its products produced between Aug. 1, 2017 and April 2018 have tested positive for the microbial contamination.

The company said use of the medicines could result in increased or life-threatening infections. There have been no reports of illnesses, according to the FDA, and King Bio issued the recall "out of an abundance of caution."

The recalled products are used to treat dozens of conditions, including bed wetting, chicken pox, common colds, nosebleeds, sore throat and teething, and were sold nationwide between August 2017 and July 2018. 

Customers are urged to stop using the affected products immediately and contact King Bio by email at recall@kingbio.com or call the company at 866-298-2740, Monday through Friday from 8:30 a.m. ET to 3:30 p.m. ET., to make arrangements for a return and replacement of the product. Consumers who believe they may have been sickened by one of the recalled products should contact their physician or healthcare provider. 

All of the recalled products listed below come in 2-ounce bottles except for Kids Candida, which comes in a 4-ounce bottle. Products marked "SCRX" are only used by professionals. For a complete list of UPC and Lot numbers click here

• DK Attention & Learning Enh.
• Chicken Pox Symptom Relief
• Children's Appetite & Weight
• Children's Appetite Enhance
• Children's Cough Relief
• Children's Fever Reliever
• Children's Growth & Development
• DK Newborn Tonic
• DK Nosebleed Relief
• TonsilPlex
• Children's Ear Relief Formula
• DK Teething
• DK Colic Relief
• Tummy Aches
• Kids Multi-Strain Flu Relief
• Kids Stress & Anxiety
• Kids Sleep Aid
• Kids Bed Wetting (NP)
• Kids Candida - 4-ounce bottle
• Kids Attention & Learning (SCRX)
• Bed Wetting Prevention (SCRX)
• Chicken Pox Symptom Relief (SCRX)
• Childrens Cough (SCRX)
• Children’s Ear Formula (SCRX)
• Children’s Fever Reliever (SCRX)
• Children’s Growth & Development (SCRX)
• Colic Relief (SCRX)
• Newborn Tonic (SCRX)
• Teething (SCRX)
• Tummy Aches (SCRX)
• Children’s Apetite & Weight (SCRX)
• Children’s Appetite Enhancer (SCRX) 



Photo Credit: Dr. King's by King Bio]]>
<![CDATA[FDA Extends EpiPen Expiration to Cover Shortages]]>Wed, 22 Aug 2018 06:01:53 -0500https://media.nbcnewyork.com/images/213*120/epiAP_16272622879970.jpg

The Food and Drug Administration said Tuesday that people can use some expired EpiPens for a few months longer to help cover spot shortages that have put some parents into a panic at the beginning of a new school year, NBC News reported.

Some batches of the devices, which inject lifesaving medication to stop severe allergic reactions, can be used for four months beyond their expiration, the FDA said. The affected devices hold the 0.3-milligram dose. The FDA said it reviewed data from Mylan, which sells EpiPen, showing that the product is still effective beyond the expiration date.

"We are doing everything we can to help mitigate shortages of these products, especially ahead of the back-to-school season," the FDA’s Dr. Janet Woodcock said in a statement.



Photo Credit: Pablo Martinez Monsivais/AP, File ]]>
<![CDATA[Suit: Hospital Honored Patient's Request for No Black Nurse]]>Sun, 19 Aug 2018 12:44:17 -0500https://media.nbcnewyork.com/images/213*120/nurseGettyImages-97769656.jpg

A nurse is suing a Michigan hospital for allegedly honoring a patient's request to not be cared for by a black woman.

Teoka Williams filed a federal lawsuit Monday against Beaumont Hospital in Dearborn, alleging that the health system violated federal and state civil rights laws by barring her from caring for a patient because of her race.

Williams, who has worked as a registered nurse at Beaumont for 10 years, said she overheard a patient in October 2017 request to not have a black woman as a caregiver. Williams said she reported the comment to her clinical manager, who then restricted her from caring for the patient.

Williams' suit contends that she complained to the hospital's human resources department about the issue. Williams alleges she was told that "patient requests are honored all the time and the next time it happens she would simply be taken off the assignment altogether."


Beaumont Hospital declined to comment on pending litigation. But the health system issued a statement saying that its "highest priority is providing a safe environment that is free from discrimination for both our patients and staff, and delivering care with compassion, dignity and respect."

Williams' attorney Julie Gafkay said health care institutions shouldn't accommodate patients' requests at the expense of employees' civil rights.

Gafkay said the lawsuit "is about being denied the opportunity to do your job duties based on your race, and being segregated from your job duties based on your race." She said the health system "accommodated racism and allowed a patient to discriminate against a very good and valuable employee."

The lawsuit seeks compensatory and punitive damages, as well as court costs and attorney fees.

Copyright Associated Press / NBC New York



Photo Credit: Christopher Furlong/Getty Images]]>
<![CDATA[EpiPen Shortage Has Parents Struggling as Schools Open]]>Fri, 17 Aug 2018 18:40:21 -0500https://media.nbcnewyork.com/images/213*120/epiAP_16272622879970.jpg

Brenda Thiel and Alyssa Wachtler live on opposite sides of the country. But they've got at least one thing in common: both have sons with severe nut allergies. And when they made their usual back-to-school trips to the pharmacy to procure their EpiPens for the new year, they were told the same thing.

"The pharmacist literally walked up to me and said, 'I'm really sorry, we do not have any epinephrine here,'" Thiel, who lives in Tucson, Arizona, told CNBC. "He said there's a shortage, and you're not going to be able to find EpiPens anywhere."

The lifesaving allergy medicine has had manufacturing disruptions since May, but allergy sufferers and caregivers may find it especially hard to find now, as parents try to stock up to send their kids back to school. EpiPen prescriptions typically spike in August, when parents buy multiple packs to give to their kids' teachers, nurses and sports teams.

"In my busy pediatric clinic, we've noticed there are a number of patients calling in wondering where they can procure their EpiPens, since most pharmacies are having trouble keeping them in stock," said Dr. Stacy Dorris, of the department of pediatric allergy and immunology at the Vanderbilt University Medical Center in Nashville, Tennessee.

It's a problem across the country. CNBC called two dozen pharmacies, from Boston to San Francisco, and nearly each one said it had no EpiPens, or very few, in stock. Some said the back-order date keeps getting pushed back, while others said it wasn't clear when more would be made available.

Patient advocacy group FARE, or Food Allergy Research & Education, said it heard from 600 people in 43 states in a survey about EpiPen availability, and more than 80 percent indicated they either couldn't fill or could only partially fill their prescriptions.

"We've heard there are widespread shortages of EpiPen," said Wells Fargo analyst David Maris, who estimates the product drew $1 billion in revenue in 2016 for drugmaker Mylan. (The company now reports financial results differently, making it difficult to ascertain how the EpiPen is performing, he said.)

"It's clearly a headwind," Maris said. "And no one's talking about how soon it will be cleared up."

New Jersey-resident Wachtler, whose 6-year-old son, Hudson, is starting first grade this year, is among parents who struggled to secure an EpiPen. She said she had to call eight to 10 local pharmacies before she found one that had a set of EpiPens in stock that were covered by her insurance.

"I said, 'Put it on hold! I will be there in the morning!'" Wachtler told CNBC. "And I rushed over and got the last box."

While EpiPen is marketed by Mylan, it's manufactured by a subsidiary of Pfizer. Mylan says it's "exploring several options with Pfizer that would help stabilize supply," while Pfizer cites "delayed shipments due to process changes," and the supply of "third-party components" for the disruptions.

The Pfizer subsidiary, Meridian Medical Technologies, received a warning letter from the Food and Drug Administration in September, citing "significant violations of current good manufacturing practice requirements" at its Missouri plant. Pfizer spokesman Steven Danehy said that the warning letter didn't restrict supply at the time it was received, but that "there has been some impact on manufacturing capacity" as a result of new processes it put into place to fix the issues the FDA cited.

The EpiPen isn't the only option for allergy sufferers, though it is by far the most dominant. There is an identical authorized generic version also sold by Mylan, but at half the price, but it too faces manufacturing issues.

Amneal Pharmaceuticals makes the Adrenaclick, a similar epinephrine auto-injector, while private drugmaker Kaleo makes the Auvi-Q, a smaller, rectangle-shaped device that talks the user through how to use it.

The Adrenaclick faced its own manufacturing issues earlier this year, but Amneal spokesman Mark Donohue said this week that the epinephrine auto-injectors are available. The Adrenaclick is also made by Pfizer, he said.

"While we experienced intermittent supply of products from our third-party manufacturer throughout the second quarter and during the month of July, we are receiving shipments," Donohue said.

The Auvi-Q hasn't had similar manufacturing problems, but it has another characteristic that may make it hard for some patients to procure: a list price of $4,500 for two auto-injectors. If it's covered by insurance, many can get the device without a copay. But it's not always covered.

That was the case for Thiel. Her 12-year-old son, Dylan, just started seventh grade, and is carrying his own epinephrine auto-injector for the first time.

After fruitlessly calling multiple local pharmacies to try to find the EpiPen, Thiel said she asked her pediatrician to write a prescription for the Auvi-Q. But her insurance, provided by the government as her husband has retired from the military, doesn't cover it. Finally, after an appeal, Thiel said the insurer agreed to cover it just one time.

"This has been about a month of me calling and asking and trying to get help," Thiel said. "Just trying to make sure I can have his medicines for him to go to school."

Back in New Jersey, Wachtler said she could also get the Auvi-Q, but that the staff members at her son's school aren't trained on how to use it.

"I feel most safe sending my son to school with the EpiPen or the EpiPen generic, knowing that the faculty is trained in how to administer that medication in case of an emergency," Wachtler said.

Mylan supplies EpiPens to schools through its EpiPen4Schools program. But even that system may face delays in supply, Mylan spokeswoman Lauren Kashtan said.

Just this week, a new competitor to the EpiPen was cleared to enter the U.S. market : a directly substitutable generic copy from Israeli drugmaker Teva Pharmaceuticals. It will be the first direct generic competitor sold by a company other than Mylan. (Mylan introduced the authorized generic in late 2016 after an uproar over the escalating price of the branded EpiPen, and it now commands about half the U.S. market, according to data from Wells Fargo. Mylan's branded EpiPen holds another 25 percent.)

It's unlikely, though, that the new competitor will solve the problems parents are facing as they send their kids back to school. Teva said in a statement that it's applying its "full resources to this important launch in the coming months." It didn't specify a launch date, or a price.

Meanwhile, Vanderbilt's Dorris notes that in a bind, recently expired EpiPens can be used in an emergency situation, though it's not recommended if nonexpired products can be obtained.

And she stressed that, though many may feel concerned about their ability to obtain an EpiPen, it's not a good idea to hoard them.

"On each epinephrine auto-injector, there is an expiration date," Dorris said. "If it's not expiring soon, it's probably best to wait and not rush the pharmacies right this moment. Give people time and space to get the epinephrine auto-injector they need for school."

"It's something just as a culture, as Americans," she concluded, "we need to do for each other right now."

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

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Photo Credit: AP
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<![CDATA[Weed Killer in Your Cereal? Maybe, But Don't Panic]]>Fri, 17 Aug 2018 10:13:04 -0500https://media.nbcnewyork.com/images/213*120/cereal2.jpg

Social media feeds have been swamped by news that the advocacy organization Environmental Working Group found traces of the pesticide glyphosate, the main ingredient in Roundup, in certain popular breakfast cereals like Cheerios. While the headlines have alarmed parents, there are several reasons not to panic, NBC News reported.

Research by the EWG, which actively campaigns against glyphosate, was not published in a peer-reviewed journal, the amounts found were far below the allowable limits, and most experts in the field say there’s very little evidence that glyphosate causes cancer or any other health problems.

Glyphosate also made headlines because a California jury ordered Roundup maker Monsanto to pay $290 million in damages to a groundskeeper with non-Hodgkin’s lymphoma. Still, American juries do not necessarily rule based on scientific evidence, and they are not required to.

Click here for the full story on NBCNews.com



Photo Credit: PA Images via Getty Images, File]]>
<![CDATA[Any Given Sun Day: NFL Tackles Skin Cancer With Sunscreen Drive]]>Fri, 17 Aug 2018 07:18:27 -0500https://media.nbcnewyork.com/images/213*120/AP_18216532311043-NFL-Skin-Cancer-Initiative.jpg

The toughest opponent for many NFL players and coaches during the blazing hot days of training camp sits far above the football field.

The sun's powerful ultraviolet rays are a leading cause of skin cancer, and shade is rare at most practice sites. So, slathered-on sunscreen, big bucket hats, long-sleeved T-shirts and slick sunglasses serve as lead blockers.

"I do it regularly, being red-haired with freckles, Irish heritage," Dolphins offensive tackle Sam Young said of using sunscreen. "I go to a dermatologist once a year to make sure everything is good."

Young doubles up on the protection by also wearing long sleeves during practice, despite steamy conditions that are more suited for lounging at the beach than playing on a football field.

"To me, it's not worth the risk," said Young, who grew up in South Florida and has family members who have had skin cancer. "I try to be as practical as I can about it. Sleeves mean one less thing to have to worry about."

And, there are plenty of concerns for those who spend so many hours on sun-splashed fields.

Skin cancer is the most common type of cancer, according to the American Cancer Society. The organization estimates there will be 5.4 million new cases of non-melanoma this year among 3.3 million people, and 91,270 new cases of melanoma — a more serious and aggressive form of skin cancer. Melanoma is usually curable, however, when detected in its early stages.

The NFL and American Cancer Society teamed up this summer to launch an initiative as part of its "Crucial Catch" campaign in which free sunscreen is being provided to players, coaches, fans, team employees and media at camps around the country. Some sites — such as at Jets and Giants camp — have several receptacles where people can get sunscreen from a dispenser, while packets of lotion are being handed out at others.

"One of the things we try do here that we haven't done before (is) to look at the skin cancer part of it," first-year Lions coach Matt Patricia said, "and see if there's anything you have questions about as a person, 'Hey, this doesn't look right,' or, 'What do you think about this?'"

Falcons coach Dan Quinn said he's had a spot "removed or checked on" in annual skin cancer checks during physical exams. He and some of his assistants normally wear long shirts under their T-shirts during practice — despite the Georgia heat and humidity.

"We all remind one another," Quinn said. "For the players and for the coaches, we always have the lotion that we need or the spray to use. They're pretty mindful."

Well, some are.

Plenty of players acknowledge they often hit the field focused more on picking up blocks than putting on sunblock.

"I probably should, but I'm just too lazy," said Washington rookie wide receiver Trey Quinn, who was "Mr. Irrelevant" as the last player selected in this year's draft. "Hopefully my mom doesn't see this. She'd probably recommend with my pale skin to wear a little sunscreen, but it's available to us and it's up to us to be adults and make decisions for ourselves."

Most players and coaches don't usually reapply sunscreen during practice, although the American Cancer Society recommends doing so after two hours in the sun.

Jets defensive end Henry Anderson usually remembers to put lotion on his arms before practice — not that it stays on long.

"Sometimes, I'll get a little red because O-linemen are rubbing your arms and rubbing your skin and stuff," he said. "I guess it does the job. I still get kind of burned here and there, but I just don't really want to wear sleeves out to practice in this weather."

The American Cancer Society says the lifetime risk of melanoma is higher for people who are white, especially those with fair skin that freckles or burns easily. But people of all skin colors are vulnerable, and sun damage can occur at any time of year.

Broncos linebacker Justin Simmons, who is black, recently wore tights and a long-sleeve shirt while practicing in the elevated altitude of Colorado. He also regularly wears sunscreen.

"When you're out here, yeah, you have to," Simmons said. "I just tan easy — very rarely does my skin break. But you have to put it on. You're so much closer to the sun. It may feel a little bit more humid, like where I'm from in South Florida, and may not feel as humid here. But you're so much closer and the sun is beaming on you.

"You have to protect your skin."

Hall of Fame quarterback Troy Aikman, Texans owner Bob McNair and Jaguars coach Doug Marrone are among some in the NFL community who have been successfully treated for melanomas.

But there have also been several who have been devastated by skin cancer, including former Steelers coach Bill Cowher, who lost his wife Kaye to melanoma in 2010. Former NFL assistant coach Jim Johnson died from that form of cancer in 2009, while former coach Buddy Ryan and former NFL player and coach Jack Pardee also dealt with it.

"Down in Houston with Mr. McNair, he would always remind us, 'Hey, make sure you put sunscreen on. It's important,'" said Titans coach Mike Vrabel, a Texans assistant the past four seasons. "It's something that he went through, and as you're out there every single day, just being conscious of it."

Vrabel's quarterback certainly is. Marcus Mariota grew up in Hawaii, so he's used to sunny days.

He doesn't use sunscreen, but wears a long-sleeved hoodie at practice, something he started doing last year.

"But today was a steamer," Mariota said recently. "I did consider putting on sunscreen. It's just slippery and messy. I'm not a big fan."

That's a common sentiment among players, particularly in the heat and humidity of training camp.

"I don't like doing it," Giants backup quarterback Davis Webb said. "I don't want it slipping on my hands, so I am not putting it on at practice. When I golf or I'm at the beach, I like to throw it on."

Dolphins rookie kicker Jason Sanders grew up in sunny Orange County, California, but is using sunscreen this summer for the first time in his football career.

"I get my upper arms to prevent the farmer's tan, and my neck, too," he said. "I get it on my ears and neck, but stay away from my face because I sweat a lot out here. I would say two out of three days I put sunscreen on. Some days when I kick, I don't want to be all lathered up. You can feel it when you're sweating this much. I don't want to get it anywhere near my eyes."

Just as long as it gets on every other exposed area.

Between blocks and screens, NFL players and coaches are doing everything under the sun to protect themselves.

"I think we can always get more information on all of that topic in general," Patricia said. "But (it's) something we have to be conscious about when we're out in the sun that long."

AP Pro Football Writer Teresa Walker and AP Sports Writers Tom Canavan, Pat Graham, Larry Lage, Brett Martel, Charles Odum, Stephen Whyno and Steve Wine contributed.

Copyright Associated Press / NBC New York



Photo Credit: Julio Cortez/AP]]>
<![CDATA[FDA Approves Teva’s Generic EpiPen After Yearslong Delay]]>Thu, 16 Aug 2018 13:35:25 -0500https://media.nbcnewyork.com/images/213*120/EpiPen+May+14+2018.jpg

U.S. regulators cleared the first generic competitor to Mylan's EpiPen, after a yearslong delay that many said contributed to the emergency allergy drug's rapid rise in price. 

Teva Pharmaceuticals received Food and Drug Administration approval for generic versions of both the EpiPen and EpiPen Jr, the agency said in a statement Tuesday. 

The products are the first competitors cleared by the FDA that are direct generic copies of the EpiPen and could be substituted for the brand-name product by a pharmacist. Other versions of epinephrine auto-injectors, such as the Adrenaclick and Auvi-Q, are on the market, but aren't considered EpiPen generics. 

Teva shares rose 6 percent to $37.66 on the news. 

"This approval means patients living with severe allergies who require constant access to life-saving epinephrine should have a lower-cost option, as well as another approved product to help protect against potential drug shortages," FDA Commissioner Scott Gottlieb said in the statement. 

Mylan introduced its own authorized generic form of the EpiPen in late 2016, after an uproar about the branded version's price, which rose more than 400 percent over a decade. The authorized generic, identical to the original except without the brand name, cost half the price: $300 for a two-pack. 

Teva could seek to compete by pricing its generic version even lower; typically, it takes multiple generic copies of a medicine entering the market to see prices collapse substantially. 

The Israeli company's application for a generic EpiPen was rejected by the FDA in early 2016, just before the rising price of Mylan's product exploded into a major news story heading into back-to-school season, when parents often stock up for kids with allergies. 

Though the key ingredient in the EpiPen, epinephrine, has been available for decades and is no longer covered by a patent, generic copies of the device have struggled to reach the market because the product is technically a drug-device combination, and the delivery device proved hard for generic competitors to copy to a degree that would satisfy regulators. 

The FDA issued guidance in November 2017 to try to make it easier for generic copies of complex medicines like the EpiPen to reach the market, saying some design differences may be approved as substitutable products, as long as those differences don't affect patients' ability to use the product the way it's intended. 

The FDA said Teva's generic products are expected to produce the same clinical effect and have the same safety profile as the EpiPen and EpiPen Jr. There are small differences in design, the regulator said, but they won't affect safety or efficacy.

This story first appeared on CNBC.com. Here is more from CNBC: 


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<![CDATA[Smokers Better Off Quitting, Even With Weight Gain: Study]]>Thu, 16 Aug 2018 12:02:45 -0500https://media.nbcnewyork.com/images/213*120/874373226-Cigarette-butts.jpg

If you quit smoking and gain weight, it may seem like you're trading one set of health problems for another. But a new U.S. study finds you're still better off in the long run.

Compared with smokers, even the quitters who gained the most weight had at least a 50 percent lower risk of dying prematurely from heart disease and other causes, the Harvard-led study found.

The study is impressive in its size and scope and should put to rest any myth that there are prohibitive weight-related health consequences to quitting cigarettes, said Dr. William Dietz, a public health expert at George Washington University.

"The paper makes pretty clear that your health improves, even if you gain weight," said Dietz, who was not involved in the research. "I don't think we knew that with the assurance that this paper provides."

The New England Journal of Medicine published the study Wednesday. The journal also published a Swedish study that found quitting smoking seems to be the best thing diabetics can do to cut their risk of dying prematurely.

The nicotine in cigarettes can suppress appetite and boost metabolism. Many smokers who quit and don't step up their exercise find they eat more and gain weight — typically less than 10 pounds (4.5 kilograms), but in some cases three times that much.

A lot of weight gain is a cause of the most common form of diabetes, a disease in which blood sugar levels are higher than normal. Diabetes can lead to problems including blindness, nerve damage, heart and kidney disease and poor blood flow to the legs and feet.

In the U.S. study, researchers tracked more than 170,000 men and women over roughly 20 years, looking at what they said in health questionnaires given every two years.

The people enrolled in the studies were all health professionals, and did not mirror current smokers in the general population, who are disproportionately low-income, less-educated and more likely to smoke heavily.

The researchers checked which study participants quit smoking and followed whether they gained weight and developed diabetes, heart disease or other conditions.

Quitters saw their risk of diabetes increase by 22 percent in the six years after they kicked the habit. An editorial in the journal characterized it as "a mild elevation" in the diabetes risk.

Studies previously showed that people who quit have an elevated risk of developing diabetes, said Dr. Qi Sun, one the study's authors. He is a researcher at the Harvard-affiliated Brigham and Women's Hospital.

But that risk doesn't endure, and it never leads to a higher premature death rate than what smokers face, he said.

"Regardless of the amount of weight gain, quitters always have a lower risk of dying" prematurely, Sun said.

Copyright Associated Press / NBC New York



Photo Credit: Peter Dazeley/Getty Images, File]]>
<![CDATA[How to Ease Kids' Anxiety About School Safety]]>Thu, 16 Aug 2018 11:07:14 -0500https://media.nbcnewyork.com/images/213*120/AdobeStock_113156084.jpg

Given the number of high-profile school shootings last year, both children and adults may be feeling anxiety about school safety. As many kids head back to school, knowing how to speak with them is key in helping to alleviate fear and worry about their personal safety. Here’s where to start, according to Parent Toolkit.

Create a sense of normalcy and return to a routine. Children can feel safer when things are "normal" and they may open up about their thoughts. If they don't open up, encourage them with open-ended questions and let them lead the conversation. Know their concerns and worries are valid and recognize them.

As most schools have active shooter drills or other safety practices, discuss with children why this is necessary and identify any adults they can turn to in those moments. 

Remember to keep these discussions age-appropriate. For elementary school kids, stay brief and simple and remind them they will be OK. For middle schoolers, prepare for more specific questions. For high schoolers, be ready to discuss more opinions and identify reputable online sources to seek information.

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<![CDATA[How to Pack a Stress-Free School Lunch]]>Thu, 16 Aug 2018 08:13:33 -0500https://media.nbcnewyork.com/images/213*120/cafeteria1.jpg

With the school year starting again, it’s time to start to think about the routine of packing school lunches. For many time-pressed parents, this is a formidable task.

But it doesn’t need to be. I’m a registered dietitian and a clinical instructor at Georgia State University, and I have a few easy suggestions. The first has to do with the food itself, and the others are about organizing the meal.

Packing a powerful lunch
Research has shown that a balanced lunch of complex carbohydrates and protein offers children energy and brain fuel to help them get through a day of learning. For the main course, pair a complex carbohydrate, such as whole grain breads, crackers, pasta, beans, fruit, milk and yogurt, with a protein as your child’s main course. Some examples include a turkey sandwich on whole wheat bread, beans with rice and salsa, peanut butter and jelly, tuna salad on crackers, yogurt and granola or cottage cheese with fruit.

When considering complex carbohydrates, look for three to five grams of fiber per serving. Two slices of whole wheat bread usually contains three grams of fiber or more. A piece of fruit is a good way to get in complex carbohydrates, satisfy a sweet craving and avoid sweets with added sugars. Keep in mind that research suggests children should eat less than 25 grams of added sugar per day.

Next, concentrate on selecting fruits and vegetables that are in season. The U.S. dietary guidelines recommend that school-aged children have at least two cups of fruit and three cups of vegetables per day. In-season fruits and vegetables, which are at their taste peak and are more abundant, are good choices. Choose fruits and vegetables that will not brown quickly or get smashed in the lunch bag.

Include a few snacks that your child can eat along with lunch or during snack time at school. Good snack choices include easy-to-open items such as granola bars, trail mixes, string cheese with a piece of fruit, individual yogurts or cottage cheeses, and pretzels and hummus. Be sure to check for added sugars in yogurts and trail mixes, keeping in mind the recommendation for less than 25 grams.

Do not forget hydration. A water bottle for the day along with milk or a low-sugar – 10 grams or less per serving – juice box or pouch is a good option. Many juice companies offer options that are lower in sugar or include a serving of vegetables blended in with 100 percent fruit juice.

The logistics of lunches
Start your kids off early by involving them in the planning and shopping for the ingredients needed to pack their school lunches. Allow young packers to grab the side items to go into their lunch, such as fresh fruit and granola bars, while you pack the main, more labor-intensive food items.

Utilize the time to role-model healthy nutrition by packing your lunch for work with your child. Set aside time in your daily routine for lunch-packing so that it doesn’t creep up during stressful times such as running out the door in the morning. Assembly lines are a fun way to involve the whole family in packing lunches. A job can be created for all ages and cooking abilities.

Invest in reusable lunch containers. They may have more upfront cost, but overall the containers reduce waste and save money otherwise spent on lunch baggies. Firmer plastic or glass containers can also help to prevent browning and smashing of lunch items. Kids can have an added allowance opportunity of cleaning out their lunch boxes and containers to have them ready for the next day!

When shopping for lunch items, shop in bulk for nonperishable items such as granola bars, crackers and snacks and look for buy-one-get-one-free deals at your local grocery store. If concerned about fruits browning or bulk items going to waste, consider the cost benefit of prepackaged items that have longer expiration dates and will not brown. Examples include fruit squeeze pouches, single guacamole or hummus packets, peanut butter packet and yogurts.

Do not feel like your child needs something different each day. School is often a stressful time, and the lunch period is usually 20 minutes or less with the focus being on little talking and more eating so that kids can get back to learning on a full stomach. Often, lunch is “comfort food” from home for kids, and they enjoy having a routine lunch that they can count on during their school day.

If shopping, preparing and packing lunches is too overwhelming, you cannot go wrong with the National School Lunch Program. Often, you can save money and have more nutrition than packing a lunch from home. Farm-to-school initiatives and better overall nutrition have made school lunches a healthy, affordable option for families. When considering the financial impact of packing lunch from home versus buying school lunch, be sure to fill out your federal eligibility application for free or reduced meal eligibility.

This article was originally published on The Conversation, an independent and nonprofit source of news, analysis and commentary from academic experts. Read the original article here

Copyright Associated Press / NBC New York



Photo Credit: Getty Images]]>
<![CDATA[Measles Sickens 107 From 21 States in First Half of Year]]>Wed, 15 Aug 2018 15:00:42 -0500https://media.nbcnewyork.com/images/213*120/GettyImages-927424104.jpg

More than 100 people from 21 states were reported to have contracted measles in the first half of 2018, the Centers for Disease Control and Prevention says on its website.

There have been a total of 107 cases of measles between Jan. 1 and July 14, 2018. The cases were reported in D.C. and states including California, Connecticut, Florida, Maryland, New Jersey, New York, Pennsylvania and Texas.

The majority of people who have contracted measles were unvaccinated, the CDC says

Because measles is common in other parts of the world, including some countries in Europe and Asia, travelers with measles can bring the disease in the U.S. The disease can spread within the U.S. when it reaches a community with groups of unvaccinated people.

Symptoms of measles include high fever, cough, runny nose and red, watery eyes. A rash also forms three to five days after symptoms begin. The disease very contagious and can spread through coughing and sneezing

The U.S. experienced a record number of measles cases in 2014 with 667 reported cases from 27 states. It was the greatest number of cases since elimination of the disease was documented in the U.S. in 2000.

There was also a large, multi-state outbreak in 2015. It was linked to an amusement park in California, likely originating from a traveler who got infected abroad before visiting the park. A total of 188 people from 24 states and D.C. were reported to have gotten measles.

In 2017, 118 people from 15 states and D.C. A total of 86 people from 19 states contracted the disease in 2016.



Photo Credit: Karl Tapales/Getty Images, File]]>
<![CDATA[Set a GamePlan for Health in 2019]]>Fri, 11 Jan 2019 17:02:36 -0500https://media.nbcnewyork.com/images/213*120/BECK+GAMEPLAN+FOR+HEALTH.jpg]]>