Stress literally eats away at your brain's cognitive reserve - Study Finds
- Stress literally eats away at your brain's cognitive reserve Study Finds
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- An active brain can protect you from dementia, but stress might eat up your 'cognitive reserve' – new study The Conversation Indonesia
- Stress can undo the benefits of a healthy lifestyle Jamaica Gleaner
- Stress Eats Away at Cognitive Reserve, Study Suggests, Fueling Dementia The New York Sun
10 months 2 weeks ago
Medical News, Health News Latest, Medical News Today - Medical Dialogues |
JnJ submits application to USFDA for expansion of Pediatric indication for HIV-1 Therapy Prezcobix
Titusville: Johnson & Johnson has announced the submission of a supplemental New Drug Application (sNDA) to the U.S. Food and Drug Administration (FDA) seeking to expand the indication of PREZCOBIX (darunavir/cobicistat) to include the treatment of HIV-1 infection in younger children at least 6 years of age weighing at least 25 kg.
A parallel line extension application and type 2 variation application have also been submitted to the European Medicines Agency (EMA) for expanded pediatric use in Europe, where the product is marketed as REZOLSTA.
If the applications are approved, PREZCOBIX/REZOLSTA could be administered to adults and pediatric patients at least 6 years of age, weighing at least 25kg. A new co-formulated tablet containing a weight-adjusted pediatric dose (darunavir 675 mg/cobicistat 150 mg) has been developed to aid administration for younger children. The new pediatric tablets are scored to facilitate breaking for ease of swallowing.
“We are proud of this latest step in our years of work to ensure that some of the youngest people living with HIV have access to different treatment regimens that can work for them,” said Penny Heaton, M.D., Global Therapeutic Area Head, Infectious Diseases and Vaccines and Global Public Health R&D at Johnson & Johnson. “If approved, this medicine could offer healthcare providers a new treatment option that ensures weight-appropriate dosing to better meet the needs of young people living with HIV.”
The applications to the FDA and EMA are supported by data from a clinical study sponsored by Janssen Research & Development, LLC, that evaluated the pharmacokinetics of the new combination tablet and established that it is bioequivalent to darunavir and cobicistat when dosed as single agents (NCT04718805). The efficacy, safety and tolerability of cobicistat-boosted darunavir for the treatment of younger children with HIV-1 was established in a Phase 2/3 clinical trial conducted by Gilead Sciences (NCT02016924).
Based on these data, Janssen Products, LP, a division of Johnson & Johnson, is seeking an expanded indication to allow the use of PREZCOBIX/REZOLSTA in treatment-naïve and treatment-experienced pediatric patients aged 6 years and older, weighing at least 25 kg, and who have no viral resistance mutations associated with darunavir.
PREZCOBIX/REZOLSTA is a two-drug fixed-dose combination tablet containing darunavir, an HIV-1 protease inhibitor, and cobicistat, a CYP3A inhibitor that serves as a PK enhancer or “booster.” The booster enables once-daily dosing and optimal therapeutic levels of darunavir.
This product is currently indicated for the treatment of HIV-1 infection in treatment-naïve and treatment-experienced adults and adolescent patients weighing at least 40 kg with no darunavir resistance-associated mutations.
Darunavir as a single agent is marketed by Janssen Products, LP as PREZISTA in the United States, and cobicistat, developed by Gilead Sciences, Inc., is marketed as TYBOST. The fixed-dose combination PREZCOBIX/REZOLSTA is a collaboration between Janssen R&D Ireland and Gilead Sciences, Inc.
Read also: Johnson & Johnson concludes acquisition of Shockwave Medical
10 months 2 weeks ago
News,Industry,Pharma News,Latest Industry News
Medical News, Health News Latest, Medical News Today - Medical Dialogues |
NEET 2024 Results: Here are the 100 toppers, Check list
New Delhi: In the recently announced results of NEET UG 2024, the NTA has issued a list of a total of 100 candidates who topped the MBBS entrance exam including a record-breaking 67 candidates securing All India Rank (AIR) 1.
According to the scorecard of the qualified candidates for the National Eligibility cum Entrance Test (NEET) released by the National Testing Agency (NTA) on Tuesday, the top rankers include 26 girls and 74 boys.
Rajasthan has the highest number of candidates in the top 100 with 15 candidates, followed by Maharashtra with 11 candidates, Tamil Nadu and Haryana with eight candidates.
Also read- NEET 2024 Result Highlights: NTA Issues Toppers List, All Details Here
The top 100 candidates in NEET 2024 belong to states- West Bengal, Tamil Nadu, Maharashtra, Delhi, Haryana, Rajasthan, Uttar Pradesh, Andhra Pradesh, Punjab, Uttarakhand, Tripura, Himachal Pradesh, Jharkhand, Kerala, Karnataka, Chandigarh, Gujarat, Bihar, Telangana and Madhya Pradesh.
Here is the list of the 100 candidates who have topped the NEET UG- 2024 exam-
- Rupayan Mandal, Arghyadeep Dutta, Saksham Agrawal, Arindam Chowdhury from West Bengal
- Syed Aarifin Yusuf M, Shailaja S, Aditya Kumar Panda, Sriram P, Rajaneesh P, Jayathi Poorvaja M, Rohith R, Sabareesan S from Tamil Nadu,
- Ved Sunilkumar Shende, Shubhan Sengupta, Umayma Malbari, Palansha Agarwal, Krishnamurti Pankaj Shiwal, Mane Neha Kuldeep, Amina Arif Kadiwala, Ritesh Sunil Thombal, Aayush Chidrawar, Shrirang Nilesh Joshi, Ipshita Tamuli from Maharashtra,
- Mridul Manya Anand, Divyansh, Lakshay, Rishika Aggarwal, Krish Agrawal, Anusha Srivastava, Aditi Das, Avni Jain from Delhi,
- Khushboo, Krish, Anjali, Prateek, Vishakha, Yash Kataria, Ishika, Prachi from Haryana,
- Prachita, Saurav, Aadarsh Singh Moyal, Isha Kothari, Shashank Sharma, Shyam Jhanwar, Dhruv Garg, Devesh Joshi, Samit Kumar Saini, Iram Quazi, Jahnvee, Gurshaan Singh Anger, Pratyush Malav, Tanishak Yadav, Dron Jain from Rajasthan,
- Ayush Naugraiya, Aryan Yadav, Pranav Srivastava, Kunwar Digvijay Singh from Uttar Pradesh.
- Kasturi Sandeep Chowdary, Gattu Bhanuteja Sai, Poreddy Pavan Kumar Reddy, Vadlapudi Mukhesh Chowdary, Mummadi Sai Jaswanth Reddy from Andhra Pradesh,
- Shaurya Goyal, Gunmay Garg, Shikhin Goyal, Karanveer Singh from Punjab,
- Akshat Pangaria from Uttarakhand,
- Chand Mallik from Tripura,
- Aryan Sharma from Himachal Pradesh,
- Kahkasha Parween, Manav Priyadarshi from Jharkhand,
- Devadarshan R Nair, Sreenand Sharmil, Abhishek V J, Abhinav Sunil Prasad, Nandana Binod from Kerala,
- Kalyan V, Sam Shreyas Joseph, Arjun Kishore, Padmanabh Menon, Prajnan P Shetty, Khushi Maganur from Karnataka,
- Taijas Singh from Chandigarh,
- Kriti Sharma, Darsh Paghdar, Rishabh Shah, Ved Patel, Harvy Patel, Bhumika Shekhawat from Gujarat
- Mazin Mansoor, Tathagat Awatar, Hritik Raj, Abhinav Kisna, Ayush Kumar, Rawal Jayant Singh, Keshav Saurabh Samdarshi from Bihar,
- Anuran Ghosh from Telangana,
- Almaan Ahmed Qureshi from Madhya Pradesh.
In conversation with Careers360, Divyansh who hails from Delhi shared how his dream of joining the Indian Army was redirected to becoming a doctor, a decision that was supported by his father and led him to Allen Kota for NEET preparation.
"Both my dad and uncle are in the Indian Armed Forces. Our family has a background marked by serving the country in the military. Inspired by them, I likewise needed to enlist in the military and wanted to take the NDA test. At the point when I imparted this to my dad, he urged me to turn into a specialist doctor and serve society," said Divyansh.
Speaking to the daily, Hritik Raj who hails from Bihar said "I hailed from Bihar. My father is a retired army officer and my mother works as a teacher. I did my schooling from CBSE board in Bihar. My parents inspired me a lot through their hard work and dedication towards their respective fields which somehow insisted me to do best in the exam. It was basically my father’s dream to choose medicine and become a doctor. In 10th class, I decided to put in more effort and started taking coaching classes to fulfil my father’s dream."
Similarly, Mazin Mansoor who also hails from Bihar told ET, “I always knew that I wanted to be a doctor. I come from a family of doctors; I have seen my maternal grandfather helping patients and so has my father, who is a dedicated doctor. My mother too has pursued a PhD in Psychology, and she has always motivated us to chase our dreams,”
“I was very focused on my study routine. I never calculated the time or made any timetable. Instead, I used to set small targets and never slept without achieving them. Consistency is the only strategy that can lead students to success in any competitive exam. One must be consistent with learning new topics and revising the already read topics," he added.
NTA conducted the (NEET-UG) for more than 24 lakh candidates at 4750 different Centres located in 571 Cities throughout the country including 14 Cities outside India on 05 May 2024 (Sunday) from 02:00 P.M. to 05:20 P.M.(IST). The Examination was conducted in 13 languages (Assamese, Bengali, English, Gujarati, Hindi, Kannada, Malayalam, Marathi, Odia, Punjabi, Tamil, Telugu, and Urdu). The examination was also conducted in 14 cities outside the country Abu Dhabi, Dubai, Bangkok, Colombo, Doha, Kathmandu, Kuala Lumpur, Kuwait City, Lagos, Manama, Muscat, Riyadh, Sharjah, and Singapore.
10 months 2 weeks ago
State News,News,Delhi,Medical Education,Medical Admission News,Latest Medical Education News,Notifications,Latest Education News
Jamaica celebrates World Family Doctor Day 2024
WORLD FAMILY Doctor Day (WFDD) was declared by the World Organizations of Family Doctors (WONCA) in 2010 and celebrated on May 19, when family doctors across the world are honoured for their service to their patients. This year marked the 10th...
WORLD FAMILY Doctor Day (WFDD) was declared by the World Organizations of Family Doctors (WONCA) in 2010 and celebrated on May 19, when family doctors across the world are honoured for their service to their patients. This year marked the 10th...
10 months 2 weeks ago
Your career as a medical practitioner
EVEN IF you try to live a healthy lifestyle, sometimes you will get sick. This may range from a mild cold or flu to a terminal illness. While you can be proactive about your health, sometimes it can seem like the luck of the draw, with seemingly...
EVEN IF you try to live a healthy lifestyle, sometimes you will get sick. This may range from a mild cold or flu to a terminal illness. While you can be proactive about your health, sometimes it can seem like the luck of the draw, with seemingly...
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The amazing mitochondria and how they sustain you
MITOCHONDRIA ARE special compartments (organelles) in our cells that are best known for their role as powerhouses, as they break down food molecules and turn out adenosine triphosphate (ATP), a molecular fuel for the rest of the cell. However, they...
MITOCHONDRIA ARE special compartments (organelles) in our cells that are best known for their role as powerhouses, as they break down food molecules and turn out adenosine triphosphate (ATP), a molecular fuel for the rest of the cell. However, they...
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FDA approves Rinvoq for JIA, psoriatic arthritis in children aged 2 years and older
The FDA has expanded the indication of Rinvoq to include active, polyarticular juvenile idiopathic arthritis and psoriatic arthritis in children aged 2 years and older, according to an AbbVie press release.The announcement represents the first indication of Rinvoq (upadacitinib, AbbVie) for pediatric patients aged 2 years and older, the company said.
To use the drug under the new indication, patients must have inadequate response or intolerance to at least one TNF inhibitor.“Pediatric patients with [polyarticular JIA] and PsA can be severely limited in their ability to complete daily
10 months 2 weeks ago
Medical News, Health News Latest, Medical News Today - Medical Dialogues |
Upadacitinib Outperforms Dupilumab in Treating Atopic Dermatitis: Study
Researchers have found that upadacitinib (Rinvoq) was more effective than dupilumab (Dupixent) in treating moderate-to-severe atopic dermatitis in a phase 3b/4 trial, according to data from the LEVEL UP trial announced on April 25, 2024. The study demonstrated that a greater proportion of patients achieved relief and resolution of symptoms with upadacitinib than with dupilumab.
This was announced by AbbVie and was conducted by Jonathan Silverberg, MD, PhD, MPH, director of clinical research and professor of dermatology at the George Washington University School of Medicine and Health Science.
Atopic dermatitis (AD) is a chronic skin condition that can significantly impact patients' quality of life. Both dupilumab and upadacitinib have become important treatments in managing AD, providing options for patients who do not respond adequately to other therapies. The LEVEL UP trial was initiated in 2022 to compare the effects of these agents and guide clinicians in their decision-making.
The LEVEL UP trial included patients aged 12 years and older with moderate-to-severe AD. Participants underwent a 16-week treatment period, followed by an additional 16-week period of treatment with protocol-defined adjustments. The primary endpoint was achieving both a 90% reduction in the Eczema Area and Severity Index (EASI 90) and a Worst Pruritus Numerical Rating Scale of 0 or 1 (WP-NRS 0/1) at the 16-week mark.
Patients in the trial received either upadacitinib starting at 15 mg daily (escalated to 30 mg based on response) or dupilumab at 600 mg initially, followed by 300 mg every two weeks for subjects weighing ≥60 kg. Those weighing less than 60 kg received an initial dose of 400 mg, followed by 200 mg every two weeks.
The key findings of the study were:
• A significantly higher percentage of upadacitinib-treated patients achieved the primary endpoint compared to those treated with dupilumab (19.9% vs 8.9%, P < .0001).
• Upadacitinib also outperformed dupilumab in terms of EASI 90 (40.8% vs 22.5%, P < .0001) and WP-NRS of 0/1 (30.2% vs 15.5%, P < .0001) at the 16-week mark.
• The safety profile of upadacitinib was consistent with previous AD studies, with no new safety concerns identified.
• Both medications had a similar rate of serious adverse events (0.9%).
The results from the LEVEL UP trial suggest that upadacitinib may be a more effective treatment option than dupilumab for patients with moderate-to-severe AD. This can help guide clinicians in selecting the most effective treatments for their patients.
The LEVEL UP trial provides evidence that upadacitinib outperforms dupilumab in treating moderate-to-severe atopic dermatitis, offering higher rates of symptom relief and skin clearance. The safety profile of upadacitinib remains consistent with previous studies, making it a promising option for AD management.
Reference:
New Data Show RINVOQ® (upadacitinib) Demonstrated Superiority Versus DUPIXENT® (dupilumab) Across Primary and All Secondary Endpoints in an Open-Label Head-to-Head Atopic Dermatitis Study. AbbVie. April 25, 2024. https://news.abbvie.com/2024-04-25-New-Data-Show-RINVOQ-R-upadacitinib-D.... Date accessed: April 25, 2024.
10 months 2 weeks ago
Dermatology,Dermatology News,Top Medical News,Latest Medical News
Men’s health, prostate cancer and nutrition
“A man is at risk of prostate cancer if he is over the age of 50, is of African descent, have a family history of prostate problems or cancer and breast cancer and if he is obese or overweight”
View the full post Men’s health, prostate cancer and nutrition on NOW Grenada.
10 months 2 weeks ago
Health, PRESS RELEASE, gfnc, grenada food and nutrition council, prostate cancer
An Arm and a Leg: Medicaid Recipients Struggle To Stay Enrolled
Medicaid — the state-federal health insurance program for low-income and disabled Americans — has cut more than 22 million recipients since spring 2023.
One of them was the son of Ashley Eades. Her family lost their Medicaid coverage in the “unwinding” of protections that had barred states from dropping people for years during the covid pandemic.
Medicaid — the state-federal health insurance program for low-income and disabled Americans — has cut more than 22 million recipients since spring 2023.
One of them was the son of Ashley Eades. Her family lost their Medicaid coverage in the “unwinding” of protections that had barred states from dropping people for years during the covid pandemic.
Many families, including Ashley’s, still qualify for Medicaid but lost it for “procedural reasons.” Basically, missing paperwork.
The unwinding process has been messy.
In this episode, host Dan Weissmann talks with Ashley about the months she spent fighting to get her son reenrolled in 2023 to get an on-the-ground look at how the unwinding is affecting families.
Then, Dan hears from staff at the Tennessee Justice Center, Joan Alker of Georgetown University’s Center for Children and Families, and KFF Health News correspondent Brett Kelman, who has been covering Medicaid in Tennessee for years.
Dan Weissmann
Host and producer of "An Arm and a Leg." Previously, Dan was a staff reporter for Marketplace and Chicago's WBEZ. His work also appears on All Things Considered, Marketplace, the BBC, 99 Percent Invisible, and Reveal, from the Center for Investigative Reporting.
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‘An Arm and a Leg’: Medicaid Recipients Struggle To Stay Enrolled
Note: “An Arm and a Leg” uses speech-recognition software to generate transcripts, which may contain errors. Please use the transcript as a tool but check the corresponding audio before quoting the podcast.
Dan: Hey there. You know what we have NEVER talked about on this show? Medicaid. The big, federally-funded health insurance program for folks with lower incomes. And I did not realize: That’s been a huge omission. Because it turns out, Medicaid covers a TON of people. Like about a quarter of all Americans. And about forty percent of all children. That’s four out of every ten kids in this country who are insured by Medicaid.
And this is the perfect time to look at Medicaid because– well: tens of millions of people are losing their Medicaid coverage right now. It seems like a lot of these people? Well, a lot of them may actually still qualify for Medicaid.
This is all kind of a “Back to the Future” moment, which started when COVID hit: The feds essentially hit pause on a thing that used to happen every year– requiring people on Medicaid to re-enroll, to re-establish whether they were eligible. And back then, tons of people got dropped every year, even though a lot of them probably still qualified.
The pause lasted through the COVID “public health emergency,” which ended in spring 2023. Since then, states have been un-pausing: Doing years and years of re-enrollments– and un-enrollments– all at once. People call it the “unwinding.” And it’s been messy. And, another thing I’ve been learning: Medicaid operates really differently from one state to another. It even has different names. In California, it’s called Medi-Cal. In Wisconsin, it’s BadgerCare. And this unwinding can look completely different from one state to the next.
We’re gonna look mostly at one state– Tennessee, where the program is called TennCare. And in some ways, according to the numbers on the unwinding, TennCare is… kinda average.
But the problems some people have had, trying to keep from getting kicked off TennCare? Before this unwinding and during it? They sound pretty bad. We’re gonna hear from one of those people– a mom named Ashley Eades.
Ashley Eades: Yeah. TennCare. Put me through the wringer, I tell you what.
Dan: We’ll hear how Ashley spent months fighting to keep her son Lucas from getting kicked off TennCare. And we’ll hear from some folks who can help us put her story in perspective. Including folks who helped Ashley ultimately win her fight. Folks who are fighting– in Tennessee and around the country– to keep programs like TennCare from putting people like Ashley through the wringer.
This is An Arm and a Leg– a show about why health care costs so freaking much, and what we can maybe do about it. I’m Dan Weissmann. I’m a reporter, and I like a challenge. So the job we’ve chosen around here is to take one of the most enraging, terrifying, depressing parts of American life, and to bring you a show that’s entertaining, empowering, and useful. Ashley Eades is a single mom in Nashville. She works in the kitchen at Red’s Hot Chicken, near Vanderbilt University.
Ashley Eades: We’re just like every other person in Nashville trying to say they got the best hot chicken.
Dan: Ashley buys her insurance from the Obamacare marketplace, but her son Lucas– he’s 12 — is on TennCare. In April 2023, Ashley got a notice from TennCare saying, “It’s time to renew your coverage!” Meaning Lucas’s coverage. Meaning, welcome to the unwinding! When I talk with Ashley, she uses one word about a half-dozen times:
Ashley Eades: it just was a nightmare. It was a nightmare. So that was the nightmare. A terrible nightmare you can’t wake up from. Oh my god, that was a nightmare.
Dan: So: After Ashley filled out the renewal packet, she got another notice, saying “We need more information from you.” TennCare wanted proof of “unearned income”– like bank statements, or a letter saying she was entitled to something like workers compensation– or a court-ordered payment. But Ashley didn’t have any unearned income. Lucas’s dad was supposed to pay child support, but– as Ashley later wrote to state officials– he didn’t have regular employment so couldn’t pay.
Ashley says she called TennCare for advice and got told, “Never mind. There’s nothing to send, so you don’t have to send us anything.” Which turned out to be wrong. A few weeks later, in May, TennCare sent Ashley a letter saying “Why your coverage is ending.”
It gave two reasons: First, it said “We sent you a letter asking for more facts… but you did not send us what we needed.” It also said “We’ve learned that you have other insurance” for Lucas. But she didn’t. And not having insurance for Lucas was going to be an immediate problem. He got diagnosed with epilepsy a few years ago, and he needed ongoing treatment.
Ashley Eades: he was on three different medications. I mean, that alone would cost me about $1,500 a month with no health insurance. And this is anti-seizure medication. Like we can’t just stop it
Dan: Yeah. Ashley says she did everything she could think of: mailed in paper forms, submitted information online, and made a lot of phone calls.
Ashley Eades: like back and forth on the phone with people I don’t even know who Italked to, just dozens and dozens of people I talked to. And every single time it was go through the same story over and over and over and over and over again and just get transferred Put on holds, you know disconnected yelled at, told I’m wrong like
Dan: It went on for months. She reapplied. She was approved. Then she was un-approved. She appealed. The appeal was denied. Then, in July, the full nightmare: Lucas ended up in the emergency room after a seizure. While he was officially uninsured.
Ashley Eades: I just didn’t know what to do. Like, I was shutting down mentally.
Dan: And then, out of nowhere, a relative mentioned that a nonprofit called the Tennessee Justice Center had helped *her* out with a TennCare application. Ashley called the group right away.
Ashley Eades: and I’m not a spiritual person, but they were like a fudging godsend. You know what I mean? Like, it was amazing
Dan: A client advocate named Luke Mukundan looked at all of TennCare’s letters to Ashley and confirmed one thing right away: Ashley wasn’t wrong to be confused.
Ashley Eades: He’s like going through all of these letters and he’s like, it doesn’t even make sense
Dan: Later I talked with Luke, on kind of a lousy Zoom connection. But he said to me: This was confusing, even to him.
Luke Mukundan: she was providing the information that they asked for, um,
Dan: But they kept asking the same questions. And they kept saying that her son had some other insurance.
Luke Mukundan: when I knew and she knew that wasn’t the case
Dan: Luke’s boss at the Tennessee Justice Center, Diana Gallaher, told me she wasn’t surprised that Ashley got confused by that early question about un-earned income. She says the process can be really confusing.
Diana Gallaher: Heck, I get confused. I still, I’ll look at a question and say, you know, wait, what are they asking? How do I answer this one?
Dan: And you’ve been doing this for a while, right?
Diana Gallaher: Oh, yeah. Yeah.
Dan: How long have you been doing this?
Diana Gallaher: Since 2003, 2004.
Dan: More than twenty years. Of course, Ashley’s been going through this process at an especially rough time: The unwinding. When so many people were going through this process at once.
For instance, Luke and Diana say the help lines at TennCare were super-jammed– like, it wasn’t unusual to spend 45 minutes or an hour on hold.
By the time Ashley found the Tennessee Justice Center, it was August. She’d been fighting alone for months. Luke helped Ashley with a new appeal. And on September 22, TennCare sent Ashley an update. Her son is approved. “You qualify for the same coverage you had before,” it says. “And you’ll have no break in coverage.”
So Ashley’s “nightmare” was one person’s experience of the unwinding. But it’s not a one-off: According to reports from KFF and Georgetown University, more than two-thirds of the people who lost Medicaid in the last year were disenrolled, like Ashley, for what are called “procedural reasons.” Missing paperwork.
Now, some of those people who got dropped for “procedural reasons” probably didn’t even try to renew Medicaid because they didn’t need it anymore. They had new jobs that came with insurance.
But we know those folks are in a minority. Researchers at KFF– the parent group of our journalist pals at KFF Health News– did a survey of folks who got dropped from Medicaid. Most of them– seventy percent– ended up either uninsured or, the biggest group, back on Medicaid. And again, more than two-thirds of the folks who got dropped were cut for “procedural reasons”– paperwork. Like Ashley’s son Lucas.
So, when a lot of people can’t renew their Medicaid for “procedural” reasons, it seems worth looking at that procedure. And what’s happening in the unwinding isn’t actually a new phenomenon. It’s just un-pausing an old procedure– a system that always had these problems. And that’s really clear in Tennessee, because people in Tennessee have been documenting– and fighting– these problems for a long time.
Next up: Taking TennCare to court.
This episode of An Arm and a Leg is a co-production of Public Road Productions and KFF Health News. The folks at KFF health news are amazing journalists– and in fact, we’re about to hear from one of them, right now.
Brett Kelman: My name is Brett Kelman.
Dan: Brett’s an enterprise correspondent with KFF Health News
Brett Kelman: And I report from the city of Nashville, where I have lived for about seven years.
Dan: Brett came to Nashville initially to cover health care for the local daily, the Tennessean. Which meant he heard about Medicaid– about people losing medicaid– a lot.
Brett Kelman: You hear two versions of the same story. You hear patients who get to the doctor’s office and suddenly discover they don’t have Medicaid when they used to, and they thought they still did. And then you hear the other side of that coin. You hear doctors, particularly a lot of pediatricians, where their patients get to their office and then discover in their waiting rooms they don’t have Medicaid.
Dan: And by the way– you noticed how Brett said he heard especially from pediatricians about this issue in Tennessee. That’s because Tennessee is one of the states that never expanded Medicaid after the Affordable Care Act took effect. In those states, Medicaid still covers a lot of kids but a lot fewer adults than other states. Docs treating patients with Medicaid– a lot of them are gonna be pediatricians.
So, Brett’s hearing all of this seven years ago– the before-time. Before the unwinding. Before COVID. People kept losing Medicaid and not knowing about it until they got to the doctor’s office. And Brett wanted to know: how did that happen? He and a colleague ended up doing a huge investigation. And came back with a clear finding:
Brett Kelman: Most of the time, when people lose their Medicaid in Tennessee, it is not because the state looked at their finances and determined they aren’t qualified. Paperwork problems are the primary reason that people lose Medicaid coverage in Tennessee.
Dan: Brett and his reporting partner used a public-records request to get a database with the form letters sent to about three hundred thousand people who needed to renew their Medicaid coverage.
Brett Kelman: And what we determined was that, you know, 200,000 plus children, had been sent a form letter saying that they were going to lose their Medicaid in Tennessee, again, not because the state determined they were ineligible, but because they couldn’t tell.
Dan: About two thirds of people in that database got kicked off Medicaid for “procedural reasons”– paperwork issues. This is years before the current “unwinding” but that two-thirds number, it’s pretty similar to what we’re seeing today.
Brett Kelman: And, you know, that raises a lot of questions about if we’re doing the system correctly, because do we really want to take health care away from a family who is low income? Because somebody messed up a form or a form got lost in the mail.
Dan: Around the time Brett published that story in 2019, the Lester family found out that they had lost their Medicaid– because a form had gotten lost in the mail. It took them three years to get it back. Brett met them at the end of that adventure
Brett Kelman: they were a rural Tennessee family, a couple of rambunctious boys who seemed to injure themselves constantly. And honestly, I saw him almost get hurt while I was there doing the interview. One of the young boys had. Climbed up to the top of a cat tower. And I believe jumped off as I was interviewing his parents and I could see the insurance, I could see the medical claims racking up before my eyes.
Dan: In 2019, one of the boys had broken his wrist jumping off the front porch. And when the Lesters took him to the doctor, that’s when they learned they’d been cut from Medicaid. Over the next three years, they racked up more than a hundred thousand dollars in medical debt– dealing with COVID, with more injuries, with the birth of another child. Finally, the Tennessee Justice Center helped them get Medicaid back– and figure out what had gone wrong.
Brett Kelman: And when it all came down to it, we eventually determined that this paperwork that their health insurance hinged on, the health insurance that they were entitled to, they had lost it because the state had mailed that paperwork to the wrong place.
Dan: Oh, and where had the state been mailing that paperwork to? A horse pasture.
Brett Kelman: It wasn’t far from their house, but there was certainly no one receiving mail there
Dan: Was there like a mailbox for the horses? Like where did they, where did it even go? Get left.
Brett Kelman: I don’t remember if there was a mailbox for the horses. I don’t think so. I mean, if you think about this chain of events, they were sent paperwork they were supposed to fill out and return to keep their health insurance, but it went to the horse pasture, so they didn’t fill it out. Then they were sent a letter saying, Hey, you never filled out that paperwork. We’re gonna take your health insurance away. But it went to the horse pasture, so they didn’t fix it, and then they were sent paperwork saying, we’ve cut off your health insurance. You won’t have health insurance as of this date But it was sent to the horse pasture, so they didn’t know about it.
Dan: And their three-year fight to get Medicaid back took place AFTER Brett published his initial story. So, some things, it seemed, hadn’t changed a whole lot. But one thing had happened: In 2020, the Tennessee Justice Center had filed a class-action lawsuit, demanding that TennCare re-enroll about a hundred thousand people who had gotten cut off– the lawsuit alleges, without due process. Here’s Brett’s take:
Brett Kelman: And yes, I recognize that there could just have a Medicaid recipient who is not on top of this and ignores the paperwork and lets it rot in a pile of mail on their kitchen counter. I have some mail like that. I’m not going to pretend like I have never done this, but how do you tell the difference between that person and somebody who never got this paperwork that their child’s health care hinges upon?
Dan: This exact question comes up in the lawsuit. In a filing, the state’s lawyers say TennCare does not owe a hearing to anybody who says they just didn’t get paperwork. “The simple reason for this policy is that it is well known that mail is ordinarily delivered as addressed, TennCare enrollees have a responsibility to keep the program apprised of address changes (as explained to them in TennCare’s notices), and it is exceedingly common for individuals who have missed a deadline to claim they did not receive notice.”
Class action lawsuits move slowly. This one, filed more than four years ago, only went to trial recently. A judge’s decision is … pending. In a post-trial filing, the Tennessee Justice Center tells the stories of 17 people cut off from Medicaid allegedly due to errors by TennCare.
In TennCare’s filings, the state’s lawyers say, in effect: None of this proves there’s a systemic problem. And as a couple people have said to me: You don’t have to set out to build a bad system. If you don’t take care to build a good one, your system will definitely have problems.
We sent TennCare a long note about what we’ve been learning: About Brett Kelman’s reporting, about the class-action lawsuit, and about what happened to Ashley Eades. We asked them for any comment– or to let us know if they thought we’d gotten anything wrong. We haven’t heard back from them.
So, let’s zoom out a little bit to look at how these systems are working across 50 states. The person to talk to here is Joan Alker. She’s a professor at Georgetown, and she runs the university’s Center for Children and Families.
Joan Alker: Yeah, Medicaid really is my jam. I have been working on Medicaid issues for about 25 years now, which is a little frightening.
Dan: So of course she and her colleagues have been tracking how all 50 states have been dealing with the unwinding, compiling all kinds of data. When we talked, they’d just updated a ticker showing how many kids have been dropped in each state.
Joan Alker: We just hit 5 million net child Medicaid decline just today. Um, so that’s very troubling.
Dan: And according to Joan Alker’s report, kids were even more likely to be dropped for “procedural reasons”– paperwork issues– than adults.
Joan Alker: Most of these children are probably still eligible for Medicaid and many of them won’t have another source of coverage. And that’s what I worry a lot about.
Dan: But it varies a TON. A couple states– Maine and Rhode Island– actually have MORE kids enrolled than when the unwinding started. A half-dozen others have dropped very few kids.
Joan Alker: But then we had some states that went out really assertively and aggressively to, um, to To have fewer people enrolled in Medicaid
Dan: Her numbers show that Texas is a standout. They’ve got one point three million fewer kids enrolled in Medicaid than they did before the unwinding… Tennessee– with all the problems documented by Brett Kelman and the Tennessee Justice Center– is kind of around the middle of the pack.
Joan Alker: Unfortunately, this is the norm. Right? When you look at the number of disenrollments nationwide, the average for procedural red tape reasons is 70%. Only 30 percent of those people losing Medicaid nationwide have lost it because they’ve clearly been determined to be ineligible.
Dan: Obviously, Joan Alker is not happy about this. But she is also not hopeless! The unwinding has been an example of what happens– what can happen– when you require people to renew their enrollment every year. But now some states are experimenting with … not requiring that anymore, at least not for young kids.
Joan Alker: …because we know so many of them are going to remain eligible. They’re cheap to insure. They’re not where the money is being spent in our healthcare system. But they need regular care.
Dan: Oregon, Washington, and New Mexico now keep kids enrolled through age six. Another seven states are aiming to do the same.
Joan Alker: This is an idea that we’ve been promoting for like 15 years and we were kind of crying out in the wilderness for a long time, but it’s breaking through now
Dan: I’m not gonna lie. There’s a ton that’s not gonna get fixed with Medicaid anytime soon. We don’t know yet how the judge in the Tennessee Justice Center’s class-action lawsuit is gonna rule. But seeing these fights, it reminds me of something I’ve said before on this show: We are not gonna win them all. But we don’t have to lose them all either.
By the way, a little news about Ashley Eades– our mom in Nashville, who fought to keep her son on TennCare.
Ashley Eades: Last year, I started going back to school, and I’m going to school full time, and I’m working full
Dan: Oh my gosh!
Dan: And she’s home-schooling Lucas.
Ashley Eades: I was like, “we’re going to go to school together, buddy.” Like, we share a desk, you know, and he’s like in class and I’m in class.
Dan: Wow
Ashley Eades: I had to get creative. um, so, yeah, I’m like, working this really crappy, stinky job and going to school
Dan: And it’s working out.
Ashley Eades: I, um, made Dean’s List this semester, like got straight A’s.
Dan: Yeah!
Dan: Ashley wants to go to Medical school. I thought you’d want to know.
Before we go, I just want to say THANK YOU. In our last episode, we asked you to help us understand sneaky facility fees, by sending your own medical bills, and you have been coming through in a big way. We’ve heard from more than 30 people at this point. Some of you have been annoyed by these fees for years– a couple of you have told us about driving 30 or 40 miles across town, hoping to avoid them. And we’ve been hearing from folks inside the medical billing world, offering us some deeper insight. And I could not be pleased-er. Thank you so much!
If you’ve got a bill to share, it’s not too late to pitch in, at arm-and-a-leg-show, dot com, slash FEES. I’ll catch you in a few weeks. Till then, take care of yourself.
This episode of An Arm and a Leg was produced by me, Dan Weissmann, with help from Emily Pisacreta, and edited by Ellen Weiss. Thanks this time to Phil Galewitz of KFF Health News, Andy Schneider of Georgetown University’s Center for Children and Families, and Gordon Bonnyman of the Tennessee Justice Center for sharing their expertise with us. Adam Raymonda is our audio wizard. Our music is by Dave Weiner and blue dot sessions. Gabrielle Healy is our managing editor for audience. Gabe Bullard is our brand-new engagement editor. Bea Bosco is our consulting director of operations. Sarah Ballama is our operations manager.
And Armand a Leg is produced in partnership with KFF Health News. That’s a national newsroom producing in-depth journalism about healthcare in America and a core program at KFF, an independent source of health policy research, polling and journalism. Zach Dyer is senior audio producer at KFF Health News. He’s editorial liaison to this show.
And thanks to the Institute for Nonprofit News for serving as our fiscal sponsor, allowing us to accept tax exempt donations. You can learn more about INN at INN. org. Finally, thanks to everybody who supports this show financially– you can join in any time at arm and a leg show dot com, slash, support– thanks for pitching in if you can, and thanks for listening.
“An Arm and a Leg” is a co-production of KFF Health News and Public Road Productions.
To keep in touch with “An Arm and a Leg,” subscribe to the newsletter. You can also follow the show on Facebook and the social platform X. And if you’ve got stories to tell about the health care system, the producers would love to hear from you.
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KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
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10 months 2 weeks ago
Health Care Costs, Insurance, Medicaid, Multimedia, An Arm and a Leg, Podcasts, Tennessee
Opinion: Outdated Medicare rules prevent some dementia patients from getting the medications they need
Memory loss is the most obvious symptom of Alzheimer’s disease.
But for the more than 6.5 million Americans who suffer from Alzheimer’s disease — and the people who support them — memory lapses are often the least of their problems. Many people with Alzheimer’s or other forms of dementia also experience mood and behavior symptoms ranging from anxiety and depression to violent outbursts and psychosis.
Family members, caregivers, and even some medical providers often dismiss these so-called neuropsychiatric symptoms as acting out, with behavior that’s within an individual’s control. Although these symptoms can be very disruptive and overwhelming, they aren’t the individual’s fault or an extension of their personality — they are another manifestation of the disease.
10 months 2 weeks ago
First Opinion, Health, Advocacy, Alzheimer’s, Dementia, Medicare
New Executive Director at Grenada Planned Parenthood Association
In her new role, Amicah James is excited to expand access to essential services, advocate pre and postnatal support, and build strong partnerships within the community
View the full post New Executive Director at Grenada Planned Parenthood Association on NOW Grenada.
10 months 3 weeks ago
Health, PRESS RELEASE, amicah james, gppa, grenada planned parenthood association
Ask a doctor: 'Why are my hands swelling and what should I do about it?'
If you notice your hands are swelling, it could be both uncomfortable and unsettling, but in most instances the cause could be situational — caused by factors such as temperature, exercise, diet, medications you’re taking or certain health conditions.
If you notice your hands are swelling, it could be both uncomfortable and unsettling, but in most instances the cause could be situational — caused by factors such as temperature, exercise, diet, medications you’re taking or certain health conditions.
You may notice your rings aren’t fitting correctly, among other things.
To find out more about the condition, Fox News Digital asked two doctors what causes hand swelling and what can be done to treat it.
ASK A DOCTOR: ‘WHY AM I HEARING MY HEARTBEAT IN MY EARS?’
Here’s what you need to know.
Most commonly, hand swelling is due to fluid buildup in the soft tissue.
"Soft tissue swelling, or edema, is not always a cause for concern, and can occur with weather changes or fluid shifts in the body," said Amy Kehl, M.D., RhMSUS, a board-certified rheumatologist with Saint John's Physician Partners in Santa Monica, California.
Most patients observe some degree of soft tissue swelling or edema with hot weather and with exercise, according to Kehl.
Fluid shifts can also occur with too much salt intake, she noted, which can lead to increased hand or foot swelling, she said.
"Additionally, certain medications, such as blood pressure medications like amlodipine; steroids such as Prednisone or Medrol; or hormone treatments, can contribute to soft tissue swelling in the hands or feet," Kehl added.
If a person notices an increase in hand or foot swelling that is not reversible or intermittent — or if the hand swelling is also accompanied by leg swelling with marked elevations in blood pressure or shortness of breath — medical attention should be sought, Kehl said.
ASK A DOCTOR: ‘IS IT DANGEROUS TO SWALLOW GUM?’
A person "should ensure they have had proper medical evaluation to assess both kidney and cardiac function, as hand or foot swelling can be an indicator of kidney dysfunction, protein loss in the urine, or cardiac dysfunction," she cautioned.
"Your doctor may order tests to assess your kidney function, urine studies or, in some cases, an echocardiogram."
Diuretics may be needed to remove the excess fluid if it is related to cardiac dysfunction, she said.
ASK A DOCTOR: ‘IS IT DANGEROUS TO CRACK MY NECK OR BACK?’
Another possible cause of fluid build-up is lymphedema, which can occur if the patient has had surgery, such as a lymph node resection for breast cancer treatment, according to Kehl.
"This may be treated with local lymphatic drainage treatments, arm elevation, compression sleeves and exercise," the doctor said.
Individuals should also be cognizant of other symptoms.
"Certainly, if the hand swelling is associated with joint pains, this may indicate an underlying inflammatory arthritis, such as rheumatoid arthritis or psoriatic arthritis," Kehl told Fox News Digital. "Again, an examination may be warranted to distinguish soft tissue swelling from articular or joint swelling."
Patients should also be aware if the swelling is asymmetric.
"This can be a sign of something more serious, such as a blood clot, and patients should seek medical attention right away if new and asymmetric swelling and pain develops," Kehl warned.
ASK A DOCTOR: 'HOW CAN I IMPROVE MY POSTURE?'
If a patient notices hand swelling in association with facial or lip swelling, this warrants immediate medical attention, she said.
If the hand swelling is deemed to be due to "benign causes," this is typically reversible, Kehl noted.
"For instance, to reduce hand swelling after exercising, elevating the hands and performing arm circles may be helpful to increase the blood flow to the hands," she said.
Similarly, it may be necessary to review your medication list with your medical provider to identify any pharmaceutical culprits.
"Typically, with discontinuation of the offending medication, the swelling should subside," Kehl said.
ASK A DOCTOR: 'HOW CAN I PREVENT HIGH CHOLESTEROL?'
Diet should also be monitored.
Maintaining the proper balance of salt and water is important, and reducing salt intake and following a low-sodium diet may be advisable for some patients, the expert noted.
Lifestyle changes, such as movement, can also be incorporated to help alleviate the swelling.
"Stretch both arms up, move your hands and wrists, and make fists several times," Beth Oller, M.D., a family physician with Rooks County Health Center in Stockton, Kansas, told Fox News Digital.
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Running your hands under cool water may help, she said, and taking off jewelry or constricting clothes while exercising can also help prevent swelling due to temperature changes.
"Staying well-hydrated can also help keep fluids circulating," Oller added.
Pregnancy is another common cause of swelling. In that case, Oller said that moving the extremities can help.
"If swelling in pregnancy occurs suddenly or is extreme, talk to your physician immediately, as this can be a symptom of elevated blood pressure," she also said.
10 months 3 weeks ago
ask-a-doctor, Health, health-care, healthy-living, high-blood-pressure, arthritis, rheumatoid-arthritis, heart-health, medications
Gen Z's vaping habits could be making them look older: docs - New York Post
- Gen Z's vaping habits could be making them look older: docs New York Post
- Social media users believes Gen Z is 'aging like milk' – Deseret News Deseret News
- Expert urges health education as youth face premature aging | Daily Sabah Daily Sabah
- Have you got VAPE FACE? Amid claims that Gen Z look older than they should, a top dermatologist reveals how va Daily Mail
- Here's the age that Gen Z considers to be 'old' Metro.co.uk
10 months 3 weeks ago
Health Archives - Barbados Today
Fogging schedule for June 3 – 7
The Ministry of Health and Wellness’ mosquito reduction programme will forge ahead this week when the Vector Control Unit visits areas in the parishes of Christ Church and St Michael.
Fogging will begin on Monday in the following Christ Church districts: Coral Lane, Seaside Drive, Seclusion Road, Ocean Mist Drive, Enterprise Coast Road, Light House Drive, and surrounding communities.
The Ministry of Health and Wellness’ mosquito reduction programme will forge ahead this week when the Vector Control Unit visits areas in the parishes of Christ Church and St Michael.
Fogging will begin on Monday in the following Christ Church districts: Coral Lane, Seaside Drive, Seclusion Road, Ocean Mist Drive, Enterprise Coast Road, Light House Drive, and surrounding communities.
The Unit will remain in the south of the island on Tuesday, when it visits Upper Carters Gap, Rollins Road, Bournes Land, Goodland Gardens, and Highway U.
On Wednesday the team will take the fogging programme to St Michael, where it will stay for the remainder of the week. The Unit will go into Skeete Road and avenues, Ivy and avenues, Hoytes Road, Gittens Road, and environs.
The next day, Thursday, Howells Cross Road, Pinder Gap, Back Ivy, Mayers Road, Proute Road, and Dean’s Road will be targeted.
The fogging exercise for the week will conclude on Friday in Gittens Road, Gittens Gap, Martinique Road, Lovers Road, Welches Terrace and Avenues, and neighbouring districts.
Fogging takes place from 4:30 to 8:30 p.m. daily. Householders are reminded to open their windows and doors to allow the spray to enter. Children should not be allowed to play in the spray.
Members of the public are advised that the completion of scheduled fogging activities may be affected by events beyond the Unit’s control. In such circumstances, the Unit will return to communities affected in the soonest possible time. (PR)
The post Fogging schedule for June 3 – 7 appeared first on Barbados Today.
10 months 3 weeks ago
Health, Local News
PAHO/WHO | Pan American Health Organization
World Health Assembly agreement reached on wide-ranging, decisive package of amendments to improve the International Health Regulations, and sets date for finalizing negotiations on a proposed Pandemic Agreement
World Health Assembly agreement reached on wide-ranging, decisive package of amendments to improve the International Health Regulations, and sets date for finalizing negotiations on a proposed Pandemic Agreement
Cristina Mitchell
1 Jun 2024
World Health Assembly agreement reached on wide-ranging, decisive package of amendments to improve the International Health Regulations, and sets date for finalizing negotiations on a proposed Pandemic Agreement
Cristina Mitchell
1 Jun 2024
10 months 3 weeks ago
PAHO/WHO | Pan American Health Organization
Pandemic preparedness and response, equity among key topics for the Americas at Seventy-seventh World Health Assembly
Pandemic preparedness and response, equity among key topics for the Americas at Seventy-seventh World Health Assembly
Luciana Viegas
1 Jun 2024
Pandemic preparedness and response, equity among key topics for the Americas at Seventy-seventh World Health Assembly
Luciana Viegas
1 Jun 2024
10 months 3 weeks ago
High patient admittance for influenza
Santo Domingo – Private clinics and clinical laboratories are receiving a significant increase of patients in their consultation and emergency areas, as well as clinical laboratories of people with flu-like symptoms seeking tests to determine the presence of Covid-19, influenza or any other respiratory virus.
Santo Domingo – Private clinics and clinical laboratories are receiving a significant increase of patients in their consultation and emergency areas, as well as clinical laboratories of people with flu-like symptoms seeking tests to determine the presence of Covid-19, influenza or any other respiratory virus.
The number of people with fever, sore throat and muscle pain, headache and general malaise and in some cases diarrhea, vomiting and loss of smell and taste, has increased in recent weeks in the country, which is attributed by specialists to the rains and high temperatures that have been recorded.
The high demand of patients with indications to undergo respiratory panels, to determine the type of virus affecting them, or only Covid-19 and influenza tests has been increasing in the main clinical laboratories of the country, according to patients’ reports.
In addition, the search for information from people interested in knowing where the Ministry of Public Health is performing the free Covid test is increasing.
INFLUENZA A AND B
A similar situation is also being experienced in private clinics, with an increase of patients with respiratory processes, mostly with influenza A and B, both in their consultation services, emergencies and in some cases, hospitalization, confirmed Rafael Mena, president of the National Association of Private Clinics and Hospitals (ANDECLIP).
He said that so far it is a moderate increase, which has not overflowed the capacity of the centers, and that when the test is done most of the cases are influenza A and B.
The doctor explained that hospitalizations are occurring mostly in those patients who have comorbid conditions, among them those suffering from asthma.
Special attention to hygiene
Avoid conglomerates, use masks when going to health centers or where people are crowded, cover your mouth when coughing using handkerchiefs or your elbow, stay at home isolated, do not go to work, school, or places where there are more people, are among the recommendations made by doctors specialized in the management of viral processes to avoid spreading the disease.
They consider it essential not to self-medicate and to go to the doctor, because there is also circulation of dengue and other diseases and it is important to know what type of virus is affecting the patient and to sanitize hands frequently.
10 months 3 weeks ago
Health, Local
Health – Demerara Waves Online News- Guyana
GPHC performs first paediatric liver resection surgery in Guyana
The Georgetown Public Hospital Corporation (GPHC) on Friday announced the successful completion of the first paediatric liver resection in Guyana. The hospital said that groundbreaking surgery was performed on an 18-month-old female patient from Linden, diagnosed with a rare and aggressive paediatric liver cancer known as hepatoblastoma. The patient’s journey began with a diagnosis of ...
The Georgetown Public Hospital Corporation (GPHC) on Friday announced the successful completion of the first paediatric liver resection in Guyana. The hospital said that groundbreaking surgery was performed on an 18-month-old female patient from Linden, diagnosed with a rare and aggressive paediatric liver cancer known as hepatoblastoma. The patient’s journey began with a diagnosis of ...
10 months 3 weeks ago
Health, News, aggressive tumour, Georgetown Public Hospital Corporation (GPHC), multidisciplinary team, paediatric liver resection