Modern Healthcare: Doctors, Hospitals Face Cuts As Congress Takes Christmas Off
When Congress went on its winter break before Christmas, it left much of its healthcare business—along with most of it other responsibilities for 2023—unfinished, and now faces an intense scramble to get it all done in just weeks. At the top of the healthcare list is funding programs that depend on annual appropriations for the Health and Human Services Department, which like the rest of the government is running on the latest stopgap funding bill enacted since fiscal 2023 ended Sept. 30. In addition, numerous health-related programs and initiatives expired and are also operating on a short-term lifeline. (McAuliff, 12/21)

Stat: 2023 Sets A New Record For Health Data Breaches 
Odds are, you’ve gotten at least one of the unnerving letters in your mailbox this year: “We’re writing to inform you of a cybersecurity incident,” it might start. It’s the standard notice many health care organizations are required to provide when your protected health information gets exposed — and in 2023, data leaks, hacks, and mishandling led more of them to be delivered than ever before. (Palmer, 12/21)

Modern Healthcare: Olive AI, Cano Health And Other Digital Health Flops Of 2023
While record funding in 2021 and 2022 launched companies to new heights, 2023 will be remembered as the year some of them came crashing down to earth. “There are many, many organizations that just tried and failed at providing a solution,” said Peter Micca, national health tech leader at professional services firm Deloitte. But Micca said this doesn't dampen his enthusiasm for the sector at all. "I'm incredibly bullish on the future of health and innovation." (Turner, 12/21)

Stat: Three Issues To Watch In Global Health In 2024
As we enter the fifth year of this challenging decade, life finally appears to be inching toward normal — a new normal — on the infectious diseases front. Humans and the SARS-CoV-2 virus seem to be making progress toward a detente with each other. Covid is still a major disruptor, a significant cause of illness and death. But the massive disease waves of the early 2020s have calmed down. Masks, in the main, have disappeared. Holiday parties are back. Covid is falling out of the headlines. (Branswell, 12/22)

KFF Health News' 'What The Health?' Podcast: 2023 Is A Wrap 
Even without covid dominating the headlines, 2023 was a busy year for health policy. The ever-rising cost of health care remained an issue plaguing patients and policymakers alike, while millions of Americans lost insurance coverage as states redetermined eligibility for their Medicaid programs in the wake of the public health emergency. (12/21)

St. Louis Post-Dispatch: St. Louis Nursing Home Lost Major Medicaid Cash Infusion
A north St. Louis nursing home that abruptly closed Friday, leaving workers unpaid and some families unable to locate loved ones, had recently lost a special $1 million annual Medicaid payment. The chaos following the closure of Northview Village Nursing Home continued to unfold Tuesday as workers, union officials and city leaders gathered in front of the building to air their anger at the shuttering of what had been the largest nursing home in St. Louis. Almost 175 residents were moved to more than a dozen different nursing homes over the weekend, sometimes without informing their families. (Barker and Merrilees, 12/20)

WFYI: Indiana Medicaid Program Is $1 Billion More Expensive After Forecasting Error
Indiana’s Medicaid program will cost about $1 billion more in the current state budget than previously expected. The state revealed an error Tuesday in the estimates lawmakers used to write the budget earlier this year. The underestimate is centered largely on home- and community-based long-term care services. Access to those services were made easier during the COVID-19 pandemic. Once pandemic-era policies ended, demand stayed high, which wasn’t reflected in the funding estimate legislators received in April. (12/19)

News Service of Florida: Florida Is Suing The Federal Government Over Medicaid Records 
As it tries to fend off a potential class-action lawsuit over dropping people from the Medicaid program, Gov. Ron DeSantis’ administration this week alleged that federal health officials have violated an open-government law by not providing records that could be relevant to the case. (Saunders, 12/21)

Stateline: Grassroots Groups Help Medicaid Recipients Regain Lost Coverage
Eight months after states started dropping millions of low-income families from Medicaid rolls, grassroots groups say they are leading the push to re-enroll people denied coverage for bureaucratic reasons. Nationwide, more than 12.5 million people have lost coverage since April. That’s when the federal pandemic provision that had required states not to drop anyone from the rolls expired and states restarted income eligibility checks. (Hassanein, 12/21)

Tennessee Lookout: Republican Rep Wants To Return Medicaid Expansion Authority To Governor 
Outgoing Republican Rep. Sam Whitson is mulling a reversal of state law requiring the governor to gain approval from the Legislature before expanding Medicaid. Whitson, a Franklin lawmaker who recently announced he will not seek re-election in 2024, said Tuesday he’s been considering such a measure for two years with Tennessee forgoing billions in federal funding that could enable the working poor to obtain insurance coverage. He has not filed a bill yet. The amount Tennessee is losing ballooned from about $1 billion in 2014 to $2.1 billion this year, according to healthinsurance.org. (Stockard, 12/21)

KFF Health News: Bold Changes Are In Store For Medi-Cal In 2024, But Will Patients Benefit? 
California’s safety-net health program, Medi-Cal, is on the cusp of major changes that could rectify long-standing problems and improve health care for the state’s low-income population. Starting Jan. 1, Medi-Cal, California’s Medicaid program, will implement new standardized contracts with its 22 managed care health plans, which collectively cover 99% of enrollees. The new contracts tighten enforcement of quality measures, especially for women and children; require the health plans to report publicly on the performance of medical providers ― and in some cases other insurers ― to whom they delegate care; and mandate that plans reveal the number of enrollees who don’t have access to primary care and invest more to plug the gap. They also commit plans to better integration of physical and mental health care and greater responsiveness to the cultural and linguistic needs, sexual orientation, and gender identity of members. (Wolfson, 12/22)

CIDRAP: Reviews Uncover No Consistent Link Between Antiviral Drugs Like Paxlovid And COVID Rebound 
Two systematic reviews by US federal agencies on the possible link between antiviral treatment for COVID-19 and viral rebound—one specifically on Paxlovid—find no consistent association. The studies were published today in Morbidity and Mortality Weekly Report. The National Institutes of Health COVID-19 Treatment Guidelines recommend early treatment with a first-line (nirmatrelvir/ritonavir [Paxlovid] or remdesivir) or second-line (molnupiravir [Lagevrio]) antiviral drug to help prevent hospitalization and death in high-risk COVID-19 patients with mild or moderate illness. (Van Beusekom, 12/21)

On the spread of covid —

The Baltimore Sun: Traveling For The Holidays? Here’s How To Check Flu And COVID Levels At Your Destination 
When you get ready to travel for the holidays, you may want to know how sick people are in destination where you are going. As of Friday, 17 states are reporting “high” or “very high” levels of respiratory illness activity, federal health data shows. The states where illness activity is highest are scattered throughout the U.S. but most of the Southeastern states are seeing high levels, along with Western states like California, Nevada and Colorado. New Jersey and New York City also are seeing high levels, based on percentage of visits to outpatient healthcare providers or emergency departments for fever and cough or sore throat. (Goodman, 12/21)

The Boston Globe: Mass. Hospitals Resume Mask Requirements As Infections Rise
With COVID-19 cases and other respiratory illnesses rising across the region, some area hospitals have begun to bring back face mask requirements to halt the spread of infections. Boston Medical Center said Thursday it would resume masking requirements in all patient-care areas beginning Friday. On Monday, the Dana-Farber Cancer Institute reinstated its mask requirements in all clinical and public spaces, and the Beth Israel Lahey Health system (BILH) updated its policies to require masking for all health care personnel upon entry to a patient room or bed space. (Piore, 12/22)

The Boston Globe: COVID-19 Vaccine Disparities Return As JN.1 Variant Surges
The post-Thanksgiving COVID-19 wave is threatening to become an annual rite of passage, as predictable as Black Friday crowds and holiday weight gain. But public health officials say this year’s seasonal surge has a new, potentially deadly wrinkle: the lowest vaccination rates since the start of the pandemic. Though the latest version of booster shots confers broad protection against a new, highly contagious variant that is expected to gain dominance in the coming weeks, just 17 percent of Massachusetts residents have received it, according to the latest numbers from the Department of Public Health. (Piore, 12/21)

Also —

Global News: Canadian Covid Test Supplier Received Billions In Pandemic Contracts After Submitting Edited Results 
A year-long investigation into federal procurement revealed that BTNX, a small rapid test supplier based outside Toronto, deleted dozens of specimens, or samples, from a study it submitted to Health Canada. The deletions made BTNX’s test appear more reliable and sensitive than it really was, according to researchers Global News consulted. (Sonntag, 12/21)

Modern Healthcare: Hospital Observation Status Appeals Under Medicare Outlined
The Centers for Medicare and Medicaid Services has outlined an appeals process for Medicare beneficiaries who believe hospitals inappropriately classified their stays as observations instead of admissions. The proposed rule published Thursday aims to resolve a 12-year-old class-action lawsuit seeking redress for fee-for-service enrollees whose hospital or nursing home care wasn't covered under Medicare Part A because hospitals designated them as outpatients. (Bennett, 12/21)

KFF Health News: Cancer Patients Face Frightening Delays In Treatment Approvals 
Marine Corps veteran Ron Winters clearly recalls his doctor’s sobering assessment of his bladder cancer diagnosis in August 2022. “This is bad,” the 66-year-old Durant, Oklahoma, resident remembered his urologist saying. Winters braced for the fight of his life. Little did he anticipate, however, that he wouldn’t be waging war only against cancer. He also was up against the Department of Veterans Affairs, which Winters blames for dragging its feet and setting up obstacles that have delayed his treatments. (Sausser, 12/22)

In other health care industry developments —

Modern Healthcare: 50 Healthcare Mergers Challenged By FTC In 2022: Report
The Federal Trade Commission and Justice Department challenged 50 merger and acquisition proposals across all sectors of the economy in 2022, including six proposed healthcare deals, according to a new report. The FTC’s 24 merger enforcement challenges in 2022—including five in healthcare—marked the second-highest number over the prior 10 years, according to the annual report for the fiscal year ended Sept. 30 on the Hart-Scott-Rodino Act premerger notification program issued Thursday. (Kacik, 12/21)

NBC News: Vital Signs Vs. Dollar Signs: At HCA Hospitals, The Person Monitoring Your Heart May Be Doing It For 79 Other Patients. Is That Safe?
In Wesley Medical Center, and in most hospitals today, the people monitoring patients’ heart rhythms, blood pressure or respiratory functions are not nurses who interact with them. They are “telemetry” technicians who are supposed to alert those nurses to meaningful changes in the vital signs transmitted by electronic devices hooked up to the patients. The technicians in telemetry units typically watch screens showing heart rhythms and numbers for many patients at a time — sometimes dozens — and often sit in a room far from the patients they are watching. (Morgenson, 12/21)

Stat: Keeping Primary Care Docs In Field Isn't Impossible, Says AAFP CEO
In ten years, the United States could be short as many as 48,000 primary care doctors. The specialty is underpaid, to a point that doctors are lobbying Medicare to pay it extra. Even medical residents who chose the specialty are leaving primary care; some 45% of residents who planned to be generalists changed their mind during their residencies. (Trang, 12/22)

NPR: Shortage In Primary Care Clinicians Eroding Patient Trust
First, her favorite doctor in Providence, R.I. retired. Then her other doctor, at a health center a few miles away, left the practice. Now, Piedad Fred has developed a new chronic condition: distrust in the American medical system. "I don't know,'' she said, eyes filling up. "To go to a doctor that doesn't know who you are? That doesn't know what allergies you have, the medicines that make you feel bad? It's difficult...I know that I feel cheated, sad, and like I have my hands tied.'' (Arditi, 12/22)

Roll Call: Democrats Eye Appropriations To Protect Pediatrician Training 
House Republicans attempting to tie the reauthorization of a critical pediatrician training program to efforts to limit gender-affirming care for transgender children acknowledge those efforts will collapse. Now lawmakers are looking to fund the program as-is through the appropriations process. Federal authorization for the Children’s Hospitals Graduate Medical Education Program, which trains more than half of pediatric specialists and almost half of general pediatricians nationwide, lapsed on Sept. 30. (Cohen, 12/21)

Axios: Seattle Children's Hospital Sues Texas AG Over Trans Minors Treatment Demands
Texas Attorney General Ken Paxton (R) has made "sham requests" seeking to force Seattle Children's Hospital to provide details of Texas residents who've received gender-affirming care, alleges a lawsuit from the nonprofit health care provider. Seattle Children's Hospital said in its lawsuit that Paxton's office claimed it was investigating potential violations of Texas' ban on gender-affirming care for minors, but Washington's recently passed "Shield Law" protected it from subpoenas from states seeking to "restrict or criminalize reproductive and gender-affirming care." (Falconer, 12/21)

AP: DeSantis Spread False Information While Pushing Trans Health Care Ban And Restrictions, A Judge Says 
A federal judge hearing a challenge to a transgender health care ban for minors and restrictions for adults noted Thursday that Republican Florida Gov. Ron DeSantis repeatedly spread false information about doctors mutilating children’s genitals even though there’s been no such documented cases. The law was sold as defending children from mutilation when it is actually about preventing trans children from getting health care, Judge Robert Hinkle said to Mohammad Jazil, a lawyer for the state. (Farrington, 12/22)

Time: Malpractice Premiums Are Blocking Gender-Affirming Care For Minors
After Iowa lawmakers passed a ban on gender-affirming care for minors in March, managers of an LGBTQ+ health clinic located just across the state line in Moline, Illinois, decided to start offering that care. The added services would provide care to patients who live in largely rural eastern Iowa, including some of the hundreds previously treated at a University of Iowa clinic, saving them half-day drives to clinics in larger cities like Chicago and Minneapolis. (Nowell, 12/21)

St. Louis Public Radio: Advocates Launch Emergency Program For Missouri Trans Kids
Transgender Missourians under 18 and their families can now get help finding gender-affirming care in other states through a regional project operated by a North Carolina-based nonprofit. (Fentem, 12/21)

Also —

AP: For Years, He Couldn't Donate At The Blood Center Where He Worked. Under New FDA Rules, Now He Can 
Over the last six years, blood center employee Dylan Smith was often asked how frequently he gave blood himself. His answer was always the same: As a gay man, he couldn’t. That changed this month. Thanks to new federal guidelines finalized in May, gay and bisexual men in monogamous relationships can now donate at many blood centers around the country without abstaining from sex. Bloodworks Northwest, where Smith works as a donor services supervisor, adopted the change on Dec. 6. He and his partner gave blood for the first time the next day. (Valdes and Rush, 12/22)

NBC News: FDA Warns Against Unauthorized Fat-Melting Injection Treatments
The Food and Drug Administration issued a warning about the dangers of using unauthorized versions of fat-dissolving injections, saying it has received reports of severe side effects, such as persistent scarring, severe infections and skin deformities. ... The FDA on Wednesday noted the presence of unapproved fat-dissolving injections popping up at clinics and med spas across the U.S., including those sold online under brand names like Aqualyx, Lipodissolve, Lipo Lab and Kabelline. (Lovelace Jr., 12/21)

Reuters: US FDA Warns About Counterfeit Versions Of Novo's Diabetes Drug Ozempic
The U.S. Food and Drug Administration on Thursday warned consumers not to use counterfeit versions of Novo Nordisk's diabetes drug Ozempic that have been found in the country's drug supply chain. The health regulator said it will continue to investigate counterfeit Ozempic 1 milligram injections and has seized thousands of units, but flagged that some may still be available for purchase. (12/21)

CBS News: Ozempic And Wegovy Gain Popularity For Weight Loss, Also Causing Spike In Emergency Calls For Adverse Side Effects
While the drugs have proven useful for many in their weight loss journey, doctors note that stopping the medication will in most cases result in consumers gaining all of the weight back. More concerningly, Saltz said many who started taking the medications have had to go to the emergency room with other symptoms. "It can cause gallbladder disease and diarrhea. Those kinds of things will lead to dehydration which will lead to an ER visit," Saltz said. (Thomas, 12/21)

The New York Times: Bellevue Hospital Bariatric Surgery Program Is Under NY State Scrutiny 
The New York State Department of Health is scrutinizing Bellevue Hospital’s use of unlicensed technicians to assist doctors in weight-loss surgeries. Bellevue, a large public hospital in Manhattan, churns thousands of low-income patients through bariatric surgery every year, The New York Times reported this month. Doctors are paid in part based on the volume of surgeries. (Silver-Greenberg and Kliff, 12/21)

USA Today: ADHD Drug Prices Rise As Adderall Shortage Leaves Patients Scrimping To Fill Prescriptions
Amid a nationwide ADHD drug shortage, patients are paying significantly more for medication to help them direct their focus at school, work and home. The shortage has placed financial pressure on families, forcing them to search for alternatives. Often, the only options they can find are expensive brand-name drugs. The upward trend can be seen in the prices retail community pharmacies pay for several popular ADHD drugs, which a USA TODAY analysis found have outpaced inflation – and in some cases doubled or tripled in price – since Adderall fell into short supply starting in October 2022. (Garzella, 12/21)

Stat: How Pharma Companies Keep Drug Prices High And Competition Low
To ring the register, a pharmaceutical company may create a patent thicket, which involves filing dozens of patents that, in some cases, add little value to their medicines but extend precious monopolies. And one crucial, but little-known tool for making this happen is something called a terminal disclaimer. (Silverman, 12/21)

Stat: FDA Approves AstraZeneca, Ionis Treatment For Rare Nerve Disease 
The Food and Drug Administration approved a novel medicine for a rare and devastating nerve disease Thursday, clearing a treatment that promises to be more convenient than available therapies. (Garde, 12/21)

Reuters: Jazz Pharmaceuticals' PTSD Drug Fails In Mid-Stage Trial 
Jazz Pharmaceuticals (JAZZ.O) said on Thursday its post-traumatic stress disorder (PTSD) drug failed to meet the main goal in a mid-stage study. Shares of the company fell as much as 4% in after-market trading. The drugmaker said it does not anticipate moving forward with additional development of the drug called JZP150. (12/21)

KFF Health News and CBS News: ‘AGGA’ Inventor Testifies His Dental Device Was Not Meant For TMJ Or Sleep Apnea 
A Tennessee dentist who has been sued by multiple TMJ and sleep apnea patients over an unproven dental device he invented has said under oath that he never taught dentists to use the device for those ailments — contradicting video footage of him telling dentists how to use it. Steve Galella, the inventor of the Anterior Growth Guidance Appliance, or “AGGA,” has said in court depositions that his device had been used on about 10,000 patients, and that he trained many dentists to use the AGGA in classes around the U.S. and overseas. (Kelman and Werner, 12/22)

In global news —

Los Angeles Times: Some Mexican Pharmacies Are Selling Full Bottles Of Adderall. But It's Actually Meth
As a shortage of Adderall stretches into its second year, millions of patients are still struggling to fill their prescriptions in U.S. pharmacies. But in Mexico, some pharmacies are selling the pricey orange pills over the counter, in sealed bottles bearing the names and logos of well-known pharmaceutical companies. One problem: They’re not real. Some are counterfeits made of methamphetamine, while others contain appetite suppressants, acetaminophen or caffeine. (Blakinger, Sheets, and Mejia, 12/21)

Reuters: Exclusive: India Probe Into Bribery Claim In Toxic Syrup Tests Nears Completion 
India is close to finishing an investigation into a "comprehensive and exhaustive" complaint that a state drug regulator, in return for a bribe, helped switch samples of cough syrups linked to the deaths of children in Gambia before the samples were tested in India, the investigator told Reuters. While the World Health Organization (WHO) linked the syrups made by India's Maiden Pharmaceuticals to the deaths of 70 children in the African country last year, India's government says tests at an Indian government laboratory showed the syrups were not toxic. Maiden has said it had not "done anything wrong". (Das, 12/21)

The New York Times: Hormonal Implants, A Once Unpopular Birth Control, Surge Among Teens 
The hormonal implant, a long-acting reversible contraceptive, is an increasingly popular choice among teenagers, according to data published last week from the Centers for Disease Control and Prevention. Just over 13 percent of sexually active teenage girls used the implant between 2015 and 2019, compared with 0.6 percent between 2006 and 2010. This represents the biggest jump in usage compared to all other contraceptive methods. The uptick “probably contributed to a decline in teen pregnancies and births that we’ve seen,” said Joyce Abma, a social scientist with the National Center for Health Statistics and co-author of the latest C.D.C. report. The report notes that both teenage pregnancies and births have reached “historic lows.” (Gupta, 12/21)

CBS News: Woman's Waist Size May Be Contributing Factor To Infertility, Study Says
One in four couples struggle with infertility and a new study finds that a woman's waist size may be a contributing factor. A team in China studied more than 3,000 women of reproductive age and found that the chances of getting pregnant declined as waist size increased, independent of a woman's body mass index or BMI. In fact, for every 1 cm increase in waist circumference, the risk of infertility increased by 3 percent. (Marshall, 12/21)

Bloomberg: Fertility Startup With a ‘Profit Mindset’ Pushes Doctors for More Egg Retrievals
In September, the fertility startup Kindbody gathered its doctors at a weekend retreat in a Los Angeles hotel. They bonded over morning yoga and swapped best practices for helping women conceive babies. But an announcement by Kindbody executives cast a pall over the event. The company was burning through cash. If it was going to turn a profit and go public, the 32 reproductive endocrinologists would need to raise the number of monthly egg retrieval attempts they perform by 12, according to physicians who received performance plans reviewed by Bloomberg. (Davalos, 12/22)

The Texas Tribune: Texas Midwives Push For Their Profession To Grow
It was early in the COVID-19 pandemic when Tereé Fruga received a call from an expectant mother inquiring about an at-home birth. The woman on the other end of the phone call told Fruga, a registered midwife, she had never considered giving birth outside a hospital. But she was scared about the level of care she’d receive as a Black woman. COVID-19 precautions at the time would have prevented the pregnant mother to have an extensive support system in the hospital. (Runnels, 12/22)

WyoFile: As Wyoming Maternal Care Dwindles, Tribal Clinics Build It Up
When teacher Fredde Reed became pregnant with her first child in March, her choice for prenatal care was easy, she said. “Being Native American enrolled, I can receive care at Indian Health Service,” said Reed, who is Eastern Shoshone. (Klingsporn, 12/21)

In abortion updates —

AP: Top Wisconsin Republican Wants To Put Abortion Laws On A Future Ballot 
Wisconsin’s top Republican wants to let voters decide whether to shrink the window of time in which women can get abortions, but the state’s Democratic governor says he won’t allow it. Current state law bans abortions after the 20th week of pregnancy. Republican Assembly Speaker Robin Vos said Wednesday that he hopes to put a proposal on some future ballot that would lower the limit to somewhere between the 12th and 15th week. (Venhuizen, 12/21)

The Washington Post: Colon Cancer Is Rising In Young Americans. It’s Not Clear Why. 
The five people gathered around the restaurant table do not fit the profile of colon cancer patients. They’re female, and they’re young. Two were diagnosed in their 20s, one in her 30s, two in their early 40s. Their colon cancer support group gathers about once a month to share stories, such as the one about the doctor who said you just need a laxative, the one about the oncologist who said there’s nothing we can do for you but give you chemotherapy the rest of your life, the one about friends saying, “You don’t look sick,” without realizing that isn’t helpful. “It’s making themselves feel better,” said Carly Brown, 29, a schoolteacher diagnosed with Stage 4 colon cancer five years ago. (Achenbach and McGinley, 12/21)

In other health and wellness news —

The Baltimore Sun: New Online Tool Helps Caregivers Pass On Plans For Loved Ones With Disabilities 
There is now an online tool that enables parents and guardians of people with disabilities to build personalized plans that are simple, secure and easy to share with other caregivers. “It is completely different from a will, which usually focuses on who gets what. The plan allows you to specify details (of your loved ones’) daily routine, pick-up times, medications and more,” Joel Pearlman said. “It is a really powerful day-to-day look at what makes their day and your life work best.” ... The Dani Plan has a free 21-day trial period as well as paid premium options. (Thwing, 12/21)

The Washington Post: VR Can Help Seniors In Nursing Homes With Mood, Memory And Loneliness 
On Wednesday mornings, residents at Citrus Place, a retirement community in this middle-class town, gather for a weekly institution: 30 minutes in virtual reality. The activity is voluntary, and attendance is good. On this day, about a dozen participants from the facility’s assisted-living wing sat on love seats in a circle, wearing VR headsets that looked like big goggles. Their virtual schedule was packed: a hot-air balloon ride, then a safari, then to the grocery store. (Hunter, 12/21)

WUSF: How To Cope With Grief During The Holidays 
Mental health experts say it's OK to not be merry this holiday season if you're struggling with loss. They encourage people to look for small moments of joy. (Colombini, 12/21)

The New York Times: The Army Said Tank Blasts Don’t Harm Troops. His Case Raises Doubts.
Christian Beyer worked around the ground-shaking blasts of one of the Army’s most powerful weapons — the M1 Abrams tank — for 23 years. And for nearly all that time, he was a model soldier, given awards for meritorious service and promoted all the way up to master sergeant in charge of training young tank crews. Then in 2020, at age 38, he started to fall apart. He couldn’t sleep. His family noticed that his balance had turned unsteady and he began to slur his speech. He would weep about small things and dwell on imagined conspiracies. (Philipps, 12/21)

The Wall Street Journal: A New Way To Treat Back Pain
What if the best way to treat your chronic back pain is by retraining your brain? That’s the premise of a novel approach to chronic pain. Many people feel pain even after a physical injury has healed or when doctors can’t find a physical cause. The approach, called “pain reprocessing therapy,” tries to train the brain not to send false pain signals. Some early results are promising. In a study published last year in JAMA Psychiatry, 66% of a group of people who did the therapy for a month were pain-free or nearly pain-free up to a year later. (Reddy, 12/21)

CBS News: New UCSF Study Finds Some Diagnosed With Kidney Disease May Not Need Dialysis
Dr. Chi Hsu is the Chief of the division of Nephrology at UCSF, he along with Dr. Ian McCoy were conducting a study on how patients with acute kidney disease requiring dialysis are currently being managed at outpatient dialysis clinics. ... "Most of the research on acute kidney injury has been on when patients should start dialysis or how much dialysis they need in the hospital. and there has been relatively little research on how to take people off of dialysis when they start recover and how to recognize recovery." (Cook, 12/21)

The Wall Street Journal: Flesh-Rotting ‘Tranq’ Undermines Fight Against Fentanyl 
Carisa Collins-Caddle peered at a scar in the crook of Regina Locklear’s arm. Weeks earlier, a wound that appeared after Locklear injected illicit drugs had swelled to the size of an orange. She had texted a photo to Collins-Caddle, who provides help including clean syringes to drug users. Collins-Caddle had been spreading the word about an infiltrator in North Carolina’s drug supply: xylazine, an animal tranquilizer that can rot flesh, requiring amputations.  “I never thought there would be a day when I would say there was something that scared me more than fentanyl. But here I am,” said Collins-Caddle, 47 years old. (Wernau, 12/21)

The Hill: California Law That Would Ban Firearms In Most Public Places Blocked 
A California law that would ban firearms in most public places was blocked by a federal judge Wednesday. The law, struck down because U.S. District Judge Cormac Carney ruled that it violates the Second Amendment, would have gone into effect at the beginning of next month. It was signed by California Gov. Gavin Newsom (D) back in September and would have barred the concealed carrying of guns in locations like public parks and playgrounds, churches, banks and zoos.  (Suter, 12/21)

The New York Times: Gunfire Echoing Through School Grounds? Parents Are Terrified. Kids Stopped Noticing. 
The gunshots rang out at 8:13 a.m., echoing across the high school football field and middle school garden. They continued for 49 minutes without interruption: an AR-15-style rifle, with .223-caliber bullets, ripping at 94 decibels through a community that did not even pause to wonder if a disaster was unfolding at the schools. It was just a typical morning in Cranston, R.I., where more than 2,000 children attend school within 500 yards of a police shooting range. There, local police officers sharpen their gun skills, sometimes until 8:30 at night. (Baumgaertner, 12/20)

Public health alerts from California and Mississippi —

CBS News: Person With Contagious Tuberculosis Identified At UC Davis; Contact Tracing Underway
Health officials have started contact tracing after a person at the UC Davis campus was identified as having contagious tuberculosis. UC Davis officials announced on Wednesday that they were working on identifying and notifying people who had been in close contact with the infected person. Only people who had at least 8 hours of exposure to the person are classified as close contacts. (Padilla, 12/21)

CIDRAP: Contaminated Water, Soil Tied To Rare Tropical Disease Melioidosis In 3 Men In Same Mississippi County 
Over a 3-year period, three men in Mississippi were infected with a newly identified strain of the bacterium that causes melioidosis after contact with contaminated water and soil, the first known cases of environmental transmission in the continental United States, the New England Journal of Medicine reports today. Caused by Burkholderia pseudomallei, melioidosis is a potentially life-threatening disease typically spread through inhalation, ingestion, or skin contact with the water or soil of tropical and subtropical regions, where it is endemic. (Van Beusekom, 12/21)

In other health news from across the U.S. —

The Baltimore Sun: Last Open-Air Water Reservoirs In Baltimore Covered
The last open-air water reservoirs in Baltimore have been covered. Drinking water at Lake Ashburton and Druid Lake previously exposed to both the elements and microscopic danger are now in protected tanks, the city department of public works said Thursday. The illness-inducing parasite cryptosporidium was detected in the water at Druid Lake Reservoir in September, prompting state officials to issue a boiled water advisory. (Mullan, 12/21)

St. Louis Post-Dispatch: Mercy Rolls Out New At-Home Program For Acutely Ill Patients In The St. Louis Area
While Marie Alexander was battling a serious infection, her “hospital room” was at her daughter’s home in Des Peres, where she was waited on by her grandchildren and snuggled with the family dog at night. Alexander, 75, was given an oxygen machine and intravenous medications to treat the infection. A doctor came by once a day, and nurses twice. She used an iPad to connect to providers virtually if she needed. (Munz, 12/21)

WGCU: Clinical Research Center In Southwest Florida Works To Help Improve Brain Health
In Florida, one out of five residents is older than 65 and they have become one of the fastest growing in the state. Florida also has one of the fastest rising rates of Alzheimer’s dementia — 580,000 Floridians aged 65 and older are living with Alzheimer’s. Alzheimer’s is a growing public health crisis in Florida and the impact of the disease is projected to rise as the population continues to age. (Monteilh, 12/21)

The Texas Tribune: How Texas’ Mental Health Vision Fell Apart
It was in early 2020, a few months into the COVID-19 pandemic, that the world Elizabeth Ramirez knew – filled with her three kids’ activities and a job as a human resource specialist – came to an abrupt halt. A teacher had called from her son’s El Paso school. Her 13-year-old, Orlando, mentioned suicide during a virtual class, sending Ramirez into a desperate search for an in-patient mental health facility. (Simpson, 12/22)

The New York Times: Behind The Shortage Keeping Cancer Patients From Chemo 
Stephanie Scanlan learned about the shortages of basic chemotherapy drugs this spring in the most frightening way. Two of the three drugs typically used to treat her rare bone cancer were too scarce. She would have to go forward without them. Ms. Scanlan, 56, the manager of a busy state office in Tallahassee, Fla., had sought the drugs for months as the cancer spread from her wrist to her rib to her spine. By summer it was clear that her left wrist and hand would need to be amputated. (Jewett, 12/19)

The New York Times: Possible Ways To Ease Drug Shortages 
At several congressional hearings this year, ideas to fix drug shortages were as numerous as the number of scarce drugs. The rationing of key chemotherapies added urgency to the crisis. Two of these drugs, carboplatin and cisplatin, are inexpensive and are used to treat up to 20 percent of cancer patients, according to the National Institutes of Health. (Jewett, 12/19)

The Washington Post: Flashes, Shimmers And Blind Spots: Here’s What Migraine Aura Looks Like 
Blurred vision. Shimmering lights. Blind spots. Zigzag lines. This is what migraine aura looks like. Migraine is a neurological disorder characterized by severe, even debilitating, pain on one side of the head, and can be accompanied by other symptoms such as aura, a sensory disturbance that can cause temporary visual impairment. The Washington Post spoke to four chronic-migraine sufferers about living with migraine aura. Based on their vivid descriptions, we created video illustrations to show what migraine auras look like through the eyes of people who suffer from them. (Ard and Monroe, 12/21)

Politico: ‘Sex Is A Normal Activity And Part Of Our Human Experience’ 
Dr. Leandro Mena has plenty of reasons to lie awake at night. Over the two years he led the CDC’s Division of STD Prevention, he’s seen sexually transmitted infections hit record levels, including the highest number of syphilis cases since the Truman administration. Then there’s the deeply troubling evolution of antibiotic-resistant gonorrhea and the spate of outbreaks of the new virus mpox in LGBTQ communities. And don’t forget that Congress is eager to slash funding to combat all these crises. Meanwhile, stigma around sex and STDs remains pervasive — even in the medical community — which only makes it harder for people to get the help they need. “We, as a society, have a tremendous difficulty talking about sex and recognizing that sex is a normal activity and part of our human experience,” he said in an interview. (Ollstein, 12/17)

The New York Times: Is Biological Age Testing Accurate Or Useful? 
If you’ve ever been to a high school reunion, you know that some people seem to age faster than others. Twenty-five years after graduation, one classmate can appear a decade younger than the rest, another a decade older. “People know that intuitively,” said Dr. Nir Barzilai, director of the Institute for Aging Research at the Albert Einstein College of Medicine, “but they don’t understand that it’s a biology that we’re trying to discover.” Scientists are working to quantify this phenomenon and put a number to a person’s “biological age” by looking at their cellular health instead of how many years they’ve been alive. (Smith, 12/19)

In global health news —

Bloomberg: World’s Oldest Lab Rats Contribute To Anti-Aging Research 
In medical research, lab mice and rats die for us in great numbers. Sacrificed during or after experiments, they leave us with information that, over the years, has helped us understand diseases, develop medicines and map the functions of particular genes. But some aging-focused research projects require something else from these animals: that they stay alive, and healthy, for as long as possible. So in labs from North Dakota to Mumbai, select rodents grow old under heavy scrutiny.

AP: The War Took Away Their Limbs. Now Bionic Prostheses Empower Wounded Ukrainian Soldiers
When Alexis Cholas lost his right arm as a volunteer combat medic near the front lines in eastern Ukraine, his civilian career as a surgeon was over. But thanks to a new bionic arm, he was able to continue working in health care and is now a rehab specialist helping other amputees. The 26-year-old is delighted with his sleek black robotic arm — he described it as “love at first sight” — and realizes how lucky he was to get one. “There are fewer (bionic) arms available than lost ones,” Cholas said. (Arhirova, 12/22)

Stat: In Spain, A Hospital Brews Its Own CAR-T Therapy
Some of the patients waiting in the oncology ward of a hospital here, with its green-tiled floor and white walls, had arrived for a newfangled remedy for blood cancers, what’s known as a CAR-T therapy. The patients were not here for one of the brand-name medicines — a Kymriah or Yescarta — that have shown the power of these cell-based approaches and helped reap their makers hundreds of millions of dollars. Rather, they would be receiving a CAR-T brewed up right here at Hospital Clínic de Barcelona. (Joseph, 12/19)

The New York Times: Mystery Amid An Anthrax Outbreak In Africa 
Five African countries are battling outbreaks of anthrax, with nearly 1,200 people affected so far and 20 deaths, according to the World Health Organization. But the official tally belies confusion about the exact nature and scale of the outbreaks, which may complicate the efforts needed to contain them. Of the 1,166 presumed anthrax cases in Kenya, Malawi, Uganda, Zambia and Zimbabwe, only 35 have been confirmed with lab tests. That is not unusual or unreasonable, experts said, especially in regions with limited resources. But at least in Uganda, many of the presumed cases have resulted in negative tests for anthrax, raising the possibility that a second disease is circulating. (Mandavilli, 12/19)

The New York Times: New Hope — And An Old Hurdle — For A Terrible Disease With Terrible Treatments 
Three years ago, Jesús Tilano went to a hospital in a thickly forested valley in Colombia with large open lesions on his nose, right arm and left hand. He was diagnosed with leishmaniasis, a parasitic disease that is spread in the bite of a female sand fly and which plagues poor people who work in fields or forests across developing countries. He was prescribed a drug that required three injections a day for 20 days, each one agonizingly painful. Mr. Tilano, 85, had to make repeated expensive bus trips to town to get them. Then his kidneys started to fail, which is a common side effect of the drug, as are heart failure and liver damage. “The cure was worse than what I had before,” Mr. Tilano said. (Nolen, 12/19)

Scientific American: How Two Pharmacists Figured Out That Decongestants Don't Work 
In 2005, federal law compelled retailers nationwide to move pseudoephedrine, sold as Sudafed, from over-the-counter (OTC) to behind it, so as to combat its use in making illicit methamphetamine. This move changed the formulas of cough and cold medicines in the U.S.. It also led me and my colleague Leslie Hendeles to prove that pseudoephedrine’s replacement, oral phenylephrine, was ineffective as a decongestant. (Randy Hatton, 12/21)

The New York Times: Crack-House Memories Are Blocking Real Help For Addicts 
It’s been two years since New York City became home to the nation’s first legally sanctioned supervised consumption program, where people can take illicit drugs like heroin, crack and methamphetamine under medical supervision. By many accounts that program is thriving. More than 1,000 potentially fatal overdoses have been reversed and many people who use the facilities have been connected to support services, including addiction treatment. (Jeneen Interlandi, 12/22)

Los Angeles Times: This Supreme Court Decision Should Be Easy — Keep Medication Abortion Accessible 
In 2022, the court took away the constitutional right to abortion by overturning Roe vs. Wade and created a chaotic patchwork of abortion access in this country. Now the issues before the court involve the most commonly used abortion method — medication abortion with the drug mifepristone — and whether the U.S. Food and Drug Administration has final authority to make its own rules and regulations governing drugs. (12/22)

The New York Times: Abortion History Repeats Itself 
Much of the country no doubt watched in amazement last week as a woman with a doomed pregnancy was forced to flee her home state, Texas, to get the abortion her doctors deemed necessary to protect her future ability to bear children. Could this really be happening in the United States in 2023? (Linda Greenhouse, 12/22)

Stat: Christmas In The PICU Brings Some Surprising Joy 
In the days leading up to Christmas in the pediatric intensive care unit (PICU), medical teams work to send as many children home as they can. Kids should be with their people for the holidays. And it makes sense. But for parents of children receiving in-home care — parents like me — it can be a relief to surrender to the hospital’s siren song. For families like mine, the PICU can be a respite, especially during Christmas. (Maria Kefalas, 12/22)

Newsweek: What's Missing From Our Current Conversation About AI And Medicine
The current AI frenzy is focused on generative AI technologies like ChatGPT, DALL-E, and Gemini that create original writing, images, computer code, and even music. In medicine, people are throwing GPT at every problem under the sun, testing it as a scribe that can help doctors complete medical records, a chatbot that can offer public health advice, and a tool to diagnose patients and recommend treatment. (Archana Venkataraman, 12/21)

The Washington Post: 5 Health Stories From 2023 That Give Me Hope 
As 2023 comes to an end, I want to highlight five hopeful health stories that I’ve had the privilege to report on this year. (Leana S. Wen, 12/21)