hrt

Women Taking HRT For Menopause Have A Lower Risk Of Dementia, New Study Suggests 

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According to a new study, women who use hormone replacement therapy (HRT) may have a reduced risk of dementia. 

The study itself took place in the United Kingdom and was the largest of its kind, tracking over 180,000 post menopausal women. The scientists found that the participants who used HRT were 10% less likely to develop any kind of dementia and 16% less likely to be diagnosed with Alzheimer’s, compared to those who never used it, according to reports. 

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The study and its findings were published in the journal Alzheimer’s & Dementia, and was led by Professor Anne-Marie Minihane, who is also the director of the Norwich Institute for Healthy Aging at the University of East Anglia. 

Minihane revealed that they saw the greatest risk reduction in women using HRT who also underwent surgical menopause, finding a 26% lower risk of developing any type of dementia compared to women who didn’t use the therapy. 

“While HRT has long been prescribed primarily to relieve menopausal symptoms such as hot flashes and night sweats, this work suggests it may also play a role in long-term cognitive health for some women.”

Women are more likely to develop dementia due to the fact that, statistically, they live longer than men. Scientists also think it could be related to the impact of menopause on their brain metabolism and the impact of the main risk gene for Alzheimer’s being greater on women. 

“We wanted to better understand how HRT could prevent dementia and to assess if particular groups of women may respond differently,” Minihane said. 

The study used data from the UK Biobank, allowing them to track 183,450 postmenopausal women over about 13 years. Throughout that timespan almost 4,000 cases of dementia were identified, and the scientists looked at whether or not using HRT of any kind for at least one year changed women’s risk of developing dementia. 

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The study also pointed out that women who naturally had lower oestrogen exposure throughout their life, either due to starting their periods late or going through early menopause, would benefit more from HRT, with a 16% lower risk of any kind of dementia. 

Of course, genetics also play a role. Women who carried the Apoe4 gene had a stronger association with HRT use and dementia. 

“This is really important because Apoe4 carriers are typically considered at higher risk and have fewer established prevention options,” said Minihane.

The results of this study are based on observational data rather than a randomized-controlled trial, so there’s no way to prove a causal link.

Dr Susan Kohlhaas, the executive director of research and partnerships at Alzheimer’s Research UK, said: 

“This study alone isn’t enough to tell us whether HRT should be used to reduce dementia risk, but it provides further evidence that the timing of HRT and a woman’s hormonal history may matter.

“We now need research that can establish whether HRT itself is responsible for these differences in dementia risk and understand which forms of HRT may have an effect.

“Anyone considering starting or stopping HRT should speak to their GP about the potential benefits and risks for them.”

covid

US Experiencing Covid-19 Surge In Every State 

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Every state in the US is currently experiencing a rise in Covid-19 cases, with healthcare professionals and experts warning citizens to be on the lookout for symptoms, and stay diligent with healthy lifestyle practices. 

Dr. John Brooks, an infectious disease doctor at Emory University in Atlanta, Georgia who also used to work at the Centers for Disease Control and Prevention, told NPR about how as a country, “we’re now in the midst of a growing summer surge of Covid.” 

“I think most of us kind of feel like it’s fading away and are certainly very grateful for that. But nationally we’re seeing [Covid-19] ticking up pretty much everywhere.”

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According to the CDC, the disease is mainly spreading in the South and West, but is also rising in the Northeast and Midwest. As of right now, however, the virus is still at very low levels, and the current wave of infections is following along the trend of getting milder each year, with less people being hospitalized or dying. 

“What we’re seeing is very likely evidence of growing herd immunity if you will,” Dr. Brooks said. 

“More and more people have had one or more infections that give them some immunity against the virus and have had more than one vaccination, or maybe both, and all of that really has begun to offer us a lot of protection.”

The most important thing that doctors want US residents to remember is Covid-19 never disappeared, and is still greatly impacting communities around the nation. Many are still finding themselves feeling intensely sick for up to two weeks, and for some people, Covid can still cause serious disease, hospitalizations, and in the worst of cases, death. 

Caitlin Rivers, an epidemiologist at Johns Hopkins University in Baltimore, MD, emphasized this point to NPR, stating that “Covid-19 is still dangerous, particularly for older adults, infants, and people who are immunocompromised.” 

“In a typical office if you have 20 colleagues, it’s likely that one or two of them are some degree of immunocompromised. So it’s very common that people have risk factors that make Covid-19 dangerous.”

Rivers also pointed out that unlike flu season, which sees a major surge in the winter months, Covid-19 has seen spikes twice a year since the initial pandemic in 2020. That biannual surge remains a mystery to experts. 

“It’s a big mystery as far as I’m concerned. It is the only seasonal respiratory virus that has a summer season. To my knowledge, we don’t know what is causing this seasonality.”

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Rivers advises the general public to stay up to date on their vaccines, and pointed out how she still wears a mask when she’s in crowded places. Staying consistent with your vaccines also allows the body to stay strong against the new and dominant strains that emerge. 

The CDC has not issued any updated recommendations for Covid-19 vaccinations due to litigation over the Trump administration’s work to overhaul immunizations in the US, according to reports. 

The administration itself no longer recommends that everyone aged 6 months and older routinely get an annual shot. Major medical groups, however, still highly recommend it. 

Major insurance companies throughout the nation have also emphasized that they will continue to cover the costs of vaccinations, and the shots themselves will also still be free through other government programs. 

Public health experts are worried about the opposing messages regarding vaccines and how they might confuse more vulnerable populations as well. 

Claire Hannan, for example, is an executive director of the Association of Immunization Managers which works to advocate for immunization and the multiple free programs that offer them throughout the US. 

“The message is that the Covid-19 vaccine and the flu vaccine will be available, they’re covered by insurers, they’re recommended by medical societies. People should get them and get them for their kids.”

Dr. Brooks also pointed out that there’s also now a new drug called Xocova that individuals can take right after they’ve been exposed to the virus to decrease their chances of getting sick from Covid-19. This will especially be useful for individuals working in the healthcare industry who are exposed to a myriad of sick patients every day. 

“It is something for people to just have in the back of their mind.”

EPA

5 Dead in Louisiana After Contracting Flesh-Eating Vibrio Bacteria

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Five people in Louisiana have died this year after contracting Vibrio vulnificus, a potentially deadly bacterium found naturally in warm coastal and brackish waters, state health officials said.

Louisiana has reported nine cases of Vibrio vulnificus so far this year, with another four people hospitalized. Every case involved a wound that had been exposed to seawater, according to health officials, and all nine patients had underlying health conditions that can raise the risk of serious illness and complications.

Health officials are urging people with open wounds to avoid saltwater and brackish water and to thoroughly wash any wound with soap after possible exposure. Brackish water is a mixture of fresh and salt water, often found where rivers meet the ocean.

Vibrio bacteria can infect people in multiple ways. In addition to entering the body through an open wound exposed to contaminated water, the bacteria can be contracted by eating raw or undercooked shellfish, particularly oysters. Officials are also advising people to fully cook seafood and keep cooked seafood away from raw seafood and its juices.

Signs of a Vibrio wound infection can include fever, pain, redness, swelling, discoloration or fluid discharge around the affected area, according to the CDC.

The bacteria are most prevalent between May and October, when coastal waters are warmer. But scientists have increasingly detected Vibrio in areas where water temperatures were once considered too cold for the pathogen to thrive.

Researchers in New York, for example, said in April that they had detected Vibrio vulnificus in several bodies of water off the coast of Long Island. Previous cases have also been reported around Long Island Sound, a development scientists have linked, in part, to warming waters driven by climate change.

Farther south, Maryland health officials have also urged swimmers to use caution in the Chesapeake Bay after more than two dozen cases were confirmed in the state this year.

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Researchers with the U.S. Department of Agriculture and the Environmental Protection Agency have estimated that the number of Vibrio infections in the United States could increase by 50 percent by 2090 compared with 1995 levels as sea temperatures continue to rise.

Dr. Peter Hotez, dean of the National School of Tropical Medicine at Baylor College of Medicine, told CBS News the bacteria are appearing progressively farther north as the climate warms.

“With every year now, because of climate change, we’re seeing it higher and higher in more northerly latitudes.”

Louisiana is not the only state reporting infections this year. Florida has recorded 14 Vibrio vulnificus cases, including two deaths, according to the Florida Department of Health. One person died in Marion County in Central Florida, while another death was reported in Palm Beach.

Florida officials have also warned that hurricanes and other major storms can increase the risk of exposure by pushing brackish coastal water farther inland.

The state experienced an especially deadly year for Vibrio vulnificus in 2024, when Hurricanes Helene and Milton struck the region. Florida reported 19 deaths from the bacterium that year.

The dangers of wound exposure were illustrated by the case of Summerlin Skipworth, who told CBS News she injured her foot on rocks while visiting Orange Beach, Alabama, over Labor Day weekend last year and contracted the infection. Within several days, the pain became severe enough that she went to an emergency room, where she tested positive for Vibrio vulnificus.

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“It felt like somebody poured gasoline on my foot and lit it on fire.”

Skipworth underwent emergency surgery and was released shortly afterward. Doctors credited early detection with helping her recover. “An infection never crossed my mind,” she said. “I just knew I had pain in my foot.”

Vibrio vulnificus is among roughly a dozen Vibrio species capable of causing an illness known as vibriosis, according to the Centers for Disease Control and Prevention. The CDC estimates that approximately 80,000 cases of vibriosis occur in the United States each year.

Vibrio vulnificus infections can be particularly dangerous. About one in five people infected with the bacterium die, according to the CDC, sometimes within just one or two days after becoming sick.

Symptoms can include diarrhea, stomach cramps, nausea, vomiting and fever. In more severe cases, the infection can spread into the bloodstream, potentially causing low blood pressure and blistering skin lesions.

Hotez said people with underlying risk factors should be particularly careful about entering coastal waters with cuts or abrasions.

“If you have those risk factors, and if you have an open wound or abrasion in your skin, you do not want to go swimming in brackish waters along the Gulf Coast and the Atlantic Seaboard,” he said.

The growing geographic range of Vibrio has become a concern as ocean temperatures rise. Although the bacteria have long been associated with warmer coastal areas, infections and detections in places such as the Northeast suggest that the conditions favorable to Vibrio are expanding beyond their traditional range.

ebola

Ebola Outbreak Outpacing Recovery Efforts As Aid Workers Go On Strike Over Pay 

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The world is currently experiencing one of the fastest-growing Ebola outbreaks in history. The virus is currently spreading at a rate faster than the efforts to fight it, according to the head of the World Health Organization (WHO), Tedros Adhanom Ghebreyesus. 

Ghebreyesus spoke with officials during a visit to the Congo, where some health workers are also currently on strike over a lack of pay, which is also slowing recovery efforts. 

This outbreak has been occurring for about three months with new courses doubling in some of the hot spots, Ghebreyesus stated in a post to his social media after meeting with officials in the capital Kinshasa. This marks the second visit that the WHO director-general took to the country since the outbreak was officially declared in mid-May. 

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“We all agree that we must urgently and massively scale up all our efforts across all pillars of the response and by all partners.”

The outbreak itself has had over 3,800 confirmed cases and over 1,700 deaths as of the beginning of this week, according to the latest data from Congo’s Ministry of Health. 

In the epicenter of the outbreak, the Ituri province, it’s been reported that many of the front line workers have gone on strike. The healthcare workers have also been impacted by rebel conflict within one of Congo’s most remote and vulnerable areas. 

Some workers stated that they started receiving payment within the past week for the work they’ve been doing since the outbreak began, and are demanding improved wages, according to reports. 

A resident of Bunia, Anicet Baluku, told the Associated Press that he blamed the death of his two brothers from Ebola on the strike. “We urge the authorities to quickly find a solution to prevent other families from experiencing the same tragedy.”

The US Department of State said this week that it will be providing an additional $242 million in funding for immediate Ebola response and preparedness efforts in the region and for humanitarian assistance. 

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The outbreak itself has outpaced all previous Ebola outbreaks due to its speed of transmission and is currently the second-largest outbreak on record after the 2014-2016 West Africa outbreak that had over 28,000 cases and more than 11,000 deaths. 

The specific Bundibugyo virus that is causing this current outbreak has no approved treatment or vaccine. 

Doctors Without Borders stated this week that the outbreak is still “spreading at an alarming and unprecedented rate. The response is expanding but is still not reaching communities quickly enough to break transmission chains.”

Dr. Jean Kaseya, the head of Africa Centers for Disease and Control, stated that during a visit to Bunia that contact tracing isn’t working, while 60% to 70% of new cases coming outside of those being monitored after exposure to patients. 

The later detection of cases has been a main contributor to the 45% fatality rate, according to officials. The health ministry stated that of the 77 most-recent cases reported during a 24-hour period, 44 were fatal, and at least 717 patients are in isolation with 749 patients have recovered. 

Dr. Kaseya also met with Ghebreyesus this week, and stated that the Africa CDC is “aligning its efforts with responders around earlier detection, stronger contact tracing, rapid access to quality care, and deeper engagement with communities.”

“Above all, communities must be at the center of and have ownership of the response. We cannot stop Ebola without their trust, leadership, and partnership,” he said.  

Legionnaires Disease

Fourth Person Dies in New York City Legionnaires’ Disease Outbreak

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New York City officials say they believe the source of a Legionnaires’ disease cluster on the Upper East Side has been eliminated, even as the death toll connected to the outbreak has risen to four.

The city has identified 76 cases as of Monday, according to the Health Department. Seven patients remain hospitalized, while 53 people who had been admitted for treatment have since been discharged.

Officials have linked the illnesses to Legionella bacteria detected in cooling towers at buildings in the area. Cooling towers at 76 properties tested positive for the bacteria, prompting the city to order building owners to drain, clean and disinfect the equipment.

All 76 buildings later confirmed that they had completed the required remediation, city officials said. The Health Department also reported a steep decline in the onset of new illnesses after July 8.

Mayor Zohran Mamdani attributed the apparent containment of the cluster to what he described as “the aggressive strategy of early testing, enforcement, and remediation.”

“We have not seen anyone with new symptoms in over a week. We are focused on inspecting every cooling tower that tested positive and enforcing our laws to their fullest extent,” Health Commissioner Dr. Alister Martin said in a post on X Monday.

The outbreak has been concentrated in three Upper East Side ZIP codes: 10128, 10028 and 10075. The affected area includes the Carnegie Hill and Yorkville neighborhoods. Although New York typically records hundreds of Legionnaires’ disease cases each year, health officials said the clustering of cases in those neighborhoods represented a notable increase.

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People who have spent time in the affected area over the past several weeks are being urged to monitor themselves for symptoms, including fever, chills, fatigue, headaches, loss of appetite, confusion and diarrhea. Symptoms may not appear immediately and can develop up to 14 days after exposure, according to the Health Department.

Legionnaires’ disease is a form of pneumonia caused by inhaling water droplets or vapor contaminated with Legionella bacteria. Infections can also occur when contaminated water accidentally enters the lungs. The illness is not contagious and does not spread directly from one person to another.

Officials stressed that the current cluster is not associated with drinking water, showers or air-conditioning units. The Health Department said there is no problem with the plumbing systems in buildings within the affected ZIP codes. Residents can continue drinking tap water, bathing, showering, cooking and using their home air-conditioning systems as usual.

Cooling towers are used in refrigeration and building-cooling systems. They remove heat from buildings by drawing outside air across warm water supplied by a central chiller. The water is sprayed onto the fill material as fans pull air through the system, causing a small portion to evaporate and lowering the temperature of the remaining water.

That cooled water then circulates through the system again to absorb additional heat. When Legionella bacteria are present, however, contaminated mist or vapor released by the tower can potentially be inhaled by people nearby.

Research has found that Legionella bacteria can thrive in warm, wet environments. Cooling towers are particularly susceptible, along with hot tubs, spas, decorative fountains and certain plumbing systems. The bacteria occur naturally in freshwater, though they are generally present at levels too low to cause illness. They multiply most readily in warm water and environments with warm-to-hot temperatures, according to the Centers for Disease Control and Prevention.

When Legionella enters a building’s water system, it can potentially spread through equipment such as showerheads, faucets, hot-water tanks, heaters and cooling towers.

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Most people who encounter the bacteria do not become ill. The risk is higher, however, following substantial or repeated exposure, particularly among people who are more vulnerable to infection.

Those at greater risk include adults over 50, people who smoke or vape, people with weakened immune systems and those with underlying medical conditions. Diabetes and diseases affecting the heart, kidneys, liver or lungs can also increase the likelihood of severe illness. While most patients recover after receiving antibiotics, people who are immunocompromised or have chronic lung disease can develop potentially fatal complications.

Legionnaires’ disease can generally be treated with antibiotics, especially when it is identified early. There is no vaccine or preventive medication, and masks do not appear to protect against exposure, according to the New York City Health Department.

The national rate of Legionnaires’ disease has risen over the past decade, reaching 2.71 cases per 100,000 people in 2018, according to the CDC. Reported infections declined during the first year of the COVID-19 pandemic, only to increase again in 2021.

The latest cluster follows a deadly outbreak in Harlem last year that hospitalized 92 people and killed seven. Investigators also traced those cases to cooling towers.

That outbreak helped lead the city to adopt a new law in May requiring cooling towers to undergo more frequent inspections. The measure also increased fines for property owners who fail to comply with maintenance and safety requirements.

City Council Speaker Julie Menin, whose district includes the affected area, criticized failures to follow the city’s cooling-tower regulations.

“We know for a fact that many buildings did not comply with that City Council law, which is inexcusable. One of the many questions we have about the Health Department is, how many buildings did not comply? Let’s start with looking at those buildings.”

Officials are continuing to inspect every cooling tower that tested positive during the current outbreak and said enforcement efforts remain underway, despite indications that new infections have slowed significantly.

pentagon

Pentagon Brings Back Mandatory Flu Shots For All Boot Camp Recruits

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This week, the Pentagon announced that they are reinstating a requirement that all boot camps for US military services are to enforce new recruits getting a flu vaccination after Defense Secretary Pete Hegseth previously made the shot optional for new military members at the end of April. 

The Associated Press received this confirmation from a Pentagon official after a recent growing, weekslong, flu outbreak at the US Air Force’s boot camp at Lackland Air Force Base caused around 300 people to get sick. The official who spoke with the publication mentioned, however, that the recent mandate of the vaccination was not related to that specific outbreak. 

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Back in April, when Hegseth initially announced that the flu vaccine mandate was being repealed, he cited “medical autonomy and religious freedom.” He also allowed the services to ask for specific exceptions/permission to keep the vaccine mandatory within 15 days of the policy rollout. 

The official from the Pentagon explained that the decision to reinstate was being finalized earlier in June with the timing of the outbreak at Lackland being purely coincidental. In Lackland, only 40% of the new trainees in the bootcamp were vaccinated once it became optional, according to AP. 

According to Air Force figures, this particular base handles around 700 new recruits every week, and the close quarters environment has always been relevant when it comes to the spread of sickness. 

Outbreaks in boot camp settings are unfortunately common due to the fact that recruits are exposed to high stress, low sleep environments where they’re in very close contact with each other for weeks. They typically sleep together in large, open rooms and shower communally, so it’s easy for sicknesses to spread. 

The outbreak at Lackland has now been ongoing for about three weeks with 275 confirmed cases of the flu, according to Democratic Representative Joaquin Castro, who confirmed the stats in a social media post. Castro’s district also includes part of the base where the boot camp resides. 

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Dr. Arnold Monto, a flu expert and professor, stated that this new outbreak is “not unusually concerning,” because although the flu is mainly an issue in the late fall and winter, flu viruses routinely circulate during warmer months too. 

In fact, flu outbreaks that occur during the spring and summer months are often in settings where a lot of people are in close contact with one another, like military bases or cruise ships. 

“If you want to prevent flu outbreaks, it is especially necessary to vaccinate when there are group settings,” Dr. Monto said. 

The Pentagon’s top spokesman, Sean Parnell, said in a statement to the media that exceptions were granted to the Army, Navy, Air Force, the National Security Agency, and the Defense Health Agency. 

Both Army and Navy officials, however, said that they have also asked for permission to make the vaccine mandatory for certain broad groups including troops that are being deployed overseas, healthcare workers, and child care workers. 

Advocacy organization ‘Families Fighting Flu’ openly supported this change to increase vaccine rates. 

Michele Slafkosky, the organization’s executive director, said in a statement:

“For decades, the military prioritized the health and safety of troops and the public by requiring flu vaccines for recruits. It’s unfortunate that more than 200 individuals at Lackland Air Force Base in Texas became ill when that requirement was rescinded. This updated guidance from the military will save lives.” 

Crisis Hotline

LGBTQ+ Crisis Intervention Hotline Relaunches Without The Trevor Project 

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The government is moving to restart the specialized LGBTQ+ option for youth who contact the 988 crisis intervention hotline after the Trump administration ended it. However, the group that helped pioneer and bring the option to the hotline initially, the Trevor Project, is being shut out. 

The Trevor Project is known as the leading nonprofit for suicide prevention in LGBTQ+ youth, and now they may be blocked from offering their important services that they developed specifically for the 988 hotline just a few years ago, according to reports. 

The 988 hotline is known as the 911 for mental health emergencies, and has greatly reduced the suicide rates in teenagers and young adults. The hotline offers specialized options for certain groups so that struggling callers can be matched with someone who can greatly help them with their specific needs. 

Veterans and Spanish speakers are some of the other groups that they offer specialized services for. In July, however, the Trump administration removed the “press 3” option for LGBTQ+ youth with a month’s notice, claiming that the funding ran out. 

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Now, Congress has directed officials to allocate $33 million to LGBTQ+ specific interventions to help young people within the demographic. 

The Trevor Project may not be allowed to offer their services that they developed and specialized in. Dr. Christine Yu Moutier, chief medical officer for the American Foundation of Suicide Prevention, stated that keeping the Trevor Project out of this relaunch “would not make sense” considering it’s a “long-standing, high-quality and trusted resource” for LGBTQ+ people. 

Many groups are trying to find order in the chaos of this relaunch. Statistically speaking, LGBTQ+ youth attempt suicide at higher rates than the general population, so by leaving out the Trevor Project, who’s main objective is to bring those numbers down, is leaving many activist groups confused. This also comes at a time where the Trump Administration is trying to remove protections for transgender Americans.

Wisconsin Senator Tammy Baldwin is one of the individuals who has led a bipartisan push to restore the service.

“The Trump administration never should have shut down the ‘press 3’ option and put young Americans at further risk.”

She also called on the president to “restore the service without needless limitations and with the most qualified, experienced people answering the phone calls and text messages from these vulnerable young people.”

Before the “press 3” option was removed, the Trevor Project was handling the majority of 988’s LGBTQ+ youth services. Individuals were also able to text “PRIDE” to the hotline, or use online chats to speak with counselors for a more private approach. The counselors on the other end of the line were specially trained to work with LGBTQ+ youth. 

When it was initially in service, the “press 3” option fielded 1.6 million contacts, according to the Substance Abuse and Mental Health Services Administration. The Trevor Project handled about half of that traffic. 

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Vibrant Emotional Health, the nonprofit that administers the 988 service, is looking for applications to manage the return of the “press 3” calls, and the applicants are limited to crisis centers that are “current and active members of the 988 network.” The Trevor Project is not currently active in the network due to the Trump administration canceling the service to begin with. 

“This troubling development indicates a dangerous step toward degrading the clinical standards to serve high risk groups that the ‘press 3’ specialized services were founded on,” said Jaymes Black, CEO of The Trevor Project, in a statement to the AP.

LGBTQ+ advocate groups are happy to hear that the option will be restored by the end of the year, however, there are high levels of concern over how the restoration will actually take place and operate. Advocates are also worried over the Trump administration’s anti-transgender policies and how that may impact the relaunching.

Black is worried that the next version of 988’s LGBTQ+ youth services “may exclude transgender and nonbinary youth entirely. 

“While anti-LGBTQ+ politics may be altering the very purpose of this lifeline created to help save young LGBTQ+ lives, it is critical to make clear that politics has no place in suicide prevention,” Black said.

According to a 2024 analysis from the CDC, 26% of transgender and gender-questioning students attempted suicide that year, compared to 5% cisgender male and 11% cisgender female students. 

The Trevor Project has, and continuously will, independently run its own 24/7 crisis hotline for LGBTQ+ youth. 

Antidepressants

New Study Finds Antidepressants And Antipsychotics Can Be An Alternative To Opioids

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Opioids have long been used for pain relief in emergency departments, especially in America. Paralleling these prescriptions has been a major opioid crisis in the US, which first began in the 90s and has lasted to this day. Many healthcare workers from all branches of the medical industry have looked towards alternatives to opioids to help reduce the national impact, and most recently it has been found that medications used as antidepressants and antipsychotics, could be a solution. 

According to a new recently published study, these non-opioid medications, that are already available within emergency departments, could also provide pain relief. Akash Shanmugam, a medical student at the University of California, San Francisco (UCSF) and first author of the study, told the Guardian that the goal of this research was to “create a very targeted list for specific pain conditions” that can help physicians all over the country create new “toolboxes” for themselves to treat patients. 

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While opioids do have the reputation of reducing pain effectively, uneven prescriptions and the highly addictive nature of these drugs is what’s currently fueling the opioid epidemic in America. 

The study also provided recommendations for the most common types of pain that patients come into the emergency department for such as abdominal pain, back pain, chest pain, headaches, etc. 

Dr. Kathy LeSaint, an associate professor of emergency medicine at UCSF and fellow author of the study, agreed with Shanmugam regarding the fact that opioids do still have a place in modern medicine, but this study can hopefully lead to a place where it’s not creating addiction problems for patients looking for relief. 

“The desire to reduce opioids shouldn’t come at the expense of under-treating pain.”

Dr. LeSaint also emphasized that even looking beyond concerns regarding opioid addiction and overdose, it’s integral in a general sense to have a variety of medications for pain available that will work from patient-to-patient. 

“The enzymes that are responsible for metabolizing opioids can have different strengths in people,” LeSaint explained, pointing out that the variation is often genetic depending on what medications work for each patient. 

The study examined all sorts of pain medications, starting with common ones like acetaminophen and ibuprofen. They also looked into drugs with “targeted applications” like ketamine, which is used as a common anaesthetic and showed potential for chest pain relief. SNRI (serotonin norepinephrine reuptake inhibitor) antidepressants showed promising results for back pain relief. Additionally, several kinds of antipsychotics could help with headache and abdominal pain. 

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Shanmugam pointed out that psychotropic medications have been used for a while for pain relief in addition to psychiatric symptoms. He gave the example of gabapentin and how it was initially approved to be used as a drug for epilepsy, but “now it’s used a lot for the management of neuropathic pain.” 

He emphasized that the parts of psychotropic medications that make them effective for pain are quite complex, and their efficacy is likely connected to the fact that “neural circuits that create the sensation of pain are also involved in the emotional experience of pain, and the distress that pain produces for human beings.”

“In chronic pain conditions, the nervous system can become highly sensitive, and it’s thought that antidepressants and antipsychotics can maybe reduce this heightened sensitivity in the brain,” Dr. LeSaint added. 

“Chronic pain is often linked to things like poor sleep, depression, anxiety, fatigue,” and medications that help people sleep better and experience less anxiety can also make managing pain easier to deal with. 

Dr. LeSaint emphasized how doctors need to review the evidence and what occurs with the individual patient’s specific symptoms. 

“Talking to them and asking about their prior experience with opioids prior to giving opioids can be really helpful in tailoring the pain regimen for that particular patient, for that particular pain syndrome,” Dr. LeSaint said.

According to Shanmugam, when physicians prescribe psychiatric medications specifically, it’s integral to make sure the patients understand it doesn’t mean the pain is mental. 

“I’ve seen a lot of clinicians use the basic science approach of explaining that there’s a lot of overlap between the pain mechanisms and also the emotional understanding of pain, that really helps reassure patients.”

health insurance

San Francisco Firefighter Dies After Insurance Dispute Delayed Cancer Treatment

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Ken Jones, a retired San Francisco firefighter who spent months fighting with his health insurer over access to cancer treatment, died Saturday at age 71.

Jones had been living with Stage 4 metastatic cancer and became the focus of a series of NBC Bay Area investigations examining his struggle with Blue Shield of California. The insurer twice denied treatment requested by Jones’ oncologist, a decision that sparked criticism from medical professionals, city officials, and fellow firefighters.

Blue Shield said in a statement that it was “deeply saddened” by Jones’ death and offered condolences to his wife, family, friends, and former colleagues at the San Francisco Fire Department.

Jones devoted 17 years to the department, serving not only as a firefighter but also as its lead counselor. In that role, he helped first responders navigate trauma, serious illness, and other personal crises.

Among those closest to him was former San Francisco Fire Chief Jeanine Nicholson, who had known Jones and his wife, Helen Horvath, for nearly three decades.

When Nicholson was diagnosed with breast cancer more than 10 years ago, Jones drove her to medical appointments for six months while she underwent treatment.

“Chemotherapy really is tough – it’s tough on your body because it’s killing all the good cells as well as the bad,” Nicholson said. “[Ken] had to suffer a lot through that, and then being denied further treatment— it’s just so cruel. It is so cruel.”

Nicholson believes the delays in Jones’ care had devastating consequences.

“I believe, wholeheartedly, that they expedited his death. They should be ashamed.”

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At the center of the dispute was a disagreement over whether Jones should receive a specific combination of chemotherapy and immunotherapy. Blue Shield has repeatedly maintained that its denials were not based on cost considerations but on medical guidelines that, according to the company, did not support the treatment regimen requested for Jones’ stage of cancer.

Jones’ oncologist, Dr. Matthew Gubens, strongly disagreed with that assessment.

Gubens, who heads the UC San Francisco Thoracic Medical Oncology Clinic and has helped develop some of the nation’s most widely used cancer treatment guidelines through the National Comprehensive Cancer Network, argued that Blue Shield misapplied those standards.

“There’s gray area in medicine,” Gubens previously told NBC Bay Area.

“The time spent trying to get approval of a regimen that I requested, [Ken] lost ground – tumors are growing, pain is increasing, his appetite is going down.”

After Blue Shield initially denied the treatment request, Gubens said he attempted to appeal the decision but struggled to reach the appropriate department within the company. He said repeated calls to the phone number listed in the denial letter led him in circles.

“I reached people who apologized, but they weren’t the right place to send the appeal to and often referred me back to the first person I talked to. That day, I spent about three hours calling different phone numbers for this insurance company.”

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Blue Shield did not respond to earlier requests for comment regarding why Gubens was unable to connect with the proper contact to file an appeal.

Gubens eventually submitted a written appeal, but that request was also denied, creating what he described as a weeks-long delay in care.

“Any of our cancer treatments are harder to give and less effective the weaker a patient is when we’re seeing them,” he said.

The controversy surrounding Jones’ case drew the attention of San Francisco officials. Following NBC Bay Area’s reporting, members of the Board of Supervisors called on Blue Shield executives to appear at a City Hall hearing to explain the company’s claims review process and discuss reforms intended to ensure firefighters and other first responders can obtain timely medical care.

Blue Shield is one of three insurers contracted by the city to provide health coverage to more than 40,000 employees and retirees. According to data obtained from the San Francisco Health Service System, those contracts are worth more than $1 billion.

Jones’ death has also renewed attention on the health risks firefighters face. Research from the Centers for Disease Control and Prevention’s National Institute for Occupational Safety and Health found firefighters are diagnosed with cancer at rates roughly 9 percent higher than the general population and face a 14 percent greater risk of dying from the disease.

Exposure to smoke, soot, ash, and other hazardous materials has led the World Health Organization to classify occupational exposure in firefighting as a carcinogenic risk.

Despite Jones’ passing, discussions about potential reforms are expected to continue. Blue Shield is scheduled to meet next week with leaders of the local firefighters’ union and other advocates to discuss possible changes to the claims process.

City supervisors have also indicated they plan to bring Blue Shield executives back to City Hall to provide a public update on those efforts.

“We need to hold insurance companies accountable for their actions,” Nicholson said. “They are in the business of making money. They are not always in the business of giving people the best care or the care that they deserve.”

pill

New Experimental Pill Offers Hope For People With Advanced Pancreatic Cancer 

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A new novel pill is reportedly helping people with advanced pancreatic cancer, one of the deadliest, live longer, according to new research recently published in the New England Journal of Medicine and presented at the American Society for Clinical Oncology (ASCO).

“While not curing the cancer, it is a very large step forward,” said Dr. Zev Wainberg of the University of California, Los Angeles, who helped lead the study. 

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The new drug is called daraxonrasib, and it works by blocking a mutated protein that fuels tumor growth in over 90% of pancreatic cancer cases. Pancreatic cancer is also known for being very deadly with very little viable treatment options. 

The pills are meant to be taken daily and have shown to nearly double one’s survival time with fewer side effects in a study that randomly assigned the experimental drug or more chemotherapy to 500 patients with metastatic cancer that have stopped responding to other treatments, according to reports from AP. 

The research showed that those who took daraxonrasib lived for an average of 13.2 months compared with 6.7 months for chemotherapy recipients. Dr. Wainberg said while this may seem like a small improvement, it marks the first drug to show a substantial advantage over chemotherapy. 

“Having treated pancreatic cancer for 16 years, I actually started crying when first seeing the study results,” Dr. Rachna Shroff of the University of Arizona Cancer Center, said at the ASCO meeting. 

“[I was struck by how] patients stayed on this treatment because it was providing a durable and meaningful benefit to them.”

The pills’ effects eventually decrease but those taking it for significantly longer than the chemotherapy group reported less pain and a better quality of life. Many continued to use the medications after the data was analyzed. Dr. Wainberg stated this means the survival gap may widen as researchers continue to track them. 

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Dr. Brian Wolpin, of the Dana-Farber Cancer Institute, presented the findings and said “the drug should become a new standard of care” for previously treated metastatic pancreatic cancer. Researchers also will explore its use earlier in the disease, including to see if tumor shrinkage might let more patients qualify for surgery,” AP reported. 

He also said the side effects most likely to impact the treatment course were a rash that can become severe and mouth sores. 

The Food and Drug Administration is planning to expedite their review of the drug because of its success. It was developed thanks to funding from Maker Revolution Medicines. The agency is granting “expanded access” to the drug for patients who meet the criteria. 

Pancreatic cancer is one of the most deadly forms due to the fact that it’s hard to detect before it starts spreading throughout the body. The American Cancer Society estimates around 67,000 new cases will be diagnosed in the US this year with more than 52,000 people dying from the disease. 

Pancreatic cancer is also harder to treat and doesn’t respond to chemotherapy the same way other cancers do. This drug is leaving a lot of experts very optimistic about the future of treating this deadly disease, as well as other cancers.