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Overlooked warning signs more accurately predict risk of death

first_img Columnist, Off the Charts Jennifer Adaeze Okwerekwu is a psychiatrist and a columnist for STAT. By Jennifer Adaeze Okwerekwu May 16, 2016 Reprints Quick TakeOverlooked warning signs more accurately predict risk of death Being “in good health” is often understood to mean not suffering from chronic diseases. But a new study finds that in older adults, factors such as psychosocial well-being and frailty are actually better predictors of death than typical measures like having diabetes or high blood pressure.Why it matters:The disease-centered focus of modern medicine often ignores the elements of health outside of illness. This is the first study of its kind to use a more comprehensive definition of well-being to analyze population health.The nitty gritty:Researches took a closer look at the data gathered by the National Social Life, Health, and Aging Project (NSHAP) a longitudinal, population-based study of older Americans who live at home. By interviewing and examining over 3,000 adults between 57 and 85 years of age, they found that half of the people classified as healthy by the traditional medical models actually had hidden risk factors for death and incapacity within five years.advertisement [email protected] Related: Tags diabetesmortality Jean-Sebastien Evrard/AFP/Getty Images “Our data shows that there are distinct clusters, or classes of health,” said lead investigator Martha K. McClintock, professor of psychology at the University of Chicago. The study was published in Proceedings of the National Academy of Sciences.You’ll want to know:Two previously unrecognized factors with twice the mortality and incapacity risk included people with healed broken bones and people with poor mental health.What they’re saying: “What surprised me was the importance of broken bones,” said John Haaga, who heads a division of the National Institute on Aging, which funded the research. That risk was known in older people, but “other broken bones earlier in life, in late middle age, being such a signal is interesting and worth following up,” he explained.This empirical data confirms the idea that there is no health without mental health, said Dr. Maria A. Oquendo, professor of psychiatry at Columbia University and New York State Psychiatric Institute.But keep in mind: While mental health has been historically shortchanged in medicine, the profession is increasingly recognizing that psychosocial well-being matters.“What they are considering the traditional medical model is really outdated,” said Dr. Joseph Ladapo, an assistant professor of population health and medicine at New York University Langone Medical Center.  “I don’t think it’s quite a fair comparison.”The study also concluded that certain health behaviors, like smoking, carry little weight in defining vulnerable health classes. Can we ‘cure’ aging? Scientists disagree Newsletters Sign up for Daily Recap A roundup of STAT’s top stories of the day. Please enter a valid email address. Jennifer Adaeze Okwerekwu @JenniferAdaeze The researchers created a statistical model to recategorize the study population into six tiers, from “robust” to “at-risk.” This model found that factors including loneliness, sense of hearing, mobility, and bone fractures significantly impacted mortality but were not included in traditional disease models. The authors found it more accurately reflected whether individuals would become incapacitated or die within five years than the prevailing medical model, which focuses on distinct diseases. The healthiest class of people were obese and robust. Obesity in an older adult who was otherwise healthy posed little risk for mortality.advertisement Privacy Policy About the Author Reprints Leave this field empty if you’re human: “I think one has to pause and look at the bigger  picture and really do a gut check on that kind of finding,” said Ladapo.  For many major illnesses like heart disease, stroke, and kidney disease, smoking is a major risk factor, and “it’s an enormous limitation [of the study]. … There is no doubt that smoking imparts an enormous burden on health and wellness.”The bottom line: Though a more inclusive definition of health isn’t a brand-new idea, this study adds evidence that overlooked health factors may be important indicators of health in older adults.last_img read more

Montana’s ‘pain refugees’ leave state to get prescribed opioids

first_img Corin Cates-Carney — Montana Public Radio Snook says though he might seem desperate like someone who is addicted to pain killers, he’s not. He’s not craving a quick fix. He leaves his home for treatment because he has no confidence in the doctors in Montana and he wants to be healed.“I believe pain control is a fundamental human right, or at least an attempt at pain control,” he said. “To deny someone with a horrible disease like me access to pain medications is the worst form of cruelty.”It was dark outside when Snook, his wife and the two other pain patients got off the plane in Los Angeles. They wheeled their suitcases to a rented SUV. When they got to the hotel, they smiled and greeted the lobby clerk by name.The trip has become routine. Every 90 days, they come here to see a doctor who gives them the care and prescriptions they say they can’t get at home.Fear among Montana doctorsMontana is a tough state to find many options for any medical care. Because much of the state is rural, residents often travel long distances, including out of state, for specialty care.In the past several years, the Montana Board of Medical Examiners has taken on several high-profile cases of doctors it suspects of overprescribing opioids. At least two Montana doctors have had their licenses suspended since 2014.Executive Officer Ian Marquand said his organization doesn’t play favorites. “The board does not encourage particular kinds of doctors, it does not discourage particular kinds of doctors. The door is open in Montana for any qualified, competent physician to come in and practice.”But Marc Mentel acknowledged that there’s fear around prescription painkillers in Montana’s medical community. He chairs the Montana Medical Association’s committee on prescription drug abuse, and he said he does hear of doctors being more wary. Related: For some chronic pain patients, ‘without opioids, life would be torture’ HealthMontana’s ‘pain refugees’ leave state to get prescribed opioids About the Author Reprints APStock Please enter a valid email address. By Corin Cates-Carney — Montana Public Radio July 22, 2016 Reprints To manage chronic pain, use the whole toolkit, not just opioids center_img “My pain, it’s all from my waist down,” he said. “It’s like being boiled in oil 24 hours a day.” Snook has been taking opioids since he had spine surgery for a ruptured disk 14 years ago. After the operation, he says he was in so much pain he couldn’t work. He’s tried all kinds of things to get better.“I got a surgery, epidural steroid injections, acupuncture, anti-inflammatories, physical therapy, pool exercises,” he said. “I’ve tried anything that anyone has ever suggested me to try. Unfortunately what I do right now is the only thing that works.”advertisement Newsletters Sign up for Pharmalot Your daily update on the drug industry. Federal authorities say about 78 Americans die every day from opioid overdose. In Montana, health care officials report that abuse there is worse than the national average. But the casualties of the opioid epidemic are not all drug abusers.On a recent night, three Montana residents, who call themselves pain refugees, boarded an airplane from Missoula to Los Angeles. They say that finding doctors willing to treat chronic pain in Montana is almost impossible, and the only way they can get relief is to fly out of state.Before Gary Snook dropped into his seat, he paused in the aisle, pressing his fingertips into his upper thigh. He bent his knees slightly and moved his hips side to side. He was getting in one final stretch before takeoff.advertisement Tags chronic painopioids Leave this field empty if you’re human: But opioids can also help people, Tennant said. Because of that, he said, the drugs shouldn’t be stigmatized, but used responsibly.“They are the last resort, when there is no other option. You don’t use them until everything else has failed,” he said.Tennant is lobbying for a Montana bill to guarantee more access to opioids for pain patients, so people like Snook don’t need to travel so far for a prescription.“Had I stayed in Montana, I would have killed myself,” said Snook. “I just want humanitarian care, and I get that in California.”This story, originally published by Kaiser Health News, is part of a reporting partnership with NPR, Montana Public Radio and Kaiser Health News. Related: Privacy Policy Mentel, who started practicing medicine in the 1990s, said that when he was training, medical education didn’t include treating long-term pain.“The perfect tool, the perfect medicine that would take away a person’s pain and allow them to function normally does not yet exist,” he said. “So we are trying to use any tool, any means we can to help lessen the severity of their pain.”Mentel said opioids do help some patients, but he hopes his generation of doctors will learn more about pain and understand ways to treat it beyond opioids.In March, the Centers for Disease Control and Prevention published long-awaited guidelines that said opioids should be the treatment of last resort for pain, and if used, should be combined with other treatments such as exercise therapy.“Patients are in pain,” Mentel said. “We don’t have great tools for them and we need to recognize that this is going to be a chronic-disease state. They may be in pain for the rest of their lives. So … how do we treat them without actually harming them?” he said.The California solutionFor Snook, relief is found at a small strip-mall clinic in suburban Los Angeles run by Dr. Forest Tennant, a former Army physician who says he has consulted for the National Institute on Drug Abuse, the National Football League and NASCAR.He has about 150 patients, half of them from out of state.Tennant says there are legitimate reasons to be concerned about opioids, and that’s why doctors need to specialize in pain management.To an untrained physician, Tennant said, addicts and pain patients can look similar. “Doctors can get conned,” he said. “I think that it is true that we’ve had a lot of opioids that get out on the street, and people get them … whether it is heroin or a prescription opioid.”last_img read more

13.8 million goal set for Obama’s final health care sign-up season

first_img Going into its fourth sign-up season, President Barack Obama’s health care law has yet to achieve stability. Enrollment has been lower than initially projected, insurers say patients turned out to be sicker-than-expected, and a complex internal system to help stabilize premiums did not work as intended, partly because of actions by congressional Republicans.The law offers subsidized private insurance to people who do not have coverage through their jobs, along with a state option to expand Medicaid for low-income people. Largely as a result of the Affordable Care Act, the nation’s uninsured rate has dropped below 9 percent, a historically low level. More than 21 million people have gained coverage since the law passed in 2010.The government said enrollment averaged more than 10 million people through the first half of 2016, and more than 8 in 10 were receiving financial help.Nonetheless, the law remains politically divisive and Republicans are still vowing to completely repeal it.The administration is hoping for a strong sign-up season to validate the president’s signature program, and for a victory by Democrat Hillary Clinton in the presidential election to close out the long-running political saga. Clinton has outlined steps she’d take to build enrollment and sweeten subsidies for consumers.Sign-up season doesn’t start until Nov. 1, but previously window shopping has been available about a week earlier on HealthCare.gov, now used by 39 states. That should be the case again.Officials say returning customers will notice a smoother, more informative website, making it easier to compare plans. It’s also been optimized for mobile devices. Those who are satisfied with their current plan don’t need to do anything; they’ll be automatically renewed. Depending on availability, consumers will have a new option of picking “Simple Choice” plans. These are plans that have fixed deductibles and standard copayments, making it easier to compare them on premiums and provider networks. They’ll display prominently on HealthCare.gov’s plan comparison tool.The administration is also planning a major outreach effort, including more than 10 million pieces of direct mail and a steady stream of email to an electronic mailing list of more than 20 million people. A top goal is to entice younger, healthier people to enroll. Expect pitches on social media platforms as well as television and radio.This year, officials will emphasize the sticks — not just the carrots. Consumers will get reminded that going without health insurance risks a fine from the IRS, and the basic penalty is now $695.Open enrollment ends Jan. 31, but consumers who want their coverage to take effect with the new year must act by Dec. 15.— Ricardo Alonso-Zaldivar By Associated Press Oct. 19, 2016 Reprints Politics13.8 million goal set for Obama’s final health care sign-up season Related: The administration says taxpayer-provided subsidies will cushion most of the impact of premium increases that are expected to be well into the double digits in many states.For policyholders whose insurance company will no longer offer coverage, the government is automatically matching them with another carrier’s plan. It’s up to the consumer whether or not to accept the match or keep shopping.advertisement Tags health insuranceObamaObamacarepolicy States move beyond ‘Obamacare’ to refocus health care Associated Press About the Author Reprints WASHINGTON — Facing new challenges to a legacy law, the Obama administration on Wednesday set its goals for the president’s final health care sign-up season.Health and Human Services Secretary Sylvia Burwell said she expects 13.8 million people to sign up.This is shaping up to be the most difficult sign-up season since HealthCare.gov launched in 2013 and the computer system froze up. But technology isn’t the issue now. Premiums are going up sharply in many parts of the country, and some major insurers have exited the program, leaving consumers with fewer choices next year.advertisement Senator John Barrasso (R-Wyo.) is one of several members of Congress who are critical of Obamacare. Andrew Harnik/APlast_img read more

Don’t cut the cord too fast: A pause benefits most newborns

first_imgHealthDon’t cut the cord too fast: A pause benefits most newborns An extra half minute may not seem like much, but a lot of oxygen-rich blood reaches the baby through the umbilical cord shortly after birth, said Dr. Maria Mascola of ACOG’s Committee on Obstetric Practice.advertisement WASHINGTON — Don’t cut that umbilical cord too soon: A brief pause after birth could benefit most newborns by delivering them a surge of oxygen-rich blood.New recommendations for US obstetricians, the latest in a debate over how quick to snip, suggest waiting “at least 30 seconds to 60 seconds after birth,” for all healthy newborns.That’s double what often happens now. It’s common in the US for doctors to cut the cord almost immediately, within 15 to 20 seconds of birth, unless the baby is premature.advertisement Surprising study finds possible culprit in preterm births The latest evidenceStudies began showing that babies born prematurely benefit from longer access to cord blood, with a lower risk of transfusions, anemia and bleeding in the brain. In response, ACOG recommended a pause for them.Now ACOG cites research showing full-term babies benefit, too, with a lower risk of even mild iron deficiency that can delay cognitive development. One study showed waiting 3 minutes to cut the cord led to slightly better early brain development.Today’s adviceThe World Health Organization says to wait one minute; some other groups say it’s OK to wait two minutes, or even five. ACOG settled on “at least” 30 seconds to one minute.However long the pause, it shouldn’t interfere with mom holding her baby. NIH’s Raju recommends telling parents, “While the baby’s nice and warm on your skin, we’ll take our time and then clamp.”Are there risks?Doctors won’t delay cutting if the baby has problems breathing and needs emergency care.An initial fear that delayed clamping spurs maternal bleeding has proved unfounded. But babies do need to be monitored for signs of jaundice, a risk for any newborn but one that may be slightly increased with delayed clamping.What about cord blood banking?Some parents bank their child’s umbilical cord blood for possible future medical use. Delayed cord cutting means there’s less left to store, and ACOG said families should be counseled accordingly.— Lauran Neergaard About the Author Reprints It may flow for up to five minutes, she said, but much of the placental blood transfers in that first minute — and there’s increasing evidence that it has some health benefits.Here are some things to know:Does the cord really matter once the baby breathes?It can give a boost to what Dr. Tonse Raju of the National Institutes of Health calls the amazing transition that happens as the baby takes his or her first breath.In the womb, the placenta acts as the fetus’ lungs. But within seconds of birth, the circulation changes and lungs once filled with fluid inflate as the baby inhales air. Cut access to lingering placental blood in the cord too soon, and the baby misses extra oxygen to supplement those early breaths.Before the 1960s, it wasn’t uncommon to wait five minutes or more to cut the cord. Then, for unclear reasons, doctors began clamping and cutting almost immediately.“Unfortunately, the value of immediate clamping has never been shown,” said Raju, a perinatology specialist at NIH’s National Institute of Child Health and Human Development. He wasn’t involved with the new recommendation. M. Lakshman/AP Related: Cutting the cord is a memorable moment in the delivery room, and Wednesday’s advice from the American College of Obstetricians and Gynecologists won’t interfere if dads want to help. Associated Press Related: By Associated Press Dec. 21, 2016 Reprints Tags pediatricswomen’s health Do C-sections alter a baby’s microbiome, hurting later health? last_img read more

After complaints of favoritism, FDA does an about-face and opens a contract to bidding

first_img Log In | Learn More After complaints of favoritism, FDA does an about-face and opens a contract to bidding Andrew Harnik/AP What is it? By Ed Silverman May 16, 2018 Reprints Pharmalot STAT+ is STAT’s premium subscription service for in-depth biotech, pharma, policy, and life science coverage and analysis. Our award-winning team covers news on Wall Street, policy developments in Washington, early science breakthroughs and clinical trial results, and health care disruption in Silicon Valley and beyond. @Pharmalot Unlock this article by subscribing to STAT+ and enjoy your first 30 days free! GET STARTED Daily reporting and analysis The most comprehensive industry coverage from a powerhouse team of reporters Subscriber-only newsletters Daily newsletters to brief you on the most important industry news of the day STAT+ Conversations Weekly opportunities to engage with our reporters and leading industry experts in live video conversations Exclusive industry events Premium access to subscriber-only networking events around the country The best reporters in the industry The most trusted and well-connected newsroom in the health care industry And much more Exclusive interviews with industry leaders, profiles, and premium tools, like our CRISPR Trackr.center_img Pharmalot Columnist, Senior Writer Ed covers the pharmaceutical industry. GET STARTED [email protected] Tags pharmaceuticalspolicySTAT+ What’s included? Ed Silverman About the Author Reprints After complaints from various organizations, the Food and Drug Administration has done an about-face and opened up bidding on a $4.25 million contract that was already earmarked for a health policy institute at Duke University run by former FDA commissioner Mark McClellan.The decision is an unusual development that comes amid accusations of favoritism and confusion over the agency’s bidding process for certain types of grants.last_img read more

‘Neglected diseases’ are anything but neglected by the billion-plus people living with them

first_imgFirst Opinion‘Neglected diseases’ are anything but neglected by the billion-plus people living with them By Jerome H. Kim Jan. 4, 2019 Reprints Privacy Policy [email protected] In the United States, the Food and Drug Administration has a tropical disease program that grants a priority review voucher for a future (unspecified) product if a company licenses a vaccine against a particular poverty-associated infectious disease. These vouchers can be traded, and can have a value in the hundreds of millions of dollars. This is a start, but it hasn’t solved the problem.Even for vaccines whose development has been substantially funded by philanthropy, such as GlaxoSmithKline’s malaria vaccine, the in-kind, opportunity, and delay-associated costs are risks borne by pharma with only a halo effect as an incentive. I am not defending multinational pharmaceutical companies, but we must recognize that they have a number of global health vaccines in early development they have decided not to proceed further with. Instead, they wait in company freezers.Is this simply a lack of leadership? The horrors of Ebola led to a realization that the timely development of vaccines for particular epidemic diseases was impossible without a coordinated, international effort. Out of this was born the Coalition for Epidemic Preparedness Innovations, which launched in 2017 at the World Economic Forum with support from countries such as Norway, Germany, Britain, Japan, and India, and from philanthropic foundations such as the Gates Foundation and the Wellcome Trust. The coalition’s fund initially targeted vaccines for three diseases with outbreak potential — Middle East respiratory syndrome, Lassa fever, and Nipah — and it now has pledges of more than $740 million.Neglected diseases should not be victims. They must find a voice to attract leadership, advocacy, and funding so we can put PAID to solving these pressing global health needs. One useful strategy would be to prioritize and incentivize the development of vaccines for diseases that are a bigger problem in developing countries but that could also be useful in high-income countries.Health policy experts, politicians, CEOs, philanthropists, and others must step up and be the voice of the neglected. We know the problem and we have the solution in our hearts, our minds, and our wallets.Jerome Kim, M.D., is the director general of the International Vaccine Institute, a South Korea-based nonprofit international organization devoted to the discovery, development, and delivery of vaccines for global health. Jerome H. Kim Tags global healthNeglected DiseasesVaccines I dislike the term “neglected tropical diseases.” This collection of communicable diseases is neglected — a pejorative term — only by countries unaffected by them. They aren’t neglected by the 1 billion or more individuals afflicted with them, the millions who die from them, or the countries in which they live.The World Health Organization initially listed 13 diseases as “neglected.” Gaining consensus around what constitutes these diseases is as difficult as pronouncing dracunculiasis, schistosomiasis, or chromoblastomycosis. What’s more, there are diseases that kill tens or hundreds of thousands of people every year that don’t make the list, like hepatitis E, which kills 70,000 pregnant women a year, and group A streptococcus (the cause of strep throat), which kills 500,000 people a year.Peter Hotez, dean of the National School of Tropical Medicine at Baylor College of Medicine, has argued that many of the neglected diseases aren’t exclusively “tropical” or even relegated to developing countries: dengue and Chagas disease have certainly been problems in the United States.advertisement Related: Newsletters Sign up for First Opinion A weekly digest of our opinion column, with insight from industry experts. Related:center_img Group A streptococcus kills 500,000 people a year. NIAID via AP 3 global health challenges to watch in 2019 Given the wide variety of these diseases, their symptoms, and the populations they affect, there is no face, no poster child that can be used to excite the sympathy of donors, engage the imagination of funders, or raise the specter of global contagion.At the most basic level, the global health community isn’t certain of the magnitude of some of these diseases. Does hepatitis E kill 70,000 people a year (the most widely quoted estimate) or 10,000 a year (the estimate provided by the Bill and Melinda Gates Foundation-funded Institute for Health Metrics Evaluation)? Does schistosomiasis kill 12,000 people a year or 200,000?There isn’t consensus on how to prioritize work against poverty-associated infectious diseases. Should we pick low-hanging fruit such as guinea worm, which now afflicts a small number of people (30 cases worldwide) but is nearing eradication, or should we focus on non-typhoidal salmonella that may kill 680,000 this year?If these diseases affected developed countries, incentives would exist for companies to develop new diagnostics, drugs, and vaccines. There would be funding to understand the critical elements of disease transmission and to implement effective prevention and control programs. An alternative designation, poverty-associated infectious diseases (PAID), better captures the essence of this hodgepodge. But it doesn’t do much to help define, prioritize, fund, and create incentives for action to reduce the burden of PAID around the world.What should be done to remedy this systematic failure, including the failure to promptly develop vaccines, the most cost-effective approach to infectious diseases and an essential part of the comprehensive solution to these diseases?advertisement About the Author Reprints Please enter a valid email address. @drjeromekim1 Leave this field empty if you’re human: It seems remarkable that the G-FINDER public search tool, a source of information on research funding, indicates that $1 billion is spent each year on neglected tropical disease research. Yet 80 percent of that funding goes to HIV/AIDS, tuberculosis, and malaria, short-changing the other poverty-associated infectious diseases. Group A streptococcal disease, for example, received around $1 million in 2016 despite causing 500,000 deaths each year.Incentives are the complement to government research funding. If the U.S. National Institutes of Health funding pushes innovation, the promise of a “big vaccine” — and with it the creation of shareholder value — serves as a lure. If major vaccine companies were given sufficient incentives, including the removal of risk-related disincentives, to develop vaccines for Mali or South Sudan, perhaps solutions would already be at hand for schistosomiasis.Remarkable vaccines now exist against diseases like rotavirus diarrhea and cervical cancer that are problems in high-income as well as low-income countries. Getting those new products into vaccination programs has been a real achievement. But can we now flip the model and develop new vaccines against diseases that are a bigger problem in developing countries that might also be useful in high-income countries as well?From a pharmaceutical company’s perspective, it may cost $500 million to $1 billion to develop a vaccine, and only 1 in 10 new vaccines eventually reach the commercial market. In short, vaccines are expensive to develop and have a high risk of failure. That investment of time and money may pay off for a vaccine against pneumonia — Pfizer’s Prevenar brought in nearly $6 billion in 2017 — but it doesn’t for vaccines against dysentery, strep throat, or schistosomiasis that afflict people whose average income is less than a dollar a day. Priority review vouchers for tropical disease drugs simply aren’t working last_img read more

Johnson & Johnson and Bayer agree to pay $775 million to settle thousands of Xarelto lawsuits

first_img Janssen Parmaceuticals Inc./AP Tags legalpharmaceuticalsSTAT+ After more than five years of litigation, Bayer (BAYRY) and Johnson & Johnson (JNJ) agreed to pay $775 million to settle about 25,000 lawsuits over claims they failed to warn about side effects associated with the Xarelto blood thinner, which the companies jointly market.The settlement, which will be split evenly between the drug makers, resolves both federal and state cases that alleged the companies downplayed potentially fatal risks of internal bleeding and aggressively marketed the drug as an alternative to warfarin for people who sought to avoid blood clots. Neither of the companies admitted liability, although both noted they prevailed in six cases that went to trial. Pharmalot STAT+ is STAT’s premium subscription service for in-depth biotech, pharma, policy, and life science coverage and analysis. Our award-winning team covers news on Wall Street, policy developments in Washington, early science breakthroughs and clinical trial results, and health care disruption in Silicon Valley and beyond. About the Author Reprints Log In | Learn More Daily reporting and analysis The most comprehensive industry coverage from a powerhouse team of reporters Subscriber-only newsletters Daily newsletters to brief you on the most important industry news of the day STAT+ Conversations Weekly opportunities to engage with our reporters and leading industry experts in live video conversations Exclusive industry events Premium access to subscriber-only networking events around the country The best reporters in the industry The most trusted and well-connected newsroom in the health care industry And much more Exclusive interviews with industry leaders, profiles, and premium tools, like our CRISPR Trackr. What is it? What’s included?center_img Pharmalot Columnist, Senior Writer Ed covers the pharmaceutical industry. GET STARTED Johnson & Johnson and Bayer agree to pay $775 million to settle thousands of Xarelto lawsuits Ed Silverman @Pharmalot [email protected] Unlock this article by subscribing to STAT+ and enjoy your first 30 days free! GET STARTED By Ed Silverman March 25, 2019 Reprintslast_img read more

Diabetic foot ulcers: a silent killer of veterans

first_imgI first encountered diabetic foot ulcers as a fourth-year student in podiatric medicine when I was assigned to a Veterans Affairs medical center in Los Angeles. One of my patients, a veteran with diabetes, had a callus — an area of thickened skin — on his foot. It was about the size of a dime and was so generally insignificant that it would normally be ignored, but something about it didn’t look right. As I trimmed this bump of toughened skin, I identified an infected abscess and an ulcer. Privacy Policy @dgarmstrong Tags diabetesgovernment agenciesresearchveterans First OpinionDiabetic foot ulcers: a silent killer of veterans Leave this field empty if you’re human: Despite how devastating these ulcers are for those who suffer from them, and despite the massive costs they incur on the health care system, too few research dollars go toward understanding or fixing them. The National Institutes of Health spends about $1 billion per year on diabetes research, a relatively small amount considering that diabetes is a $300 billion problem. But the NIH spends just $1 million per year on lower-extremity diabetic research even though problems with the lower extremities are responsible for thousands of times that in annual diabetes costs.Fortunately, the VA is highly aware of the seriousness of diabetic foot ulcers. In fact, it is a pioneer when it comes to treating them, employing all kinds of next-generation technologies and textiles that can detect the beginnings of a diabetic foot ulcer and give patients, patient’s families, and even their care teams an early warning.Until we find the root cause of diabetic foot ulcers and identify highly effective ways to prevent and treat them, what we really need is a subscription prescription: making preventive items such as socks, shoes, and bandages available through a monthly subscription package, just like getting Netflix or Spotify. Such items are essential for helping stop the development of diabetic foot ulcers, mainly because they minimize pressure points when patients walk. If this type of service was readily available, patients with limited mobility or resources would be able to get the essentials they need when and where they need them.Veterans have always been near and dear to my heart. One of my grandfathers served in World War I, and the other served in World War II. Both received quality care from the VA. I am proud of the VA’s efforts to treat and prevent diabetic foot ulcers today, but the thing that’s holding it back from doing even more is education: addressing the funding disparity in diabetes research begins with awareness.I’m confident that those who learn about the threat this quiet killer poses to veterans will want to take action. Our veterans are counting on it.David G. Armstrong is professor of surgery and director of the Southwestern Academic Limb Salvage Alliance at the Keck School of Medicine of the University of Southern California. Please enter a valid email address. About the Author Reprints David G. Armstrong Comparing the Covid-19 vaccines developed by Pfizer, Moderna, and Johnson & Johnson center_img [email protected] Trending Now: By David G. Armstrong Nov. 11, 2019 Reprints We treated the ulcer without the use of anesthesia because this patient had lost the ability to sense pain in his feet, a condition called neuropathy that is common for people with diabetes and that contributes to the development of foot ulcers. In an individual without diabetes and neuropathy, a callus would cause a painful pressure point. A person with diabetic neuropathy won’t feel that pain and will literally wear hole in his or her foot, as you or I might wear a hole in a shoe or a sock. When it comes to diabetes, what you can’t feel can hurt you.advertisement Veterans who survive the horrors of war or the other dangers of military service often die years later from a silent but deadly scourge: diabetic foot ulcers, open sores or lesions that typically start on the bottom of the foot.About 40% of people afflicted with this problem die within five years. The annual cost to America’s health care system for treating complications of these foot ulcers is greater than treating the five most common types of cancer, and are responsible for the vast majority of non-combat amputations seen among veterans. Yet too little is being done to prevent them.One way to honor our military veterans on this Veterans Day and to care for them in the years to come is to invest more in targeted research to learn why foot ulcers are so common in people with diabetes and why they recur so frequently, as well as to embrace new ways to prevent them from occurring.advertisement Newsletters Sign up for First Opinion A weekly digest of our opinion column, with insight from industry experts. MARTIN BUREAU/AFP via Getty Images All this patient told me was, “Thank you, son. I so very much appreciate you looking after me.”Today, I have the privilege of looking after a center at the University of Southern California that spans four hospitals and a diverse population of some 10 million people. The lessons learned from that one patient, however, can be applied every day in my practice.The most common reason someone is admitted to a VA hospital is diabetes. In fact, 60% to 70% of hospitalized veterans in the United States have this disease. And the complication of diabetes that is most likely to cause veterans to be admitted to a treatment center is an infected foot ulcer. Much of this happens in silence, as these patients, who often have a great tolerance for pain to begin with, further lose the feedback because of diabetic neuropathy.Because of the silent nature of diabetic foot ulcers, they represent a big problem that few have heard of. People don’t drop dead from a “foot attack” like they do from a heart attack, but they are dying from them all the same. Indeed, after an amputation, an individual may not get out of bed much in the following months, or even years, causing his or her overall health to deteriorate, culminating in death from a stroke or heart attack. Although a foot ulcer precipitated this awful spiral, it is not recorded as a cause of death, obscuring its contribution to the death.Approximately 40% of individuals with diabetes who develop a foot ulcer get another one within a year. Two-thirds will get another one within three years, and three-quarters will get another within five years. Just as with cancer, men and women with diabetic foot ulcers aren’t healed — they are in remission.last_img read more

How much? Pharma copay cards are increasing costs for private Canadian insurers

first_img What is it? Pharma How much? Pharma copay cards are increasing costs for private Canadian insurers Adobe By Ed Silverman Nov. 11, 2019 Reprints About the Author Reprints Amid ongoing criticism of discount cards for prescription medicines, a new study finds these marketing tools increased costs for private insurers in Canada by 46% because patients were not motivated to pursue lower-cost generics.The analysis examined 2.8 million prescriptions for 89 different drugs for which brand-name discount cards were available between September 2014 and September 2017. Of nearly 940,000 claims filed with private insurers, $69.4 million was paid out compared with roughly $47.7 million for a mix of equivalent generics, a difference of $21.7 million, or 46%. For each prescription, this amounted to an extra $23.09. GET STARTED STAT+ is STAT’s premium subscription service for in-depth biotech, pharma, policy, and life science coverage and analysis. Our award-winning team covers news on Wall Street, policy developments in Washington, early science breakthroughs and clinical trial results, and health care disruption in Silicon Valley and beyond. What’s included?center_img Ed Silverman Tags drug pricingSTAT+ @Pharmalot Unlock this article by subscribing to STAT+ and enjoy your first 30 days free! GET STARTED Log In | Learn More Pharmalot Columnist, Senior Writer Ed covers the pharmaceutical industry. [email protected] Daily reporting and analysis The most comprehensive industry coverage from a powerhouse team of reporters Subscriber-only newsletters Daily newsletters to brief you on the most important industry news of the day STAT+ Conversations Weekly opportunities to engage with our reporters and leading industry experts in live video conversations Exclusive industry events Premium access to subscriber-only networking events around the country The best reporters in the industry The most trusted and well-connected newsroom in the health care industry And much more Exclusive interviews with industry leaders, profiles, and premium tools, like our CRISPR Trackr.last_img read more

The FDA identifies its first drug shortage due to coronavirus but won’t name the medicine

first_img STAT+ is STAT’s premium subscription service for in-depth biotech, pharma, policy, and life science coverage and analysis. Our award-winning team covers news on Wall Street, policy developments in Washington, early science breakthroughs and clinical trial results, and health care disruption in Silicon Valley and beyond. About the Author Reprints Andrew Harnik/AP Log In | Learn More What’s included? What is it? The FDA identifies its first drug shortage due to coronavirus but won’t name the medicine By Ed Silverman Feb. 28, 2020 Reprints Pharmalot @Pharmalot center_img For the first time since the coronavirus outbreak began, the Food and Drug Administration has reported a shortage of a medicine due to a manufacturing “issue” with an active pharmaceutical ingredient “related to a site affected by coronavirus.” However, the agency did not disclose the name of the medicine, prompting criticism over concerns the lack of information can make it difficult to plan for patient needs.In a statement issued Thursday night, the FDA explained that an unnamed manufacturer reported a shortage, but did not provide any further details. The statement added that “it is important to note that there are other alternatives that can be used by patients,” and that the FDA is working with the company and other manufacturers to mitigate the shortage. GET STARTED Pharmalot Columnist, Senior Writer Ed covers the pharmaceutical industry. Ed Silverman Daily reporting and analysis The most comprehensive industry coverage from a powerhouse team of reporters Subscriber-only newsletters Daily newsletters to brief you on the most important industry news of the day STAT+ Conversations Weekly opportunities to engage with our reporters and leading industry experts in live video conversations Exclusive industry events Premium access to subscriber-only networking events around the country The best reporters in the industry The most trusted and well-connected newsroom in the health care industry And much more Exclusive interviews with industry leaders, profiles, and premium tools, like our CRISPR Trackr. [email protected] Unlock this article by subscribing to STAT+ and enjoy your first 30 days free! GET STARTED Tags Coronavirusgovernment agenciespharmaceuticalslast_img read more

What goes into the decision to discharge a president with Covid-19?

first_img If you value our coronavirus coverage, please consider making a one-time contribution to support our journalism. Does it matter where they are going when they are discharged — and when in the course of their infection?Where patients are going is critical, whether it’s home or to a rehab facility. They need people to care for them and to keep a watchful eye over them so they can raise a red flag if something isn’t going right.In the first week, people have what’s called the viral portion of the disease. A small proportion of people will get sicker in the second week — and those cases present more like an inflammatory syndrome, Boucher said. “We worry about that second phase. That happens around day 7 through 10. We’ll be monitoring anybody like that.”Thomas File, president of the Infectious Diseases Society of America, said at the hospital where he practices, Summa Health in Akron, Ohio, only half of Covid-19 patients go home after five or six days, which is the median length of stay when ICU patients are excluded. Others go to extended care facilities to be monitored and cared for with more medical attention than at home. Trump looks on from the back of a car in a motorcade outside of Walter Reed Medical Center in Bethesda, Md., on Sunday. ALEX EDELMAN/AFP via Getty Images About the Authors Reprints The 8 most important leaders of Operation Warp Speed What do you do when people want to leave against medical advice?During a public health emergency with a communicable infectious disease, it is appropriate in some cases to prevent people from leaving against medical advice if they don’t have a safe place to go, Boucher said. During Boston’s spring surge in Covid-19 cases, hospitals sent patients to a nearby empty convention center to keep them in isolation after discharge, whether their leaving was with or without their doctors’ blessing. The discharge plan for any Covid patient has to involve making sure the patient has a very clear understanding that the individual will be isolated for the duration, Boucher said.“In the vast majority of those cases, we would do everything we could to ensure a safe discharge,” she said. That might include things like having a visiting nurse come to the home, oxygen in the home, and physical therapy. “I’d also try to talk them into staying.” WASHINGTON — President Trump is set to leave Walter Reed Medical Center in Bethesda, Md., on Monday evening. But it’s unclear if Trump’s doctors were discharging their patient purely on medical grounds — or whether the president, anxious about the optics of a lengthy hospital stay and eager to resume his reelection campaign, simply demanded he be allowed to leave.In a brief press conference Monday afternoon, Sean Conley said Trump was displaying few of the symptoms he’d experienced over the weekend, and that he generally met the medical criteria that would justify a hospital discharge.Those medical criteria can vary — depending on the patient, on the progression of their disease, and the place they’re getting discharged to, infectious disease experts told STAT.advertisement Please enter a valid email address. Trending Now: Washington Correspondent Nicholas Florko reports on the the intersection of politics and health policy. He is the author the newsletter “D.C. Diagnosis.” @NicholasFlorko PoliticsWhat goes into the decision to discharge a president with Covid-19? [email protected] Related: Related: The lesson from Trump catching Covid-19: With this virus, there are no magic bullets [email protected] There are other, larger medical clinics on the White House campus, too. The White House also does not currently have anything resembling the trappings of the intensive care units used to care for the sickest of Covid-19 patients.The largest clinic, according to photos, resembles an average internist’s office — though, uniquely, it has the White House seal emblazoned on certain walls. There are multiple exam rooms, which are outfitted with the standard vinyl leather exam chair. A 2009 photo shows an eye chart and a run-of-the-mill computer for accessing medical records.“Literally when you walk in, it’s like a doctor’s office in that there’s a receptionist there,” said Caldera.That clinic is located in an office building next door, and it’s normally available to anyone on the grounds. One White House physician, in her memoir, describes treating everyone from a tourist who fainted after not eating breakfast to an Army official who suffered a fatal brain hemorrhage. The office has been in the spotlight, too, for overzealously treating overworked White House staffers: Several news outlets reported in 2018 that the office would routinely hand out prescription drugs, like the sleeping pill Ambien, to White House staffers. Support STAT: Nicholas Florko Elizabeth Cooney Related: Are people using oxygen at home?Trump has already been given supplemental oxygen at the White House, when he experienced a drop in his oxygen levels Friday before being flown to Walter Reed.Generally speaking, it is not unreasonable to think that some people might require oxygen at home, perhaps when they slept at night for some period, Boucher said. In general, things are getting better and they would be requiring less oxygen if not no oxygen right before they left.File of the Infectious Diseases Society said when patients arrive, supplemental oxygen is their biggest requirement. But they can be discharged when that need lessens, usually to another setting where they can be monitored. “We would like for them to be able to go home without oxygen supplementation,” he said.Shortness of breath doesn’t have to be all the way resolved, Bell said, but it should have significantly improved. Are there public health risks to discharging a Covid-19 patient too early?Federal guidelines require people who have been symptomatic with Covid-19 to isolate themselves for 10 days after they start showing symptoms. Bell, the UVA doctor, worries about the people around the president, calculating that if he was symptomatic on Wednesday, he should isolate until Oct. 10.“What really concerns me is, how is he going to behave once he gets back to the White House? He’s actually got to isolate and make sure that people are safe, especially if he’s in this infectious period still. Is he going to eschew a lot of these public health guidelines that they’ve shown a willingness to violate so many times consistently already, including yesterday?”He was referring to Trump’s decision to take his motorcade out for a drive in Maryland, a decision that meant several Secret Service officers rode with him, in close proximity. The experts were quick to note, however, that there is far too little public information for them to say whether the decision to discharge Trump is in keeping with normal medical practice. Conley, the White House physician, for example, declined to provide specifics regarding how high Trump’s fever reached, how low his oxygen levels dropped, or what his lung scans looked like. He also declined to provide the date of Trump’s most recent negative Covid-19 test.There is also relatively little known about the kind of care Trump can receive at home at the White House. There is a small medical unit on the campus, including an exam room and office located close to the president’s personal residence. But its capabilities fall substantially short of the specialized care and state-of-the-art technology available at Walter Reed.advertisement A one-page memo could defuse the panic about Trump’s Covid-19. Where is it? Doctors look for progress before allowing any hospitalized patient to leave the hospital.“The kinds of criteria that we use in deciding to discharge someone would include things like their ability to eat and drink, to walk around without needing oxygen, and how their lab tests look,” said Helen Boucher, chief of geographic medicine and infectious diseases at Tufts Medical Center in Boston, who declined to discuss Trump’s case.That doesn’t mean perfect scores on blood counts or measures of inflammatory biomarkers. Doctors want to see any abnormalities that were present trending in the right direction, she said. “People don’t have to be all better. They have to be on the road to being better.” Related: Comparing the Covid-19 vaccines developed by Pfizer, Moderna, and Johnson & Johnson The infectious disease experts also noted that there are major risks for discharging any Covid-19 patient, anywhere, too early. While Trump may be nearing full health, it is also possible he could soon take a turn for the worse, as can happen for Covid-19 patients roughly a week after they start showing symptoms.The treatments Trump has been getting suggest he may have a more severe case of Covid-19 than his doctors have indicated, said Taison Bell, a critical care and infectious disease physician at the University of Virginia. “The medical team is going to be monitoring him very closely the next few days and keep checking vital signs.”Below, STAT lays out what we know — and what we can’t know — about Trump’s discharge. Trump is receiving dexamethasone, a steroid usually given to patients with severe Covid-19 General Assignment Reporter Liz focuses on cancer, biomedical engineering, and how patients feel the effects of Covid-19. Privacy Policy Newsletters Sign up for Daily Recap A roundup of STAT’s top stories of the day. What kind of treatment is available at the White House?Trump isn’t going to be discharged into your standard suburban home. The White House residence itself has a small doctor’s office, and there’s also a sizable clinic next door. One official said that the entire enterprise, known as the White House Medical Unit, operates akin to an “urgent care clinic,” which can rapidly be scaled up into something resembling a top-tier hospital.“Releasing him to the White House permits a much higher level of medical attention and intervention than any other person in the nation would ever receive. It’s not like releasing you or me to go home,” said Louis Caldera, who from January 2009 to May 2009 directed the White House Military Office, which includes the medic’s office.Trump’s doctor said Monday, ahead of his discharge, that there was no care being provided to the president at Walter Reed that couldn’t be done at the White House’s medical unit, as of now.Most likely, Trump would be seen in the White House physician’s personal office and exam room, which are on the ground floor of the White House, just steps from the president’s personal residence. The tiny office is tucked next to the ornate Map Room. It is connected by elevator to the residence, two floors above. [email protected] By Elizabeth Cooney , Nicholas Florko , and Lev Facher Oct. 5, 2020 Reprints Do most people with Covid-19 leave the hospital while they still have symptoms?Trump’s medical team said during Monday’s press conference that the president’s vital signs were normal and that he was walking around and feeling better. Bell, the UVA doctor, said he was encouraged that the team was releasing more information on the president’s clinical status. At UVA Hospital where he works, if patients are still in a period where they can be shedding the coronavirus and potentially infecting others, they are discharged with specific instructions on how to isolate to keep themselves and others safe.In 2020 in America, most people leave the hospital still having symptoms, Boucher said. “We hope they’re better. So the criteria, say, for us to allow folks out of isolation after 10 days having Covid, they don’t say all your symptoms have to be gone. You have to be better. We make sure that someone has a spouse, a child, a sister or somebody, you know, it goes right with them or who can look after them.” Related: @cooney_liz Lev Facher Trump to be discharged from Walter Reed, doctor says, but ‘might not be entirely out of the woods’ Washington Correspondent Lev Facher covers the politics of health and life sciences. @levfacher Leave this field empty if you’re human: How do doctors decide when a Covid-19 patient can leave the hospital?Patients who have been sick enough to need hospitalization — about 20% of people who have Covid-19 symptoms — usually end up in a hospital bed because they experienced shortness of breath or had a fever so high it left them dehydrated and losing weight. Trump reportedly suffered a low-grade fever Friday, and Conley said he experienced minor dehydration upon arriving at Walter Reed. While his oxygen levels dropped, Conley said, Trump did not experience shortness of breath. Tags CoronavirusDonald Trumppublic healthlast_img read more

Gilead sues Russia over a compulsory license issued to a company making remdesivir

first_img STAT+ is STAT’s premium subscription service for in-depth biotech, pharma, policy, and life science coverage and analysis. Our award-winning team covers news on Wall Street, policy developments in Washington, early science breakthroughs and clinical trial results, and health care disruption in Silicon Valley and beyond. [email protected] By Ed Silverman May 4, 2021 Reprints What is it? Unlock this article — plus daily coverage and analysis of the pharma industry — by subscribing to STAT+. First 30 days free. GET STARTED Tags legalSTAT+ GET STARTED @Pharmalot Daily reporting and analysis The most comprehensive industry coverage from a powerhouse team of reporters Subscriber-only newsletters Daily newsletters to brief you on the most important industry news of the day STAT+ Conversations Weekly opportunities to engage with our reporters and leading industry experts in live video conversations Exclusive industry events Premium access to subscriber-only networking events around the country The best reporters in the industry The most trusted and well-connected newsroom in the health care industry And much more Exclusive interviews with industry leaders, profiles, and premium tools, like our CRISPR Trackr. Gilead sues Russia over a compulsory license issued to a company making remdesivir center_img Pharmalot Ed Silverman Amid worldwide clamoring for Covid-19 vaccines and other therapies, Gilead Sciences (GILD) last month filed a lawsuit against the Russian government for allowing a domestic company to manufacture and market its remdesivir treatment, which is also known as Veklury.The move came after the government late last year issued a compulsory license to a company called Pharmasyntez, which unsuccessfully approached Gilead about obtaining a license to produce a version of the medicine. At the time, the health minister pursued the step “in the interest of national security,” and the company indicated plans to sell its version about half the cost. Yichuan Cao/Sipa USA What’s included? Pharmalot Columnist, Senior Writer Ed covers the pharmaceutical industry. Log In | Learn More About the Author Reprintslast_img read more

St. Matthew’s House food distribution on Tuesday, changes to December schedule

first_imgWhere to get free food in SWFL this week June 15, 2021 Hungry? St. Matthew’s House is giving away food in SWFL today June 3, 2021 Warehouse to help St. Matthew’s House better serve SWFL residents in need May 11, 2021 NAPLES, Fla. — St. Matthew’s House will hold a regular food distribution line tomorrow, Dec. 1 in Naples.The distribution site will be open from 1 p.m. until 3 p.m. at Fairway Bible Church located at 3855 The Lords Way, Naples, FL 34114.The regular food distribution sites usually held on Thursdays at First Baptist Church will be postponed for the month of December.Food distributions at Mount Olive AME Church in Fort Myers will continue every Thursday from 4:00-7:00 PM in December, except on Christmas Eve, Dec. 24. Where to get free food in SWFL April 26 – 29 April 26, 2021 RELATEDTOPICS AdvertisementRecommended ArticlesBrie Larson Reportedly Replacing Robert Downey Jr. As The Face Of The MCURead more81 commentsGal Gadot Reportedly Being Recast As Wonder Woman For The FlashRead more29 commentscenter_img AdvertisementDC Young Fly knocks out heckler (video) – Rolling OutRead more6 comments’Mortal Kombat’ Exceeded Expectations Says WarnerMedia ExecutiveRead more2 commentsDo You Remember Bob’s Big Boy?Read more1 commentsKISS Front Man Paul Stanley Reveals This Is The End Of KISS As A Touring Band, For RealRead more1 comments Advertisement Advertisement AdvertisementSt. Matthew’s House broke their personal record this Thanksgiving by distributing 4,551 turkeys and meals. That’s 1,859 more households served then last years’ record of 2,692.During their “Hope For The Holidays” campaign, volunteers with St. Matthew’s House have been able to feed 37,366 people so far.With the increased need in the community, donations to St. Matt’s are helping more than ever. They are always in need of non-perishable food items or you can give online anytime here. AdvertisementTags: food distribution siteSt. Matthew’s Houselast_img read more

These foods can lower heart disease and stroke risk, study says

first_imgFORT MYERS, Fla. / CNN — Foods with antioxidants and vitamins like leafy greens, carrots, tomatoes, whole grains, fruits, nuts, fatty fish, and olive oil can support a healthy inflammatory response and minimize cardiovascular risk.The study, which was posted in the Journal of the American College of Cardiology, followed nearly 166,000 women and 44,000 men for 24 to 30 years. Researchers found that those who ate higher levels of red and processed meats like bacon and sausage and sugary, processed foods had a 28 percent higher risk of stroke and a 46 percent higher risk of heart disease.“Foods that are associated with lower inflammation include leafy green vegetables, dark yellow vegetables, fruit, whole grain, tea, coffee and wine,” the lead author of the study, Dr. Jun Li, said. RELATEDTOPICS AdvertisementTags: foodhealthhealthy food AdvertisementThe study results remained “robust,” Li said, even after controlling for such confounding factors as hypertension, obesity, diabetes and other chronic health conditions, multivitamin use and various medications, aspirin and other anti-inflammatory drugs, along with antihypertensive and lipid lowering medications.How does food cause inflammation?The exact biological way food impacts inflammatory pathways isn’t fully understood, but researchers believe sugary, processed foods in the Western diet, along with pollution, cigarette smoke, radiation and medications, may lead to the increased activation of free radicals in the body. AdvertisementRecommended ArticlesBrie Larson Reportedly Replacing Robert Downey Jr. As The Face Of The MCURead more81 commentsGal Gadot Reportedly Being Recast As Wonder Woman For The FlashRead more29 comments Struggling to afford food? Here’s where to get some help in SWFL this week March 9, 2021 Free radicals are molecules with unpaired electrons that are driven to search for a match. During their search, they rob other cells of their electrons, causing cellular damage which can contribute to disease.Eating a lot of unhealthy, “ultraprocessed” foods may even shorten your life — just a 10% increase in such foods was significantly associated with a 14% higher risk of death from all causes, studies have shown.The good news is that research has suggested that anti-inflammatory elements such as vitamins, carotenoids and flavonoids in foods like fruits and vegetables may neutralize free radicals and reduce the stress on the body.You should eat more leafy greens, tomatoes, fruits, nuts, fatty fish and olive oil and cut back on foods such as:Ice cream, cookies, pastries, cereal bars and cakesPremade pies, pasta and pizza dishesPoultry and fish nuggets and sticksRed and processed meats such as bacon, sausages and hot dogsSugary sodas and fruit-flavored drinks“Health” and “slimming” products such as powdered or “fortified” meal and dish substitutes, powdered and packaged instant soups, noodles and dessertsThe-CNN-Wire™ & © 2020 Cable News Network, Inc., a WarnerMedia Company. All rights reserved. AdvertisementDC Young Fly knocks out heckler (video) – Rolling OutRead more6 comments’Mortal Kombat’ Exceeded Expectations Says WarnerMedia ExecutiveRead more2 commentsDo You Remember Bob’s Big Boy?Read more1 commentsKISS Front Man Paul Stanley Reveals This Is The End Of KISS As A Touring Band, For RealRead more1 comments More people are developing food sensitivities during the pandemic March 2, 2021 Cheese connoisseurs rejoice: The Quesalupa is back March 12, 2021 Don’t let your unused food go to waste — Here’s how to help hungry local families March 23, 2021last_img read more

Florida man wins big money twice in lottery scratch off game

first_imgFlorida nursing homes report COVID-19 infection rates nearly double the national average June 16, 2021 RELATEDTOPICS JACKSONVILLE, Fla. – A Florida man hit the scratch-off jackpot twice winning $6 million in total, with both tickets bought from the same gas station. Munib Garvanovic, 56, of Jacksonville won a $5 million top prize in a Florida Lottery scratch-off game three years after winning $1 million in another lottery game, lottery officials announced this week.The big prize came from the 200X the Cash game. Garvanovic chose to receive a one-time, lump-sum payment of $4,450,000, the Florida Times-Union reported. Earlier, he had claimed a $1 million prize from the $5,000,000 Gold Rush Doubler game.He bought the $20 ticket at a Gate gas station in Jacksonville. The retailer will receive a $10,000 bonus commission for selling the winning ticket, lottery officials said. AdvertisementTags: FloridaLottery Florida moves against foreign theft of intellectual property June 8, 2021 Over 1,000 unemployment claim call takers let go as DEO cancels contract June 12, 2021 Advertisement“Every November I play my favorite scratch-off games because I feel it brings me extra luck,” he said. Two suffer shark bites off Florida beach June 16, 2021 AdvertisementRecommended ArticlesBrie Larson Reportedly Replacing Robert Downey Jr. As The Face Of The MCURead more81 commentsGal Gadot Reportedly Being Recast As Wonder Woman For The FlashRead more29 commentsDC Young Fly knocks out heckler (video) – Rolling OutRead more6 comments’Mortal Kombat’ Exceeded Expectations Says WarnerMedia ExecutiveRead more2 commentsDo You Remember Bob’s Big Boy?Read more1 commentsKISS Front Man Paul Stanley Reveals This Is The End Of KISS As A Touring Band, For RealRead more1 commentslast_img read more

Reality TV star punches Disney cast member after refusing to leave line, report says

first_imgAdvertisementThe cast member was transported to a local hospital.Smith was arrested and faces a battery charge. He has since posted bond. AdvertisementRecommended ArticlesBrie Larson Reportedly Replacing Robert Downey Jr. As The Face Of The MCURead more81 commentsGal Gadot Reportedly Being Recast As Wonder Woman For The FlashRead more29 comments Advertisement Naples man tells deputies to ‘F*** off’ after calling 911 multiple times June 8, 2021 Disney Cruise Line will set sail on 2-night COVID test cruise June 3, 2021 AdvertisementDC Young Fly knocks out heckler (video) – Rolling OutRead more6 comments’Mortal Kombat’ Exceeded Expectations Says WarnerMedia ExecutiveRead more2 commentsDo You Remember Bob’s Big Boy?Read more1 commentsKISS Front Man Paul Stanley Reveals This Is The End Of KISS As A Touring Band, For RealRead more1 comments Naples man caught kissing mistress accused of getting violent when wife asks for divorce May 27, 2021center_img AdvertisementTags: arrestedBatteryDisney RELATEDTOPICS Samuel E. Wright, the voice of Sebastian in ‘The Little Mermaid,’ dies at 74 May 27, 2021 LAKE BUENA VISTA, Fla. — A hip-hop and reality television personality is accused of punching a cast member at Disney World after a dispute.Spectacular Blue Smith was walking toward a ride at Disney’s Animal Kingdom when he made a sneezing gesture and said “coronavirus,” authorities said.The cast member told Smith that he was not funny, so Smith allegedly replied, “I thought it was,” NBC affiliate WESH reported.When the cast member tried to block Smith from continuing in the line, Smith punched him twice, according to an arrest report. Advertisementlast_img read more