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    Heart-Valve Patients Should Have Earlier Surgery, Study Suggests

    The results of a new clinical trial have overturned the “wait and see” approach that cardiologists have long favored for symptom-free patients.For decades, people with failing heart valves who nevertheless felt all right would walk out of the cardiologist’s office with the same “wait and see” treatment plan: Come back in six or 12 months. No reason to go under the knife just yet.A new clinical trial has overturned that thinking, suggesting that those patients would be much better off having their valves replaced right away with a minimally invasive procedure.The trial, whose results were published this week in The New England Journal of Medicine, could change the way doctors treat severe aortic stenosis, a narrowing of the valve that controls blood flow from the heart. The disease, which has a prognosis worse than that of most cancers, afflicts more than 3 percent of people ages 65 and older. It is expected to become more common as people live longer.Replacing people’s heart valves, even if they were not yet experiencing any ill effects, appeared to roughly halve their risk of being unexpectedly hospitalized for heart problems over at least two years, the trial found.Patients who were put on the more conservative treatment plan overwhelmingly ended up needing surgery anyway: Roughly 70 percent of them developed symptoms and needed to have their valves replaced within two years, suggesting that the disease worsens more quickly than previously understood.“You may be able to at least prevent that progression and perhaps improve patient outcomes by treating earlier,” said Dr. Gregg Stone, a professor of medicine at the Icahn School of Medicine at Mount Sinai, describing the implications of the trial. The findings, he said, “will have a major effect on practice.”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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    U.S. Study on Puberty Blockers Goes Unpublished Because of Politics, Doctor Says

    The leader of the long-running study said that the drugs did not improve mental health in children with gender distress and that the finding might be weaponized by opponents of the care.An influential doctor and advocate of adolescent gender treatments said she had not published a long-awaited study of puberty-blocking drugs because of the charged American political environment.The doctor, Johanna Olson-Kennedy, began the study in 2015 as part of a broader, multimillion-dollar federal project on transgender youth. She and colleagues recruited 95 children from across the country and gave them puberty blockers, which stave off the permanent physical changes — like breasts or a deepening voice — that could exacerbate their gender distress, known as dysphoria.The researchers followed the children for two years to see if the treatments improved their mental health. An older Dutch study had found that puberty blockers improved well-being, results that inspired clinics around the world to regularly prescribe the medications as part of what is now called gender-affirming care.But the American trial did not find a similar trend, Dr. Olson-Kennedy said in a wide-ranging interview. Puberty blockers did not lead to mental health improvements, she said, most likely because the children were already doing well when the study began.“They’re in really good shape when they come in, and they’re in really good shape after two years,” said Dr. Olson-Kennedy, who runs the country’s largest youth gender clinic at the Children’s Hospital of Los Angeles.That conclusion seemed to contradict an earlier description of the group, in which Dr. Olson-Kennedy and her colleagues noted that one quarter of the adolescents were depressed or suicidal before treatment.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 propuso que la fertilización in vitro fuera gratuita. ¿Es posible?

    Conseguir que se cubran los costosos tratamientos de fertilidad sería algo que no puede hacer un presidente solo, dijeron los expertos en políticas de salud.[Estamos en WhatsApp. Empieza a seguirnos ahora]El expresidente Donald Trump dijo el jueves en campaña que quiere que el tratamiento de fertilización in vitro (FIV) sea gratuito para todos los estadounidenses.“Bajo un gobierno de Trump, tu gobierno pagará o tu compañía de seguros estará obligada a pagar todos los costos asociados con el tratamiento de fertilización in vitro”, dijo Trump el jueves en un mitin en Potterville, Míchigan.La fecundación in vitro suele costar decenas de miles de dólares. Las políticas para cubrir esos costos serían difíciles de implementar, dijeron los expertos.Exigir a las aseguradoras que paguen estos procedimientos probablemente significaría aprobar leyes en el Congreso o persuadir a un panel de expertos para que añadan la FIV a una lista de servicios preventivos gratuitos de salud femenina establecidos por la Ley de Asistencia Asequible, la ley de cobertura de salud que Trump trató de derogar.Si el gobierno pagara directamente la FIV, se crearía un sistema de pagador único para una sola condición. El enfoque requeriría que el Congreso financie una nueva división del gobierno federal para supervisar el programa.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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    Sadness Among Teen Girls May Be Improving, C.D.C. Finds

    A national survey found promising signs that key mental health measures for teens, especially girls, have improved since the depths of the pandemic.In 2021, a survey by the Centers for Disease Control and Prevention on teen mental health focused on a stark crisis: Nearly three in five teenage girls reported feeling persistent sadness, the highest rate in a decade.But the newest iteration of the survey, distributed in 2023 to more than 20,000 high school students across the country, suggests that some of the despair seen at the height of the pandemic may be lessening.Fifty-three percent of girls reported extreme depressive symptoms in 2023, down from 57 percent in 2021. For comparison, just 28 percent of teenage boys felt persistent sadness, about the same as in 2021.Suicide risk among girls stayed roughly the same as the last survey. But Black students, who reported troubling increases in suicide attempts in 2021, reported significantly fewer attempts in 2023.Still, the number of teens reporting persistent sadness in 2023 remained higher than at any point in the last decade aside from 2021. And around 65 percent of lesbian, gay, bisexual and transgender high school students reported persistent hopelessness, compared with 31 percent of their cisgender or heterosexual peers. One in five L.G.B.T.Q. students reported attempting suicide in the past year.“For young people, there is still a crisis in mental health,” said Kathleen Ethier, head of the C.D.C.’s adolescent and school health program. “But we’re also seeing some really important glimmers of hope.”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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    A Blood Test Accurately Diagnosed Alzheimer’s 90% of the Time, Study Finds

    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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    Moving In Childhood Contributes to Depression, Study Finds

    A study of more than a million Danes found that frequent moves in childhood had a bigger effect than poverty on adult mental health risk.In recent decades, mental health providers began screening for “adverse childhood experiences” — generally defined as abuse, neglect, violence, family dissolution and poverty — as risk factors for later disorders.But what if other things are just as damaging?Researchers who conducted a large study of adults in Denmark, published on Wednesday in the journal JAMA Psychiatry, found something they had not expected: Adults who moved frequently in childhood have significantly more risk of suffering from depression than their counterparts who stayed put in a community.In fact, the risk of moving frequently in childhood was significantly greater than the risk of living in a poor neighborhood, said Clive Sabel, a professor at the University of Plymouth and the paper’s lead author.“Even if you came from the most income-deprived communities, not moving — being a ‘stayer’ — was protective for your health,” said Dr. Sabel, a geographer who studies the effect of environment on disease.“I’ll flip it around by saying, even if you come from a rich neighborhood, but you moved more than once, that your chances of depression were higher than if you hadn’t moved and come from the poorest quantile neighborhoods,” he added.The study, a collaboration by Aarhus University, the University of Manchester and the University of Plymouth, included all Danes born between 1982 and 2003, more than a million people. Of those, 35,098, or around 2.3 percent, received diagnoses of depression from a psychiatric hospital.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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    Gilead Shot Provides Total Protection From HIV in Trial of Young African Women

    An injection given just twice a year could herald a breakthrough in protecting the population that has the highest infection rates.Researchers and activists in the trenches of the long fight against H.I.V. got a rare piece of exciting news this week: Results from a large clinical trial in Africa showed that a twice-yearly injection of a new antiviral drug gave young women total protection from the virus.“I got cold shivers,” said Dr. Linda-Gail Bekker, an investigator in the trial of the drug, lenacapavir, describing the startling sight of a line of zeros in the data column for new infections. “After all our years of sadness, particularly over vaccines, this truly is surreal.”Yvette Raphael, the leader of a group called Advocacy for Prevention of H.I.V. and AIDS in South Africa, said it was “the best news ever.”The randomized controlled trial, called Purpose 1, was conducted in Uganda and South Africa. It tested whether the every-six-months injection of lenacapavir, made by Gilead Sciences, would provide better protection against H.I.V. infection than two other drugs in wide use in high-income countries, both daily pills.The results were so convincing that the trial was halted early at the recommendation of the independent data review committee, which said all participants should be offered the injection because it clearly provided superior protection against the virus.None of the 2,134 women in the arm of the trial who received lenacapavir contracted H.I.V. By comparison, 16 of the 1,068 women (or 1.5 percent) who took Truvada, a daily pill that has been available for more than a decade, and 39 of 2,136 women (1.8 percent) who received a newer daily pill called Descovy were infected.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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    New Report Underscores the Seriousness of Long Covid

    The National Academies said the condition could involve up to 200 symptoms, make it difficult for people to work and last for months or years.One of the nation’s premier medical advisory organizations has weighed in on long Covid with a 265-page report that recognizes the seriousness and persistence of the condition for millions of Americans.More than four years since the start of the coronavirus pandemic, long Covid continues to damage many people’s ability to function, according to the National Academies of Sciences, Engineering and Medicine, a nongovernmental institution that advises federal agencies on science and medicine.“Long Covid can impact people across the life span, from children to older adults, as well as across sex, gender, racial, ethnic and other demographic groups,” it said, concluding that “long Covid is associated with a wide range of new or worsening health conditions and encompasses more than 200 symptoms involving nearly every organ system.”Here are some of the National Academies’ findings, drafted by a committee of 14 doctors and researchers:How many people have long Covid?The report cited data from 2022 suggesting that nearly 18 million adults and nearly a million children in the United States have had long Covid at some point. At the time of that survey, about 8.9 million adults and 362,000 children had the condition.Surveys showed that the prevalence of long Covid decreased in 2023 but, for unclear reasons, has risen this year. As of January, data showed nearly 7 percent of adults in the United States had long Covid.Diagnosis and consequencesThere is still no standardized way to diagnose the condition and no definitive treatments to cure it. “There is no one-size-fits-all approach to rehabilitation, and each individual will need a program tailored to their complex needs,” the National Academies said, advising that doctors should not require patients to have a positive coronavirus test to be diagnosed with long Covid.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