The Food and Drug Administration released new standards in March of 2023 in an effort to help more women detect breast cancer sooner. The FDA gave providers until Sept. 9, 2024 to comply with the new rule for them to include a note on mammogram reports noting if their patients have dense breasts.

“It’s really an opportunity to put the power back into the hands of the patients and letting them know what type of density they have,” Molly Guthrie, with the Susan G. Komen Breast Cancer Foundation, told News4.

About half of women over the age of 40 in the U.S. have dense breast tissue, which can make cancers more difficult to spot on a mammogram, the FDA said. Dense breasts have also been identified as a risk factor for developing breast cancer.

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D.C. resident Cheryl Shaw beat breast cancer in 2008, but said she never imagined it would come back 11 years later.

“As a mom, as a grandma, I want to be around for them,” Shaw said. “You know, I have a lot more to do in life. I’m not done.”

When her cancer came back, doctors didn’t discover it until it was already in stage 3, even though she’d had a mammogram just months before.

It wasn’t detected because Shaw has dense breasts with a lot of tissue. But she said doctors hadn’t warned her about her breast density.

“If we don’t know what’s going on with our bodies, if we don’t know what the cause is or we don’t know what to look for, we don’t know what questions to ask,” she said.

Those with dense breasts may need to get MRIs or ultrasounds, depending on other risk factors.

According to the Centers for Disease Control and Prevention, breast density can change over time.

Women are more likely to have dense breasts if they’re younger, have a lower body weight, and are pregnant or breastfeeding.

Shaw is now in remission. She works at the Smith Center for Healing and the Arts on U Street, helping give back to cancer patients and spreading awareness on the importance of screenings.

“Some people see cancer as something they don’t want to know about, and that if they find out about it, they’re no longer gonna be here. But the reality is, there’s so many survivors and I’m one of them,” she said.

Eli Lilly’s highly popular weight loss drug reduced the risk of developing Type 2 diabetes by 94% in obese or overweight adults with prediabetes compared with a placebo, according to initial results from a long-term study released Tuesday. 

The late-stage trial on tirzepatide, the active ingredient in the company’s weight loss injection Zepbound and diabetes drug Mounjaro, also found that patients experienced sustained weight loss over the roughly three-year treatment period. Adults on the highest weekly dose of the drug saw a 22.9% decrease in body weight on average after 176 weeks, compared with 2.1% for those who received a placebo. 

The results suggest that Eli Lilly’s treatment could meaningfully delay a potential diagnosis for people with prediabetes, or those with blood sugar levels that are higher than normal but not high enough to be classified as Type 2 diabetes. 

More than 1 in 3 Americans have prediabetes, according to the latest government data, which health experts say can be reversed with lifestyle changes such as diet and exercise. People who are overweight or have obesity are at a higher risk for prediabetes. 

The new data also shows the potential long-term health benefits of taking a buzzy class of obesity and diabetes medications called GLP-1s, which mimic hormones produced in the gut to tamp down appetite and regulate blood sugar. As Eli Lilly’s Zepbound and Mounjaro and injections from rival Novo Nordisk have skyrocketed in popularity over the last two years, the companies have raced to study other clinical uses for their drugs.

“Obesity is a chronic disease that puts nearly 900 million adults worldwide at an increased risk of other complications such as Type 2 diabetes,” Dr. Jeff Emmick, senior vice president of product development at Eli Lilly, said in a statement. “These data reinforce the potential clinical benefits of long-term therapy for people living with obesity and pre-diabetes.”

Eli Lilly tested tirzepatide in more than 1,000 adults over 176 weeks in the phase three trial, followed by a 17-week period where patients stopped treatment. It is the longest completed study on the drug to date, according to the company. 

The drugmaker will submit the latest results to a peer-reviewed journal and present them at an upcoming medical conference in November. Eli Lilly published 72-week weight loss results on a larger group of patients from the same trial, called SUMOUNT-1, back in 2022. 

Patients in the trial who stopped taking tirzepatide during the 17 weeks began to regain weight and saw an increase in progression to diabetes. But those participants still had an 88% lower risk of developing diabetes compared with a placebo, according to the latest phase three results.

The safety data on tirzepatide during the trial was consistent with previous studies on the drug, according to Eli Lilly. The most common side effects were gastrointestinal, such as diarrhea, nausea, constipation and vomiting, and were generally mild to moderate in severity.

Eli Lilly’s Zepbound works by imitating two naturally produced gut hormones called GLP-1 and GIP. 

GLP helps reduce food intake and appetite. GIP, which also suppresses appetite, may also improve how the body breaks down sugar and fat.

The FDA recently approved a new gene therapy treatment for those who suffer from the debilitating condition. 

Dave Robinson, a 61-year-old IT consultant from Falls Church, Virginia, was born with the rare genetic blood disorder caused by an insufficient level of a protein known as factor IX. 

That protein helps blood form clots to stop bleeding and seal wounds. Without it, hemophilia B patients bruise easily and bleed more frequently and for longer periods. 

“The biggest problems are caused by doing everyday things that will cause internal bleeding,” said Robinson. 

Due to his condition, Robinson would give himself an infusion at home every 10 days. Things changed when he enrolled in a clinical trial and received a single infusion of BEQVEZ, a new Pfizer drug.

BEQVEZ is a one-time treatment that helps patients produce their own factor IX protein to prevent and control bleeding. 

“It’s very exciting. This provides us with an additional tool to treat hemophilia. Not all patients will be candidates for gene therapy, but for those that are good candidates, this is another game changer in their lifetime quality and also their ability to assume normal lives,” said Dr. Craig  Kessler, a hematologist with MedStar Georgetown University Hospital. 

“We will have to monitor these patients for at least 15 years to know if there’s durability to the gene therapy,” he said. “There are others. About 15% of individuals who don’t respond adequately to the gene therapy and in the clinical trials had to go back to their clotting factor concentrate regiments.” 

Robinson took part in the trial seven years ago, eliminating his need for weekly infusions. 

“I’ve been able to avoid treating myself 271 times … That burden has been completely removed,” he said. 

Since the gene therapy, Robinson has pushed himself to walk 7,000 or 8,000 steps per day, and for the 7,000 Americans living with hemophilia B, that’s a huge accomplishment. 

BEQVEZ is approved for those over the age of 18 who meet certain criteria, but doctors still aren’t sure what the out-of-pocket cost will be for patients. 

The four medical schools are Charles R. Drew University of Medicine & Science, Howard University College of Medicine, Meharry Medical College and Morehouse School of Medicine.

The company will also provide seed funding to support the creation of Xavier Ochsner College of Medicine, a new medical school in New Orleans, Louisiana.

Howard University President Ben Vinson III said in the press release that the transformative gift will cultivate the next generation of health professionals and invest in the intergenerational wealth and health of medical students and the communities they serve.

“Endowment support has traditionally been an area of underinvestment for Historically Black Colleges and Universities, but today’s gift is an extraordinary vote of confidence in the lasting benefits of such support,” Vinson III said.

The donation is part of its Greenwood Initiative where its mission is to “advance racial wealth equity including addressing systemic underinvestment in Black institutions and communities,” according to the press release.

“We have much more to do to build a country where every person, regardless of race, has equal access to quality health care – and where students from all backgrounds can pursue their dreams,” said Michael R. Bloomberg, founder of Bloomberg Philanthropies and Bloomberg L.P. said in a press release.

In 2020, Bloomberg Philanthropies gave $100 million to the four historically Black medical schools and an additional $6 million in 2021 to help provide access to COVID-19 vaccines to their communities.

The four historically Black medical schools are reported to graduate around half of Black doctors in the U.S. but have significantly underfunded endowments as a result of systemic funding inequities including lower federal and state support, according to the press release.

Howard University College of Medicine, Meharry Medical College and Morehouse School of Medicine will each receive a gift of $175 million. Charles R. Drew University of Medicine & Science will receive $75 million.

The Xavier Ochsner College of Medicine, in partnership with Xavier University of Louisiana and Ochsner Health, will receive a $5 million grant.

“As the only HBCU medical school in the Gulf South, Xavier Ochsner College of Medicine will train physicians who reflect the diversity of the communities they serve and help address a critical healthcare shortage in the region,” said Xavier University of Louisiana President Dr. Reynold Verret in the press release.

Starting in the fall, the donation will cover full tuition for medical students from families earning less than $300,000. Living expenses and fees will be covered for students from families who earn up to $175,000.

Bloomberg Philanthropies said that currently almost two-thirds of all students seeking a doctor of medicine degree from Johns Hopkins qualify for financial aid, and 45% of the current class will also receive living expenses. The school estimates that graduates’ average total loans will decrease from $104,000 currently to $60,279 by 2029.

The gift will also increase financial aid for students at the university’s schools of nursing, public health, and other graduate schools.

“By reducing the financial barriers to these essential fields, we can free more students to pursue careers they’re passionate about – and enable them to serve more of the families and communities who need them the most,” Michael Bloomberg, founder of Bloomberg Philanthropies and Bloomberg LP, said in a statement on Monday. Bloomberg received a bachelor’s degree in electrical engineering from Johns Hopkins University in 1964.

The entire gift has been delivered to John Hopkins’ endowment and every penny will go directly to students, said Ron Daniels, president of Johns Hopkins University.

“Mike has really been moved by the challenges that the professions confronted during the course of the pandemic and the heroic efforts they’ve made to protecting and providing care to American citizens during the pandemic,” Daniels said in an interview. “I think he simply wanted to recognize the importance of these fields and provide this support to ensure that the best and brightest could attend medical school and the school of nursing and public health.”

Bloomberg Philanthropies previously gifted $1.8 billion to Johns Hopkins in 2018 to ensure that undergraduate students are accepted regardless of their family’s income.

Johns Hopkins will be the latest medical school to offer free tuition to most or all of their medical students.

In February Ruth Gottesman, a former professor at the Albert Einstein College of Medicine and the widow of a Wall Street investor, announced that she was donating $1 billion to the school. The gift meant that four-year students immediately received free tuition and all other students will be offered free tuition in the fall.

In 2018, Kenneth and Elaine Langone gave $100 million to the NYU Grossman School of Medicine to make tuition free for all current and future medical students through an endowment fund. The couple gave a second gift of $200 million in 2023 to the NYU Grossman Long Island School of Medicine to guarantee free tuition for all medical students. Kenneth Langone is a co-founder of Home Depot.

Other medical schools, like UCLA’s David Geffen School of Medicine, offer merit-based scholarships thanks to some $146 million in donations from the recording industry mogul, David Geffen. The Cleveland Clinic Lerner College of Medicine has also offered tuition-free education for medical students since 2008.

Candice Chen, associate professor, Milken Institute School of Public Health at The George Washington University, has researched the social missions of medical schools and had a strong reaction to the recent major gifts to John Hopkins, NYU and Albert Einstein.

“Collectively the medical schools right now, I hate to say this, but they’re failing in terms of producing primary care, mental health specialists as well as the doctors who will work in and serve in rural and underserved communities,” Chen said. She would have loved to see this gift go to Meharry Medical College in Tennessee, for example, which is a historically Black school that has produced many primary care doctors who work in communities that have shortages.

There have been only a handful of previous $1 billion donations to universities in the U.S., most coming in the past several years.

In 2022, the venture capitalist John Doerr and his wife, Ann, gave $1.1 billion to Stanford University for a new school focusing on climate change.

The small liberal arts school, McPherson College, in Kansas, has received two matching pledges since 2022 from an anonymous donor totaling $1 billion. The school, which has around 800 enrolled students, has a program for automotive restoration and is located about 57 miles north of Wichita, Kansas.

Bloomberg, the former New York mayor, gave $3 billion to charities in 2023, making him one of the largest donors, according to research by the Chronicle of Philanthropy.

But for patients in Maryland, there’s a program that can help, providing free medical equipment to those who need it.

In Brandywine, there’s a huge warehouse filled with refurbished wheelchairs, motorized beds and other items. It looks a little like a medical equipment superstore — and everything in the inventory is free to Maryland residents, through the state’s Durable Medical Equipment Reuse program.

“You can be insured or uninsured,” said Cherrell Keys, the program services coordinator. “The only real requirement is that you would have to be a Maryland resident.”

The equipment is collected through donations from people who no longer need it.

Rob Brilliante, for example, donated some crutches, saying “I hate to just throw them in the trash. It’s really great that we have a place like this.”

The equipment is then inspected and repaired. And the warehouse has pretty much everything.

All of the equipment is also cleaned and sterilized. News4 watched a wheelchair going through what the program calls the “hub scrub” machine. The chair was sprayed with disinfectant and rinsed, and then passed through a germ-killing UV light cycle.

“The basic equipment is what you’d see if you walked into a CVS or a Walgreens,” said Ian Edwards, the director of the program. “Like canes, crutches and walkers, and bathroom equipment like shower chairs. And transfer equipment and bedside commodes.”

“Then we have more advanced equipment like manual wheelchairs, power wheelchairs, scooters and home hospital beds and Hoyer lifts,” Edwards continued.

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To get the equipment, all a Maryland resident needs to do is fill out the online form, or call — though some of the more complex equipment will also need a sign-off from a healthcare provider.

The program is life-changing for some patients.

“I was essentially a quadriplegic at that time,” said Patrick O’Malley of his 105 days in the hospital and rehab, after a paralyzing accident in 2023.

O’Malley wasn’t allowed home until he had the necessary medical equipment.

“I didn’t have the money to buy the equipment, and insurance was not able to provide it,” O’Malley said. “I can only imagine that I would have been in the hospital for months longer, had this program not been available.

There’s equipment for all ages, including children, and the program is always looking for more donations.

If you want to contribute to the Maryland Durable Medical Equipment Reuse program, you can drop off medical equipment at donation centers around the state, including in Montgomery and Prince George’s counties.

Learn more about the program here.

Dr. Martin Forman previously worked at Reston Pediatrics. The Virginia Board of Medicine voted unanimously last month to suspend his medical license.

News4 spoke with three parents who say Dr. Forman allegedly touched either them or their children inappropriately.

One dad said the doctor allegedly squeezed his newborn’s nipple.

“He said that you can, quote, ‘milk a child,’ end quote,” the dad said. “And then he proceeded, without hesitation, to go squeeze my child’s nipple.”

The dad said at another appointment, Dr. Forman also allegedly kept touching the mom’s leg.

The family filed a complaint with the Virginia Board of Medicine.

“I just hope that this guy never practices medicine again, he’s never in a room with a child again or alone with any mothers and children again,” the dad said.

His family is one of four that have come forward in the past seven years accusing Dr. Forman of sexual misconduct.

The other three families have all sued the doctor and Reston Pediatrics for sexual battery.

“He kept touching her knee. And he was staring straight at her breasts,” one mom said of her teenage daughter.

The mom said the day after they saw Dr. Forman, he showed up uninvited at their house, hit the family dog, groped the teen and asked for her number. The mom said he then invited the teen to come home with him.

“I’m looking for knives in the kitchen, I’m looking like, do I go out the back door to go get help?” the mom said. “I didn’t feel safe for my life or my family’s life.”

Two years ago, a Loudoun County jury found Dr. Forman civilly liable for battery in that case and ordered him and the practice to pay more than one million dollars.

The other two lawsuits are still pending.

One was filed by a teen patient, who says the doctor allegedly groped her. The other suit was filed by a mom who said Dr. Forman allegedly straddled her with his legs and then rubbed against her with his private parts.

“I feel like it was very disturbing, and just even that word alone is not enough to describe how I was feeling,” that mom said.

Dr. Forman’s attorney sent News4 a statement that said, “[He] denies the allegations and will appear before the Board to present his side, and we are confident that after the Board hears his side, it will dismiss the cases.”

Dr. Forman’s attorney also said he retired last year with no intention of returning to practice.
The date for his board hearing has not yet been set.

The Federal Trade Commission on Tuesday sent warning letters to 10 drugmakers, taking issue with patents on popular drugs for weight loss, diabetes, asthma and other respiratory conditions. The letters allege that certain patents filed by Novo Nordisk, GlaxoSmithKline, AstraZeneca and seven other companies are inaccurate or misleading.

Brand-name drugmakers use patents to protect their medicines and stave off cheaper, generic medicines. Most blockbuster drugs are protected by dozens of patents covering various ingredients, manufacturing processes and intellectual property. Generic drugmakers can only launch their own cheaper versions if the patents have expired or are successfully challenged in court.

“By filing bogus patent listings, pharma companies block competition and inflate the cost of prescription drugs, forcing Americans to pay sky-high prices for medicines they rely on,” said FTC Chair Lina Khan, in a statement.

Ozempic is part of a class of drugs that were originally developed to treat diabetes but which have recently been approved to treat obesity, generating a surge in prescribing. Medicare spending on the drugs has also spiked in recent years.

The drug’s manufacturer, Novo Nordisk, declined to comment.

FTC’s latest announcement follows a similar action in September when regulators challenged more than 100 patents held by drugmakers, including Abbvie, AstraZeneca and Boehringer Ingelheim.

Companies receiving the letters have 30 days to withdraw or update their patent listings, or “certify under penalty of perjury” that they are legitimate, according to the FTC. The patents are registered with the Food and Drug Administration, which reviews and approves new drugs.

The patent challenges are part of a strategy by President Joe Biden to bring down drug prices, including allowing Medicare to negotiate with drugmakers and permitting states like Florida to import cheaper drugs from other countries.

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“I thought I didn’t have any, but I do,” Patricia Adams said. “I found a few and I am going to drive up there and I’m going to have those disposed of.”

Drug Take Back Day offers a chance for you to safely dispose of drugs you no longer need or that are expired — and it’s also an opportunity to help curb the opioid epidemic that’s claimed so many lives.

Adams, a retired social worker, knows firsthand about the dangers of having prescription medications in the home. Awhile back, her young 3- and 5-year-old nieces were visiting.

“And they came downstairs and said to me, ‘Oh, I have candy.’ And I thought, ‘I don’t have candy upstairs.’ And I said, ‘Let me see.’ And of course, it was a pill,” she said.

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Adams shared her story with Jean Moise of D.C.’s Department of Behavioral Health, who is helping to raise awareness about Drug Take Back Day.

“We have an opioid crisis out there right now,” Moise said. “This is one of our main harm reduction strategies. We want to make sure we get the drugs out of the home and out of the hands of youth and children or people that might be inclined to misuse them.”

Last year, on the 25th anniversary of Drug Take Back Day, nearly 600,000 pounds of drugs were collected across the country. In this region, that included:

• In Washington, D.C.: 602 pounds
• Delaware: 4,073 pounds
• Maryland: 10,599 pounds
• Virginia: 16,454
• West Virginia: 4,326 pounds

Adams is urging all her friends and neighbors to check their medicine cabinets like she did.

“Take the opportunity like I am,” she said. “Pay attention, because no matter who’s in your home, no matter how they are loved, you know, we know some of our family have addiction problems, and just pay attention and pass the word on so that they can participate.”

You can drop of any types of pills or liquid medications during Drug Take Back Day. You won’t be asked for ID. There are thousands of dropoff locations across the country Saturday in every state, with 17 locations in D.C.

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He promotes a $35 price cap for the medication for Americans on Medicare — in White House speeches, campaign stops and even at non-health care events around the country. His reelection team has flooded swing-state airwaves with ads mentioning it, in English and Spanish.

All that would seemingly add up to a sweeping political and economic impact. The reality is more complicated.

As his campaign tries to emphasize what it sees as an advantage over presumptive Republican nominee Donald Trump, Biden often overstates what those people who are eligible for the price cap once paid for insulin. It’s also not clear whether the number of Americans being helped will be enough to help sway November’s election, even in the most closely contested states that could come down to a few thousand votes.

“It is about political signaling in a campaign much more than it is about demonstrating for people that they benefit from the insulin cap,” said Drew Altman, president and CEO of KFF, a nonprofit that researches health care issues. “It is a way to make concrete the fact that you are the health care candidate.”

Many who are benefiting from the price cap were already getting insulin at reduced prices, were already Biden supporters, or both. Others who need reduced-price insulin, meanwhile, cannot get it because they do not have Medicare or private health insurance.

Biden’s campaign is emphasizing the president’s successful efforts to reduce insulin prices and contrasting that with Trump, who first ran for president promising to lower drug prices but took limited action in office.

“It’s a powerful and tangible contrast,” said Biden campaign spokesman Charles Lutvak. “And it’s one we are campaigning on early, aggressively, and across our coalition.”

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Roughly 8.4 million people in the United States control their blood sugar levels with insulin, and more than 1 million have Type 1 diabetes and could die without regular access to it. The White House says nearly 4 million older people qualify for the new, lower price.

The price cap for Medicare recipients was part of the Inflation Reduction Act, which originally sought to cap insulin at $35 for all those with health insurance. When it passed in 2022, it was scaled back by congressional Republicans to apply only to older adults.

The Biden administration has also announced agreements with drugmakers Sanofi, Novo Nordisk and Eli Lilly, to cap insulin co-payments at $35 for those with private insurance. They account for more than 90% of the U.S. insulin market.

But Biden says constantly that many people used to pay up to $400 monthly, which is an overstatement. A Department of Health and Human Services study released in December 2022 found that people with diabetes who were enrolled in Medicare or had private insurance paid an average of $452 annually, not monthly.

The high prices the president cites mostly affected people without health insurance. But the rates of the uninsured have fallen to record lows because of the Obama administration’s signature health care law and the Biden White House’s aggressive efforts to ensure those eligible to enroll are doing so more frequently.

So, in effect, one of the administration’s policy initiatives is undermining the economic argument for another.

That effort has not reached everyone, though.

Yanet Martinez who lives in Phoenix and supports Biden. She does not work or have health insurance, but gets insulin for around $16 per month thanks to steep discounts at her local clinic.

The lower prices only apply if her husband, a landscaper, does not make enough to exceed the monthly income limit. If he does, her insulin can jump to $500-plus, she said.

“I’ve heard people talk about the price of insulin going down. I’ve not seen it,” said Martinez, 42. “It should be uniform. There are a lot of people who don’t have any way to afford it and it makes things very difficult.”

Sen. Raphael Warnock, D-Ga., is sponsoring bipartisan legislation to make the $35 insulin cap universal, even for people without health insurance. In the meantime, he said, what’s been accomplished with Medicare recipients and drugmakers agreeing to reduce their prices is “literally saving lives and saving people money.”

“This is good policy because it centers the people rather than the politics,” Warnock said. He said that as he travels Georgia, a pivotal swing state in November, people say “thank you for doing this for me, or for someone in my family.”

That includes people like Tommy Marshall, a 56-year-old financial services consultant in Atlanta, who has health insurance. He was diagnosed with Type 1 diabetes at age 45 and injects fast-acting insulin several times daily. He paid about $250 for four weeks to eight weeks worth of medication last November, but saw the price fall by half in February, after Novo Nordisk agreed to cut prices.

“If I was his political consultant, I’d be telling (Biden) to talk about it constantly,” said Marshall, a lifelong Democrat and longtime public advocate for cutting insulin prices, including for the advocacy group Protect Our Care Georgia.

Marshall said the price caps “have meaningful emotional resonance” and could sway a close election but also conceded, “You’re talking about 18- to 65-year-olds. I can just imagine there’s probably two or three other issues that are in front of this one.”

“Maybe someone sort of on-the-fence, he added “this could maybe sway them.”

Geoff Garin, a pollster for Biden’s reelection campaign, said the insulin cap is one of the president’s highest performing issues. He said the data was “clear, consistent and overwhelming.”

Rich Fiesta, executive director of the Alliance for Retired Americans, which has endorsed Biden, called the insulin cap a strong issue for the president among older voters.

“For the persuadables — and there are some still out there, believe it or not — drug costs are a very important factor,” said Fiesta, whose group has 4.4-million members and advocates for health and economic security for older people.

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Trump’s campaign did not respond to questions. But Theo Merkel, senior fellow at the conservative Paragon Health Institute, countered that the insulin price cut an example of “policies written to fit the talking points other than the other way around.”

Merkel, who was a Trump White House adviser on health policy, said manufacturers that have long made insulin prefer caps on how much the insured pay because it gives them more leverage to secure higher prices from insurance companies.

The president’s approval ratings on health care are among his highest on a range of issues, but still only 42% of U.S. adults approve of Biden’s handling of health care while 55% disapprove, according to a February poll from The Associated Press and the NORC Center for Public Affairs Research.

KFF found in its own poll in December that that 59% of U.S. adults trust the Democratic Party to do a better job addressing health care affordability issues compared to 39% for Republicans, even if only 26% of respondents in the same poll said they knew about the insulin price cap.

“In political terms, the Democrats and Biden have an advantage on health care,” Altman said. “They’re pressing it.”

“Your health is one of your most important assets, and it should be prioritized in a way that makes you feel comfortable,” says Dr. LaTasha Seliby Perkins who is a family physician at Georgetown University.

There are some pretty straightforward ways to determine if you should stick with your current care provider or start searching for a new one.

Here are three signs that Seliby Perkins says means you should consider switching your doctor.

3 signs that it’s time to break up with your doctor

1. Your doctor isn’t asking the right questions: When you come to your doctor with a health concern and they don’t inquire about your symptoms or ask for further information, that’s not a good sign, Seliby Perkins says.
2. You don’t feel heard: “You should feel that your doctor is listening to you,” she says. “At the end of the day, you [should] feel heard. Feeling heard is very important.”
3. You’re receiving treatment for a curable diagnosis but aren’t getting better: It can be a red flag if “you’ve gotten a diagnosis that sounds right, and you’re treating it but it’s not getting better,” Seliby Perkins says. Sometimes it’s a matter of getting a second opinion or seeing a specialist, but your doctor should support you in that process.

How can you find the right doctor for you?

If you’re experiencing any of the above signs, then it’s probably time for you to get a new doctor. Here’s how you should go about the process, according to Seliby Perkins:

• Learn what your insurance is and see if the doctors you’re considering accept it
• Inquire about if the doctor you’re eying is in your network
• Ask your primary care doctor for recommendations if you’re looking for a specialist
• Look into the doctors’ online ratings and reviews
• Research where their clinics are to be sure you’re choosing a physician who’s a convenient distance from you
• Find out if they offer telemedicine appointments if that’s a need
• Think about if having a doctor that looks like you (based on gender, race or other factors) matters

“Once those boxes are checked, go to your first appointment, meet them and make sure that it’s a good fit for you,” she says.

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But a sweeping ruling in Alabama over frozen embryos could affect the future of IVF throughout the nation. That ruling says that frozen embryos are people, and those who destroy them can be held liable.

When Anistie Held was diagnosed with stage 3 breast cancer, doctors told her she needed chemo to save her life — but the treatment would also make her unable to conceive. The American Cancer Society says certain surgeries and treatments can cause infertility in about two-thirds of all young patients.

“I always wanted to be a mom,” said Held, who now lives in Springfield, Virginia. “I wanted to have multiple kids. And cancer took that away from me, initially, I thought.”

Living in Florida at the time, Held froze her eggs at a nearby clinic in Alabama. She and her then-fiancée had to cancel their wedding plans to afford it. They eloped on the beach instead.

This all happened as she prepared to start chemo and battle cancer.

“It is the most traumatizing thing a person can go through, and I’m sure other cancer patients can understand,” she said.

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‘The chilling effect of this decision’

Held has now finished treatment and is cancer free. She and her husband moved to Northern Virginia after Roe vs. Wade was overturned.

“We heard about that news. I was like, ‘IVF is gonna be next; I just know it,'” she said.

In the wake of the Alabama ruling, several fertility clinics there have already paused IVF treatments. The clinic where Held went is among them.

“They said they paused all their IVF treatments. So I’m so glad that I did decide to move, but I know that other people aren’t as lucky to do so,” she said. “So my heart breaks for them.”

But Held faces another challenge: getting her eggs out of Alabama. She’s trying to hire a service to help.

“I’m an IVF baby as well, so it’s passionate for me. My parents tried so hard to have me, and they explained that to me every day of my life,” she said.

If Held is able to get her eggs, she and her husband hope to start IVF later this year.

The American Cancer Society issued a statement about the Alabama ruling, saying it’s “concerned about the chilling effect of this decision on access to care and fertility services for cancer patients.”

The U.S. Food and Drug Administration said in a notice published last week that Azurity Pharmaceuticals is recalling one lot of Zenzedi 30-milligram dextroamphetamine sulfate tablets.

The move comes after a pharmacist in Nebraska found carbinoxamine maleate tablets, an antihistamine drug, inside a bottle of Zenzedi tablets. 

Zenzedi is a stimulant prescription medicine often used to treat ADHD and narcolepsy by increasing attention and decreasing impulsiveness, according to the National Institute of Health. Carbinoxamine maleate has sedative and drying properties, and is often used to treat seasonal allergies, meaning the two drugs have opposing reactions. 

“Patients who take carbinoxamine instead of Zenzedi will experience undertreatment of their symptoms, which may result in functional impairment and an increased risk of accidents or injury,” the FDA said.

Adverse effects include drowsiness, sleepiness and other serious conditions including thyroid disorder.

The recalled medication has a lot number F230169A with an expiration date of June 2025. It was shipped to wholesales nationwide between Aug. 23 and Nov. 29, 2023.

The impacted tablets are light yellow and have a hexagonal shape with “30” embossed on one side and “MIA” embossed on the other. They come in a white bottle with black lettering. Carbinomaxine Maleate tablets have “GL” imprinted on one side and “211” on the other. 

Massachusetts-based Azurity said it has not received any reports of adverse events related to the mishap.

According to the FDA, consumers should contact their doctor or healthcare provider if they’ve experienced any problems related to taking the recalled medication. Any adverse reactions could also be reported to Azurity by emailing aereports@azurity.com. 

Local hospitals have seen so many cases that, as of Friday, a major health system is bringing back mandatory masking in its Maryland facilities.

Johns Hopkins Medicine is once again requiring patients, visitors and employees to wear masks in its buildings, according to an email sent to patients.

“It’s not surprising that we have to go back to wearing masks in the hospitals, because so many people are sick,” said Dr. Elena Rios, President and CEO of the National Hispanic Medical Association.

According to Rios, the new, more contagious JN.1 variant of COVID-19 is keeping healthcare professionals on their toes and hospital beds full.

But it’s not just COVID that’s causing concern.

“What’s being called a trifecta of, not only COVID-19, but influenza and RSV,” Rios said. “And it’s increased so much that there’s been more hospitalizations.”

That’s why the experts are sending out a reminder about getting your annual COVID, flu, and RSV vaccines if you qualify.

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Those on the front lines say there’s no time to waste.

“Masks are our friends,” said allergist and immunologist Dr. Juanita Mora

Because of the JN.1 variant, many people may not realize they have COVID. So when it comes to testing, it’s better to be safe than sorry.

“It presents with a sore throat, nasal congestion, and maybe a cough and body aches,” Mora said. “It sounds like a common cold, which means our threshold for doing a rapid COVID-19 test should be low.”

Johns Hopkins Medical says it expects the mask requirement to be temporary, while cases are elevated.

Experts say if you’re vulnerable to illness, wear a mask anytime you’re around large groups of people.

Ozempic, Wegovy and similar drugs have been in short supply over the past year as demand has grown.

For those who do manage to find them, the drugs aren’t cheap. They typically cost more than $1,000 a month without insurance.

Between high costs and and nationwide shortages, many have turned to knockoff versions.

Searches for “Ozempic dupe” have skyrocketed by 373% in the past year, according to Kaly.com, and #Ozempic has gained 1.3 billion views on social media platforms like TikTok.

Some compounding pharmacies, which mix and alter drug ingredients to create custom medications for patients, are offering copycat injections at a fraction of the cost. They’re about $100 to $200 for a month’s supply, but the Food and Drug Administration hasn’t approved the medications.

The FDA told News4 it’s monitoring the internet for fraudulent or unapproved products and has issued warning letters to pharmacies to stop the distribution of illegally marketed semaglutide – the active ingredient in both Wegovy and Ozempic.

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“No one knows exactly what it is and no one knows where it’s coming from So it’s actually pretty dangerous,” said Dr. Domenica Rubino with the Washington Center for Weight Management and Research in Arlington, Virginia.

Rubino said the copycat versions of semaglutide are often mixed with vitamins or other ingredients that haven’t been tested and might not be safe.

Regulators are also sounding the alarm. Four states, including West Virginia, Louisiana, Mississippi and North Carolina, are threatening legal action over safety concerns, saying it’s almost impossible for compounding pharmacies to replicate weight loss drugs on the market.

That’s because there are no FDA-approved generic versions of Wegovy or Ozempic, and drug maker Novo Nordisk said it doesn’t supply its ingredients to others.

“You have to understand that there’s a desperateness,” Rubino said.

Despite the risk, News4 found dozens of companies selling semaglutide on social media platforms, some promising overnight delivery of vials with liquid that patients are told to inject weekly.

Several websites even offer telehealth visits in which people can get the medications without ever seeing a provider on video or in person.

“This is about health. It’s not about weight loss. It’s not about fitting into your designer dress — and I can’t stress that enough,” Rubinio said.

Patients who are considering taking weight loss medication should always consult with a doctor or health care provider.

Doctors said it’s also important for people to do their research before taking the medications and understand the potential side effects, which can include nausea and vomiting to changes in vision and kidney problems. In serious cases, Ozempic and Wegovy could cause intestinal blockages, according to the drug’s warning label.

The 67-year-old from Nashville, Tennessee, could not afford to see a dentist on the $1,300-a-month his family gets in Social Security and disability payments. So he waited for the state to roll out a program this year that offers dental care to the more than 650,000 Medicaid recipients like him who are 21 and older. Tennessee is spending about $75 million annually on the program.

“Man, I thought I had made it to heaven because the pain was over,” he said after the tooth was pulled in July at the Meharry Medical College School of Dentistry. “When they did pull it out, I was so happy. I was so glad. Everything just changed after that.”

His wife, Cindy, who also is on Medicaid, has had her teeth pulled at the clinic.

Medicaid, the federal and state health insurance program for the poor, requires states to provide dental coverage for children but not adults. But with a growing recognition of the economic and health costs of poor dental health and an influx of federal pandemic dollars, six states began or expanded their Medicaid programs this year to provide coverage for adults.

Access remains difficult in many of those states with some dentists refusing to treat Medicaid patients. Even those who want to expand their practice are finding themselves caught up in red tape.

Dr. Victor Wu, the chief medical officer for Tennessee’s Medicaid program, said he was pleased with the rollout of Medicaid dental benefits that started in January, but he acknowledges the state needs to build out its network and increase the participation rate among dentists.

While dental care often is seen as routine, the poor often go without any care for years or even decades. Doing so has significant costs, both to taxpayers and to those who cannot afford treatment.

One study from Texas A&M University found that treatment for preventable dental conditions represents up to 2.5% of emergency room visits, at a cost of $2 billion a year. An additional $45 billion is lost year in productivity in the United States annually from untreated oral disease, according to the federal Centers for Disease Control and Prevention.

“You put off care and you get sicker and then it becomes a crisis where you’re missing work or you end up going to the emergency department where you get a big bill and you don’t get the tooth actually taken care of,” said Dr. Rhonda Switzer-Nadasdi, the chief executive officer of Interfaith Dental Clinic which has offices in Nashville and Murfreesboro, Tennessee.

“You need good teeth to have good employment,” Switzer-Nadasdi said.

All states provide some Medicaid dental benefits for adults, but some limit it to only specific segments of the population, like pregnant women or those who have intellectual disabilities, or cover only emergency care, according to CareQuest Institute for Oral Health, a nonprofit that advocates for expanded dental care.

Hawaii, Tennessee, Kentucky, Michigan, Maryland and New Hampshire were the latest to begin or expand their dental coverage; they did so this year.

In New Hampshire, the state is spending $33.4 million over 12 months to provide dental care to its 88,000 Medicaid recipients.

“There is an increasing understanding that oral health is inseparable from health care,” said New Hampshire Democratic Rep. Joe Schapiro, who was the prime sponsor of the expanded dental benefits bill. “The amount of money spent on other health care problems that are related to oral health and the amount of money spent on emergency care when people can’t get any kind of preventive or restorative care is not only unfortunate for those people’s health but cost a tremendous amount of money.”

In Kentucky, Democratic Gov. Andy Beshear pressed ahead with emergency regulations ensuring that about 900,000 Kentuckians would continue having access to dental care after the Republican-led legislature rejected his proposal.

“We are focused on removing roadblocks that prevent people from getting back into the workforce, and this program does just that,” he said.

Virginia expanded its Medicaid program in 2021, budgeting $282 million for the 2022 and 2023 fiscal years to cover dental procedures for more than a million recipients. Last year, Kansas gave dental access to nearly 137,000 Medicaid recipients at a cost of $3.5 million in 2022 and $1.2 million in 2023.

While advocates are welcoming these changes, Texas, Alabama, Mississippi, Utah and Louisiana still only offer limited benefits.

Even as states add dental coverage, millions of beneficiaries are being culled from the Medicaid program nationwide as part of a review of eligibility, something states were prohibited from doing during the pandemic.

There are also plenty of hiccups in states that have expanded care, including Tennessee. Among the biggest is that too few dentists, especially in rural areas, are taking Medicaid patients, resulting in long waiting times and hours-long drives in search of care. Only about 15% of dentist take Medicaid in New Hampshire, 24% in Tennessee and 27% in Virginia.

Many dentists and groups advocating for expanded care blame Medicaid reimbursement rates. New Jersey only covers 13.3% of what a dentists normally charge, Michigan covers 17% and Rhode Island 22.4%, according to 2022 data analyzed by the American Dental Association. Illinois, New York, Ohio and Oregon each cover a little more than 28%.

Most states, though, cover between 30% and 50% with Alaska and North Dakota covering at least 55% and Delaware, 76.9%.

Dr. Heather Taylor, an assistant professor at the Richard M. Fairbanks School of Public Health at Indiana University, said some of Indiana’s Medicaid reimbursement rates for dental have not increased since 1998.

“It’s almost like we’re incentivizing our dentists not to treat the ones that are in need, because we don’t pay them even half of what they could get from private insurers,” she said.

Tennessee Family Dental, which has four clinics in the state, has experienced overwhelming demand from Medicaid patients. Dr. Ryan O’Neill, a dentist who owns the business, said he got some 300 calls on the first day and that some of his patients have traveled from 30 minutes away or more.

He wants to hire more dentists but said it can take upward of four months to get one certified under Medicaid. He also is struggling with a Medicaid billing system that routinely rejects some claims and he said there is “a lot of inconsistency over what is approved and what is denied.”

“Offices are hesitant to go in network because there’s a lot of unknowns,” O’Neill said. “We’re still learning what the rules are and, you know, trial and error in terms of how we’re supposed to deal with a particular situation.”

Danielle Wilkes, a 26-year-old mother of five from Ashland, Tennessee, drove 90 minutes to see O’Neill after calling dozens of dentists in her area and finding none who takes Medicaid. Her cousin, June Renee Pentecost, also came with her for treatment.

For the past five years, Wilkes had been waiting to see a dentist after getting several teeth knocked out in a car wreck. She was told it would cost her thousands of dollars for multiple crowns, which she could not afford.

“I was mad at first but I was like there nothing she could do. I’m just going to have to wait until my kids are grown up,” she said, adding that the pain often brought her to tears.

But here she was in a dental chair, her pink hair standing out against O’Neill and dental assistant Jasmine Webb in black scrubs. Afterward, the soft-spoken Wilkes said she was “just happy” to finally get the work done, even if she had to pay $400 that Medicaid did not cover.

In a different room, Pentecost was getting examined for a root canal. It had been more than a decade since she last saw a dentist because she was deterred by the cost despite years of pain. A mother of five, she figured dental care would take away from spending on her children.

“I couldn’t play with my kids because my head was hurting,” she said.

The 30-year-old was relieved to get the work done but wondered why the state had not offered the benefit sooner.

“I’m hoping my pain would ease up and quit once I get my teeth fixed and then I won’t have so many headaches and feel so bad,” she said.

___

Associated Press writer Bruce Schreiner in Frankfort, Kentucky, contributed to this report.

.

The Food and Drug Administration released new standards in March of 2023 in an effort to help more women detect breast cancer sooner. The FDA gave providers until Sept. 9, 2024 to comply with the new rule for them to include a note on mammogram reports noting if their patients have dense breasts.

“It’s really an opportunity to put the power back into the hands of the patients and letting them know what type of density they have,” Molly Guthrie, with the Susan G. Komen Breast Cancer Foundation, told News4.

About half of women over the age of 40 in the U.S. have dense breast tissue, which can make cancers more difficult to spot on a mammogram, the FDA said. Dense breasts have also been identified as a risk factor for developing breast cancer.

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D.C. resident Cheryl Shaw beat breast cancer in 2008, but said she never imagined it would come back 11 years later.

“As a mom, as a grandma, I want to be around for them,” Shaw said. “You know, I have a lot more to do in life. I’m not done.”

When her cancer came back, doctors didn’t discover it until it was already in stage 3, even though she’d had a mammogram just months before.

It wasn’t detected because Shaw has dense breasts with a lot of tissue. But she said doctors hadn’t warned her about her breast density.

“If we don’t know what’s going on with our bodies, if we don’t know what the cause is or we don’t know what to look for, we don’t know what questions to ask,” she said.

Those with dense breasts may need to get MRIs or ultrasounds, depending on other risk factors.

According to the Centers for Disease Control and Prevention, breast density can change over time.

Women are more likely to have dense breasts if they’re younger, have a lower body weight, and are pregnant or breastfeeding.

Shaw is now in remission. She works at the Smith Center for Healing and the Arts on U Street, helping give back to cancer patients and spreading awareness on the importance of screenings.

“Some people see cancer as something they don’t want to know about, and that if they find out about it, they’re no longer gonna be here. But the reality is, there’s so many survivors and I’m one of them,” she said.

The unnamed woman, who is in her 20s, underwent the procedure in 2020 due to complications with her pregnancy and the patient’s “elevated maternal body mass,” according to the report, which was released on Monday by New Zealand’s Health and Disability Commissioner, Morag McDowell.

The woman complained of severe chronic pain for months after the birth of her child, and doctors eventually discovered that an Alexis wound retractor — a round, soft tubular device used to draw back the edges of a wound during surgery — had been accidentally left inside her during the operation.

Read more at NBCNews.com.

Surgeon Hari Priya Bandi was performing a biopsy through a hole in the 64-year-old patient’s skull at Canberra Hospital last year when she used forceps to pull out the parasite, which measured 8 centimeters, or 3 inches.

“I just thought: ‘What is that? It doesn’t make any sense. But it’s alive and moving,’” Bandi was quoted Tuesday in The Canberra Times newspaper.

“It continued to move with vigor. We all felt a bit sick,” Bandi added of her operating team.

The creature was the larva of an Australian native roundworm not previously known to be a human parasite, named Ophidascaris robertsi. The worms are commonly found in carpet pythons.

Bandi and Canberra infectious diseases physician Sanjaya Senanayake are authors of an article about the extraordinary medical case published in the latest edition of the journal Emerging Infectious Diseases.

Senanayake said he was on duty at the hospital in June last year when the worm was found.

“I got a call saying: ‘We’ve got a patient with an infection problem. We’ve just removed a live worm from this patient’s brain,’” Senanayake told Australian Broadcasting Corp.

The woman had been admitted to the hospital after experiencing forgetfulness and worsening depression over three months. Scans showed changes in her brain.

A year earlier, she had been admitted to her local hospital in southeast New South Wales state with symptoms including abdominal pain, diarrhea, a dry cough and night sweats.

Senanayake said the brain biopsy was expected to reveal a cancer or an abscess.

“This patient had been treated … for what was a mystery illness that we thought ultimately was a immunological condition because we hadn’t been able to find a parasite before and then out of nowhere, this big lump appeared in the frontal part of her brain,” Senanayake said.

“Suddenly, with her (Bandi’s) forceps, she’s picking up this thing that’s wriggling. She and everyone in that operating theater were absolutely stunned,” Senanayake added.

Six months after the worm was removed, the patient’s neuropsychiatric symptoms had improved but persisted, the journal article said.

She had returned home but remains under medical observation. Details of her current condition have not been made public.

The worms’ eggs are commonly shed in snake droppings which contaminate grass eaten by small mammals. The life cycle continues as other snakes eat the mammals.

The woman lives near a carpet python habitat and forages for native vegetation called warrigal greens to cook.

While she had no direct contact with snakes, scientists hypothesize that she consumed the eggs from the vegetation or her contaminated hands.

Scientists around the country are racing to learn how to use animal organs to save human lives, and bodies donated for research offer a remarkable rehearsal.

The latest experiment announced Wednesday by NYU Langone Health marks the longest a pig kidney has functioned in a person, albeit a deceased one -– and it’s not over. Researchers are set to track the kidney’s performance for a second month.

“Is this organ really going to work like a human organ? So far it’s looking like it is,” Dr. Robert Montgomery, director of NYU Langone’s transplant institute, told The Associated Press.

“It looks even better than a human kidney,” Montgomery said on July 14 as he replaced a deceased man’s own kidneys with a single kidney from a genetically modified pig — and watched it immediately start producing urine.

The possibility that pig kidneys might one day help ease a dire shortage of transplantable organs persuaded the family of Maurice “Mo” Miller from upstate New York to donate his body for the experiment. He’d died suddenly at 57 with a previously undiagnosed brain cancer, ruling out routine organ donation.

“I struggled with it,” his sister, Mary Miller-Duffy, told the AP about her decision. But he liked helping others and “I think this is what my brother would want. So I offered my brother to them.”

“He’s going to be in the medical books, and he will live on forever,” she added.

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Attempts at animal-to-human transplants, or xenotransplantation, have failed for decades as people’s immune systems attacked the foreign tissue. Now researchers are using pigs genetically modified so their organs better match human bodies.

Last year with special permission from regulators, University of Maryland surgeons transplanted a gene-edited pig heart into a dying man who was out of other options. He survived only two months before the organ failed for reasons that aren’t fully understood but that offer lessons for future attempts.

Next, rather than last-ditch efforts, the Food and Drug Administration is considering whether to allow some small but rigorous studies of pig heart or kidney transplants in volunteer patients.

The NYU experiment is one of a string of developments aimed at speeding the start of such clinical trials. Also Wednesday, the University of Alabama at Birmingham reported another important success — a pair of pig kidneys worked normally inside another donated body for seven days.

Kidneys don’t just make urine — they provide a wide range of jobs in the body. In the journal JAMA Surgery, UAB transplant surgeon Dr. Jayme Locke reported lab tests documenting the gene-modified pig organs’ performance. She said the weeklong experiment demonstrates they can “provide life-sustaining kidney function.”

These kinds of experiments are critical to answer remaining questions “in a setting where we’re not putting someone’s life in jeopardy,” said Montgomery, the NYU kidney transplant surgeon who also received his own heart transplant — and is acutely aware of the need for a new source of organs.

More than 100,000 patients are on the nation’s transplant list and thousands die each year waiting.

Maryland’s Dr. Muhammad Mohiuddin cautions that it’s not clear how closely a deceased body will mimic a live patient’s reactions to a pig organ. But he said the research educates the public about xenotransplantation so “people will not be shocked” when it’s time to try again in the living.

Previously, NYU and a team at the University of Alabama at Birmingham had tested pig kidney transplants in deceased recipients for just two or three days. An NYU team also had transplanted pig hearts into donated bodies for three days of intense testing.

But how do pig organs react to a more common human immune attack that takes about a month to form? Only longer testing might tell.

The surgery itself isn’t that different from thousands he’s performed “but somewhere in the back of your mind is the enormity of what you’re doing … recognizing that this could have a huge impact on the future of transplantation,” Montgomery said.

The operation took careful timing. Early that morning Drs. Adam Griesemer and Jeffrey Stern flew hundreds of miles to a facility where Virginia-based Revivicor Inc. houses genetically modified pigs — and retrieved kidneys lacking a gene that would trigger immediate destruction by the human immune system.

As they raced back to NYU, Montgomery was removing both kidneys from the donated body so there’d be no doubt if the soon-to-arrive pig version was working. One pig kidney was transplanted, the other stored for comparison when the experiment ends.

One other trick: Surgeons attached the pig’s thymus to the transplanted kidney in hopes that the gland, which helps train immune cells, would increase human tolerance of the organ. Otherwise, the team is relying on standard immune-suppressing drugs used by today’s transplant patients.

“You’re always nervous,” Griesemer said. To see it so rapidly kickstart, “there was a lot of thrill and lot of sense of relief.”

How long should these experiments last? Alabama’s Locke said that’s not clear -– and among the ethical questions are how long a family is comfortable or whether it’s adding to their grief. Because maintaining a brain-dead person on a ventilator is difficult, it’s also dependent on how stable the donated body is.

In her own experiment, the donated body was stable enough that if the study wasn’t required to end after a week, “I think we could have gone much longer, which I think offers great hope,” she said.

AP video journalist Shelby Lum contributed to this report.

The Food and Drug Administration released new standards in March of 2023 in an effort to help more women detect breast cancer sooner. The FDA gave providers until Sept. 9, 2024 to comply with the new rule for them to include a note on mammogram reports noting if their patients have dense breasts.

“It’s really an opportunity to put the power back into the hands of the patients and letting them know what type of density they have,” Molly Guthrie, with the Susan G. Komen Breast Cancer Foundation, told News4.

About half of women over the age of 40 in the U.S. have dense breast tissue, which can make cancers more difficult to spot on a mammogram, the FDA said. Dense breasts have also been identified as a risk factor for developing breast cancer.

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D.C. resident Cheryl Shaw beat breast cancer in 2008, but said she never imagined it would come back 11 years later.

“As a mom, as a grandma, I want to be around for them,” Shaw said. “You know, I have a lot more to do in life. I’m not done.”

When her cancer came back, doctors didn’t discover it until it was already in stage 3, even though she’d had a mammogram just months before.

It wasn’t detected because Shaw has dense breasts with a lot of tissue. But she said doctors hadn’t warned her about her breast density.

“If we don’t know what’s going on with our bodies, if we don’t know what the cause is or we don’t know what to look for, we don’t know what questions to ask,” she said.

Those with dense breasts may need to get MRIs or ultrasounds, depending on other risk factors.

According to the Centers for Disease Control and Prevention, breast density can change over time.

Women are more likely to have dense breasts if they’re younger, have a lower body weight, and are pregnant or breastfeeding.

Shaw is now in remission. She works at the Smith Center for Healing and the Arts on U Street, helping give back to cancer patients and spreading awareness on the importance of screenings.

“Some people see cancer as something they don’t want to know about, and that if they find out about it, they’re no longer gonna be here. But the reality is, there’s so many survivors and I’m one of them,” she said.

The Food and Drug Administration released new standards in March of 2023 in an effort to help more women detect breast cancer sooner. The FDA gave providers until Sept. 9, 2024 to comply with the new rule for them to include a note on mammogram reports noting if their patients have dense breasts.

“It’s really an opportunity to put the power back into the hands of the patients and letting them know what type of density they have,” Molly Guthrie, with the Susan G. Komen Breast Cancer Foundation, told News4.

About half of women over the age of 40 in the U.S. have dense breast tissue, which can make cancers more difficult to spot on a mammogram, the FDA said. Dense breasts have also been identified as a risk factor for developing breast cancer.

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D.C. resident Cheryl Shaw beat breast cancer in 2008, but said she never imagined it would come back 11 years later.

“As a mom, as a grandma, I want to be around for them,” Shaw said. “You know, I have a lot more to do in life. I’m not done.”

When her cancer came back, doctors didn’t discover it until it was already in stage 3, even though she’d had a mammogram just months before.

It wasn’t detected because Shaw has dense breasts with a lot of tissue. But she said doctors hadn’t warned her about her breast density.

“If we don’t know what’s going on with our bodies, if we don’t know what the cause is or we don’t know what to look for, we don’t know what questions to ask,” she said.

Those with dense breasts may need to get MRIs or ultrasounds, depending on other risk factors.

According to the Centers for Disease Control and Prevention, breast density can change over time.

Women are more likely to have dense breasts if they’re younger, have a lower body weight, and are pregnant or breastfeeding.

Shaw is now in remission. She works at the Smith Center for Healing and the Arts on U Street, helping give back to cancer patients and spreading awareness on the importance of screenings.

“Some people see cancer as something they don’t want to know about, and that if they find out about it, they’re no longer gonna be here. But the reality is, there’s so many survivors and I’m one of them,” she said.

At nearly 82, though, this nurse in Winchester, Virginia, is ready to retire. She spent 55 years on the job.

At a bittersweet retirement reception at Valley Health’s Winchester Medical Center on Friday, McWhinney spoke about her decades of experience.

“So I started out with white shoes, white hose, white dress and a cap,” she said, showing an old photo.

She knew when she was 9 years old that she wanted to become a nurse. Her mother was stricken with tuberculosis, and she gave her daily shots.

“I gave it to her, vomited and said, ‘I want to be a nurse,’” McWhinney said.

Her nursing career began in 1967, when she graduated as a member of Shenandoah University’s first-ever nursing class.

Over the next five decades, she worked in several hospital departments but always related to surgery. She treated some patients for decades.

“We love her a bunch,” one patient said. “I’m sure they’re going to miss her here, as will I.”

Doctors said they learned from her.

“She’s forgotten more stuff than I’ve learned in all my years of training as a doctor,” Dr. Terral Goode said.

Back in the days of strict visiting hours, McWhinney helped a young father sneak in his baby daughter to see her mother, who was dying of cancer.

She ran into that little girl, now a grown woman, in the hospital. She had become a nurse.

“She said, ‘I became a nurse because of you and I remember my mom because of all the pictures we took,'” McWhinney said. “So that was probably one of the very special days for me.”

McWhinney’s long career spanned some of medicine’s greatest recent challenges, including polio, the AIDS epidemic and the COVID-19 pandemic. She herself fell ill with COVID in September 2020, before vaccines were available.

“I kept a calendar and I wrote there one day, ‘Dear God, please let me die. I’m ready,’ because It was just horrible,” she said.

Once she recovered, though, she said she never thought twice about returning to work.

“The nurses I work with, my God, they were overwhelmed, and I didn’t want them to fight by themselves,” she said.

Nurses, doctors and hospital staff gathered Friday to say goodbye, give hugs, and share laughter and tears.

“I’ve cried all day,” McWhinney said. “It’s kind of happy tears, but I have such great support here. I mean, it’s just a wonderful place to work.”

She said it’s finally time for her to travel and take care of herself, although she’s not finished caring for others. In her retirement, she plans to volunteer as a hospice nurse.

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The drug, Leqembi, received conditional approval from the Food and Drug Administration in January based on early results suggesting it could slow Alzheimer’s progression by several months. The FDA now is reviewing more definitive results to decide whether the drug should receive the agency’s full endorsement.

The decision carries extra significance because insurers have held off on paying for the infused treatment until it has full FDA approval.

The FDA panel of outside advisers voted 6-0 that a large company study confirmed the drug’s benefits for patients with mild or early Alzheimer’s. The nonbinding vote amounts to a recommendation for full approval, and the FDA is scheduled to issue a final decision on the matter by July 6.

The FDA’s initial OK for Leqembi came via the agency’s accelerated approval program, which allows early access to drugs based on laboratory and biological measures suggesting that they might help patients. The drug, marketed by Eisai and Biogen, helped clear a brain plaque that is a hallmark of Alzheimer’s.

The FDA panel reviewed more recent data from an 1,800-patient study in which people taking the drug showed a modestly slower rate of decline on measures of memory, judgment and other cognitive tests.

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“For an illness like this where we don’t have very much, these are meaningful changes for patients with Alzheimer’s,” said Dr. Merit Cudkowicz of Harvard Medical School. “A couple more months in the highly functional state is really meaningful.”

Drugs approved via the accelerated pathway can technically be withdrawn by the FDA if their benefits aren’t confirmed, though regulators rarely take that step. Gaining full approval allows medications to stay on the market indefinitely.

Normally the process of converting an accelerated approval attracts little attention, and FDA rarely convenes its advisers to weigh in on such decisions.

But concerns about the cost and effectiveness of new plaque-targeting drugs like Leqembi have attracted new scrutiny to the process from academics, members of Congress and health insurers.

Medicare, the federal health plan that covers 60 million seniors, has essentially blocked coverage of Leqembi and a similar drug, Aduhelm, pending full FDA approval. That policy, which has little precedent, was announced last year amid concerns that Aduhelm, priced at $28,000-a-year, would drive up costs for Medicare recipients.

The federal program provides health insurance for the vast majority of people with Alzheimer’s, and private insurers tend to follow its lead.

Leqembi is priced similarly at $26,500 per year and the handful of patients who have received it to date have mainly had to pay out of pocket.

Facing pressure from Alzheimer’s advocates and patients, Medicare’s administrator, Chiquita Brooks-LaSure, has made clear the program will immediately begin covering the drug if it gets FDA’s full OK.

But last week she announced extra requirements even after Medicare coverage begins: All patients receiving the drug will need to be enrolled in a federal registry to track Leqembi’s safety and effectiveness. That approach is occasionally used for complex new medical devices, but rarely for drugs.

The move was criticized by advocacy groups, including the Alzheimer’s Association, which has lobbied the federal government for months to begin paying a drug that they say could potentially help many thousands of Americans.

Leqembi is the first drug that’s been convincingly shown to slow Alzheimer’s by targeting the underlying biology of the disease. The delay in progression amounts to about five months, and some experts disagree on whether the difference is enough to meaningfully improve people’s lives.

But most FDA panelists were impressed by Eisai’s results, which they said showed significant differences in patients’ cognitive abilities and function, as well as reduced burden for caregivers.

The study, funded by Japanese drugmaker Eisai, tracked patients for 18 months using a scale measuring key indicators of cognitive function. At the end of the trial, patients receiving Leqembi declined more slowly — a difference of less than half a point on the scale — than patients who received a dummy infusion.

The drug was also associated with potentially serious side effects, including swelling of the brain and small bleeds in brain vessels.

Three patients taking Leqembi died during the study, two after experiencing a stroke linked to brain bleeding. But FDA reviewers said it was unclear whether the drug played a role in the deaths due to other underlying factors affecting the patients, including the use of blood-thinning medications that can increase the risk of bleeding.

“There are adverse effects,” said Dr. Robert Alexander of the University of Arizona, who chaired the panel. “But they’re monitorable and I think the benefit is clear.”

In the 18-month trial, people in the early stages of Alzheimer’s who received infusions of donanemab showed 35% less decline in thinking skills compared to those given a dummy drug, Lilly announced in a press release.

The drug is designed to target and clear away a sticky protein called beta-amyloid that builds up into brain-clogging plaques that are one hallmark of Alzheimer’s.

A similar amyloid-targeting drug, Eisai and Biogen’s Leqembi, recently hit the market with similar evidence that it could modestly slow Alzheimer’s — and also some safety concerns, brain swelling or small brain bleeds.

Donanemab also comes with that risk. Lilly said in its study, the brain side effects caused the deaths of two participants and a third also died after a serious case.

The preliminary study results haven’t been vetted by outside experts. Indianapolis-based Lilly plans to release more details at an international Alzheimer’s meeting this summer and is seeking Food and Drug Administration approval of the drug.

___

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.

The following content is created in partnership with University of Maryland Capital Region Health. It does not reflect the work or opinions of the NBC Washington editorial staff. Click here to learn more about University of Maryland Capital Region Health.

For those unfamiliar with the terminology, it’s easy to confuse family medicine for general practice or internal medicine. And while patients should always choose the practice that best suits their needs, it’s important to understand the full range of options available. Read on to learn more about family medicine and why it might be the right choice for you.

Family medicine is a one-stop shop for most of your medical needs

As the name suggests, family medicine is a branch of medicine designed to provide continuing and comprehensive healthcare to the all members of a family. Accordingly, family medicine practices provide healthcare across all ages, genders, and conditions, meaning a single practice will offer a wide range of specialties from pediatrics, obstetrics, and geriatrics. Thanks to the sheer breadth of expertise and range of specialties in a family practice, a patient is less likely to be referred elsewhere for specialized care.

Family medicine offers convenience for busy individuals

The range of care offered in family medicine makes it an easy choice for many, but especially for parents. Instead of visiting multiple practices for different family members, everyone in your family can receive care in the same location–expecting moms, newborns, teens, adults, grandparents and more. Treating entire families also allows doctors to better understand many factors that affect people’s health, including employment, living conditions, care giving needs, educational level as well as cultural background. Additionally, many family medicine practices, like UM Capital Region Health, offer same and next-day appointments.

Family medicine promotes a long-term doctor-patient relationship

Every family medicine doctor undergoes rigorous training to address the health needs of all age groups and genders. This enables a long-term relationship between a family medicine doctor and their patients over many years. The doctor becomes better informed, and you are more empowered as a patient.

“We’re able to make a more significant impact on people’s health because of our long- lasting relationships and opportunities to interact on multiple levels at different points and important milestones in their lives,” says Alexander Kaysin, MD, MPH, medical director of the UM Capital Region Health Family Medicine Practice at New Carrollton.

Furthermore, Dr. Kaysin says, “certain family medicine practices such as our own can provide direct care for patients not just in the office but also in the hospital, including labor and delivery, the newborn nursery and regular inpatient units. This enables us to provide the highest quality of care through a deep understanding of our patients’ health and the trust we are able to build.”

Family medicine allows for a holistic approach

According to Dr. Donna Prill of UM Capital Region Health, family physicians don’t just treat illness.

“A benefit of seeing a family medicine physician is that we seek to optimize patient health from every angle. We consider what’s happening with patients psychologically and socially and how these factors affect their health.”

Indeed, health outcomes are dependent on countless factors, including lifestyle, diet, family history, relationships, and mental health. Thanks to the nature of their practice, family medicine doctors are uniquely positioned to consider the full scope of a patient’s life outside of a clinical setting. 

Family medicine improves community-wide outcomes

Family medicine physicians make up the majority of the primary care physician workforce. This is noteworthy because of the unique vantage point that family physicians have in understanding community-level factors and social determinants of health.  

“I believe that if we want to have healthier communities, we need to have healthier families,” says Dr. L. Latéy Bradford, a family physician at UM Capital Region Health.

Indeed, access to regular primary care has been shown to result in lower infant mortality, higher birth weights, higher immunization rates, lower overall healthcare costs, and longer, healthier lives. And because they consider patients’ cultural traditions as well as barriers they may face in accessing healthcare, family medicine physicians are well-positioned to understand their patients and provide outstanding care.

Navigating medical care can be overwhelming, but the experts at University of Maryland Capital Region Health are ready to assist you and support you and your family in achieving your health goals. Click here to learn more about UM Capital Region Health Family Medicine in New Carrollton and National Harbor, and Suitland, which offer telehealth and same and next-day appointments.

“The (U.S. Food and Drug Administration) says we should (clean) it twice a year, so right before spring and summer and then again in the fall and winter. I would think of it like the end of your school year for your kids and the beginning of the school year for your kids,” NBC medical contributor Natalie Azar told TODAY in a segment on April 20. 

So which items need to go and when? Certain bathroom staples are breeding grounds for bacteria and have a shorter shelf life than your twice-a-year purge: 

• Toothbrush: You should replace your toothbrush every 3 to 4 months, according to the CDC. Dr. Azar agreed, even recommending to err on the side of caution with 3 months.
• Contact lens cases: Replace every 3 months.
• Razors: Toss after every five to seven uses.
• Loofa: Replace once a month.

Medications: Do expiration dates matter?

We’ve all been there: We’re cleaning out our medicine cabinet and wonder, do I really have to toss this almost full bottle of medication?

“It depends on what the medicine is for,” said Azar. “Anything that’s prescription, anything that’s liquid or anything that is life-saving (like EpiPens or nitroglycerin), get rid of it by the expiration date.” 

But what if you have a splitting headache and the only pain-reliever you can find is a bit past due? “It’s not dangerous if it’s past its expiration date. It just might not work as well,” she said. “That’s why I say watch out with prescription drugs — because let’s say you use an antibiotic that’s past its expiration date or a blood thinner that’s past its expiration date. We don’t want that because we want that to be at its full potency.”

When it comes to medication expiration dates, follow these general guidelines:

• OTC medications: Pills are good for three years past the expiration date, but know they may not be as effective. Liquid medications like cough syrup should be thrown out after the expiration date.
• Prescription medications: Throw out by expiration date.

How do I dispose of old medications?

When you do have drugs to dispose of, Azar said the best way to dispose of them safely is through a drug take-back program, which you can find by searching on the U.S. Drug Enforcement Agency website or asking your local pharmacy. There are certain drugs that are flushable. The FDA website has a “flush list” of medications that they actually prefer you flush down the toilet, like opioids.

Finally, for the medications you are going to toss in the trash, Azar suggested putting them in a Ziplock baggie with something that doesn’t taste good like cat litter or coffee grounds, to make sure kids and pets don’t ingest them. And always use a Sharpie to cross out all personal information on medicine bottles before you recycle them.

5 medicine cabinet staples

Now that you purged your supply, it’s time to replenish your stock. What should everyone have in their medicine cabinet? To make it easy, remember the four As, said Azar:

• Acetaminophen/aspirin 
• Antihistamines
• Antacids
• Antibiotic ointments

The final thing we should all have on hand is a thermometer. It’s a matter of preference which type you use, but for parents with younger kids, the American Academy of Pediatrics recommends using rectal, underarm or in-ear thermometers for the most accurate readings.

Summer medicine cabinet essentials

This time of year, Azar suggested a few additional staples to make sure you have on hand:

• Sunscreen: The American Academy of Dermatology recommends using SPF 30 at a minimum. When it comes to that bottle of sunscreen left over from last year, Azar said to follow the same rule of thumb that you do for over-the-counter medication: It’s not dangerous, but it may not be as effective.
• Tweezers: A must for removing splinters and ticks.
• OTC ear drops: For swimmer’s ear, or the inflammation and pain that happens when water gets stuck in the ear canal.
• Hydrocortisone cream: Helps reduce the redness and itching associated with different rashes, insect bites and even poison ivy.
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The Food and Drug Administration released new standards in March of 2023 in an effort to help more women detect breast cancer sooner. The FDA gave providers until Sept. 9, 2024 to comply with the new rule for them to include a note on mammogram reports noting if their patients have dense breasts.

“It’s really an opportunity to put the power back into the hands of the patients and letting them know what type of density they have,” Molly Guthrie, with the Susan G. Komen Breast Cancer Foundation, told News4.

About half of women over the age of 40 in the U.S. have dense breast tissue, which can make cancers more difficult to spot on a mammogram, the FDA said. Dense breasts have also been identified as a risk factor for developing breast cancer.

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D.C. resident Cheryl Shaw beat breast cancer in 2008, but said she never imagined it would come back 11 years later.

“As a mom, as a grandma, I want to be around for them,” Shaw said. “You know, I have a lot more to do in life. I’m not done.”

When her cancer came back, doctors didn’t discover it until it was already in stage 3, even though she’d had a mammogram just months before.

It wasn’t detected because Shaw has dense breasts with a lot of tissue. But she said doctors hadn’t warned her about her breast density.

“If we don’t know what’s going on with our bodies, if we don’t know what the cause is or we don’t know what to look for, we don’t know what questions to ask,” she said.

Those with dense breasts may need to get MRIs or ultrasounds, depending on other risk factors.

According to the Centers for Disease Control and Prevention, breast density can change over time.

Women are more likely to have dense breasts if they’re younger, have a lower body weight, and are pregnant or breastfeeding.

Shaw is now in remission. She works at the Smith Center for Healing and the Arts on U Street, helping give back to cancer patients and spreading awareness on the importance of screenings.

“Some people see cancer as something they don’t want to know about, and that if they find out about it, they’re no longer gonna be here. But the reality is, there’s so many survivors and I’m one of them,” she said.

You’ve likely used shampoo or sunscreen days — or even months — beyond their expiration dates and that is probably OK. But it’s a different story for medications, says Erin Burton, a pharmacy manager at CVS Health.

“It’s important to check out the expiration dates on medications because once we’re past that date, they become less effective,” Burton tells CNBC Make It.

Depending on what you’re treating, taking ineffective, or less effective, medicine can be harmful, she adds. “You don’t want to be taking a medication that’s not helping you with the disease you’re trying to treat,” especially if it’s a severe condition.

The bottom line: “People really need to follow what’s printed on the label,” says Burton. “Really we shouldn’t be using them a day past, but no one’s perfect.”

‘There are certain medications that we really don’t want lying around our home’

Keeping medication past its expiration date, or not disposing of leftover medicine, leaves room for them to fall into the wrong hands, Burton notes.

“There are certain medications that we really don’t want lying around our home,” she says, including pain medicine like opioids, stimulants or depressants. These prescriptions can be very addictive, she adds.

“We know that two-thirds of teens who misused pain relievers in the past year, say they got them from a family [member] or friend. That includes our home medicine cabinets,” says Burton.

How to properly dispose of expired medications

Given the decrease in effectiveness after expiration dates, and the potential harms of keeping old medications in cabinets, you should dispose of prescriptions that you no longer need.

But, there is an ideal way to do so, that Burton strongly encourages:

• Find a take-back site near local pharmacies. “One important note is that you want to remove any personal information from the labeling before disposing of the medication,” says Burton.
• Toss them in household trash. You should mix them with an undesirable substance and place them in a sealable container or bag.

CVS drug disposal units accept prescription medications, over-the-counter treatments and liquid medicine. They don’t accept illegal substances, needles or syringes, medical devices or batteries, aerosol cans or inhalers.

You can throw away inhalers by contacting your local trash or recycling facility, so it can be disposed of safely, Burton says.

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Eli Lilly‘s experimental Alzheimer’s drug lowered levels of brain plaque in patients who are in the earliest stages of the devastating disease, initial data shows. 

A higher dose of the up-and-coming treatment, remternetug, had a larger effect on clearing amyloid plaque, according to early clinical trial data the company presented during a conference in Sweden on Friday.

Amyloid is a protein that builds up on the brain in Alzheimer’s patients and disrupts cell function. Researchers have argued that accumulation of amyloid plaque is a crucial first step toward the cognitive decline observed in Alzheimer’s disease.

The early data comes as Eli Lilly continues its decades-long bid to bring an Alzheimer’s drug to the market. Remternetug follows another drug called donanemab and failed treatment solanezumab. Remternetug and donanemab target plaque deposited on the brain, while solanezumab focused on the kind that floats in brain fluid.

The remternetug trial featured 41 patients in the early stages of Alzheimer’s disease. They were randomized to receive infusions of a placebo or remternetug in various dose sizes every four weeks.  

Eli Lilly found the drug caused a “rapid and robust” clearance of amyloid plaque, the presentation said. Clearing amyloid plaque is defined as lowering the level to 24.1 centiloids — a unit used to measure amyloid in the brain — or less.

Plaque levels were “dose-dependent,” the company said. The majority of patients who received remternetug at the three highest dose sizes saw amyloid plaque cleared by day 169 of the study. 

The Indianapolis, Indiana-based company is conducting an ongoing phase three trial on remternetug, but it did not indicate which dose sizes are being studied. Eli Lilly expects to complete the trial in 2025. 

The results suggest remternetug “may provide more robust plaque removal” than donanemab, said J.K. Wall, an Eli Lilly spokesperson.

A phase two trial of donanemab found 40% of participants treated with the drug achieved amyloid clearance as early as six months, or around 182 days, after starting the treatment. 

But Wall added that it’s too early to make quantitative comparisons of the two drugs. 

Akash Tewari, an equity analyst at Jefferies, also highlighted “hints of faster amyloid clearance with remternetug vs donanemab” in a Friday note. But Tewari said it’s unclear if clearing amyloid plaque will lead to clinical benefits like a reduction in cognitive decline. 

He noted that some research has demonstrated a causal relationship between plaque removal and the rate of cognitive decline, but “we haven’t seen this supported in donanemab’s” data.

Tewari also compared the two drugs’ safety profiles. He estimates that remternetug could show similar or higher rates of a problematic brain swelling side effect compared to donanemab. 

Eli Lilly observed the side effect – known as amyloid-related imaging abnormality, or ARIA – in 10 out of 24 patients who received remternetug. One of those patients stopped the treatment due to a serious adverse event.

ARIA has dogged similar Alzheimer’s drugs from other companies, such as Biogen and Eisai’s Leqembi. The companies expect the Food and Drug Administration to grant full approval of Leqembi by the summer.

An estimated 6.7 million Americans age 65 and older are living with Alzheimer’s, according to the Alzheimer’s Association. By 2050, that group is projected to rise to almost 13 million. 

One in three seniors die with Alzheimer’s or another form of dementia, which kills more people than breast cancer and prostate cancer combined, the association said. 

More than 600,000 people die of cardiovascular disease in the U.S. every year — the leading cause of death for both men and women, according to the Centers for Disease Control and Prevention.

Even heart doctors themselves can suffer a heart attack.

Wouldn’t you like to lower your risk?

Hippocrates famously said, “Let food be thy medicine,” and that applies to heart health: Diet is incredibly important, noted Dr. Andrew Freeman, director of cardiovascular prevention and wellness at National Jewish Health in Denver, Colorado, and a member of the American College of Cardiology’s Prevention of Cardiovascular Disease Section Leadership Council.

“If you go to parts of the world where they have not been exposed to a Western lifestyle, meaning a sedentary lifestyle and eating processed foods, heart disease is in very limited existence,” Freeman told TODAY.

Still, it may not always be possible to eliminate problem foods, so moderation and portion control are key.

“There isn’t a food that will save your life … And there isn’t one that’s going to kill you. It is about balance,” said Dr. Sharonne Hayes, professor of cardiovascular medicine and founder of the Women’s Heart Clinic at the Mayo Clinic in Rochester, Minnesota.

“So the occasional Cheeto or piece of cheesecake isn’t going to kill you, but it really is what you eat and how much you eat that’s so critical.”

TODAY asked Freeman and Hayes to share some of the top foods they try to avoid or limit for optimal health. Here are eight of the items on their lists:

1. Bacon, sausage and other processed meats

Hayes, who has a family history of coronary disease, is a vegetarian. But even before she stopped eating animal protein some 25 years ago, she avoided processed meats because they’re high in calories, saturated fat, salt and have added ingredients like nitrates.

It’s not only heart health that may be affected by overindulging in hot dogs, salami, bacon, ham and jerky: The World Health Organization has determined eating processed meats causes cancer, Freeman pointed out.

2. Potato chips and other processed, packaged snacks

Stay away from the little pouches of salty, crunchy carbs you might encounter in a vending machine, the doctors advised.

“Our culture values convenience, which is great, but convenience doesn’t mean you have to eat packaged processed foods with added sugars and salt,” Freeman said. “Nature has provided for us the exact foods we should be eating; we just need to eat them.”

Those easy, portable, natural foods include apples, carrots and other fruits and vegetables — all fiber-rich, nutrient-full options.

Hayes agrees with many nutritionists that simple carbs — found in chips, breads and crackers — are a bigger issue than fat. Look for ways to increase the complexity of what you eat, in terms of grains and other nutrients, she advised.

3. Dessert

Enjoy added sugars in very limited quantities, if at all, Freeman noted.

When it comes to desserts like pies, ice cream and candy bars, Hayes indulges once a week at most and keeps her portion small to limit calories. Her main goal is to maintain a healthy weight: She’s weighed about the same for the past 30 years.

4. Too much protein

“We seem to be obsessed with protein in this country,” Freeman said. “It’s not uncommon to see people getting two times as much protein as they may need in a day and that taxes the kidneys and may cause more problems down the road.”

Another issue is that the extra protein often comes from meats high in saturated fats, which may raise LDL or bad cholesterol, and comes at the expense of other food groups, the American Heart Association warns.

So don’t overdo it and opt for plant protein, both doctors advised.

5. Fast food

It’s been years since Hayes has had any fast food. Some chains let you concoct a reasonably healthy item with fresh vegetables, but most burger and chicken fast food restaurants should be avoided “because there’s virtually nothing on the menu that’s healthy for you,” she said. Even the items that aren’t fried are typically high in simple carbs.

6. Energy drinks

Freeman said he avoids them because they contain added sugar, plus ingredients that may potentially induce problems like high blood pressure or arrhythmia.

That doesn’t mean you should skip caffeine. It’s quite healthful to drink tea or coffee in moderation every day, he said. Just watch what you put in your cup: Black coffee can turn into a calorie bomb if you add sugar, whipped cream, caramel and other toppings.

7. Added salt

There’s virtually no American who doesn’t get too much salt in their diet, Hayes noted. It’s not uncommon for a person to get three or four times the recommended daily amount, Freeman added. Added salt lurks in products you may not realize: cereal, a pickle that comes with your sandwich or a chicken breast that’s been brined to stay juicy and moist.

Read the labels and be aware of how much sodium you’re taking in. You need salt to live, but a high-sodium diet raises blood pressure.

8. Coconut oil

It has more saturated fat than lard, Freeman said.

“It’s used in some studies to induce atherosclerosis — sludge in the pipes, if you will, in rats and other animals,” he noted. “It works great topically — it’s a wonderful moisturizer for hair and skin — but I wouldn’t eat too much of it.”