
Homeowners Battle Insurers Over $2.9 Trillion Climate Risk
Subsidence is a worsening risk and insurers don't want to pick up the tab.
When Bernard Weisse first noticed a tiny crack in the outer wall of his house on the outskirts of Paris, he dismissed it as little more than a nuisance. But in the four years since, a spiderweb of fissures has spread from floor to ceiling and snaked into virtually every corner of his home.
'We can hear loud cracking noises especially when it's warm outside,' said the retired salesman and father of three. 'Sometimes, I think we should get all our stuff together and leave.'

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Medscape
2 hours ago
- Medscape
Fast Five Quiz: Ovarian Cancer Overview
Ovarian cancer poses a significant threat to women's health, often developing quietly and without early symptoms. It is commonly discovered after progression. This late detection, along with resistance to treatment and frequent relapse, contributes to poor outcomes. Although medical and surgical interventions have evolved, survival rates remain low. These challenges highlight the critical importance of early detection methods, precise diagnostic technologies, and individualized care coordinated across medical specialties. How much do you know about ovarian cancer? Test your knowledge with this quick quiz. High-grade serous carcinoma is by far the most prevalent, representing approximately 70%-80% of epithelial ovarian cancer cases. In contrast, the low-grade form of serous carcinoma is much less common (< 5%). Endometrioid and clear cell subtypes are each responsible for about 10% of cases and have known associations with endometriosis. Mucinous carcinomas are uncommon, comprising a small fraction (around 3%) of epithelial ovarian cancers. Learn more about ovarian cancer. According to the National Institute for Health and Care Excellence guidelines, for patients with inherited mutations linked to a higher chance of developing ovarian cancer (eg, alterations in BRCA1, BRCA2, RAD51C, RAD51D, BRIP1, PALB2 ), the most effective preventive surgical procedure is the bilateral salpingo-oophorectomy (which is the removal of both fallopian tubes and ovaries). This intervention has been proven to greatly reduce ovarian cancer risk and enhance long-term survival among these high-risk groups. However, when performed in premenopausal women, it induces menopause. Removing one ovary (unilateral oophorectomy) or the uterus (total hysterectomy) does not offer adequate protection against ovarian cancer. Procedures like cervical conization are unrelated to ovarian cancer and are used to manage cervical abnormalities. Learn more about salpingo-oophorectomy. HRT is typically recommended for women who undergo bilateral salpingo-oophorectomy before reaching the natural age of menopause and have not had breast cancer. This type of surgery causes a sudden and early drop in estrogen levels, which can result in bothersome symptoms and increase the risk for long-term health issues such as bone loss or cardiovascular problems. HRT helps ease these effects and maintain health until the typical menopausal age. In contrast, women older than age 50 years are often already in or near menopause, and HRT is not routinely needed unless specific symptoms arise. Patients who have a history of breast cancer must be assessed on a case-by-case basis because HRT might not be safe. Women with a uterus should be offered combined HRT, whereas women without a uterus should be offered estrogen-only HRT. Additionally, women who have not had their ovaries removed do not experience the abrupt hormonal shift that warrants preventive HRT. Learn more about HRT. Individuals who carry a BRCA1 mutation face a significantly elevated risk of developing ovarian cancer, often at a younger age than those with other hereditary mutations. If a woman with a BRCA1 mutation decides not to undergo surgery to remove her ovaries and fallopian tubes, monitoring for early signs of cancer should begin after age 35 years. This timing aligns with evidence suggesting that BRCA1 -related ovarian cancers tend to occur earlier than those linked to BRCA2 or other genetic variants. Initiating surveillance at age 30 years is generally premature and not part of standard recommendations. For BRCA2 carriers, screening is usually deferred until after age 40 years, whereas those with alterations in genes like RAD51C, RAD51D, BRIP1 , or PALB2 typically begin surveillance after age 45 years. Individuals with Lynch syndrome-related mutations (eg, MLH1, MSH2, MSH6 ) are also advised to start at age 35 years if surgery is postponed. Learn more about breast cancer risk factors. Although mucinous tumors can arise directly from the ovary, many are actually secondary cancers that have spread from other organs, most notably the gastrointestinal system, including the colon and appendix. Distinguishing between primary and metastatic mucinous tumors is crucial for proper diagnosis and management. High-grade serous cancers more commonly begin in the epithelium of the fallopian tubes rather than the ovaries. On the other hand, low-grade serous carcinomas are thought to originate in the ovary and are typically diagnosed in younger females, with outcomes generally more favorable than their high-grade counterparts. Germ cell tumors and sex cord-stromal tumors are far more frequent in adolescents and young adults, with most cases occurring before age 30 years and not in women older than 45. Learn more about endometrioid carcinoma.


Medscape
6 hours ago
- Medscape
Fast Five Quiz: Obstructive HCM Management
Learn more about beta-blockers for obstructive HCM. Guidelines from the US, Canada, and Europe recommend alcohol septal ablation over invasive surgery for patients with advanced age and comorbidities, due to its less invasive nature and shorter recovery time. However, alcohol septal ablation has been associated with higher risk for complete heart block requiring permanent pacing and might result in less uniform reduction in LVOT gradient, similar to myectomy. It should not be used in pediatric or younger patients or those with cardiac abnormalities that would require surgery. Learn more about alcohol septal ablation for obstructive HCM. Transaortic septal myectomy is the preferred treatment for patients with obstructive HCM who have severe, drug-refractory symptoms, according to a state-of-the-art review from the Journal of American College of Cardiology. Similarly, Canadian guidelines note that surgical myectomy is 'usually' the most effective therapy for obstruction and has a low risk for adverse outcomes, although contraindications to its use do exist. The AHA also notes that transaortic septal myectomy adds little risk to other cardiac procedures and that the relief in left ventricular outflow tract obstruction can minimize postoperative hemodynamic instability. Although dual chamber pacing and mitral valve replacement are effective treatments and can be used for management in some cases, transaortic septal myectomy is generally the preferred option. Learn more about surgical myectomy for obstructive HCM. Surgical myectomy is encouraged to be performed in high-volume HCM centers because in-hospital mortality for surgical myectomy is inversely correlated with surgical volume. Specifically, one recent review found that high-volume hospitals had an in-hospital mortality rate for surgical myectomy of 2.4% compared with 3.9% for medium volume and 5.7% for low volume centers. Another recent review notes that mortality rate for surgical myectomy has decreased 'strikingly' from the highs of up to 8% from 30 years ago but also acknowledges the need for more experienced surgeons in the US and Europe to increase its accessibility. Learn more about surgical outcomes for obstructive HCM. A recent review of HCM published by the American Journal of Cardiology lists history of sustained or repetitive ventricular tachycardia, unexplained syncope, massive left ventricular hypertrophy, or extensive late gadolinium enhancement or a family history of this complication as indications for implantable cardioverter-defibrillators. Similarly, the AHA/ACC joint guidelines specifically recommend an implantable cardioverter-defibrillator for patients with any prior history of sudden cardiac arrest, ventricular fibrillation, or sustained ventricular tachycardia. It should also be considered in shared decision-making with a 5-year risk estimate if a patient has an ejection fraction < 50%, apical aneurysm, unexplained syncope, massive left ventricular hypertrophy, or a family history of sudden cardiac death. Though mild left ventricular hypertrophy and minimal late gadolinium enhancement on cardiac MRI can cause cardiovascular events in patients with obstructive HCM, they are typically not sole indicators for implanting a cardioverter-defibrillator. Asymptomatic status with normal exercise capacity is not an indicator as well. Learn more about implantable cardioverter defibrillators for obstructive HCM. This article was created using several editorial tools, including generative AI models, as part of the process. Human review and editing of this content were performed prior to publication. Lead image: Science Source


Entrepreneur
7 hours ago
- Entrepreneur
Entrepreneur UK's London 100: Numan
Numan is one of the UK's fastest-growing digital healthcare companies, redefining how patients approach their health through personalised, technology-driven solutions Opinions expressed by Entrepreneur contributors are their own. You're reading Entrepreneur United Kingdom, an international franchise of Entrepreneur Media. Industry: Healthtech Numan is one of the UK's fastest-growing digital healthcare companies, redefining how patients approach their health through personalised, technology-driven solutions. The company was founded in 2018 by Sokratis Papafloratos, an experienced entrepreneur with a track record of building and backing successful tech businesses. Numan began as a men's health startup focused on treating erectile dysfunction. In just six years, it has evolved into a full-scale digital healthcare provider, supporting over 500,000 patients through over 150 London-based staff with treatments for conditions like obesity, hair loss, and sexual health. The company generated £30m in revenue in 2023 and more than doubled that figure in 2024 – which was largely driven by the launch of their weight loss management service. The company recently launched its AI-powered Health Assistant, to support their holistic weight loss programme that includes GLP-1 prescribing. This proprietary tool is designed to provide real-time, personalised health guidance while ensuring rigorous safety and clinical oversight. With its rapid growth, technological advancements, and unwavering focus on safety and innovation, Numan is one of the most exciting and impactful London-based startups – deserving a place in the Entrepreneur UK London100 list as it continues to shape the future of digital health.