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    F.D.A. Expands Access to Clozapine, a Key Treatment for Schizophrenia

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    Federal regulators will no longer require patients to provide blood tests before receiving the drug from pharmacies.The Food and Drug Administration has taken a crucial step toward expanding access to the antipsychotic medication clozapine, the only drug approved for treatment-resistant schizophrenia, among the most devastating of mental illnesses.The agency announced on Monday that it was eliminating a requirement that patients submit blood tests before their prescriptions can be filled.Clozapine, which was approved in 1989, is regarded by many physicians as the most effective available treatment for schizophrenia, and research shows that the drug significantly reduces suicidal behavior. Clozapine is also associated with a rare side effect called neutropenia, a drop in white blood cell counts that, in its most severe form, can be life-threatening.In 2015, federal regulators imposed a regimen known as risk evaluation and mitigation strategies, or REMS, that required patients to submit to weekly, biweekly and monthly blood tests that had to be uploaded onto a database and verified by pharmacists.Physicians have long complained that, as a result, clozapine is grossly underutilized.Dr. Frederick C. Nucifora, director of the Adult Schizophrenia Clinic at the Johns Hopkins School of Medicine, said he believed that around 30 percent of patients with schizophrenia would benefit from clozapine — far more than the 4 percent who currently take it.“I have had many patients who were doing terribly, who struggled to function outside the hospital, and cycled through many medications,” he said. “If they go on clozapine, they really tend to not be hospitalized again. I’ve had people go on to finish college and work. It’s quite remarkable.”We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      Trump Secretly Stayed in Touch With Putin After Leaving Office, Book Says

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      Former President Donald J. Trump has secretly spoken with President Vladimir V. Putin of Russia as many as seven times since leaving office, even as he was pressuring Republicans to block military aid to Ukraine to fight Russian invaders, according to a new book by the journalist Bob Woodward.The book, titled “War” and scheduled to be published next week, describes a scene in early 2024 at Mar-a-Lago, Mr. Trump’s estate in Florida, when the former president ordered an aide out of his office so he could conduct a phone call with Mr. Putin. The unidentified aide said the two may have spoken a half-dozen other times as well since Mr. Trump left the White House.The book also reports that Mr. Trump, while still in office early during the Covid-19 pandemic in 2020, secretly sent Mr. Putin what were then rare tests for the virus for the Russian’s personal use. Mr. Putin, who has been described as particularly anxious about being infected at the time, urged Mr. Trump to not publicly reveal the gesture because it could damage the American president politically. “I don’t want you to tell anybody because people will get mad at you, not me,” Mr. Putin reportedly told him.The disclosures raise new questions about Mr. Trump’s relationship with Mr. Putin just weeks before an election that will determine whether the former president will reclaim the White House. A copy of the book was obtained by The New York Times. The Washington Post, where Mr. Woodward has worked for more than half a century, and CNN, where he often appears as a commentator, also reported on the book on Tuesday.Mr. Trump’s campaign dismissed Mr. Woodward’s book by assailing the author with typically personal insults — “a total sleazebag,” “slow, lethargic, incompetent and overall a boring person with no personality” — without addressing any of the specifics reported in it.“None of these made-up stories by Bob Woodward are true and are the work of a truly demented and deranged man who suffers from a debilitating case of Trump Derangement Syndrome,” Steven Cheung, the campaign communications director, said in the statement. Mr. Cheung said Mr. Trump did not give Mr. Woodward access for the book and noted that the former president was suing the author over a previous book.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      Trump prometió hacer público su historial médico pero sigue sin hacerlo

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      Si vuelve a ser elegido, se convertirá en el presidente de mayor edad al final de su mandato. Sin embargo, se niega a revelar incluso la información médica básica.[Estamos en WhatsApp. Empieza a seguirnos ahora]Como candidato presidencial en 2015, Donald Trump se negó a publicar su historial médico, ofreciendo en su lugar una carta de cuatro párrafos de su médico personal en la que proclamaba que sería “la persona más sana jamás elegida para la presidencia”.En 2020, cuando estuvo hospitalizado por COVID-19 y se presentaba a la reelección, los médicos de Trump dieron una información mínima sobre su estado, que, según se supo más tarde, fue mucho más grave de lo que dejó entrever las descripciones públicas.En 2024, días antes de convertirse en el candidato presidencial republicano oficial por tercera vez, fue rozado por una bala de un posible asesino, pero su campaña no celebró una sesión informativa sobre su estado, no publicó los registros hospitalarios ni puso a disposición a los médicos de urgencias que lo trataron para ser entrevistados.Ahora, a poco más de un mes de unas elecciones que podrían convertir a Trump, de 78 años, en la persona de mayor edad en ocupar la presidencia (82 años, 7 meses y 6 días cuando su mandato termine en enero de 2029), se niega a revelar incluso la información más básica sobre su salud.Si gana, Trump podría entrar en el Despacho Oval con una serie de problemas potencialmente preocupantes, según los expertos médicos: factores de riesgo cardíaco, posibles secuelas del intento de asesinato de julio y el deterioro cognitivo que se produce de forma natural con la edad, entre otros.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      Do You Have Healthy Brain Habits? Take This Quiz to Find Out.

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      What can I do to take good care of my brain and lower my risk for a neurological disease? That’s the No. 1 question neurologist Dr. Jonathan Rosand hears from his patients (and their family members) at the Massachusetts General Hospital McCance Center for Brain Health. To help answer it, he and his colleagues, with […] More

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      Tell us: Have you been forgoing Covid tests?

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      It’s the fifth summer of Covid, and most people seem eager to move on. We want to understand the pervasiveness of the ignorance-is-bliss attitude.Covid cases are surging, but in contrast to summers past, our lives seem to be carrying on with all of their scheduled programming.Covid is still a serious threat to people who are immunocompromised or elderly, but for many others, a positive Covid case seems to be regarded much like the common cold of the before times, and some are abandoning their once-meticulous methods of testing and isolation in favor of a more laissez-faire attitude.The Times is trying to assess how people are thinking about their own transition into a life where the disease is by some standards endemic. On days when you haven’t felt very well, have you bothered to test for Covid, or decided it didn’t really matter what respiratory condition was behind it? If someone in your household has come down with Covid, did you go to work, school or the gym anyway, despite your exposure? Have you found yourself purposely skipping a Covid test for fear of having your social or vacation plans canceled?Please respond by Monday, Aug. 19. We won’t publish any part of your response without following up with you first, verifying your information and hearing back from you. And we won’t share your contact information outside the Times newsroom or use it for any reason other than to get in touch with you. More

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      A Blood Test Accurately Diagnosed Alzheimer’s 90% of the Time, Study Finds

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      It was much more accurate than primary care doctors using cognitive tests and CT scans. The findings could speed the quest for an affordable and accessible way to diagnose patients with memory problems.Scientists have made another major stride toward the long-sought goal of diagnosing Alzheimer’s disease with a simple blood test. On Sunday, a team of researchers reported that a blood test was significantly more accurate than doctors’ interpretation of cognitive tests and CT scans in signaling the condition.The study, published Sunday in the journal JAMA, found that about 90 percent of the time the blood test correctly identified whether patients with memory problems had Alzheimer’s. Dementia specialists using standard methods that did not include expensive PET scans or invasive spinal taps were accurate 73 percent of the time, while primary care doctors using those methods got it right only 61 percent of the time.“Not too long ago measuring pathology in the brain of a living human was considered just impossible,” said Dr. Jason Karlawish, a co-director of the Penn Memory Center at the University of Pennsylvania who was not involved in the research. “This study adds to the revolution that has occurred in our ability to measure what’s going on in the brain of living humans.”The results, presented Sunday at the Alzheimer’s Association International Conference in Philadelphia, are the latest milestone in the search for affordable and accessible ways to diagnose Alzheimer’s, a disease that afflicts nearly seven million Americans and over 32 million people worldwide. Medical experts say the findings bring the field closer to a day when people might receive routine blood tests for cognitive impairment as part of primary care checkups, similar to the way they receive cholesterol tests.“Now, we screen people with mammograms and PSA or prostate exams and other things to look for very early signs of cancer,” said Dr. Adam Boxer, a neurologist at the University of California, San Francisco, who was not involved in the study. “And I think we’re going to be doing the same thing for Alzheimer’s disease and hopefully other forms of neurodegeneration.”In recent years, several blood tests have been developed for Alzheimer’s. They are currently used mostly to screen participants in clinical trials and by some specialists like Dr. Boxer to help pinpoint if a patient’s dementia is caused by Alzheimer’s or another condition.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      3 Presumed Bird Flu Cases Reported in Colorado

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      The cases, which have yet to be confirmed, were identified in farmworkers culling infected birds. The risk to the public remains low, health officials said.Three workers at a poultry farm in northeast Colorado have preliminarily tested positive for bird flu, according to state health officials.The workers had been culling birds from an infected population at the farm, the Colorado Department of Public Health and Environment said on Friday. All three workers had direct contact with infected birds and were experiencing mild symptoms, including conjunctivitis and “common respiratory infection symptoms,” the department said.The results are preliminary, and the tests have been sent to the Centers for Disease Control and Prevention for confirmation, the C.D.C. said.So far, four farmworkers in the United States have been infected with the virus, called H5N1, which is tied to a continuing outbreak among dairy cattle in several states.One case has been reported in Colorado, another in Texas and two more in Michigan, according to the C.D.C. All of those cases involved direct exposure to dairy cows, according to the state and federal health authorities, and officials have said that there is no evidence that the H5N1 virus spreads easily among humans.The risk to the public remains low, the C.D.C. said, but the agency added that it had sent a team to Colorado at the state’s request to help investigate.The C.D.C. said that it would look into whether workers were wearing personal protective equipment. Farmworkers are advised but not required to wear such equipment, including masks, safety goggles and gloves.“These preliminary results again underscore the risk of exposure to infected animals,” the C.D.C. said of the three new cases in Colorado. “There are no signs of unexpected increases in flu activity otherwise in Colorado, or in other states affected by H5 bird flu outbreaks in cows and poultry.”Avian influenza refers to a group of flu viruses primarily adapted to birds. The virus infecting farmworkers, H5N1, was first identified in 1996 in China and reported in people in 1997 in Hong Kong. A new form of H5N1, which surfaced in Europe in 2020, has rapidly spread around the world, and an outbreak in the United States has affected more than 99 million birds.The outbreak has been spreading among dairy farms since at least March, and 152 dairy herds in 12 states have tested positive for the virus. Scientists are researching how the virus is being transmitted through cows.The virus has also spread to a wide array of animals, including marine mammals like seals and bottlenose dolphins, skunks, squirrels and even domestic cats. More

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      Why Chronic Illness Symptoms are Commonly Dismissed as Just Stress

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      Chronic disease symptoms are often dismissed by physicians — and patients themselves. But that comes from a complex relationship between sickness and stress itself.Amina AlTai had always prided herself on her drive and resilience. When she began experiencing brain fog and fatigue, Ms. AlTai, 39, simply thought it was from working long hours in her marketing job. So she started writing down reminders to keep herself on track. But then her hair started falling out, she gained and lost a lot of weight and she started having gastrointestinal issues.Ms. AlTai was certain that something was wrong. But the first six doctors she saw didn’t take her seriously, she said. Some told her she had so much hair that losing a little bit shouldn’t be a problem. Several said she seemed healthy, and dismissed her symptoms as simply stress. It was only when another physician ordered blood tests that Ms. AlTai was diagnosed with Hashimoto’s disease and celiac disease, two autoimmune conditions that can damage the thyroid and the small intestine.“They called me and told me, ‘Don’t go into work. Go to the hospital instead, because you’re days away from multiple organ failure,’” Ms. AlTai remembered. The two chronic diseases had upended her ability to regulate hormones and absorb critical vitamins and nutrients.Scientists now know that stress is intimately linked with many chronic diseases: It can drive immune changes and inflammation in the body that can worsen symptoms of conditions like asthma, heart disease, arthritis, lupus and inflammatory bowel disease. Meanwhile, many issues caused by stress — headaches, heartburn, blood pressure problems, mood changes — can also be symptoms of chronic illnesses.For doctors and patients, this overlap can be confusing: Is stress the sole cause of someone’s symptoms, or is something more serious at play?“It’s really hard to disentangle,” said Scott Russo, director of the Brain-Body Research Center at the Icahn School of Medicine at Mount Sinai.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe. More

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      How Your Body and Mind Change in Midlife

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      Midlife, typically defined as ages 40 to 60, is an inflection point. It’s a time when our past behaviors begin to catch up with us and we start to notice our bodies and minds aging — sometimes in frustrating or disconcerting ways. But it’s also an opportunity: What our older years will look and feel […] More