Dawsonites voice frustration over declining pharmacy service
Customers of Dawson City's only pharmacy have been voicing frustrations. Some residents say service is declining and it's letting people down in their time of need.
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CNN
2 hours ago
- CNN
Why men with broken heart syndrome are more likely to die than women
Heart disease Chronic diseasesFacebookTweetLink Follow Get inspired by a weekly roundup on living well, made simple. Sign up for CNN's Life, But Better newsletter for information and tools designed to improve your well-being. A 59-year-old man arrived at the Peking University First Hospital in Beijing for a procedure when he started having severe chest pain and shortness of breath. Four months earlier, he had cancerous tumors removed from his bladder. Around his family, he tried his best to appear strong and avoided discussions of his health. Privately, his severe anxiety over the possibility of a cancer recurrence kept him awake at night. Doctors said the man was experiencing takotsubo cardiomyopathy — also known as broken heart syndrome, as documented in a 2021 case study. The rare stress-induced heart condition has been observed primarily in women, but a study published in the Journal of the American Heart Association in May found that the illness may be more deadly for the men who get it. Thought to be caused by extreme emotional or physical events — such as learning about the death of a loved one, winning the lottery or lifting a heavy sofa — takotsubo cardiomyopathy, or TC, occurs when the heart muscle is flooded with stress hormones, causing part of it to 'freeze' in place. As the heart struggles to properly pump blood, symptoms resemble those of a heart attack, including chest pain, heart palpitations and irregular heartbeat. The new study analyzed data from nearly 200,000 patients hospitalized for TC in the United States between 2016 and 2020. While women accounted for 83% of the cases, men were more than twice as likely to die from the condition — with a mortality rate of 11.2%. 'The differences between men and women are a very striking finding,' said study coauthor Dr. Mohammad Reza Movahed, a clinical professor of medicine at the University of Arizona in Tucson. 'It raises a new, interesting question that should really be studied.' Similar to differences between men's and women's cardiovascular health more generally, the discrepancies in TC death rates are not well understood, Movahed said, especially because they counter trends in other heart diseases. It's widely theorized, however, that differences in hormone levels play a role. Stressful situations trigger the adrenal glands to release our fight-or-flight hormones, called catecholamines. They are meant to increase our blood pressure and raise our heart rate, but extreme levels can temporarily 'stun' cells in the heart's tissue, leading to TC, Movahed explained. Men are thought to produce more catecholamines during stressful situations compared with women, possibly leading men to present with more severe cases of TC, he suggested. Estrogen, a sex hormone produced at higher levels in women, may also have a protective effect on the cardiovascular system, making it easier to manage an extreme influx of catecholamines and reducing the risk of severe complications from TC, said Dr. Louis Vincent, a noninvasive-cardiology research fellow at the University of Miami, who coauthored a similar, multiyear study investigating discrepancies in men and women who had TC. Vincent was not involved in the new study. Beyond biological differences, social factors may play a role as well. 'Most (physicians) know about takotsubo, but they may think of it as a disease just affecting women, so the diagnosis might be overlooked in men,' said Dr. Deepak Bhatt, a cardiologist and the director of Mount Sinai Fuster Heart Hospital who was not involved in the study. 'With misdiagnosis, care is delayed, and that can sometimes lead to worse outcomes.' Men may also seek care at a later stage of illness, believing that their symptoms are manageable or may pass, said Dr. Alejandro Lemor, an assistant professor of interventional cardiology at the University of Mississippi Medical Center who was also not involved in the study. Deadly complications from TC include blood clots, stroke, cardiac arrest and heart failure, Lemor said. If the condition is caught early, medications can reduce the risk of having these complications, restore proper heart function and allow for full recovery within weeks, he added. Movahed's team was able to factor for important variables like age, race, income, chronic lung disease, hypertension and diabetes in the findings. However, there was no patient data on other comorbid diseases, such as a history of stroke or the presence of a Covid-19 infection, Vincent said. Additionally, the new study included in-patient diagnostic data only for those hospitalized with TC, so those who received outpatient care or died later from complications outside the hospital were likely not counted in the analysis, Movahed noted. To establish a firmer explanation for the differences in mortality rates between men and women and further test treatment methods, a more detailed dataset would be needed, Vincent said. 'People should be aware in studies like this, we're presenting findings that are based on diagnostic codes, and we're not looking at patient procedures or lab results,' Vincent said. 'But it's powerful in the sense that it lets us look at large populations and look at trends. And I think that this trend of a higher mortality in men is worth taking a deeper look into.' Sudden, severe chest pain or shortness of breath should always be treated as a medical emergency, warned Bhatt, who is also a professor of cardiovascular medicine at the Icahn School of Medicine at Mount Sinai in New York City. 'It's not a time to tough it out at home or get on the internet to figure it out. … Don't try to track down your primary care provider. Call emergency services,' Bhatt said. 'Time matters. By winning those few hours, you could save yourself irreparable damage to your heart.' Symptoms following physical stressors — a common cause of TC in men — should not be ignored, Movahed said, especially preceding medical events such as asthma attacks, seizures or complications from drug use. And while TC is caused by sudden stress, Bhatt said that managing chronic stress with daily meditation or exercise can lead to better cardiovascular health overall while giving you routines to fall back on in unexpected situations.
Associated Press
2 hours ago
- Associated Press
Who's in charge? CDC's leadership ‘crisis' apparent amid new COVID-19 vaccine guidance
WASHINGTON (AP) — There was a notable absence last week when U.S. Health and Human Services Secretary Robert F. Kennedy Jr. announced in a 58-second video that the government would no longer endorse the COVID-19 vaccine for healthy children or pregnant women. The director of the Centers for Disease Control and Prevention — the person who typically signs off on federal vaccine recommendations — was nowhere to be seen. The CDC, a $9.2 billion-a-year agency tasked with reviewing life-saving vaccines, monitoring diseases and watching for budding threats to Americans' health, is without a clear leader. 'I've been disappointed that we haven't had an aggressive director since — February, March, April, May — fighting for the resources that CDC needs,' said Dr. Robert Redfield, who served as CDC director under the first Trump administration and supported Kennedy's nomination as the nation's health secretary. $9.2 billion-a-year agency without leader as nomination awaits The leadership vacuum at a foremost federal public health agency has existed for months, after President Donald Trump suddenly withdrew his first pick for CDC director in March. A hearing for his new nominee — the agency's former acting director Susan Monarez — has not been scheduled because she has not submitted all the paperwork necessary to proceed, according to a spokesman for Sen. Bill Cassidy, R-La., who will oversee the nomination. HHS did not answer written questions about Monarez's nomination, her current role at the CDC or her salary. An employee directory lists Monarez, a longtime government employee, as a staffer for the NIH under the Advanced Research Projects Agency for Health. Redfield described Kennedy as 'very supportive' of Monarez's nomination. Instead, a lawyer and political appointee with no medical experience is 'carrying out some of the duties' of director at the agency that for seven decades has been led by someone with a medical degree. Matthew Buzzelli, who is also the chief of staff at the CDC, is 'surrounded by highly qualified medical professionals and advisors to help fulfill these duties as appropriate,' Andrew Nixon, an HHS spokesperson said in a statement. Adding to the confusion was an employee-wide email sent last week that thanked 'new acting directors who have stepped up to the plate.' The email, signed by Monarez, listed her as the acting director. It was was sent just days after Kennedy said at a Senate hearing that Monarez had been replaced by Buzzelli. The lack of a confirmed director will be a problem if a public health emergency such as the COVID-19 pandemic or a rapid uptick in measles cases hits, said Michael Osterholm, an epidemiologist at the University of Minnesota. 'CDC is a crisis, waiting for a crisis to happen,' said Osterholm. 'At this point, I couldn't tell you for the life of me who was going to pull what trigger in a crisis situation.' An acting director rarely seen, and stalled decisions At CDC headquarters in Atlanta, employees say Monarez was rarely heard from between late January – when she was appointed acting director – and late March, when Trump nominated her. She also has not held any of the 'all hands' meetings that were customary under previous CDC chiefs, according to several staffers. One employee, who insisted on anonymity because they were not authorized to speak to the media and fears being fired if identified said Monarez has been almost invisible since her nomination, adding that her absence has been cited by other leaders as an excuse for delaying action. The situation already has led to confusion. In April, a 15-member CDC advisory panel of outside experts met to discuss vaccine policy. The panel makes recommendations to the CDC Director, who routinely signs off on them. But it was unclear during the meeting who would be reviewing the panel's recommendations, which included the expansion of RSV vaccinations for adults and a new combination shot as another option to protect teens against meningitis. HHS officials said the recommendations were going to Buzzelli, but then weeks passed with no decision. A month after the meeting ended, the CDC posted on a web site that Kennedy had signed off on recommendations for travelers against chikungunya, a viral disease transmitted to humans by mosquitos. But there continues to be no word about a decision about the other vaccine recommendations. Controversial COVID-19 vaccine recommendations bypassed CDC panel The problem was accentuated again last week, when Kennedy rolled out recommendations for the COVID-19 vaccine saying they were no longer recommended for healthy children or pregnant women, even though expectant mothers are considered a high-risk group if they contract the virus. Kennedy made the surprise announcement without input from the CDC advisory panel that has historically made recommendations on the nation's vaccine schedule. The CDC days later posted revised guidance that said healthy kids and pregnant women may get the shots. Nixon, the HHS spokesman, said CDC staff were consulted on the recommendations, but would not provide staffer's names or titles. He also did not provide the specific data or research that Kennedy reviewed to reach his conclusion on the new COVID-19 recommendations, just weeks after he said that he did not think 'people should be taking medical advice' from him. 'As Secretary Kennedy said, there is a clear lack of data to support the repeat booster strategy in children,' Nixon said in a statement. Research shows that pregnant women are at higher risk of severe illness, mechanical ventilation and death, when they contract COVID-19 infections. During the height of the pandemic, deaths of women during pregnancy or shortly after childbirth soared to their highest level in 50 years. Vaccinations also have been recommended for pregnant women because it passes immunity to newborns who are too young for vaccines and also vulnerable to infections. Nixon did not address a written question about recommendations for pregnant women. Kennedy's decision to bypass the the advisory panel and announce new COVID-19 recommendations on his own prompted a key CDC official who works with the committee – Dr. Lakshmi Panagiotakopoulos – to announce her resignation last Friday. 'My career in public health and vaccinology started with a deep-seated desire to help the most vulnerable members of our population, and that is not something I am able to continue doing in this role,' she wrote in an email seen by an Associated Press reporter. Signs are mounting that the CDC has been 'sidelined' from key decision-making under Kennedy's watch, said Dr. Anand Parekh, the chief medical adviser for The Bipartisan Policy Center. 'It's difficult to ascertain how we will reverse the chronic disease epidemic or be prepared for myriad public health emergencies without a strong CDC and visible, empowered director,' Parekh said. 'It's also worth noting that every community in the country is served by a local or state public health department that depends on the scientific expertise of the CDC and the leadership of the CDC director.'
Washington Post
2 hours ago
- Washington Post
Will you be able to get a COVID-19 shot? Here's what we know so far
Want a COVID-19 vaccination this fall? For many Americans, it's not clear how easy it will be to get one — and some doctors already see signs of trouble. Health Secretary Robert F. Kennedy Jr., who was a longtime anti-vaccine activist, said last month that the shots are no longer recommended for healthy children and pregnant women, usurping a decision normally made by scientific experts, not political appointees . Days later, the Centers for Disease Control and Prevention said healthy children and pregnant women 'may' get COVID-19 vaccinations, removing stronger language that those groups 'should' get the shots. Its website currently lists no advice for pregnant women — graying out that section of the vaccine guidance chart. The change follows an earlier Trump administration step to limit COVID-19 vaccinations among healthy people under age 65. Until now, the U.S. — following guidance from independent experts who advise the CDC — has recommended yearly COVID-19 vaccinations for everyone age 6 months and older. Together, the moves have left health experts, vaccine makers and insurers uncertain about what to advise and what comes next. In Seattle, University of Washington infectious disease expert Dr. John B. Lynch said he recently advised a fellow health care worker who's pregnant to get vaccinated. She agreed, only to be turned away by two pharmacies. 'That's the practical implication,' Lynch told reporters in an Infectious Diseases Society of America briefing. 'We see confusion play out. We see chaos play out. And we see barriers to access.' The conflicting statements are also leaving primary care doctors uncertain of how to advise patients, Lynch added. 'I'm not sure when that confusion is going to be abated,' he said. Some of this season's vaccine is still available. Insurance industry experts say if people had coverage before Kennedy's announcement, insurance likely would still pay for the shots. In a move that could help access, Wisconsin's health department announced that state 'continues to recommend the current COVID-19 vaccine during pregnancy and for every person 6 months and older,' and reiterating the its state Medicaid program will continue to cover it. Who will be able to get what vaccines this fall is still unclear. Vaccine manufacturers plan to issue updated COVID-19 shots in the late summer or fall. But the Food and Drug Administration has said it plans to limit approval of seasonal shots to seniors and others at high risk, pending more studies of everyone else. Even if the U.S. approves vaccines only for certain groups, it still may be possible for others to get the shot depending on the outcome of upcoming advisory meetings, regulatory moves and decisions from insurers and employers. Insurers base coverage decisions on the recommendations of that CDC panel, the Advisory Committee on Immunization Practices. It's not clear what role that panel now will play. Paying out of pocket could cost about $200. The CDC says its new language for healthy kids — known as shared decision-making — means health insurers must pay for the vaccinations. Some insurers and employers may decide to still cover the shots no matter what, said Jen Kates, a senior vice president at the non-profit KFF, which studies health care issues. She noted that they may view the expense as worthwhile if it avoids a higher bill from someone hospitalized by the coronavirus. The FDA published a list of health conditions it said would qualify, including asthma, cancer, diabetes, obesity and physical inactivity. The CDC has a more extensive list. But, again, it isn't yet known how this will play out. For example, it could be hard for people to prove they're qualified. If they're vaccinated at a drugstore, for instance, the pharmacist wouldn't normally know about underlying health problems or even ask. And Ajay Sethi, an epidemiologist at the University of Wisconsin-Madison, said 'this elephant in the room' is that blocking vaccination to the healthy may mean people who have a risk factor and simply don't know it will miss out. Adding to the confusion was Kennedy's implication that the coronavirus isn't dangerous to pregnant women. COVID-19 complications during pregnancy can include preterm birth as well as serious illness in the mother, and the Society for Maternal-Fetal Medicine said it 'strongly reaffirms' its recommendation for vaccination during pregnancy. Moreover, vaccinating mom can provide spillover protection for the newborn for a few months, until he or she is old enough for their own vaccination, Lynch stressed. ___ Associated Press writer Mike Stobbe contributed to this report. ___ The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute's Science and Educational Media Group and the Robert Wood Johnson Foundation. The AP is solely responsible for all content.
