Latest news with #IcahnSchoolofMedicineat
Al Etihad
7 days ago
- Health
- Al Etihad
'Forever Chemicals' linked to higher risk of Type 2 diabetes
23 July 2025 13:36 NEW YORK (ALETIHAD) Exposure to a class of synthetic chemicals known as per- and polyfluoroalkyl substances (PFAS)—often called 'forever chemicals'—may increase the risk of developing type 2 diabetes, according to a new study led by Mount Sinai researchers. The findings were published on Tuesday in eBioMedicine. The team conducted a nested case-control study - an observational study that is conducted within a larger cohort study - within BioMe, a large, electronic health record-linked research database comprising records of more than 70,000 study participants who have sought care at The Mount Sinai Hospital in New York City since 2007. Based on available data, the study analysed 180 people recently diagnosed with type 2 diabetes and compared them to 180 similar individuals without diabetes. Researchers used blood samples to analyse PFAS levels—a group of chemicals used in everything from nonstick cookware to stain-resistant furniture to waterproof clothing—and found that higher levels of PFAS were associated with a significantly greater risk of developing type 2 diabetes in the each increase in range of PFAS exposure was linked to a 31 percent increase in risk. The team also found that these associations could be due to metabolic irregularities in amino acid biosynthesis and drug metabolism, which may help explain how PFAS affect the body's ability to regulate blood sugar.'PFAS are synthetic chemicals that resist heat, oil, water, and stains, and are found in countless everyday consumer products,' said Vishal Midya, PhD, MStat, corresponding author and Assistant Professor, Environmental Medicine, Icahn School of Medicine at Mount Sinai.'Because they don't break down easily, PFAS accumulate in the environment—and in human bodies. Our study is one of the first to examine how these chemicals may disrupt the body's metabolism in ways that increase diabetes risk—particularly in diverse US populations.' Findings from this study underscore the importance of preventing PFAS exposures to promote public health and of advancing knowledge about potential mechanisms underlying the PFAS impacts on human metabolism. The researchers called for further research studies, integrating environmental with genetic data to better understand how environmental exposures interact with human metabolism and contribute to chronic disease. They also call for larger study populations, expanding over the life course, from preconception to elderly, to understand environmental health impacts across the lifespan and at vulnerable life periods. Source: Aletihad - Abu Dhabi
NBC News
21-07-2025
- Health
- NBC News
FDA panel promotes misinformation on antidepressants during pregnancy, psychiatrists say
A Food and Drug Administration panel on Monday discussing the use of antidepressants during pregnancy largely amounted to misinformation or facts taken out of context, according to several psychiatrists who tuned into the meeting. The panel had promised to feature diverse viewpoints about antidepressants and pregnancy. But nearly all of the 10 panelists bucked medical consensus on the drugs' safety and emphasized what they said were risks of taking the drugs while pregnant— such as causing autism, miscarriages or birth defects. In some cases, they claimed that antidepressants do not work at all and depression goes away on its own. Three of the 10 panelists were from outside the U.S. Another runs a clinic to help people taper off of psychiatric drugs. 'They were really rousing concerns about safety that are not evidence-based or established, and not at all balanced with concerns about the risks of untreated depression,' said Dr. Joseph Goldberg, a clinical professor of psychiatry at the Icahn School of Medicine at Mount Sinai in New York City. 'I'm disappointed that the FDA brought people in from outside of the United States when there's so many experts here in the United States who truly know this [medical] literature inside and out,' added Dr. Jennifer Payne, director of the Reproductive Psychiatry Research Program at the University of Virginia. A spokesperson for the FDA said the claim that the panel was one-sided was 'insulting to the independent scientists, clinicians, and researchers who dedicate their expertise to these panels.' The spokesperson added that '[FDA] Commissioner Makary has an interest in ensuring policies reflect the latest gold standard science and protect public health.' Health and Human Services Secretary Robert F. Kennedy Jr. has called for a probe into the risks of antidepressants. His 'Make America Healthy Again' report in May claimed there were 'potentially major long-term repercussions' associated with use of the drugs in childhood. The panel discussion focused on a class of antidepressants known as selective serotonin reuptake inhibitors, or SSRIs, which includes Lexapro, Prozac and Zoloft. The medications increase levels of serotonin, a chemical messenger in the brain that can improve mood. Psychiatrists often advise women who are taking SSRIs to continue doing so during pregnancy, since the risks of untreated depression tend to outweigh the potential risks of the medication to mother and child. However, the decision is a personal one. For ethical reasons, there are no randomized-control trials of SSRIs in pregnant women, meaning that data on potential risks mostly comes from observational studies and drug registries. Some babies born to mothers taking SSRIs may develop symptoms such as jitteriness, irritability or difficulty eating or sleeping that resolve quickly — what's known as 'neonatal adaptation syndrome.' The symptoms may be caused by medication in the baby's system or withdrawal from it. Certain studies have also found a slightly elevated risk of miscarriage associated with antidepressant use in pregnancy, though others have found no association. However, there's no convincing evidence to suggest that SSRIs are linked to autism or birth defects. 'Well-controlled studies continue to not find an association,' Payne said. Women with a history of depression are also at an increased risk of symptoms recurring during pregnancy, and depression can come with its own risks — including thoughts of self-harm or low birth weight. 'The best thing a pregnant individual could do for herself and her baby is to get the treatment that they need,' said Dr. Nancy Byatt, a perinatal psychiatrist at UMass Chan Medical School, who was not part of the panel. In addition to raising concerns about side effects, several panelists questioned the efficacy of antidepressants or suggested that data favoring the use of SSRIs was manipulated by the pharmaceutical industry. 'It's been said that SSRIs help people who are severely depressed. They don't,' said David Healy, an FDA panelist and fellow at the Royal College of Psychiatrists in the United Kingdom. Goldberg and other psychiatrists said that's simply untrue. 'You can say the moon landing was faked. Conspiracy theories abound in our world. But there is not a doubt about whether SSRIs work,' said Goldberg, a past president of the American Society of Clinical Psychopharmacology who has previously consulted for pharmaceutical companies. He said he was invited to join the FDA panel, but declined because the language of the invitation suggested it would not be a fair discussion. Healy, the panelist, also claimed that some people 'recover spontaneously' from depression. Another panelist, psychologist Roger McFillin — who hosts a podcast that challenges conventional mental health advice — suggested that depression was not an illness, but rather a product of 'women just naturally experiencing their emotions more intensely.' He added, without evidence, that many women feel coerced into taking antidepressants. Psychiatrists who weren't part of the discussion broadly decried those characterizations. 'I have never, ever, ever, ever heard of a third party pushing a prescription in pregnancy,' Goldberg said. However, he said he is aware of some obstetrician-gynecologists who aren't as familiar with SSRIs wrongly telling pregnant patients to stop taking the medications. The American College of Obstetricians and Gynecologists said in a statement on Monday that SSRIs can be lifesaving for some pregnant individuals. 'Today's FDA panel on SSRIs and pregnancy was alarmingly unbalanced and did not adequately acknowledge the harms of untreated perinatal mood disorders in pregnancy,' the organization said. 'On a panel of 10 experts, only one spoke to the importance of SSRIs in pregnancy as a critical tool, among others, in preventing the potentially devastating effects of anxiety and depression when left untreated during pregnancy.' One panelist, Dr. Kay Roussos-Ross, a psychiatrist and an OB-GYN at the University of Florida College of Medicine, was the most vocal advocate for the use of SSRIs, often pushing back against others' assessments of the risks. Psychiatrists who weren't on the panel praised her science-backed commentary. 'All of us can find a study that agrees with exactly what we think,' Roussos-Ross told the panel. 'But we need to look at the data very objectively.' Several psychiatrists who weren't on the panel said they worry the discussion could lead to regulatory action that makes it harder to access SSRIs. For example, panelist Dr. Adam Urato, chief of maternal-fetal medicine at MetroWest Medical Center in Framingham, Massachusetts, called for stronger warnings on SSRI labels. 'I am just very nervous that some of the discourse around the risks of antidepressants could lead to even more barriers for people seeking care,' said Dr. Lindsay Lebin, an assistant professor of psychiatry at the University of Colorado Anschutz Medical Campus, who was not part of the FDA discussion.
Straits Times
15-07-2025
- Health
- Straits Times
Do regular facials actually improve your skin?
Glowing skin is a major and immediate benefit of getting a facial. But that perk tends to fade after a few days or weeks. NEW YORK – Smoother skin, smaller pores, better hydration – these are just a few of the many benefits facials claim to offer . And who is not relaxed after being horizontal for an hour while someone massages his or her fac e? Glowing skin is a major and immediate benefit of getting a facial. But the perk tends to fade after a few days or weeks. And aestheticians will often say that if you want longer-term improvements, such as fewer wrinkles, less acne or an even skin tone, you will need to get facials regularly. Is that true? T hree dermatologists weigh in. What are the benefits? Facials come in many forms, said Dr Susan Massick, a dermatologist at the Ohio State University Wexner Medical Center. Standard ones incorporate some type of deep cleansing, exfoliating, moisturising, massaging and sometimes 'extraction', or squeezing the gunk out of your pores, she said. They are also often tailored to address specific skin issues such as acne, dullness or discolouration, she added. You can get facials at medical spas or salons, and dermatology offices. When your skin is cleansed, massaged and exfoliated, dead skin cells are removed from the outermost layer of the skin called the epidermis, said Dr Helen He, an assistant professor of dermatology at the Icahn School of Medicine at Mount Sinai in New York City. This speeds up the skin's cell turnover rate, which may help brighten your complexion, smooth its texture and shrink pores, she added. The skin is also typically massaged during the cleansing, moisturising and serum application steps. This can boost circulation and lymphatic drainage, Dr He said, which may minimise puffiness. Top stories Swipe. Select. Stay informed. Singapore $3b money laundering case: MinLaw acts against 4 law firms, 1 lawyer over seized properties Asia China's economy grows 5.3% in first half of 2025, momentum slowing amid trade tensions Business 'Some cannot source outside China': S'pore firms' challenges and support needed amid US tariffs Multimedia From local to global: What made top news in Singapore over the last 180 years? Singapore Turning tragedy into advocacy: Woman finds new purpose after paralysis Opinion Sumiko at 61: Everything goes south when you age, changing your face from a triangle to a rectangle Sport Poor water quality off Sentosa delays World Aquatics C'ship open water swimming event by a day Singapore HSA intensifies crackdown on vapes; young suspected Kpod peddlers nabbed in Bishan, Yishun Beyond skincare , regular facials can help you to unwind and de-stress, said Dr Basia Michalski-McNeely, an assistant professor of dermatology at the Washington University School of Medicine in St Louis. 'It's an hour where you don't have any interruptions, and it's just focused on wellness and taking care of yourself,' she said. Will regular facials extend those effects? Generally, the benefits of a single facial are short-lived, lasting a few days to a couple of weeks, Dr Michalski-McNeely said. This is because the epidermis naturally renews about every month, Dr He said. When this happens, dead skin cells build up and can clog pores, potentially leading to acne and dull skin, she explained. A good skincare routine can address this build-up, but getting facials regularly – every four to eight weeks, for instance – can s upport healthy skin cell turnover, which may enhance collagen production, leading to more firmness and elasticity in the long run, Dr He said. Regular facials that are tailored to your skin may also offer extended benefits, Dr Massick said. If you are prone to acne, you might get one that incorporates extraction. If you have dry skin, you might seek extra moisturising steps. Still, there are some skin qualities that regular facials may not improve. People with deep wrinkles or skin sagging, for instance, may not get as many skin-smoothing or tightening benefits from facials alone, Dr He said. Sometimes, facials incorporate treatments such as chemical peels or LED light therapy, which, when done regularly, can bring more 'lasting results' than traditional facials, such as lightening dark spots or treating acne, Dr Massick said. What else should you consider? Regular facials are safe for most people, Dr Massick said, though she recommended avoiding them if you have an active skin infection – such as cold sores or shingles – or facial wounds that are still healing. She also recommended being cautious of facials or consulting a doctor if you have rosacea, psoriasis, eczema or sensitive skin. Dr Michalski-McNeely said she does not discourage people from getting facials, but she also does not think they are necessary for those with a good, consistent skincare routine. A basic one includes cleansing, moisturising and wearing sunscreen of at least SPF 30 daily, Dr Massick said. Dr Michalski-McNeely also suggested incorporating an over-the-counter retinol or a prescription retinoid. It is a more effective and longer-lasting option for increasing skin cell turnover, improving collagen production and brightening the skin. This, with a good skincare regimen, is far more effective for anti-ageing than facials alone, Dr Massick said. But facials can complement these habits, she added. Cosmetic procedures such as Botox, microneedling or laser resurfacing treatments can also offer longer-term benefits than facials, such as boosting collagen, smoothing fine lines and minimising the appearance of acne scars and dark spots, Dr Michalski-McNeely added. But these can be expensive too and might require a visit to a dermatologist, which she recommended. If you get a facial at a medical spa or salon, Dr Massick suggested seeking out a licensed and experienced aesthetician – and asking about the products he or she uses, the procedure and what to expect afterwards. Always tell your aesthetician if you are allergic to fragrances or other ingredients that may be in skincare products. Facials can be 'a fun and relaxing treat', Dr Massick said, just make sure you set appropriate expectations and do not rely on them as your sole source of skincare. NYTIMES
Miami Herald
23-06-2025
- Health
- Miami Herald
‘Problematic' MAHA report minimizes success of lifesaving asthma medicines, doctors say
Medical experts are dismayed over a federal report's claim that kids are overprescribed asthma medications, saying it minimizes how many lives the drugs save. Safe treatment protocols for asthma management have been carefully studied over the years, said Dr. Perry Sheffield, a pediatrician and professor at the Icahn School of Medicine at Mount Sinai. "The federal government actually has some really beautiful and clear guidelines and strategies, and things that are vetted by and carefully edited by many experts in the field," said Sheffield, who co-directs a region of the federally funded Pediatric Environmental Health Specialty Units that serves New Jersey, New York, Puerto Rico and the U.S. Virgin Islands. Asthma affects more than 4.6 million American children, according to the federal Centers for Disease Control and Prevention. It's one of the most common long-term diseases in U.S. children. The Make America Healthy Again Commission report released in late May, parts of which have been widely criticized, alleges that American children are on too much medication of various kinds, including asthma treatments. Experts worry that the administration will set policy based on the assessment that would dissuade insurers from covering asthma prescriptions. They also say that the report's assertions could worsen disparities that affect children's access to those medications and undermine years of research around the drugs. The MAHA commission has until August to release a strategy based on the findings in the report. Black and Indigenous children as well as those living in inner cities or in lower-income households are among those with the highest rates of asthma. Pollution disproportionately shrouds communities of color and can be a trigger that exacerbates the disease. The report's message could heighten those disparities, said Dr. Elizabeth Matsui, a University of Texas at Austin professor and a past chair of the American Academy of Pediatrics' Section on Allergy and Immunology. "One thing that has been very clear is that kids of color are less likely to be appropriately managed in terms of their asthma medication management," she said. "So a message of overprescription that is simply not supported by the evidence also could potentially exacerbate already-existing racial and ethnic disparities in asthma that we have really not made much headway on." The commission's claims The report touches on childhood prediabetes, obesity and mental health. However, firearm injuries - the leading cause of death for children and teens in 2020 and 2021, according to the CDC - weren't mentioned. The 70-page report from the commission, chaired by Secretary of Health and Human Services Robert F. Kennedy Jr., claims four main issues are the drivers behind childhood chronic disease: poor diet, aggregation of environmental chemicals, lack of physical activity and chronic stress, and "overmedicalization." Matsui and other experts said the report's use of that word is "problematic." "The implication could be, unfortunately, that when a child has asthma - so, they have coughing, chest tightness, wheezing - that that is not really a disease," said Matsui. "We know for a fact that that's a disease, and we know that it is quite treatable, quite controllable, and that it has profound impacts on the child's day-to-day life." Other scientists have similarly criticized the report, saying it makes sweeping and misleading generalizations about children's health without sufficient evidence. The White House corrected the report after nonprofit news outlet NOTUS found that it cited studies that didn't exist. In an emailed statement to Stateline, Health and Human Services press secretary Emily Hilliard wrote: "The MAHA report discusses concerns about the potential overprescription of asthma medications - particularly in mild cases - not to question their importance, but to encourage evidence-based prescribing." When it comes to asthma, the report says, "Asthma controller prescriptions increased 30% from 1999-2008." That sentence originally cited a broken link to a study from 2011; the link was later replaced. Controller meds include inhalers. The MAHA report also claims that "There is evidence of overprescription of oral corticosteroids for mild cases of asthma." The original version of the report listed estimated percentages of oral corticosteroids overuse, citing a nonexistent study. The wording was changed and the citation was later replaced with a link to a 2017 study by pediatric pulmonologist Dr. Harold Farber. The study was not a randomized controlled trial, which increases reliability. Farber told NOTUS that the report made an "overgeneralization" of his research. Stateline also reached out to Farber, whose public relations team declined an interview request. Oral corticosteroids are liquid or tablet medications used to reduce inflammation for conditions including allergies, asthma, arthritis and Crohn's disease. For asthma, they're used to treat severe flare-up episodes. The Asthma and Allergy Foundation of America says the medications have been shown to reduce emergency room visits and hospitalizations, and that while they do come with risk of side effects, they're mostly used in acute flare-ups. And while rare, asthma-related deaths in kids do occur, and are often preventable. "Asthma medications, including oral steroids, are lifesaving," said Dr. Elizabeth Friedman, a pediatrician at Children's Mercy Kansas City. "I believe that physicians, not politicians, are best equipped and most effectively trained to make the determination of whether or not these medications are needed for our patients." Friedman worries that federal characterizations of asthma meds will affect how state Medicaid agencies cover the drugs. When Medicaid coverage changed for a common prescribed inhaler last year, many of her Missouri Medicaid patients were suddenly without the drug. They ended up hospitalized, she said. Friedman directs Region 7 of the Pediatric Environmental Health Specialty Units, a network of experts that works to address reproductive and children's environmental health issues. Region 7 provides outreach and education in Iowa, Kansas, Missouri and Nebraska. She also said she's concerned that the report is "making a broad, sweeping statement based on one epidemiologic study from one state." Increased use An increase in inhaler prescriptions is not necessarily a bad thing, experts say. It's a sign that kids are getting their medication. There has been an increase in inhaler prescriptions, along with a corresponding decrease in the oral corticosteroids, which is what experts would want to see, said Chelsea Langer, bureau chief of the New Mexico Department of Health's Environmental Health Epidemiology Bureau. She said that means kids are "following their asthma action plans and taking the controller medications to prevent needing the relief or treatment (oral) meds." Asthma prevalence has increased over the years, meaning more people need medication, noted Dr. Alan Baptist, division head of Allergy and Clinical Immunology at Henry Ford Health in Michigan. He said that because steroid tablets come with risk of side effects, it is best to limit them. But for kids without access to a regular pediatric provider or to health insurance that covers an inhaler, cost can be an obstacle, he said. Fluticasone propionate, an FDA-approved medicine for people 4 and older, costs on average $200 or more for one inhaler without insurance. "What often happens with kids, and especially kids who are in Medicaid, or who are in an underserved or disadvantaged population, they are not given appropriate asthma controller medication," said Baptist, who helped write federal guidelines for asthma treatment best practices as part of a National Institutes of Health committee. Baptist noted that while he was glad to see pollution mentioned in the report as a danger for kids, it's at odds with the recent cuts to environmental health grants that aimed to address such asthma triggers. "They're somewhat cherry-picking some of the data that they're putting down," he said. "It says the U.S. government is 'committed to fostering radical transparency and gold-standard science' to better understand the potential cumulative impacts of environmental exposure. If that's what they're saying, then they should be funding even greater studies that look at the effects." Dr. Priya Bansal, an Illinois pediatrician and past president of the Illinois Society of Allergy, Asthma and Immunology, said she's concerned the report doesn't define mild, moderate or severe asthma to differentiate the different best-practice treatment plans. Bansal also said she worries that federal officials' characterization of an FDA-approved drug will lead to insurance companies refusing to cover inhalers or oral steroids for her patients who rely on them. "I'm going to be worried about coverage for my asthmatics," she said. "The question is, what's the next move that they're going to make? If they think that, are they going to now say, 'Hey, we're not going to cover inhalers for mild asthmatics'?" _____ Copyright (C) 2025, Tribune Content Agency, LLC. Portions copyrighted by the respective providers.
Yahoo
06-06-2025
- Health
- Yahoo
‘Problematic' MAHA report minimizes success of lifesaving asthma medicines, doctors say
Teens play basketball outside on a hot day in summer 2023 in New York City after the state issued an air quality health advisory recommending active children and those with asthma limit time outside. Experts worry that a new federal report minimizes how millions of kids in the U.S. rely on asthma medications to breathe normally. (Photo by) Medical experts are dismayed over a federal report's claim that kids are overprescribed asthma medications, saying it minimizes how many lives the drugs save. Safe treatment protocols for asthma management have been carefully studied over the years, said Dr. Perry Sheffield, a pediatrician and professor at the Icahn School of Medicine at Mount Sinai. 'The federal government actually has some really beautiful and clear guidelines and strategies, and things that are vetted by and carefully edited by many experts in the field,' said Sheffield, who co-directs a region of the federally funded Pediatric Environmental Health Specialty Units that serves New Jersey, New York, Puerto Rico and the U.S. Virgin Islands. Asthma affects more than 4.6 million American children, according to the federal Centers for Disease Control and Prevention. It's one of the most common long-term diseases in U.S. children. The Make America Healthy Again Commission report released in late May, parts of which have been widely criticized, alleges that American children are on too much medication of various kinds, including asthma treatments. Experts worry that the administration will set policy based on the assessment, dissuading insurers from covering asthma prescriptions. They also say that the report's assertions could worsen disparities that affect children's access to those medications and undermine years of research around the drugs. Blue Cross Blue Shield now requires prior approval for severe asthma drugs in some states The MAHA commission has until August to release a strategy based on the findings in the report. Black and Indigenous children as well as those living in inner cities or in lower-income households are among those with the highest rates of asthma. Pollution disproportionately shrouds communities of color and can be a trigger that exacerbates the disease. The report's message could heighten those disparities, said Dr. Elizabeth Matsui, a University of Texas at Austin professor and a past chair of the American Academy of Pediatrics' Section on Allergy and Immunology. 'One thing that has been very clear is that kids of color are less likely to be appropriately managed in terms of their asthma medication management,' she said. 'So a message of overprescription that is simply not supported by the evidence also could potentially exacerbate already-existing racial and ethnic disparities in asthma that we have really not made much headway on.' The report touches on childhood prediabetes, obesity and mental health. However, firearm injuries — the leading cause of death for children and teens in 2020 and 2021, according to the CDC — weren't mentioned. The 70-page report from the commission, chaired by Secretary of Health and Human Services Robert F. Kennedy Jr., claims four main issues are the drivers behind childhood chronic disease: poor diet, aggregation of environmental chemicals, lack of physical activity and chronic stress, and 'overmedicalization.' Matsui and other experts said the report's use of that word is 'problematic.' 'The implication could be, unfortunately, that when a child has asthma — so, they have coughing, chest tightness, wheezing — that that is not really a disease,' said Matsui. 'We know for a fact that that's a disease, and we know that it is quite treatable, quite controllable, and that it has profound impacts on the child's day-to-day life.' Other scientists have similarly criticized the report, saying it makes sweeping and misleading generalizations about children's health without sufficient evidence. The White House corrected the report after nonprofit news outlet NOTUS found that it cited studies that didn't exist. The implication could be, unfortunately, that when a child has asthma … that that is not really a disease. We know for a fact that that's a disease. – Dr. Elizabeth Matsui, University of Texas at Austin professor When it comes to asthma, the report says, 'Asthma controller prescriptions increased 30% from 1999-2008.' That sentence originally cited a broken link to a study from 2011; the link was later replaced. Controller meds include inhalers. The MAHA report also claims that 'There is evidence of overprescription of oral corticosteroids for mild cases of asthma.' The original version of the report listed estimated percentages of oral corticosteroids overuse, citing a nonexistent study. The wording was changed and the citation was later replaced with a link to a 2017 study by pediatric pulmonologist Dr. Harold Farber. The study was not a randomized controlled trial, which increases reliability. Farber told NOTUS that the report made an 'overgeneralization' of his research. Stateline also reached out to Farber, whose public relations team declined an interview request. Oral corticosteroids are liquid or tablet medications used to reduce inflammation for conditions including allergies, asthma, arthritis and Crohn's disease. For asthma, they're used to treat severe flare-up episodes. The Asthma and Allergy Foundation of America says the medications have been shown to reduce emergency room visits and hospitalizations, and that while they do come with risk of side effects, they're mostly used in acute flare-ups. And while rare, asthma-related deaths in kids do occur, and are often preventable. 'Asthma medications, including oral steroids, are lifesaving,' said Dr. Elizabeth Friedman, a pediatrician at Children's Mercy Kansas City. 'I believe that physicians, not politicians, are best equipped and most effectively trained to make the determination of whether or not these medications are needed for our patients.' Friedman worries that federal characterizations of asthma meds will affect how state Medicaid agencies cover the drugs. When Medicaid coverage changed for a common prescribed inhaler last year, many of her Missouri Medicaid patients were suddenly without the drug. They ended up hospitalized, she said. Friedman directs Region 7 of the Pediatric Environmental Health Specialty Units, a network of experts that works to address reproductive and children's environmental health issues. Region 7 provides outreach and education in Iowa, Kansas, Missouri and Nebraska. She also said she's concerned that the report is 'making a broad, sweeping statement based on one epidemiologic study from one state.' An increase in inhaler prescriptions is not necessarily a bad thing, experts say. It's a sign that kids are getting their medication. There has been an increase in inhaler prescriptions, along with a corresponding decrease in the oral corticosteroids, which is what experts would want to see, said Chelsea Langer, bureau chief of the New Mexico Department of Health's Environmental Health Epidemiology Bureau. She said that means kids are 'following their asthma action plans and taking the controller medications to prevent needing the relief or treatment [oral] meds.' Trump has canceled environmental justice grants. Here's what communities are losing. Asthma prevalence has increased over the years, meaning more people need medication, noted Dr. Alan Baptist, division head of Allergy and Clinical Immunology at Henry Ford Health in Michigan. He said that because steroid tablets come with risk of side effects, it is best to limit them. But for kids without access to a regular pediatric provider or to health insurance that covers an inhaler, cost can be an obstacle, he said. Fluticasone propionate, an FDA-approved medicine for people 4 and older, costs on average $200 or more for one inhaler without insurance. 'What often happens with kids, and especially kids who are in Medicaid, or who are in an underserved or disadvantaged population, they are not given appropriate asthma controller medication,' said Baptist, who helped write federal guidelines for asthma treatment best practices as part of a National Institutes of Health committee. Baptist noted that while he was glad to see pollution mentioned in the report as a danger for kids, it's at odds with the recent cuts to environmental health grants that aimed to address such asthma triggers. 'They're somewhat cherry-picking some of the data that they're putting down,' he said. 'It says the U.S. government is 'committed to fostering radical transparency and gold-standard science' to better understand the potential cumulative impacts of environmental exposure. If that's what they're saying, then they should be funding even greater studies that look at the effects.' Dr. Priya Bansal, an Illinois pediatrician and past president of the Illinois Society of Allergy, Asthma and Immunology, said she's concerned the report doesn't define mild, moderate or severe asthma to differentiate the different best-practice treatment plans. Bansal also said she worries that federal officials' characterization of an FDA-approved drug will lead to insurance companies refusing to cover inhalers or oral steroids for her patients who rely on them. 'I'm going to be worried about coverage for my asthmatics,' she said. 'The question is, what's the next move that they're going to make? If they think that, are they going to now say, 'Hey, we're not going to cover inhalers for mild asthmatics'?' Stateline reporter Nada Hassanein can be reached at nhassanein@ SUPPORT: YOU MAKE OUR WORK POSSIBLE
