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Health programs under threat as debt ceiling nears collapse

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Julie Rovner KFF Health News


@jrovner

Read Julie’s stories. Julie Rovner is chief Washington correspondent and host of KFF Health News’s weekly health policy podcast “What the Health?” A renowned health policy expert, Julie is the author of the critically acclaimed Health Policy and Policy A to Z, now in its third edition.

The partisan struggle in Congress over how to raise the national debt ceiling to prevent default has accelerated as the US Treasury Department predicted that the borrowing limit could be reached as early as June 1st. There are potentially large cuts to federal spending programs on the table. including major health programs.

Meanwhile, lawmakers in two conservative states, South Carolina and Nebraska, have come close to passing very strict abortion bans as some Republicans appear to have lost interest in influencing the care of pregnant women in their states.

This week’s panelists are Julie Rovner of KFF Health News, Joan Kenen of the Johns Hopkins Bloomberg School of Public Health and Politics, Rachel Kors of Stat and Alice Miranda Olstein of Politico.

panellists

Alice Miranda Allstein Politician


@AliceAllstein

Read Alice’s stories

Statistical News Rachel Core


@rachelcohrs

Read Rachel’s stories

Joanne Kenen Johns Hopkins Bloomberg School of Public Health and Politics


@JoanKenen

Read Joanna’s stories

Among the takeaways from this week’s episode:

  • The United States is approaching its debt limit much sooner than expected. And it’s not clear how or if lawmakers will be able to resolve their differences over the budget before the country defaults on its debt. Details of a hastily crafted House Republican proposal emerge, including apparently unintended potential reductions in veterans’ benefits and a lack of exemptions to protect the disabled from losing Medicaid benefits and meals under the proposed job requirements.
  • This week, a seemingly routine surcharge on a key Senate drug price package came to fruition as it became clear that the committee’s steering group, led by Sen. Bernie Sanders (I-Vt.), had not completed its due diligence to ensure members have been informed and agree with the legislation. The Senate Committee on Health, Education, Labor and Pensions plans to revise the package next week, hoping to send it to a full Senate vote.
  • In other abortion news, Republican lawmakers in North Carolina have negotiated a new 12-week ban that will further limit already meager access to the procedure in the South. And federal investigations into two hospitals that denied emergency care to a pregnant woman in distress raise the possibility of another abortion-related litigation over states’ rights in the Supreme Court.
  • The number of deaths from covid-19 continues to decline. The public health emergency expires next week and medical facilities are refusing to wear masks. There are still problems with case counting and prevention management. What is clear is that the coronavirus is not now and may never go away, but from a public health standpoint, the situation is improving.
  • The Surgeon General has issued recommendations to combat the growing public health crisis caused by loneliness. Structural problems, such as a lack of paid vacations and few places to meet, may be ripe for government intervention. But while health experts see loneliness as a societal issue, the federal government’s recommendations are mostly about individual behavior.

In addition, as an “extra point”, the panelists suggest the health policy articles they read this week that they think you should also read:

Julia Rovner: Washington Post newspaperDog walking injuries may be more common than you think.Lindsey Bever.

Joanna Kenen: AtlanticThe Allergy Apocalypse Can’t Be Stopped”, Yasmin Tayag.

Rachel Kors: ProPublica»This pharmacist said that the prisoners would not feel pain during the lethal injection. Then some shook and gasped for air”, Lauren Gil and Daniel Moritz-Rabson.

Alice Miranda Allstein: The Wall Street JournalPatients lose access to free medicines due to spat between drug makers and health insurance plans”, Peter Loftus and Joseph Walker.

Also mentioned in this week’s issue:

loans

Francis Ying Sound Producer Emmary Huttman Editor

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HEALTH

Doctors perform life-saving surgery on the fetal brain in the womb

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3D illustration of a fetus in the womb. (iStockphoto/Getty Images)

In a first-of-its-kind procedure, doctors successfully performed intrauterine surgery to correct a rare and potentially fatal intrauterine fetal condition. Intrauterine surgery has been used for other conditions, but this is the first attempt at treating “vein of Galen malformation,” a rare blood vessel abnormality in the brain that can induce high blood pressure into the veins.

The details of the procedure, which was carried out in March, were published on Thursday in Stroke, a peer-reviewed journal of the American Stroke Association, a division of the American Heart Association. IN two hour procedureWhen the fetus was 34 weeks and 2 days gestational age, doctors used an ultrasound to pass a needle through the mother’s uterus into a vein at the back of the fetus’s head. Tiny coils were then inserted through the catheter into the needle to reduce blood flow in the vein.

The tiny patient was the first in a clinical trial currently taking place underground at Boston Children’s Hospital and Brigham and Women’s Hospital, overseen by the U.S. Food and Drug Administration, and was delivered via induced vaginal birth two days later. after the procedure.

V This was told to CNN by the parents of the child Derek and Kenyatta Coleman. that they found out about their baby’s condition during a 30-week ultrasound, and that the doctor told them that “something is wrong with the baby’s brain, and also her heart is enlarged.” Although Kenyatta said she was aware of the possible risks of joining a clinical trial, the Colemans “felt they had no other option,” writes CNN.

Weeks later, doctors say the Colemans’ little daughter, Denver, is doing well.

“In our first treated case, we were thrilled to see that the aggressive decline normally seen after birth just didn’t show up,” said lead author Dr. Darren B. Orbach says in a press release. “We are pleased to report that at six weeks the baby is doing great, not taking any medication, eating normally, gaining weight and has returned home. There are no signs of any negative effects on the brain.”

Orbach added that this is only their first patient to be treated and it is vital to continue the study to evaluate safety and efficacy in other patients. However, the results are promising.

“This approach could mark a paradigm shift in the treatment of vein of Galen malformation where we repair the malformation before birth and prevent heart failure before it happens, rather than trying to reverse it after birth,” Orbach said. “This could markedly reduce the risk of long-term brain damage, disability, or death among these infants.”

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HEALTH

Easter bunny necklaces and boutique butterfly necklaces recalled due to high levels of cadmium; Imported by Creative Education of Canada

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  • Recalled butterfly necklaces

The product’s name:

Easter Bunny and Boutique Butterfly Necklaces

Danger:

Necklaces are high in cadmium. Cadmium is toxic if swallowed by children and may cause adverse health effects.

revocation date:

April 27, 2023

remember the details

Description:

This review is for the Easter Bunny necklace model number 86140 and the Boutique Butterfly Jewel necklace model number 90422 printed on the back of the package. The recalled bunny necklaces feature a white bunny with an easter egg and a gold-colored chain. The butterfly necklaces mentioned have blue, pink or purple stones on the butterfly wings and a gold colored chain. They were sold threaded through a white plastic backing. The tag is printed “Great Challengers”.

means:

Consumers should immediately stop using the Easter Bunny and Butterfly Boutique Gem and contact Creative Education of Canada for a full refund. Consumers must cut the recalled necklace chain in half (with scissors) and provide the firm with a photograph as proof of destruction. The firm contacts all known buyers.

Sold in:

Toy and gift shops nationwide and online at greatpretenders.ca from January 2023 to March 2023 for about $2 (Easter Bunny necklace) and $4 (Boutique Butterfly necklace).

Importer(s):

Creative Education of Canada Inc., Canada

Note. Individual commissioners may have statements related to this topic. Please visit www.cpsc.gov/commissioners to search for approvals on this or other topics.

About USCCC

The US Consumer Product Safety Commission (CPSC) is responsible for protecting the public from the unreasonable risk of injury or death associated with the use of thousands of consumer products. Deaths, injuries and property damage from incidents involving consumer products cost the country more than $1 trillion annually. CPSC’s work in consumer product safety has contributed to the decline in consumer product-related injuries over the past 50 years.

Federal law prohibits any person from selling goods subject to a Commission Order or voluntary recall undertaken in consultation with the CPSC.

Life Saving Information:

Report an unsafe product

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HEALTH

The link between long telomeres and long life is a fiction, study says

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History, as is often the case in science, sounded very attractive. Cells have a molecular clock that determines how long they live. If you can just stop the clock, cells can live indefinitely. And the same should happen to people who, after all, are made up of cells. Stop the cellular clock and you can stay young.

Clocks are shaped like caps at the ends of chromosomes, long twisted strands of DNA that carry cellular genes. The caps on chromosomes, called telomeres, are chains of short, repetitive segments of DNA. Every time a cell divides, its telomeres get a little shorter, until finally they get so short that the cell dies.

“Short telomeres were thought to be bad—people with premature aging syndromes had short telomeres—so by analogy, long telomeres were considered good,” the doctor said. Mary Armanios is professor of oncology at the Johns Hopkins University School of Medicine and director of the Telomere Center at the Sidney Kimmel Comprehensive Cancer Center at the medical school. “And the longer the better.”

But, of course, in biology everything is not so simple. And paper published Thursday in the New England Journal of Medicine with the results of a study by Dr. Armanios shows that the telomere story is no exception. While short telomeres do lead to health problems, long telomeres themselves lead to health problems. Far from prolonging life, long telomeres seem to cause cancer and a blood disorder known as CHIP, a condition that increases the risk of blood cancer and heart disease.

Dr. Elizabeth Blackburn, professor emeritus at the University of California, San Francisco, who received the Nobel Prize for discovering telomeres and was not involved in the study, said it was a “great article” that goes beyond correlations and shows a direct link between them. link between long telomeres and disease. She added that the study “sheds light on this whole compromise.”

For Dr. Armanios, this is the culmination of a work she began 20 years ago.

When scientists started studying telomeres, they noticed that younger people had longer telomeres than older people. When cells are grown in the lab, their telomeres act like a ticking clock that determines how long they have left to live.

Telomeres were soon hailed as the secret to aging—companies advertised that they could determine your biological age by measuring your telomere length. Others have said that you can prolong your life by preserving your telomeres with nutritional supplements.

But dr. Armanios and other explorers noticed that telomere length appears to be limited to a narrow range, indicating that there is a price to pay for very long or very short telomeres.

Population research several groups seem to have supported the idea. They found a correlation—rather than cause and effect—with increased disease risk at both ends of the normal telomere spectrum.

Those with shorter telomeres than average were Increased Risk problems with the immune system and various degenerative diseases, as well as pulmonary fibrosis, lung disease. Those with longer than average telomeres have a slightly increased risk of developing cancer.

There were, however, some misunderstandings.

“Some organisms have insanely long telomeres, like mice,” the doctor said. Benjamin Ebert, Chief of Medical Oncology, Dana-Farber Cancer Institute. And mice don’t live that long.

Dr. Armanios, as a human geneticist, was thinking how to get answers, what to study people. “There are things you just can’t deduce from studying cells,” she said.

She suspected, she said, that “you just can’t lengthen telomeres without a price,” and began looking for people with very long telomeres to see what the cost might be.

She decided to look for people with a common POT1 genetic mutation that can lead to long telomeres. It was known to increase the risk of cancer, but most researchers thought it was for reasons other than telomere lengthening.

As a result, she had 17 people from five families. Their ages ranged from 7 to 83 and they had unusually long telomeres.

They also had tumors ranging from benign ones like goiter and uterine fibroids to malignant ones like melanoma and blood cancer. During the two-year study, four patients died from various types of cancer.

Harriet Brown, 73, of Frederick, Maryland, is one of the study participants with very long telomeres. She had benign tumors called paragangliomas on her neck and throat, thyroid cancer, and two melanomas. She also has CHIP, a blood disorder associated with heart disease and blood cancer.

She often gets scans and checkups, but, she says, “There’s really not much I can do at the moment” because there’s no way to prevent new tumors from developing.

The effect of long telomeres on people like Ms. Brown is understandable, the doctor said. Norman Sharpless is professor of cancer policy and innovation at the University of North Carolina School of Medicine and former director of the National Cancer Institute.

“Not so long telomeres make cells grow,” he said. “The thing is, they don’t have the brakes to stop them from growing.” And because the telomeres of people with POT1 mutations don’t shorten with every cell division, the cells hang in place, dividing regularly. The longer they divide in the body, the more time they have for the accumulation of random mutations, some of which cause tumor growth.

This is especially true in the blood, where cells are constantly being produced. POT1 mutations in some of these blood cells may give them time to accumulate other mutations that give them a selective growth advantage. Soon, some of these mutated blood cells will take over most of the human bone marrow. The result is CHIP.

This is a new look at the CHIP. The thought was that since people with CHIP are at an increased risk of blood cancer, this CHIP itself causes cancer.

instead, Dr. Armanios said long telomeres both create the CHIP and independently give cells time to develop cancer-causing mutations.

“The biology of aging is much more complex than we hoped,” says the doctor. Sharpless said.

Or like Dr. Blackburn observed: Long telomeres are not the secret to eternal youth.

“There are no free meals,” she said.

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