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WEDNESDAY, March 16, 2022 (HealthDay News) — Your annual screening mammogram may do more than spot breast cancer early — it may give you a heads up on your heart disease risk, too.

Digital breast X-rays can also detect a build-up of calcium in the arteries of your breasts, an early sign of heart disease. These white areas — known as breast arterial calcification, or BAC — are markers of hardening in the arteries and tend to go along with advancing age, type 2 diabetes, high blood pressure and inflammation. (It is not the same as calcification of the inner layer of the arteries that is often found in smokers or people with high cholesterol.)

“A single test that is universally accepted can address the two leading causes of death in women,” said study author Dr. Carlos Iribarren. He is a research scientist at the Kaiser Permanente Northern California Division of Research, in Oakland.

For the study, his team reviewed health records of more than 5,000 women, aged 60 to 79, who underwent one or more screening mammograms. None of these women had a history of heart disease or breast cancer when the study began. They were followed for about 6.5 years.

Those whose mammogram showed breast arterial calcifications were 51% more likely to develop heart disease or have a stroke compared with women without calcium build-up in their arteries, the study found.

In addition, women with calcium build-up were 23% more likely to develop any type of heart or vascular disorder, including heart disease, stroke, heart failure and related diseases, the study showed.

“BAC provides additional information and is not intended to replace any current risk factors for heart disease,” Iribarren said.

Counseling should be done in the context of a woman’s overall heart disease risk, he said.

“For women with low risk, BAC presence should be a trigger of adhering to healthy lifestyles including a heart-healthy diet, avoiding smoking and exercising regularly,” he advised. “For women with intermediate-risk, BAC should also prompt a discussion with the doctor about initiating treatment for risk factors such as cholesterol, blood pressure and diabetes that are not well controlled by lifestyle alone.”

Although reporting of BAC levels is not mandatory, radiologists should include this information in their report, Iribarren said.

“A relatively small proportion already do, but more importantly, there is research showing that women overwhelmingly want this information provided to them and their primary care doctors,” he said.

Because this information can be obtained during a routine screening mammogram, there would be no extra cost or radiation exposure.

The findings were published March 15 in the journal Circulation: Cardiovascular Imaging.

Dr. Natalie Avella Cameron, an instructor at Northwestern University’s Feinberg School of Medicine in Chicago, co-wrote an editorial that accompanied the findings.

“If future research shows that BAC improves heart disease risk prediction among women not yet on cholesterol-lowering medications, BAC could serve as a powerful tool to help guide heart disease prevention for the millions of women who undergo routine mammography each year,” she said.

But, Cameron noted, women without calcium build-up on their breast arteries can still develop heart disease.

“We should be assessing heart disease risk factors such as obesity, high blood pressure, high cholesterol and diabetes, and discussing how to optimize heart health through lifestyle changes such as eating a plant-based diet and staying active, regardless of BAC status,” she said.

Knowledge of BAC status could be powerful and potentially life-saving information, said cardiologist Dr. Nieca Goldberg, who reviewed the findings. She’s medical director at Atria New York City and a clinical associate professor of medicine at New York University.

“Heart disease is the No. 1 killer of women, yet many women are more worried about breast cancer,” Goldberg said. “Women’s health issues are not siloed. A test for breast cancer can give us clues to heart disease risk, too.”

Calcium build-up in arteries is an early sign of heart disease risk, she said.

“We don’t know how any intervention would change calcifications, but exercising, quitting smoking, getting diabetes under control, eating a healthier diet, and managing cholesterol and blood pressure can help lower risk for heart attack,” Goldberg said.

More information

Women can learn more about their risk for heart attack and strokes at Go Red for Women.

SOURCES: Carlos Iribarren, MD, MPH, PhD, research scientist, Kaiser Permanente Northern California Division of Research, Oakland; Natalie Avella Cameron, MD, instructor, medicine, Northwestern University Feinberg School of Medicine, Chicago; Nieca Goldberg, MD, medical director, Atria New York City, and clinical associate professor, medicine, New York University, New York City; Circulation: Cardiovascular Imaging, March 15, 2022



After 30 years as a marriage and family counselor, Gary Chapman, PhD had heard a lot of couples’ complaints — so many, in fact, that he began to see a pattern. “I realized I was hearing the same stories over and over again,” he says.

When Chapman sat down and read through more than a decade worth of notes, he realized that what couples really wanted from each other fell into five distinct categories:

  1. Words of affirmation: compliments or words of encouragement
  2. Quality time: their partner’s undivided attention
  3. Receiving gifts: symbols of love, like flowers or chocolates
  4. Acts of service: setting the table, walking the dog, or doing other small jobs
  5. Physical touch: having sex, holding hands, kissing

“I really do feel that these five appear to be rather fundamental in terms of ways to express love to people,” says Chapman, the director of Marriage & Family Life Consultants, Inc. in Winston-Salem, N.C.

Chapman termed these five categories “love languages” and turned the idea into a book, The 5 Love Languages, which went on to become a huge bestseller. Chapman says that learning each other’s love language can help couples express their emotions in a way that’s “deeply meaningful” to one another.

It’s an approach that makes sense, says Julie Nise, MA, LPC, LMFT, a marriage coach at the Aim Counseling Center in Houston and author of 4 Weeks to a Happier Relationship. “In my experience, an understanding of your partner’s perspective (whether or not you agree with it) is what’s most lacking in troubled marriages,” she says. The main thing, Nise says, “is to, on a daily basis, do your utmost best to really know how your partner feels and what they truly think about the issue. If you devote yourself to understanding their perspective … things will go a lot smoother and solutions often become obvious.”

In the book, Chapman claims his technique has the potential to save “thousands of marriages.” He says his 5 Love Languages can also help generally good marriages that just need a little tweaking. Like mine.

I thought I’d put his strategy to the test.

What’s My Love Language?

My husband and I have been married for many ears, and I think overall we have a pretty good relationship. It’s not perfect, though. ILittle things can push our buttons. For instance, I get annoyed when he lets the trash cans overflow, and he gets irritated with the sloppy way I load the dishwasher. Often we get so preoccupied with work and parenting that intimacy and romance are thrown on the back burner.

Although I’m generally skeptical about any technique that purports to fix my marriage, I figured there’s always room for improvement.

So my husband and I set about learning each other’s love languages.

According to Chapman, discovering your partner’s love language requires some careful thought and observation. You need to ask, “What’s most important to me?” and “What does my spouse seem to request most often in the relationship?”

“How do they respond to other people and how do they respond to you? If they always give you words of affirmation, that’s probably their love language,” he says.

You also need to listen carefully to your partner’s criticisms. “We often get defensive,” Chapman says, “but they’re really giving us valuable information. If they’re complaining about something, that very likely is their love language.” In other words, if your partner is always commenting that you never do the cooking, they’re probably an “acts of service” person.

My husband and I thought about what we wanted most from each other. We realized that all the best times in our relationship — the moments we went back to again and again — were the times we spent alone as a couple. Our honeymoon in Fiji. The vacation when we got snowed in at a mountain resort. Our trip to London and Paris.

We were pretty sure we knew where this was headed, but we took Chapman’s Love Languages online quiz to check. As we suspected, my husband and I share a common love language: quality time.

That doesn’t mean words of affirmation, receiving gifts, and the other two love languages aren’t important to us. It’s just that quality time is our primary love language.

“You can receive love in all five languages,” Chapman says. “If you speak the primary language adequately, then [when] you sprinkle in the others, it’s like icing on the cake.”

5 Love Languages, 7 Days

Having the same love language made it easier for my husband and me to relate to one another, but it didn’t solve our time crunch. How could we find quality time for each other when we could barely find time for ourselves, and everything else in our busy lives?

Being busy is no excuse, Chapman says. No matter what a couple’s love language is, it takes time to accommodate. “If we understand the importance of keeping the love alive in a relationship, then we need to make time to do it,” he says. “You put it into your schedule, just like you do everything else.”

Nise stresses that making quality time for one another doesn’t have to take lots of time. It can be as quick and easy as getting a cup of coffee and talking for a few minutes, as long as it’s focused attention. “You should always have couple time,” she says. “You just need to do stuff together.”

So what would we do together? At first we couldn’t agree. I suggested something romantic, like reading poetry. My husband voted for taking a shower together. Obviously, we needed to find compatible activities. Finally, we settled on seven things to do together — one for each day of the assignment.

One day we spent nearly an hour wandering through the aisles of exotic foods at a local farmers market. The next day we went antiquing. We hired a babysitter one night and talked over glasses of wine at our favorite date-night bar/restaurant.

We soon realized that we didn’t need to go out on an official date to spend quality time together. After our son went to bed, instead of sitting side-by-side watching some mindless TV show, we switched off the screen and talked. We discussed issues that were important to us — what we loved about each other and what we felt was lacking in our marriage.

Being able to focus on each other brought back feelings and emotions that hadn’t surfaced since the early days of our relationship B.C. (before children). We opened up to each other in a way we hadn’t done in years.

I tried to focus not just on my husband’s primary love language, but also on his other love languages, which included physical touch. Instead of wearily giving him the “I’m too tired” brush-off, I started making the first move. My efforts were sincerely appreciated.

At the end of each day, we followed Chapman’s advice and did what’s called a “tank check.” We asked each other, “On a scale of zero to 10, how is your love tank tonight?” “Love tank” is Chapman’s metaphor for how much love each person is feeling. If your love tank isn’t full, your spouse asks how he or she can fill it. Every time my husband and I asked each other that week, our love tanks were full.

Now we just had to figure out how to keep them that way.

Keeping Your Love Tank Full

With a minimum of effort, couples can continue to speak each other’s love language. It takes just a few minutes each day to find out what your partner needs. Then you try to meet that need.

Chapman says his Five Love Languages won’t solve every problem in a couple, but they will address the fundamental emotional needs at play. “If that need is met, you’re more likely to be able to deal with the other issues in the marriage,” he says. “This is just another tool to help you enhance the relationship, and particularly to enhance the emotional part of the relationship.”

Nise agrees that Chapman’s approach can have a positive impact. “You can’t go wrong with doing a bunch of nice things for your spouse,” she says. “And clearly, it works.”

It seems to be working for my husband and me. Our love tanks are staying pretty full these days.



March 16, 2022 — At age 32, Carole Starr, a Maine-based teacher and professional musician, was in a car accident and had a concussion.

“Everything in my life changed,” she says. She became extremely sensitive to sounds and had to give up playing in an orchestra and singing. She also developed problems with her thinking skills. “When I tried to teach, I looked at the lesson plan I had written, but it didn’t make sense anymore.”

Starr consulted several health care professionals who dismissed her symptoms, as she had a “mild” concussion. “The first neurologist said to me — pardon the language — ‘Get off your ass and get a job.’ He didn’t understand that I was desperately trying to go back to work and failing miserably.”

She is not alone. A new study published in Neurology dispels the notion that “mild” concussions have no lasting impact on mental skills like thinking, remembering, and learning.

The results suggest that problems with thinking and memory a year after a concussion “may be more common than previously thought, although it’s reassuring this happens only in a minority of these patients,” says lead researcher Raquel Gardner, MD, of the University of California, San Francisco.

Long-Term, Chronic Effects

The study followed people with a mild concussion, also called a traumatic brain injury (TBI), for a year after their injury, measuring their thinking and memory with multiple tests. The study compared 656 people who’d had concussions, ages 17 or older (average age 40 years old), to 156 people who hadn’t gotten brain injuries.

Those in the study were given up to three neurological evaluations after their injury, 2 weeks, 6 months, and 1 year later. Each evaluation provided five scores from tests of memory, language skills, processing speed, and other brain functions, also called cognition.

The researchers wanted to define recovery after a mild concussion in a way that was relevant for each person, Gardner says, taking into account expectations for test scores based on a person’s age and education and trends in the test scores as time passed.

“What if someone started off cognitively way above average, but their cognition got progressively worse [after the TBI], even if they had not reached the threshold of being ‘below average’?” she says. “If someone experienced a significant decline, we called it a poor cognitive outcome.”

The researchers found that close to 14% of people who’d had mild concussions had poor cognitive outcomes a year later, compared to about 5% of people without a brain injury.

Of the people with a concussion who had poor cognitive outcomes, 10% had cognitive impairment only, about 2% had cognitive decline only, and about 2% had both. About 3% of the non-injured people had cognitive impairment only, none had cognitive decline only, and only 1% had both.

“There is a large minority of people who have a measurable cognitive problem 1 year later,” says Gardner. The researchers don’t know yet if the problems will continue beyond a year, but they will keep tracking the people who were studied to collect data on cognition and mood and learn more about the long-term effects of mild concussions.

The researchers found several things were associated with a greater risk of having poor cognitive outcomes, including lower education, not having health insurance, being depressed before the injury, and high blood sugar.

People with good cognitive outcomes were more likely to have a higher satisfaction with life a year after their concussion, while people with worse 1-year cognitive outcomes had more distress and more mood problems.

There are many reasons for cognitive impairment after a mild concussion, Gardner says. The injury could have directly damaged parts of the brain, or problems with sleep or mood from the concussion could then cause problems with cognition.

Starr became depressed because the concussion had upended her life. “I felt my life was over, like there was no possibility of a meaningful life again if I couldn’t work or be who I was.”

Dispelling a Myth

People have the idea that those who’ve had a mild concussion always get better, says Gregory O’Shanick, MD, director emeritus of the Brain Injury Association of America. But the new study shows “this isn’t always the case.”

O’Shanick, who is also medical director of the Center for Neurorehabilitation Services in Richmond, VA, believes the issue is much bigger than what the study covered, since it did not evaluate all types of cognitive performance. Also, it didn’t include children.

He points to a relatively new subspecialty, called brain injury medicine, in which doctors are familiar with the parts of psychiatry, neurology, and physical rehabilitation relevant to brain injuries. This enables more targeted evaluation and treatment of people who have had a concussion.

“If you have any concern about your cognitive function, see your doctor and, if necessary, advocate to have more of an evaluation with a neurologist or a neuropsychologist,” Gardner advises.

You can find more information and resources about brain injury rehabilitation on the websites of the Brain Injury Association of America and the Brain Trauma Foundation.

Starr says when she finally found health care professionals who were able to help her, she “literally broke down and sobbed with relief in their office.”

It took her many years to grieve the loss of her old life and sense of self and accept her brain injury and the new person she had become.

Starr now teaches people about brain injury at scientific conferences. She founded and supports the survivor volunteer group Brain Injury Voices, and she is the author of To Root and to Rise: Accepting Brain Injury.

“I’ve reinvented myself by focusing on what I can do, one small step at a time.”



WEDNESDAY, March 16, 2022 (HealthDay News) — Ever since routine prostate-specific antigen (PSA) screening tests have no longer been recommended, there has been a troubling rise in advanced prostate cancer cases in the United States, new research has found.

The tests measure the amount of PSA in the blood, and elevated levels can signal the presence of prostate cancer.

Routine PSA screening began in the United States nearly three decades ago, leading to a drop in both advanced prostate cancer cases and prostate cancer deaths. However, routine PSA screenings also increased the risk of overdiagnosis and overtreatment of low-risk prostate cancer.

This prompted the United States Preventive Services Task Force to recommend in 2008 against routine PSA screening for men over 75, and follow that with a 2012 recommendation against such screening for all men. That recommendation was amended again in 2018, to say that men aged 55-69 should discuss PSA screening with their doctors if they desired.

To assess the impact of reduced screening, University of Southern California researchers analyzed data on more than 836,000 U.S. men 45 and older who were diagnosed with invasive prostate cancer from 2004 to 2018.

Of those cases, advanced cancer was reported in more than 26,600 men ages 45 to 74 and in more than 20,500 men 75 and older.

Among men ages 45 to 74, the incidence rate of advanced prostate cancer remained stable from 2004 to 2010, but then increased 41% from 2010 to 2018.

For men 75 and older, the incidence rate decreased from 2004 to 2011, but then increased 43% from 2011 to 2018. In both age groups, the increases were across all races.

The findings were published March 14 in the journal JAMA Network Open.

“This study is the first to document a continued rise in metastatic [advanced] prostate cancer using the most up-to-date population dataset,” said co-lead study author Dr. Mihir Desai, a professor of clinical urology at USC’s Keck School of Medicine.

“The discovery has important ramifications for men because prostate cancer, when caught early, typically through a screening, is very treatable and often curable,” Desai added in a university news release.

“This data is very important as it indicates the need to constantly reassess the impact of policy decisions,” co-lead study author Dr. Giovanni Cacciamani, an assistant professor of research urology and radiology at Keck. “Otherwise, we may see a continued rise in metastatic prostate cancer.”

The reasons for halting routine PSA screenings may now be outdated, the researchers noted.

Co-author Dr. Inderbir Gill, chair of the urology department and executive director of the USC Institute of Urology, pointed out that urologic centers are finding new ways to improve patient outcomes.

“More refined strategies, including biomarkers and magnetic resonance imaging [MRIs], have already increased detection of clinically significant cancers, while active surveillance is increasingly used for low-risk and favorable intermediate-risk disease, thus mitigating the risks of overtreatment,” Gill said in the release.

More information

There’s more on prostate cancer screening at the U.S. National Cancer Institute.

SOURCE: University of Southern California, news release, March 14, 2022



There’s a secret weapon for dealing with something unexpected. And you might be used to thinking of it as something that would undermine you, not help you shine.

Just ask Wendy Berry Mendes, PhD. She’s the Sarlo/Ekman Professor of Emotion at the University of California, San Francisco. But earlier in her life, she was a ballerina who loved performing. While she was on stage, her body sent an extra boost to her muscles and brain, helping her dance better.

What’s the scientific name for this incredibly useful reaction? Stress.

“Not all stress is necessarily bad for you,” Mendes says. She studies how people can take advantage of its benefits — sometimes called “eustress” to differentiate it from debilitating “distress.”

Good Stress vs. Bad Stress

Although you’ve almost certainly heard about how stress can lead to heart disease, muscle pain, and assorted other ailments, there’s more to it than that.

At its simplest level, stress is a very basic process that occurs whenever you sense a change in demand, says Jeremy P. Jamieson, PhD, principal investigator at the University of Rochester Social Stress Lab.

“No one says they’re stressed when they’re excited,” Jamieson says, even though that rush is a form of stress, too.

All of those hormones that your body releases are meant to give you a burst of energy and make you more alert.

“If athletes were taking them, they’d be banned for a long time,” Jamieson says. “These responses evolved to help us survive. Otherwise, we wouldn’t have them.” As Mendes notes, cortisol has been demonized as “the stress hormone,” even though not having enough of it when you need it will make you sick.

Problems generally only occur when a stress reaction happens for no reason, starts too early, lingers longer than it’s supposed to, or never lets up at all. In these cases, stress can disrupt your sleep, digestion, and other bodily functions, and instead of expanding your blood vessels, it tightens them, Mendes says. Over time, that can lead to all kinds of health problems.

Of course, some things are beyond our control and can cause chronic distress. But with many other sources of stress, our reaction can make a difference. And that depends on our mindset and approach to a situation.

Putting Stress to the Test

Take, for example, an upcoming exam. It’s natural to feel your body prepare for this event with an elevated heart rate and sweaty palms, Mendes says. For a lot of people, those signs of stress kicking in trigger unnecessary distress. And that can make it harder to focus and answer questions.

But if you explain to test takers ahead of time that these are just physiological signs that they’re getting a performance boost, they’ll earn higher scores.

“Don’t deny the changes in your body. They help you,” Jamieson says. He’s done repeated studies showing the same result. His takeaway: “Don’t be afraid to lean into stress.”

Fear of stress can make people put off critical conversations, potentially rewarding experiences, and dreams they’d like to pursue. “To achieve and grow as a person, we need to do hard things,” Jamieson says. “New challenges and new opportunities, that’s stress.”

That’s the lesson that Michael Gray, 60, has been working on teaching himself and his students at Long Beach Polytechnic High School, just south of Los Angeles. About 8 years ago, the educator and counselor’s blood pressure spiked high enough that his doctor suggested medication.

“I was not dealing with life in a productive way,” says Gray, who dove into alternative options and discovered research on rethinking stress.

Soon, Gray got married, and took a year off of work to raise his new baby while his wife started her own business. “Who does that unless they’re willing to run toward a stressful situation? We looked at it like we were on an adventure,” Gray says. “It has freed me up exponentially.”

Reaping the Benefits of Good Stress

Practicing this approach to stress alongside academic skills is invaluable for young people, says Gray, who sees how much teens struggle with interactions with friends and family. Plus, it helps set them up for career and other successes. “You’ve got to meet deadlines and try things you’re not good at, like a foreign language,” he says.

For people accustomed to avoiding stress as much as possible, embracing its benefits can take time and effort. “I’m just barely getting better at it,” Gray admits. He gets daily practice while driving on the freeway in Southern California.

It’s an area worth continuing to focus on, especially as you get older, Mendes says. Although there hasn’t been much research done on the long-term impact of positive stress, what we know is encouraging.

“There is evidence that good stress is related to less accelerated brain aging,” Mendes says. So she recommends that after retirement, keep seeking out positive forms of stress by staying mentally, socially, and physically engaged.

Most important, Jamieson says, is to stop viewing all stress as distress. “People get nervous about experiencing stress and they try to avoid it. It doesn’t work out that way,” he says. “When you need to marshal these resources, it’s OK.” And it can even be great.



March 17, 2022 — Diseases that affect the nervous system can be some of the most difficult conditions for doctors to diagnose.

Many conditions can cause similar symptoms, but two people with the same condition could have different symptoms, which can make the cause of the symptoms hard to pinpoint. Delays in diagnosing the condition mean that people go longer without the treatment they need.

But now, a new DNA test is solving that problem for more than 50 genetic diseases that affect the nervous system.

The new test covers Huntington’s disease, Lou Gehrig’s disease, fragile X syndrome, epilepsy, and various other neurological diseases that are passed on genetically from parents to children.

These diseases are collectively known as short-tandem repeat expansion disorders, which means that very long DNA sequences that repeat over and over in a person’s genes are causing problems.

The new test uses a technique called nanopore sequencing, which scans a patient’s DNA looking for 37 genes known to be involved with short-tandem repeat expansion disorders. When the test spots the genes, it checks whether they’re part of these long, repetitive sequences and what those sequences are. This identifies what condition the person has.

Though none of these conditions has a cure, early diagnosis helps patients prepare for future symptoms and helps doctors manage complications.

Before this test, doctors and patients had to rely on less accurate tests.

The new approach costs less than $750 and uses technology about the size of a stapler. It can also identify new repetitive sequences, which could lead to discovering conditions we don’t yet know about.



March 16, 2022 — As the war in Ukraine enters its fourth week, the World Health Organization reports that 43 hospitals, clinics, and ambulances have been bombed inside the country thus far.

“We have never seen globally this rate of attacks on health care. Health is becoming a target in these situations. It’s becoming part of the strategy and tactics of war,” said Michael Ryan, MD, executive director of the WHO’s Health Emergencies Program.

Targeting health care facilities and workers is not only against international law, but parties involved in conflicts are required to intentionally avoid such targets, which is not happening in Ukraine, Ryan said at a news briefing Wednesday morning.

Overall health care capacity is dropping in the country as well due to the conflict. There are 22% fewer beds with oxygen available and 20% fewer beds for surgery and treating trauma patients countrywide since the beginning of the conflict, the WHO announced.

Adding to the challenge are the locations of Ukrainian hospitals and clinics, with about 300 health facilities now in Russian-controlled territory and another 600 within about 6 miles of a front line.

Reinforcements Are Ready

Twenty international medical teams are ready to go to Ukraine, but those plans are on hold for now, the WHO announced. In an official sense, the organization is waiting for a formal request from the Ukrainian Minister of Health.

In reality, it’s too dangerous at the moment.

“How can we put emergency medical teams on the ground in the very facilities that … are going to be attacked and going to be bombed and going to suffer catastrophic damage?’ Ryan asked. “How can you do that in all conscience?”

This issue goes beyond the destruction of brick-and-mortar facilities, Ryan said.

“This isn’t just about the destruction of buildings. This is about the destruction of hope. This is about taking away the very thing that gives people the reason to live — the fact that their families can be taken care of, that they can be cured if they’re sick, they can be treated if they’re injured.”

“This is the most basic of human rights.”

The WHO’s updates on health care in Ukraine come the same day that Ukrainian President Volodymyr Zelenskyy made a plea to the U.S. Congress for more military supplies and support.

The WHO said money also is needed to support the organization’s efforts to protect health care in Ukraine.

“We face financial constraints in our ability to deliver the support needed. So far, WHO has received just 8 million U.S. dollars of our appeal for 57.5 million dollars,” said Tedros Adhanom Ghebreyesus, PhD, the WHO director-general.

“Huge amounts of money are being spent on weapons. We ask donors to invest in ensuring that civilians in Ukraine and refugees receive the care they need,” Tedros said.

While supply lines for essential medicines and medical supplies are now established, making use of them remains difficult during the conflict, he said.

Specific Health Concerns

Ukraine already had a high number of people being treated for HIV and tuberculosis, said Adelheid Marschang, MD, senior emergency officer at the WHO Emergencies Program.

“If their treatment is interrupted and obviously worsens, the risk of transmission increases, as does risk of antimicrobial resistance of the diseases themselves,” she said.

There’s also a risk for children who cannot receive their vaccinations for rubella or measles in Ukraine, Marschang said. “There’s a risk of outbreaks.”

A lack of access to drinkable water in some parts of Ukraine is adding to the concerns, she said, because people now face the risk of dysentery and other waterborne illnesses.

A Global Call to End Conflicts

Although the world’s attention is on Ukraine, military conflicts in Yemen, Afghanistan, and Ethiopia are straining health care systems and creating shortages of medicine and food as well, the WHO reported.

Tedros called on parties involved in these conflicts to end their sieges and blockades. “This is the only solution.”

WebMD Health News


News briefing, World Health Organization, March 16, 2022.

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March 17, 2022 — Sleep experts tend to agree with U.S. lawmakers about getting rid of the twice-per-year time shift, with one exception: They typically call for standard time rather than daylight saving time.

After the Senate voted unanimously on Tuesday to make daylight saving time permanent, the American Academy of Sleep Medicine issued a statement that urged caution about adopting a fixed, year-round time with potential health risks.

“We do applaud stopping the switching during the course of the year and settling on a permanent time,” Jocelyn Cheng, MD, a member of the association’s public safety committee, told The Washington Post.

But “standard time, for so many scientific and circadian rationales and public health safety reasons, should really be what the permanent time is set to,” she said.

Now it’s up to the House of Representatives to decide what to do next. The legislation, which would take effect next year, must be passed by the House and signed by President Joe Biden before becoming a law.

Legislators and health experts have debated the shift in recent years. In 2020, the American Academy of Sleep Medicine released a position statement in the Journal of Clinical Sleep Medicine that recommended that the U.S. move to year-round standard time. Standard time is more aligned with humans’ circadian rhythms and natural light/dark cycles, the group wrote, and disrupting that rhythm has been linked to higher risks of heart disease, obesity, and depression.

At the same time, few studies have focused on the long-term effects of adopting daylight saving time. Most research has focused on the short-term risks of the seasonal shift, such as reduced sleep and increased car crashes, or circadian misalignment due to other things. Some health experts have called for more research before deciding on a permanent time, the newspaper reported.

Still, Tuesday’s statement from sleep experts received support from more than 20 groups, including the National Safety Council, National Parent Teacher Association, and the World Sleep Society.

“We have all enjoyed those summer evenings with seemingly endless dusks,” David Neubauer, MD, an associate professor of psychiatry and behavioral sciences at Johns Hopkins University, told the Post.

But daylight saving time “does not ‘save’ evening light at all, it simply steals it from the morning, when it is necessary to maintain our healthy biological rhythms,” he said.

Permanent daylight saving time would lead to more dark mornings, which opponents have said could be dangerous for kids going to school, adults driving to work, and overall sleep cycles.

“With daylight saving time, we are perpetually out of synchronization with our internal clocks, and we often achieve less nighttime sleep, both circumstances having negative health impacts,” Neubauer said. “Extra evening light suppresses the melatonin that should be preparing us for falling asleep. The later dawn during daylight saving time deprives our biological clocks of the critical light signal.”

The pros and cons of daylight saving time and standard time were debated during a hearing held by a House Energy and Commerce subcommittee last week. Sleep experts argued in favor of standard time, while other industry experts argued for daylight saving time to reduce crime, save energy, and help businesses that benefit from more daylight in the evenings.

“Everybody advocates a permanent time, but this difference between 1 hour back or 1 hour froward is not so clear in everybody’s mind,” Cheng said. “I would like to see further debate and some due diligence done on these health consequences and public safety measures before anything else goes forward.”



By Dan Weissmann

Wednesday, March 16, 2022 (Kaiser News) — Patients are no longer required to pay for out-of-network care given without their consent when they receive treatment at hospitals covered by their health insurance since a federal law took effect at the start of this year.

But the law’s protections against the infuriating, expensive scourge of surprise medical bills may be only as good as a patient’s knowledge — and ability to make sure those protections are enforced.

Here’s what you need to know.

Meet the No Surprises Act.

Studies have shown that about 1 in 5 emergency room visits result in a surprise bill.

Surprise bills frequently come from emergency room doctors and anesthesiologists, among others — specialists who are often outside a patient’s insurance network and not chosen by the patient.

Before the law took effect, the problem went something like this: Say you needed surgery. You picked an in-network hospital — that is, one that accepts your health plan and has negotiated prices with your insurer.

But one of the doctors who treated you didn’t take your insurance. SURPRISE! You got a big bill, separate from the bills from the hospital and other doctors. Your insurer didn’t cover much of it, if it didn’t deny the claim outright. You were expected to pay the balance.

The new law, known as the No Surprises Act, stipulates, in broad terms, that patients who seek care from an in-network hospital cannot be billed more than the negotiated, in-network rate for any out-of-network services they receive there.

Instead of leaving the patient with an unexpected bill that insurance will not cover, the law says, the insurance company and the health care provider must work out how the bill gets paid.

But the law builds in wiggle room for providers who wish to try end runs around the protections.

Caution: The law leaves out plenty of medical care.

The changes come with a lot of caveats.

Although the law’s protections apply to hospitals, they do not apply at many other places, like doctors’ offices, birthing centers, or most urgent care clinics. Air ambulances, often a source of exorbitant out-of-network bills, are covered by the law. But ground ambulances are not.

Patients need to keep their heads up to avoid the pitfalls that remain, said Patricia Kelmar, health care campaigns director for the nonprofit Public Interest Research Group, which lobbied for the law.

Say you go for your annual checkup, and your doctor wants to run tests. Conveniently, there’s a lab right down the hall.

But the lab may be out of network — despite sharing office space with your in-network doctor. Even with the new law in effect, that lab doesn’t have to warn you it is out of network.

Beware the “Surprise Billing Protection Form.”

Out-of-network providers may present patients with a form addressing their protections from unexpected bills, labeled “Surprise Billing Protection Form.”

Signing it waives those protections and instead consents to treatment at out-of-network rates.

“The form title should be something like the I’m Giving Away All of My Surprise Billing Protections When I Sign This Form, because that’s really what it is,” Kelmar said.

Your consent must be given at least 72 hours before receiving care — or, if the service is scheduled on the same day, at least three hours in advance. If you’ve waited weeks to book a procedure with a specialist, 72 hours may not feel like sufficient advance warning to allow you to cancel the procedure.

Among other things, the form should include a “good faith estimate” of what you’ll be charged. For nonemergency care, the form should include the names of in-network providers you could see instead.

It should also inform you of an unfortunate catch-22: The provider can refuse to treat you if you refuse to waive your protections.

It is against the law for some providers to give you this form at all. Those include emergency room doctors, anesthesiologists, radiologists, assistant surgeons, and hospitalists.

Keep your antennae up on costs. Many patients report they are merely handed an iPad for recording their signature in emergency rooms and doctors’ offices. Insist on seeing the form behind the signature so you know exactly what you are signing.

If you notice a problem, don’t sign, Kelmar said. But if you find yourself in a jam — say, because you get this form and urgently need care — there are ways you can fight back:

  • Write on the form that you are “signing under duress” and note the problem (e.g., “Emergency medicine facilities are not allowed to present this form”).
  • Take a picture of the form with your notes on it. Consider also shooting a video of yourself with the form, describing how it violates federal law.
  • Report it! There is a federal hotline (1-800-985-3059) and a website for reporting all violations of the new law barring surprise bills. Both the hotline and website help patients figure out what to do, as well as collect complaints.

Speaking of that “good faith estimate” …

The new “good faith estimate” benefit applies anywhere you receive medical care.

Once you book an appointment, the provider must give advance notice of what you could expect to pay without insurance (in other words, if you do not have insurance or choose not to use it). Your final bill may not exceed the estimate by more than $400 per provider.

Theoretically, this gives patients a chance to lower their costs by shopping around or choosing not to pay with insurance. It is particularly appealing for patients with high-deductible insurance plans, but not exclusively: The so-called cash price of care can be cheaper than paying with insurance.

Also: It wouldn’t hurt to ask if this is an all-inclusive price, not just a base price to which other incidental services may be added.

It is not enough to ask: “Do you take my insurance?”

It still falls to patients to determine whether medical care is covered. Before you find yourself in a treatment room, ask if the provider accepts your insurance — and be specific.

Kelmar said the question to ask is, “Are you in my insurance plan’s network?” Provide the plan name or group number on your insurance card.

The reality is, your insurance company — Blue Cross Blue Shield, Cigna, etc. — has a bunch of different plans, each with its own network. One network may cover a certain provider; another may not.

Keep an eye on your mailbox.

To make sure no one bills you more than expected, pay attention to your mail. Hospital visits, in particular, can generate lots of paperwork. Anything billed should be itemized on a statement from your insurer called an explanation of benefits, or EOB.

Notice anything off? Make some calls before you pay — to your insurer, to the provider, and, of course, to the new federal hotline: 1-800-985-3059.



March 17, 2022 — After several weeks of declines in new reported cases of COVID-19, the numbers are increasing globally once again, particularly in parts of Asia and Western Europe, the World Health Organization says.

“These increases are occurring despite reductions in testing in some countries, which means the cases we’re seeing are just the tip of the iceberg,” WHO Director-General Tedros Adhanom Ghebreyesus, PhD, said at a news briefing Wednesday.

As a result, local outbreaks and surges in COVID-19 cases are likely, “particularly in areas where measures to prevent transmission have been lifted,” he said.

And death rates remain high in many nations, particularly those with low levels of vaccination.

“Each country is facing a different situation with different challenges, but the pandemic is not over,” Tedros said.

“I repeat, the pandemic is not over.”

His statement comes amid a reported 46% increase in COVID-19 cases in the U.K. and a jump in case numbers in China. Around the globe, weekly COVID-19 cases are up 8%, the WHO announced, despite a significant reduction in testing for COVID-19.

Given these reports, “we need to be very cautious. We need to watch this very carefully, and we need to focus on getting the most vulnerable appropriately vaccinated,” said Michael Ryan, MD, executive director of the WHO Health Emergencies Program.

Pockets of Pandemic Possible

“This virus is still moving around quite easily. In the context of waning immunity and the fact that vaccines don’t work perfectly, the likelihood is that this virus will echo around the world,” Ryan said.

The coronavirus can persist for a long time, even in small communities, waiting for its next opportunity to spread.

“It will survive in those pockets for months and months until another pocket of susceptibility opens up,” Ryan said.

The COVID-19 Picture in Ukraine

Even as the conflict in Ukraine enters its fourth week, the COVID-19 surveillance and reporting system remains largely intact, said Adelheid Marschang, MD, the senior emergency officer for the WHO Health Emergencies Program.

“We see at the same time that the testing has decreased,” she said.
“Still, we have captured now, I think, something like more than 30,000 new cases.”

Recognizing Pandemic Fatigue

The things driving the global increases in case detection “are the same factors that have been driving transmission of this virus since the beginning of the pandemic,” said Maria Van Kerkhove, PhD.

“We completely understand that the world needs to move on from COVID-19. But this virus spreads very efficiently between people,” said Van Kerkhove, technical lead for COVID-19 response at the WHO and a Health Emergencies Program expert.

“If we don’t have the right interventions in place, the virus will take opportunities to continue to spread. And the more the virus spreads, the more opportunities it has to change.”


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