
Lead program faces delays and slow spending, per report
Cleveland is still seeing persistently high rates of childhood lead poisoning six years after passing a landmark lead-safe housing law.
Why it matters: Lead poisoning in Cleveland children remains nearly four times the national average, per Cleveland Clinic, and can result in irreversible cognitive and behavioral damage.
The big picture: Councilwoman Rebecca Maurer — co-chair of the city's Lead Safe Advisory Board — argues in a new report that Cleveland's approach needs a reset.
She says resources have spread too thin and legislative or administrative tweaks are required to direct spending toward the homes, neighborhoods and housing components most likely to expose kids to lead.
Catch up quick: Maurer rose to prominence through her work with Cleveland Lead Advocates for Safe Housing, the grassroots group that successfully pushed City Council to pass the 2019 Lead Safe law.
Friction point: Despite building a public-private system to certify and remediate rental homes, Maurer says the program is hamstrung by administrative delays, tech hurdles and sluggish spending.
The city has spent less than 25% of federal HUD funds and less than 10% of state dollars dedicated to lead remediation as of spring 2025, according to her report.
What they're saying: Lead-safe housing "is at a crossroads," Maurer writes.
"We can keep doing what we are doing and hope we make enough of a dent ... Or we can take needed steps to simplify the program, focus our resources, and clearly coordinate our leadership and data reporting."
What's next: Maurer says she'll seek buy-in from her colleagues on council and the lead advisory board.
The other side: Council President Blaine Griffin told Cleveland.com that amending the law would be difficult.
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Medscape
14 hours ago
- Medscape
Bariatric Surgery Boosts Self-Esteem, But Does It Last?
The benefits of bariatric surgery can extend beyond physical weight loss and improved metabolic parameters, according to a new study finding that self-esteem surges in the first year following the surgery. 'We certainly know that bariatric surgery can help with diabetes, hypertension, and sleep apnea, but we don't talk as much about how obesity affects basic self-esteem — how the patient feels about themselves,' study investigator Justin Dhyani, MD, Geisinger Medical Center, Danville, Pennsylvania, told Medscape Medical News . 'It seems logical that when a patient loses weight, self-esteem will increase, but the nearly 40-point rise in self-esteem scores we saw in just 12 months was really impressive,' said Dhyani. But how long does it last? Leslie Heinberg, PhD, Department of Psychiatry and Psychology, Cleveland Clinic, Cleveland, told Medscape Medical News that the self-esteem boost in the first year after surgery noted in this study is 'absolutely in line' with her own clinical observations. It's after the first year when challenges may arise, said Heinberg, who wasn't involved in the research. Early Self-Esteem Boost For their study, Dhyani and colleagues used the Geisinger database to identify 5056 adults (mean age, 48 years; 85% women) with obesity (BMI ≥ 35) who had bariatric surgery between 2006 and 2019. Most had Roux-en-Y gastric bypass or sleeve gastrectomy. A total of 534 participants completed a survey on self-esteem within 12 months before and 6-24 months after weight-loss surgery. Overall, the researchers found that self-esteem scores more than doubled just 12 months after bariatric surgery — from 33.6 at baseline to 75.5 (out of 100) at 12 months ( P < .0001). However, patients with a higher BMI at the time of surgery (BMI ≥ 50) experienced smaller gains in self-esteem compared with peers with lower baseline BMI (< 40), which could be due to lingering effects of weight stigma. 'When you start out at a higher BMI, you have a longer way to go to reach what society might think is a normal weight, said Dhyani, adding that the externalized weight stigma certainly would affect how patients feel about themselves. 'That's what I think is going on,' he told Medscape Medical News. Dhyani presented the study at the 2025 American Society for Metabolic and Bariatric Surgery (ASMBS) Annual Scientific Meeting in Washington, DC. He noted that longer-term follow-up will be important to see whether these gains in self-esteem persist over time, particularly in light of known trends in weight regain after surgery. Beyond the 'Heavenly Period' Heinberg told Medscape Medical News the first year after bariatric surgery is colloquially called the 'heavenly period' because people are losing a lot of weight, they're finding big improvements in their health and quality of life, and they're often getting a lot of positive attention. But 'beyond the first year, quality of life may stabilize, and people find that they have to work hard so they don't experience weight recurrence,' said Heinberg. 'They still have the same challenges as before surgery, like stressful jobs. They're just in a smaller body.' That's why ongoing counseling is so important. 'At Cleveland Clinic, the psychology team is embedded within the bariatric program. We see patients a bit more in the first year, but then annually is recommended,' Heinberg said, adding that they are available to patients more frequently if needed. April Williams, from Gig Harbor, Washington, who had bariatric surgery in 2019, said the 'temporary high' with surgery-induced weight loss can be followed by an 'emotional crash' as the weight loss eventually slows down and people stop commenting and offering praise. People need to realize the 'chronic and progressive nature of obesity. Just because you've treated it with bariatric surgery, the disease is still progressing in your life,' Williams told Medscape Medical News . Driven in part by a lack of post-surgery support, much of it due to COVID, Williams founded BariNation, a patient-led organization that supports people at all stages of their bariatric weight loss journey. Jamie Sarver, LPN, program coordinator with Cleveland Clinic's Bariatric and Metabolic Institute, said bariatric surgery is 'an opportunity to make an investment in yourself, [but] it's not a quick fix.' Sarver also had bariatric surgery in 2019. She shared that prior to surgery, she often felt 'uncomfortable' in her own skin, but her perception of herself has 'evolved several times' since the surgery. 'Initially I was glad for the rapid weight loss, smaller clothing sizes, and noticeable changes in my abilities to do physical activities. Over time, and as I've maintained my weight loss, my perception of myself has evolved further to feeling proud and confident of what I've achieved in these 5 years since surgery,' Sarver told Medscape Medical News . Few Takers Despite the physical and psychological benefits of bariatric surgery, only about 1% of Americans eligible for bariatric surgery choose to pursue it. Dhyani said highlighting the emotional and social benefits of bariatric surgery could encourage more patients to consider the procedure. 'I think letting patients know more about the self-esteem aspect of it might open up their minds to this type of care to improve their lives,' he said. Richard M. Peterson, MD, MPH, president-elect of the ASMBS and professor of surgery at UT Health San Antonio, San Antonio, told Medscape Medical News that one of his initiatives is to 'improve the image of bariatric surgery.' 'A lot of people still have the very old-school view that bariatric surgery is dangerous. But the truth is this surgery — that improves overall health and weight loss — is safer than having your gallbladder removed,' said Peterson.
Yahoo
14 hours ago
- Yahoo
How To Know if You've Had a ‘Silent Stroke,' According to Neurologists
How To Know if You've Had a 'Silent Stroke,' According to Neurologists originally appeared on Parade. Considering that every one in six people has a neurological disorder, research on brain health is more important than ever. To learn more about how to more effectively prevent and treat conditions that impact the brain, the Cleveland Clinic has embarked on the largest brain health study to date. The study is collecting data over 20 years to identify biomarkers and targets for preventing and curing brain diseases and includes 3,857 people. In some of the healthy people who are undergoing brain scans as part of the study, researchers found that some of them have had a "silent stroke," which completely went under the radar when it can a stroke be silent and if it is, how can you know if you had one? Here, neurologists share what you need to know, including subtle symptoms and whether silent strokes are detrimental to brain health or not.🩺SIGN UP for tips to stay healthy & fit with the top moves, clean eats, health trends & more delivered right to your inbox twice a week💊 Dr. Ken Uchino, MD,a stroke neurologist at the Cerebrovascular Center at the Neurological Institute at Cleveland Clinic, explains that there are two types of strokes: ischemic and blockage. He explains that 80% of strokes are ischemic, meaning they occur when blood flow to part of the brain is blocked. A blockage stroke occurs when a blood vessel in the brain becomes completely blocked. In both cases, brain cells die due to lack of oxygen and nutrients.'A silent stroke occurs when brain cells die, but the person does not have obvious symptoms, like slurred speech or paralysis. People often find out they have had a silent stroke when they get a brain scan for another reason,' says Dr. Mill Etienne, MD, an Associate Professor of Neurology at New York Medical Dr. Uchino also says that silent strokes don't have any noticeable symptoms; that's why they are referred to as 'silent.' Like Dr. Etienne, Dr. Uchino says that, typically, the only way someone knows they had a silent stroke is because they got an MRI or CT scan for another reason (perhaps they hit their head, for example) and it shows up in the scan. The scan, however, cannot indicate when someone had a silent stroke; it only shows that one occurred. Even though silent strokes aren't detectable in the moment, often someone can look back and realize there were signs they may have missed. Dr. Jeffrey N. Quinn, MD, a vascular neurologist at Torrance Memorial Medical Center, an affiliate of Cedars Sinai Medical Center, says that silent strokes can be accompanied by abrupt memory dysfunction or changes in levels of cognition, social or motor function. Related: Dr. Etienne adds that brain fog, trouble concentrating and memory problems can also be a sign that someone has experienced a silent stroke. But because these symptoms can be caused by so many other factors, it's important to get a CT scan or MRI to truly know if a silent stroke occurred. Certainly, if someone learns from a brain imaging test that they had a silent stroke, it's alarming. But Dr. Uchino says not to freak out. 'Silent strokes are not uncommon. 10% of people in their 60s are found to have had a silent stroke according to MRI scans and that number goes up to 40% of people in their 80s,' he Uchino adds that the brain has a level of resilience and can overcome silent strokes. When a stroke is significant enough to cause damage to the brain, it will not be silent; you will notice the symptoms. All three doctors say that experiencing a silent stroke does increase the risk of having another stroke (that isn't silent) in the future, but Dr. Uchino emphasizes that the overall likelihood of having another stroke is still low. Related: If you are experiencing any new symptoms that are leading you to believe you had a silent stroke, all three neurologists say it's important to see your healthcare provider. If scans show that you did have a silent stroke, the doctors agree that it's important to change any unhealthy diet and lifestyle habits that are putting you at risk. This includes following a healthy diet and getting regular exercise. Dr. Etienne says that your healthcare provider may prescribe medication to lower your risk of having another stroke as well. 'I generally see silent strokes as a warning that a bigger stroke may be on the horizon,' he explains. 'That is why it is important to detect these silent strokes. This would prompt the medical provider to check your carotid arteries and other arteries, evaluate your heart and look for all the possible causes of the silent stroke. It is also important to note that the accumulation of silent strokes can also lead to certain types of dementia.' Whether you've had a silent stroke in the past or not, there are ways to lower your risk of ever experiencing one. Dr. Wengui Yu, MD, PhD, a Professor of Clinical Neurology and the Director of the UCI Health Comprehensive Stroke Center, says this includes not using tobacco, minimizing alcohol use, keeping cholesterol in a healthy range, and avoiding diabetes and hypertension by having healthy diet and lifestyle habits in place. When it comes to brain health, it's helpful to focus on what you can control—which is a lot! A silent stroke is a signal to make a more conscious effort to prioritize your health. Taking action will lower your risk of experiencing another stroke in the future, silent or otherwise. Up Next: Dr. Ken Uchino, MD, stroke neurologist at the Cerebrovascular Center at Neurological Institute at Cleveland Clinic Dr. Mill Etienne, MD, Associate Professor of Neurology at New York Medical College Dr. Jeffrey N. Quinn, MD, vascular neurologist at Torrance Memorial Medical Center, an affiliate of Cedars Sinai Medical Center Dr. Wengui Yu, MD, PhD, Professor of Clinical Neurology and the Director of the UCI Health Comprehensive Stroke Center How To Know if You've Had a 'Silent Stroke,' According to Neurologists first appeared on Parade on Jun 25, 2025 This story was originally reported by Parade on Jun 25, 2025, where it first appeared.


Axios
15 hours ago
- Axios
Lead program faces delays and slow spending, per report
Cleveland is still seeing persistently high rates of childhood lead poisoning six years after passing a landmark lead-safe housing law. Why it matters: Lead poisoning in Cleveland children remains nearly four times the national average, per Cleveland Clinic, and can result in irreversible cognitive and behavioral damage. The big picture: Councilwoman Rebecca Maurer — co-chair of the city's Lead Safe Advisory Board — argues in a new report that Cleveland's approach needs a reset. She says resources have spread too thin and legislative or administrative tweaks are required to direct spending toward the homes, neighborhoods and housing components most likely to expose kids to lead. Catch up quick: Maurer rose to prominence through her work with Cleveland Lead Advocates for Safe Housing, the grassroots group that successfully pushed City Council to pass the 2019 Lead Safe law. Friction point: Despite building a public-private system to certify and remediate rental homes, Maurer says the program is hamstrung by administrative delays, tech hurdles and sluggish spending. The city has spent less than 25% of federal HUD funds and less than 10% of state dollars dedicated to lead remediation as of spring 2025, according to her report. What they're saying: Lead-safe housing "is at a crossroads," Maurer writes. "We can keep doing what we are doing and hope we make enough of a dent ... Or we can take needed steps to simplify the program, focus our resources, and clearly coordinate our leadership and data reporting." What's next: Maurer says she'll seek buy-in from her colleagues on council and the lead advisory board. The other side: Council President Blaine Griffin told that amending the law would be difficult.