A Hospital Kept a Brain-Damaged Patient on Life Support to Boost Statistics. His Sister Is Now Suing for Malpractice.

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In 2018, Darryl Young was hoping for a new lease on life when he received a heart transplant at a New Jersey hospital after years of congestive heart failure. But he suffered brain damage during the procedure and never woke up.

The following year, a ProPublica investigation revealed that Young’s case was part of a pattern of heart transplants that had gone awry at Newark Beth Israel Medical Center in 2018. The spate of bad outcomes had pushed the center’s percentage of patients still alive one year after surgery — a key benchmark — below the national average. Medical staff were under pressure to boost that metric. ProPublica published audio recordings from meetings in which staff discussed the need to keep Young alive for a year, because they feared another hit to the program’s survival rate would attract scrutiny from regulators. On the recordings, the transplant program’s director, Dr. Mark Zucker, cautioned his team against offering Young’s family the option of switching from aggressive care to comfort care, in which no lifesaving efforts would be made. He acknowledged these actions were “very unethical.”

ProPublica’s revelations horrified Young’s sister Andrea Young, who said she was never given the full picture of her brother’s condition, as did the findings of a subsequent federal regulator’s probe that determined that the hospital was putting patients in “immediate jeopardy.” Last month, she filed a medical malpractice lawsuit against the hospital and members of her brother’s medical team.

The lawsuit alleges that Newark Beth Israel staff were “negligent and deviated from accepted standards of practice,” leading to Young’s tragic medical outcome.

Defendants in the lawsuit haven’t yet filed responses to the complaint in court documents. But spokesperson Linda Kamateh said in an email that “Newark Beth Israel Medical Center is one of the top heart transplant programs in the nation and we are committed to serving our patients with the highest quality of care. As this case is in active litigation, we are unable to provide further detail.” Zucker, who is no longer on staff at Newark Beth Israel, didn’t respond to requests for comment. His attorney also didn’t respond to calls and emails requesting comment.

Zucker also didn’t respond to requests for comment from ProPublica in 2018; Newark Beth Israel at the time said in a statement, made on behalf of Zucker and other staff, that “disclosures of select portions of lengthy and highly complex medical discussions, when taken out of context, may distort the intent of conversations.”

The lawsuit alleges that Young suffered brain damage as a result of severely low blood pressure during the transplant surgery. In 2019, when the federal Centers for Medicare and Medicaid Services scrutinized the heart transplant program following ProPublica’s investigation, the regulators found that the hospital had failed to implement corrective measures even after patients suffered, leading to further harm. For example, one patient’s kidneys failed after a transplant procedure in August 2018, and medical staff made recommendations internally to increase the frequency of blood pressure measurement during the procedure, according to the lawsuit. The lawsuit alleges that the hospital didn’t implement its own recommendations and that one month later, “these failures were repeated” in Young’s surgery, leading to brain damage.

The lawsuit also alleges that Young wasn’t asked whether he had an advance directive, such as a preference for a do-not-resuscitate order, despite a hospital policy stating that patients should be asked at the time of admission. The lawsuit also noted that CMS’ investigation found that Andrea Young was not informed of her brother’s condition.

Andrea Young said she understands that mistakes can happen during medical procedures, “however, it’s their duty and their responsibility to be honest and let the family know exactly what went wrong.” Young said she had to fight to find out what was going on with her brother, at one point going to the library and trying to study medical books so she could ask the right questions. “I remember as clear as if it were yesterday, being so desperate for answers,” she said.

Andrea Young said that she was motivated to file the lawsuit because she wants accountability. “Especially with the doctors never, from the outset, being forthcoming and truthful about the circumstances of my brother’s condition, not only is that wrong and unethical, but it took a lot away from our entire family,” she said. “The most important thing to me is that those responsible be held accountable.”

ProPublica’s revelation of “a facility putting its existence over that of a patient is a scary concept,” said attorney Jonathan Lomurro, who’s representing Andrea Young in this case with co-counsel Christian LoPiano. Besides seeking damages for Darryl Young’s children, “we want to call attention to this so it doesn’t happen again,” Lomurro said.

The lawsuit further alleges that medical staff at Newark Beth Israel invaded Young’s privacy and violated the Health Insurance Portability and Accountability Act, more commonly known as HIPAA, by sharing details of his case with the media without his permission. “We want people to be whistleblowers and want information out,” but that information should be told to patients and their family members directly, Lomurro said.

The 2019 CMS investigation determined that Newark Beth Israel’s program placed patients in “immediate jeopardy,” the most serious level of violation, and required the hospital to implement corrective plans. Newark Beth Israel did not agree with all of the regulator’s findings and in a statement at the time said that the CMS team lacked the “evidence, expertise and experience” to assess and diagnose patient outcomes.

The hospital did carry out the corrective plans and continues to operate a heart transplant program today. The most recent federal data, based on procedures from January 2021 through June 2023, shows that the one year probability of survival for a patient at Newark Beth is lower than the national average. It also shows that the number of graft failures, including deaths, in that time period was higher than the expected number of deaths for the program.

Andrea Young said she’s struggled with a feeling of emptiness in the years after her brother’s surgery. They were close and called each other daily. “There’s nothing in the world that can bring my brother back, so the only solace I will have is for the ones responsible to be held accountable,” she said. Darryl Young died on Sept 12, 2022, having never woken up after the transplant surgery.

A separate medical malpractice lawsuit filed in 2020 by the wife of another Newark Beth Israel heart transplant patient who died after receiving an organ infected with a parasitic disease is ongoing. The hospital has denied the allegations in court filing. The state of New Jersey, employer of the pathologists named in the case, settled for $1.7 million this month, according to the plaintiff’s attorney Christian LoPiano. The rest of the case is ongoing.

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  • 5 dental TikTok trends you probably shouldn’t try at home

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    TikTok is full of videos that demonstrate DIY hacks, from up-cycling tricks to cooking tips. Meanwhile, a growing number of TikTok videos offer tips to help you save money and time at the dentist. But do they deliver?

    Here are five popular dental TikTok trends and why you might treat them with caution.

    1. Home-made whitening solutions

    Many TikTok videos provide tips to whiten teeth. These include tutorials on making your own whitening toothpaste using ingredients such as hydrogen peroxide, a common household bleaching agent, and baking soda (sodium bicarbonate).

    In this video, the influencer says:

    And then you’re going to pour in your hydrogen peroxide. There’s really no measurement to this.

    But hydrogen peroxide in high doses is poisonous if swallowed, and can burn your gums, mouth and throat, and corrode your teeth.

    High doses of hydrogen peroxide may infiltrate holes or microscopic cracks in your teeth to inflame or damage the nerves and blood vessels in the teeth, which can cause pain and even nerve death. This is why dental practitioners are bound by rules when we offer whitening treatments.

    Sodium bicarbonate and hydrogen peroxide are among the components in commercially available whitening toothpastes. While these commercial products may be effective at removing surface stains, their compositions are carefully curated to keep your smile safe.

    2. Oil pulling

    Oil pulling involves swishing one tablespoon of sesame or coconut oil in your mouth for up to 20 minutes at a time. It has roots in Ayurvedic medicine, a traditional medicine practice that originates from the Indian subcontinent.

    While oil pulling should be followed by brushing and flossing, I’ve had patients who believe oil pulling is a replacement for these practices.

    There has been some research on the potential of oil pulling to treat gum disease or other diseases in the mouth. But overall, evidence that supports the effectiveness of oil pulling is of low certainty.

    For example, studies that test the effectiveness of oil pulling have been conducted on school-aged children and people with no dental problems, and often measure dental plaque growth over a few days to a couple of weeks.

    Chlorhexidine is an ingredient found in some commercially available mouthwashes.
    In one study, people who rinsed with chlorhexidine mouthwash (30 seconds twice daily) developed less plaque on their teeth compared to those who undertook oil pulling for eight to 10 minutes.

    Ultimately, it’s unlikely you will experience measurable gain to your oral health by adding oil pulling to your daily routine. If you’re time-poor, you’re better off focusing on brushing your teeth and gums well alongside flossing.

    3. Using rubber bands to fix gaps

    This TikTok influencer shows his followers he closed the gaps between his front teeth in a week using cheap clear rubber bands.

    But this person may be one of the lucky few to successfully use bands to close a gap in his teeth without any mishaps. Front teeth are slippery and taper near the gums into cone-shaped roots. This can cause bands to slide and disappear into the gums to surround the tooth roots, which can cause infections and pain.

    If this happens, you may require surgery that involves cutting your gums to remove the bands. If the bands have caused an infection, you may lose the affected teeth. So it’s best to leave this sort of work to a dental professional trained in orthodontics.

    4. Filing or cutting teeth to shape them

    My teeth hurt just watching this video.

    Cutting or filing teeth unnecessarily can expose the second, more sensitive tooth layer, called dentine, or potentially, the nerve and blood vessels inside the tooth. People undergoing this sort of procedure could experience anything from sensitive teeth through to a severe toothache that requires root canal treatment or tooth removal.

    You may notice dentist drills spray water when cutting to protect your teeth from extreme heat damage. The drill in this video is dry with no water used to cool the heat produced during cutting.

    It may also not be sterile. We like to have everything clean and sterile to prevent contaminated instruments used on one patient from potentially spreading an infection to another person.

    Importantly, once you cut or file your teeth away, it’s gone forever. Unlike bone, hair or nails, our teeth don’t have the capacity to regrow.

    5. DIY fillings

    Many people on TikTok demonstrate filling cavities (holes) or replacing gaps between teeth with a material made from heated moulded plastic beads. DIY fillings can cause a lot of issues – I’ve seen this in my clinic first hand.

    While we may make it look simple in dental surgeries, the science behind filling materials and how we make them stick to teeth to fill cavities is sophisticated.

    Filling a cavity with the kind of material made from these beads will be as effective as using sticky tape on sand. Not to mention the cavity will continue to grow bigger underneath the untreated “filled” teeth.

    I know it’s easy to say “see a dentist about that cavity” or “go to an orthodontist to fix that gap in your teeth you don’t like”, but it can be expensive to actually do these things. However if you end up requiring treatment to fix the issues caused at home, it may end up costing you much more.

    So what’s the take-home message? Stick with the funny cat and dog videos on TikTok – they’re safer for your smile.The Conversation

    Arosha Weerakoon, Senior Lecturer and General Dentist, School of Dentistry, The University of Queensland

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • Almonds vs Peanuts – Which is Healthier?

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    Our Verdict

    When comparing almonds to peanuts, we picked the almonds.

    Why?

    No, it’s not just our pro-almonds bias… But it’s also not as one-sided, nutritionally speaking, as you might think!

    In terms of macros, almonds have a lot more fiber, and moderately more carbs, the ratio of which give almonds the lower glycemic index. On the other hand, peanuts have a little more protein. Both of these nuts are equally fatty, but peanuts have the higher saturated fat content. All in all, we say the biggest deciding factor is the fiber, and hand this one to the almonds.

    In the category of vitamins, almonds have more of vitamins B2 and E, while peanuts have more of vitamins B1, B3, B5, B6, B7, and B9. An easy win for peanuts this time.

    When it comes to minerals, almonds have more calcium, magnesium, manganese, phosphorus, and potassium, while peanuts have more copper, iron, selenium, and zinc. Thus, a 5:4 marginal win for almonds.

    Adding up the sections makes for an overall win for almonds, but as you can see, it was close and peanuts certainly have their merits too, so by all means enjoy either or both; diversity is good!

    Unless you are allergic, in which case, obviously please don’t do that.

    Want to learn more?

    You might like to read:

    Why You Should Diversify Your Nuts!

    Enjoy!

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  • The Real Benefit Of Genetic Testing

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    Genetic Testing: Health Benefits & Methods

    Genetic testing is an oft-derided American pastime, but there’s a lot more to it than finding out about your ancestry!

    Note: because there are relatively few companies offering health-related genetic testing services, and we are talking about the benefits of those services, some of this main feature may seem like an advert.

    It’s not; none of those companies are sponsoring us, and if any of them become a sponsor at some point, we’ll make it clear and put it in the clearly-marked sponsor segment.

    As ever, our only goal here is to provide science-backed information, to enable you to make your own, well-informed, decisions.

    Health genomics & genetic testing

    The basic goal of health genomics and genetic testing is to learn:

    • What genetic conditions you have
      • Clearcut genetic conditions, such as Fragile X syndrome, or Huntington’s disease
    • What genetic predispositions you have
      • Such as an increased/decreased risk for various kinds of cancer, diabetes, heart conditions, and so forth
    • What genetic traits you have
      • These may range from “blue eyes” to “superathlete muscle type”
    • More specifically, pharmacogenomic information
      • For example, “fast caffeine metabolizer” or “clopidogrel (Plavix) non-responder” (i.e., that drug simply will not work for you)

    Wait, what’s the difference between health genomics and genetic testing?

    • Health genomics is the science of how our genes affect our health.
    • Genetic testing can be broadly defined as the means of finding out which genes we have.

    A quick snippet…

    More specifically, a lot of these services look at which single nucleotide polymorphisms (SNPs, pronounced “snips”) we have. While we share almost all of our DNA with each other (and indeed, with most vertebrates), our polymorphisms are the bits that differ, and are the bits that, genetically speaking, make us different.

    So, by looking just at the SNPs, it means we “only” need to look at about 3,000,000 DNA positions, and not our entire genome. For perspective, those 3,000,000 DNA positions make up about 0.1% of our whole genome, so without focusing on SNPs, the task would be 1000x harder.

    For example, the kind of information that this sort of testing may give you, includes (to look at some “popular” SNPs):

    • rs53576 in the oxytocin receptor influences social behavior and personality
    • rs7412 and rs429358 can raise the risk of Alzheimer’s disease by more than 10x
    • rs6152 can influence baldness
    • rs333 resistance to HIV
    • rs1800497 in a dopamine receptor may influence the sense of pleasure
    • rs1805007 determines red hair and sensitivity to anesthetics
    • rs9939609 triggers obesity and type-2 diabetes
    • rs662799 prevents weight gain from high fat diets
    • rs12255372 linked to type-2 diabetes and breast cancer
    • rs1799971 makes alcohol cravings stronger
    • rs17822931 determines earwax, sweating and body odor
    • rs1333049 coronary heart disease
    • rs1051730 and rs3750344 nicotine dependence
    • rs4988235 lactose intolerance

    (You can learn about these and more than 100,000 other SNPs at SNPedia.com)

    I don’t know what SNPs I have, and am disinclined to look them up one by one!

    The first step to knowing, is to get your DNA out of your body and into a genetic testing service. This is usually done by saliva or blood sample. This writer got hers done many years ago by 23andMe and was very happy with that service, but there are plenty of other options.

    Healthline did an independent review of the most popular companies, so you might like to check out:

    Healthline: Best DNA Testing Kits of 2023

    Those companies will give you some basic information, such as “6x higher breast cancer risk” or “3x lower age-related macular degeneration risk” etc.

    However, to really get bang-for-buck, what you want to do next is:

    1. Get your raw genetic data (the companies above should provide it); this will probably look like a big text file full of As, Cs, Gs, and Ts, but it make take another form.
    2. Upload it to Promethease. When this writer got hers done , the cost was $2; that price has now gone up to a whopping $12.
    3. You will then get a report that will cross-reference your data with everything known about SNPs, and give a supremely comprehensive, readable-to-the-human-eye, explanation of what it all means for you—from much more specific health risk prognostics, to more trivial things like whether you can roll your tongue or smell decomposed asparagus metabolites in urine.

    A note on privacy: anything you upload to Promethease will be anonymized, and/but in doing so, you consent to it going into the grand scientific open-source bank of “things we know about the human genome”, and thus contribute to the overall sample size of genetic data.

    In our opinion, it means you’re doing your bit for science, without personal risk. But your opinion may differ, and that’s your decision to make.

    Lastly, on the pros and cons of pharmacogenetic testing specifically:

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  • Rehab Science – by Dr. Tom Walters 

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Many books of this kind deal with the injury but not the pain; some source talk about pain but not the injury; this one does both, and more.

    Dr. Walters discusses in detail the nature of pain, various different kinds of pain, the factors that influence pain, and, of course, how to overcome pain.

    He also takes us on a tour of various different categories of injury, because some require very different treatment than others, and while there are some catch-all “this is good/bad for healing” advices, sometimes what will help with one injury with hinder healing another. So, this information alone would make the book a worthwhile read already.

    After this two-part theory-heavy introduction, the largest part of the book is given over to rehab itself, in a practical fashion.

    We learn about how to make an appropriate rehab plan, get the material things we need for it (if indeed we need material things), and specific protocols to follow for various different body parts and injuries.

    The style is very much that of a textbook, well-formatted and with plenty of illustrations throughout (color is sometimes relevant, so we recommend a print edition over Kindle for this one).

    Bottom line: if you have an injury to heal, or even just believe in being prepared, this book is an excellent guide.

    Click here to check out Rehab Science, to overcome pain and heal from injury!

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  • Statistical Models vs. Front-Line Workers: Who Knows Best How to Spend Opioid Settlement Cash?

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    MOBILE, Ala. — In this Gulf Coast city, addiction medicine doctor Stephen Loyd announced at a January event what he called “a game-changer” for state and local governments spending billions of dollars in opioid settlement funds.

    The money, which comes from companies accused of aggressively marketing and distributing prescription painkillers, is meant to tackle the addiction crisis.

    But “how do you know that the money you’re spending is going to get you the result that you need?” asked Loyd, who was once hooked on prescription opioids himself and has become a nationally known figure since Michael Keaton played a character partially based on him in the Hulu series “Dopesick.”

    Loyd provided an answer: Use statistical modeling and artificial intelligence to simulate the opioid crisis, predict which programs will save the most lives, and help local officials decide the best use of settlement dollars.

    Loyd serves as the unpaid co-chair of the Helios Alliance, a group that hosted the event and is seeking $1.5 million to create such a simulation for Alabama.

    The state is set to receive more than $500 million from opioid settlements over nearly two decades. It announced $8.5 million in grants to various community groups in early February.

    Loyd’s audience that gray January morning included big players in Mobile, many of whom have known one another since their school days: the speaker pro tempore of Alabama’s legislature, representatives from the city and the local sheriff’s office, leaders from the nearby Poarch Band of Creek Indians, and dozens of addiction treatment providers and advocates for preventing youth addiction.

    Many of them were excited by the proposal, saying this type of data and statistics-driven approach could reduce personal and political biases and ensure settlement dollars are directed efficiently over the next decade.

    But some advocates and treatment providers say they don’t need a simulation to tell them where the needs are. They see it daily, when they try — and often fail — to get people medications, housing, and other basic services. They worry allocating $1.5 million for Helios prioritizes Big Tech promises for future success while shortchanging the urgent needs of people on the front lines today.

    “Data does not save lives. Numbers on a computer do not save lives,” said Lisa Teggart, who is in recovery and runs two sober living homes in Mobile. “I’m a person in the trenches,” she said after attending the Helios event. “We don’t have a clean-needle program. We don’t have enough treatment. … And it’s like, when is the money going to get to them?”

    The debate over whether to invest in technology or boots on the ground is likely to reverberate widely, as the Helios Alliance is in discussions to build similar models for other states, including West Virginia and Tennessee, where Loyd lives and leads the Opioid Abatement Council.

    New Predictive Promise?

    The Helios Alliance comprises nine nonprofit and for-profit organizations, with missions ranging from addiction treatment and mathematical modeling to artificial intelligence and marketing. As of mid-February, the alliance had received $750,000 to build its model for Alabama.

    The largest chunk — $500,000 — came from the Poarch Band of Creek Indians, whose tribal council voted unanimously to spend most of its opioid settlement dollars to date on the Helios initiative. A state agency chipped in an additional $250,000. Ten Alabama cities and some private foundations are considering investing as well.

    Stephen McNair, director of external affairs for Mobile, said the city has an obligation to use its settlement funds “in a way that is going to do the most good.” He hopes Helios will indicate how to do that, “instead of simply guessing.”

    Rayford Etherton, a former attorney and consultant from Mobile who created the Helios Alliance, said he is confident his team can “predict the likely success or failure of programs before a dollar is spent.”

    The Helios website features a similarly bold tagline: “Going Beyond Results to Predict Them.”

    To do this, the alliance uses system dynamics, a mathematical modeling technique developed at the Massachusetts Institute of Technology in the 1950s. The Helios model takes in local and national data about addiction services and the drug supply. Then it simulates the effects different policies or spending decisions can have on overdose deaths and addiction rates. New data can be added regularly and new simulations run anytime. The alliance uses that information to produce reports and recommendations.

    Etherton said it can help officials compare the impact of various approaches and identify unintended consequences. For example, would it save more lives to invest in housing or treatment? Will increasing police seizures of fentanyl decrease the number of people using it or will people switch to different substances?

    And yet, Etherton cautioned, the model is “not a crystal ball.” Data is often incomplete, and the real world can throw curveballs.

    Another limitation is that while Helios can suggest general strategies that might be most fruitful, it typically can’t predict, for instance, which of two rehab centers will be more effective. That decision would ultimately come down to individuals in charge of awarding contracts.

    Mathematical Models vs. On-the-Ground Experts

    To some people, what Helios is proposing sounds similar to a cheaper approach that 39 states — including Alabama — already have in place: opioid settlement councils that provide insights on how to best use the money. These are groups of people with expertise ranging from addiction medicine and law enforcement to social services and personal experience using drugs.

    Even in places without formal councils, treatment providers and recovery advocates say they can perform a similar function. Half a dozen advocates in Mobile told KFF Health News the city’s top need is low-cost housing for people who want to stop using drugs.

    “I wonder how much the results” from the Helios model “are going to look like what people on the ground doing this work have been saying for years,” said Chance Shaw, director of prevention for AIDS Alabama South and a person in recovery from opioid use disorder.

    But Loyd, the co-chair of the Helios board, sees the simulation platform as augmenting the work of opioid settlement councils, like the one he leads in Tennessee.

    Members of his council have been trying to decide how much money to invest in prevention efforts versus treatment, “but we just kind of look at it, and we guessed,” he said — the way it’s been done for decades. “I want to know specifically where to put the money and what I can expect from outcomes.”

    Jagpreet Chhatwal, an expert in mathematical modeling who directs the Institute for Technology Assessment at Massachusetts General Hospital, said models can reduce the risk of individual biases and blind spots shaping decisions.

    If the inputs and assumptions used to build the model are transparent, there’s an opportunity to instill greater trust in the distribution of this money, said Chhatwal, who is not affiliated with Helios. Yet if the model is proprietary — as Helios’ marketing materials suggest its product will be — that could erode public trust, he said.

    Etherton, of the Helios Alliance, told KFF Health News, “Everything we do will be available publicly for anyone who wants to look at it.”

    Urgent Needs vs. Long-Term Goals

    Helios’ pitch sounds simple: a small upfront cost to ensure sound future decision-making. “Spend 5% so you get the biggest impact with the other 95%,” Etherton said.

    To some people working in treatment and recovery, however, the upfront cost represents not just dollars, but opportunities lost for immediate help, be it someone who couldn’t find an open bed or get a ride to the pharmacy.

    “The urgency of being able to address those individual needs is vital,” said Pamela Sagness, executive director of the North Dakota Behavioral Health Division.

    Her department recently awarded $7 million in opioid settlement funds to programs that provide mental health and addiction treatment, housing, and syringe service programs because that’s what residents have been demanding, she said. An additional $52 million in grant requests — including an application from the Helios Alliance — went unfunded.

    Back in Mobile, advocates say they see the need for investment in direct services daily. More than 1,000 people visit the office of the nonprofit People Engaged in Recovery each month for recovery meetings, social events, and help connecting to social services. Yet the facility can’t afford to stock naloxone, a medication that can rapidly reverse overdoses.

    At the two recovery homes that Mobile resident Teggart runs, people can live in a drug-free space at a low cost. She manages 18 beds but said there’s enough demand to fill 100.

    Hannah Seale felt lucky to land one of those spots after leaving Mobile County jail last November.

    “All I had with me was one bag of clothes and some laundry detergent and one pair of shoes,” Seale said.

    Since arriving, she’s gotten her driver’s license, applied for food stamps, and attended intensive treatment. In late January, she was working two jobs and reconnecting with her 4- and 7-year-old daughters.

    After 17 years of drug use, the recovery home “is the one that’s worked for me,” she said.

    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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    Subscribe to KFF Health News’ free Morning Briefing.

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  • The Surprising Link Between Type 2 Diabetes & Alzheimer’s

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    The Surprising Link Between Type 2 Diabetes & Alzheimer’s

    This is Dr. Rhonda Patrick. She’s a biomedical scientist with expertise in the areas of aging, cancer, and nutrition. In the past five years she has expanded her research of aging to focus more on Alzheimer’s and Parkinson’s, as she has a genetic predisposition to both.

    What does that genetic predisposition look like? People who (like her) have the APOE-ε4 allele have a twofold increased risk of Alzheimer’s disease—and if you have two copies (i.e., one from each of two parents), the risk can be up to tenfold. Globally, 13.7% of people have at least one copy of this allele.

    So while getting Alzheimer’s or not is not, per se, hereditary… The predisposition to it can be passed on.

    What’s on her mind?

    Dr. Patrick has noted that, while we don’t know for sure the causes of Alzheimer’s disease, and can make educated guesses only from correlations, the majority of current science seems to be focusing on just one: amyloid plaques in the brain.

    This is a worthy area of research, but ignores the fact that there are many potential Alzheimer’s disease mechanisms to explore, including (to count only mainstream scientific ideas):

    • The amyloid hypothesis
    • The tau hypothesis
    • The inflammatory hypothesis
    • The cholinergic hypothesis
    • The cholesterol hypothesis
    • The Reelin hypothesis
    • The large gene instability hypothesis

    …as well as other strongly correlated factors such as glucose hypometabolism, insulin signalling, and oxidative stress.

    If you lost your keys and were looking for them, and knew at least half a dozen places they might be, how often would you check the same place without paying any attention to the others?

    To this end, she notes about those latter-mentioned correlated factors:

    ❝50–80% of people with Alzheimer’s disease have type 2 diabetes; there is definitely something going on❞

    There’s another “smoking gun” for this too, because dysfunction in the blood vessels and capillaries that line the blood-brain barrier seem to be a very early event that is common between all types of dementia (including Alzheimer’s) and between type 2 diabetes and APOE-ε4.

    Research is ongoing, and Dr. Patrick is at the forefront of that. However, there’s a practical take-away here meanwhile…

    What can we do about it?

    Dr. Patrick hypothesizes that if we can reduce the risk of type 2 diabetes, we may reduce the risk of Alzheimer’s with it.

    Obviously, avoiding diabetes if possible is a good thing to do anyway, but if we’re aware of an added risk factor for Alzheimer’s, it becomes yet more important.

    Of course, all the usual advices apply here, including a Mediterranean diet and regular moderate exercise.

    Three other things Dr. Patrick specifically recommends (to reduce both type 2 diabetes risk and to reduce Alzheimer’s risk) include:

    (links are to her blog, with lots of relevant science for each)

    You can also hear more from Dr. Patrick personally, as a guest on Dr. Peter Attia’s podcast recently. She discusses these topics in much greater detail than we have room for in our newsletter:

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