Although inspired by Middle Eastern shakshuka (eggs poached in tomato sauce), this version is for meat lovers. Instead of thick tomato sauce, these eggs are simmered over ground lamb and bone broth, with a handful of charred cherry tomatoes thrown on top. The cherry tomatoes, plus a generous amount of herbs, give this high-protein meal a fresh, light flavor. It’s fantastic for breakfast, lunch or dinner.
If you want to start your day with this powerhouse meal, consider cooking the meat and tomatoes ahead of time. Right before breakfast, reheat the meat in a skillet with eggs. It’s an easier way to enjoy a hearty breakfast and still get out the door on time.
Time in the Kitchen: 45 minutes
Heat 1 tablespoon (15 ml) avocado oil over medium-high heat in a wide saucepan that has a lid. When the pan is really hot, add the cherry tomatoes and cook about 5 minutes until the tomatoes are lightly charred and begin to soften. Stir the tomatoes as little as possible. Remove the tomatoes from the pan and set aside.
Add the remaining 2 tablespoons avocado oil to the pan. Add the onion and sauté 3 to 5 minutes until the onion begins to soften. Add the garlic, and sauté 2 minutes more. Add the lamb and season with cumin, smoked paprika, and salt. Cook until lightly browned and no longer pink, about 6 minutes.
Add bone broth to the saucepan, and bring to a boil. Turn the heat to low. Crack 4 to 6 eggs in the pan on top of the meat.*
Cover the pan with a lid and cook until the egg whites are set (about 7 minutes) but the yolks are still soft.
Before serving, add the tomatoes and garnish generously with chopped parsley, dill, or other fresh herbs.
*The meat and tomatoes can be cooked ahead of time, then reheated in smaller portions with a little bit of bone broth and 1 or 2 eggs.
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September 30, 2017 at 10:11AM
Dr. Sanjay Gupta: Puerto Rico has medical supplies -- why must doctors fight for them?
Puerto Rico was already stressed with one of the poorest medical systems in the United States, but the dual blow of two major hurricanes has left this island with a medical crisis that is usually reserved for war zones.
"I haven't seen anything like this. It's really bad," Dr. Maria Rodrigueztold me when I visited
her community health center, Concilio de Salud Integral de Loíza, in a small town in the northeastern portion of Puerto Rico. She was struggling to provide care for patients in her clinic due to a lack of fuel and, later, water. Medications were in short supply.
"You go to the shelters and you see people sleeping on the floor," Rodriguez told me. "The conditions, the desperation that all these people have. We are trying to still provide services to these people."
That was one week to the day after Hurricane Maria hit the island with its 155-mph winds and then dumped 30 inches of rain, flooding the island and causing unprecedented devastation.
It hasn't improved much since.
The inability to navigate debris-covered roads, combined with a lack of communication, has made it all but impossible for a coordinated medical response on the island. Hospitals and clinics are slowly opening, but still do not have enough supplies and medications to care for the surge of patients, many of whom have been waiting for medical attention for days in nearby shelters.
Just Thursday, my crew and I transported a woman with a life-threatening infection from a shelter to a local hospital. Josefina Alvarez, 62, had beenwaiting for medical help for a week and a half in a shelter in Loiza
, not far from San Juan, but was running out of time.
"She's getting more complicated, with fever and all that, and we have nothing here to give her," said Dr. Astrid Morales, a local physician volunteering at the shelter. "Time is really limited."
Thankfully, her husband told me she is now being stabilized and is expected to undergo surgery soon.
Yet while Alvarez went without antibiotics, the port in San Juan was filled with row after row of containers of food, water and medicine, if only doctors had access to them. Instead, those supplies are still piled up, waiting for the trucks, drivers and fuel needed for distribution.
Volunteer doctors with operational cars and adequate fuel have begun taking matters into their own hands, traveling to San Juan to obtain medical necessities and transporting them back to their local hospitals, clinics and shelters.
Just what is that like? How hard is it to get your hands on these desperately needed materials? My crew and I decide to find out.
Armed with a list of critical medications needed at the Loiza clinic, we first head to the local US Department of Health & Human Services tent to talk to the local disaster management team.
A staffer named Lisa looks over my list. "Yes, we have these medications," she tells me. She asks us to wait 15 or 20 minutes.
The crew and I settle down to wait. The staffer told us they'd have to run it up two chains of command before medications could be distributed.
Forty-five minutes later, we are still waiting. But we hear about aUS-based aid organization, Direct Relief
, that has shipped $1.7 million dollars of medical supplies to San Juan.
A 10-minute drive away, we find Direct Relief staff handing out supplies to local doctors under a parking structure. The scene is controlled chaos, as each doctor tries to grab the medications they need.
I join in.
"Let me see that list," says one of the senior doctors. Before long, he's handing me the antibiotics I came for: ciprofloxacin, levaquin, azithromycin, rocephin, clindamycin and cefepime.
Minutes later we're in the car, on our way to the shelter. Rodriguez meets us in the lobby when we arrive.
"Thank you!" she beams as she looks through the bag and then hugs it to her tight, like a baby.
I hug her, thankful I could be of help.
One of my favorite professors in medical school told me something I never forgot: "You can create the best treatment in the world, but if it doesn't reach the people who need it, it has no value."
I think the same can be said about what's happening in Puerto Rico. So many lifesaving supplies are on the island, but until they get to the people who need them, they have little value.
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September 30, 2017 at 12:00AM
Health Highlights: Sept. 29, 2017
Here are some of the latest health and medical news developments, compiled by the editors of HealthDay:
Trump's Health Secretary Resigns Over Travel Controversy
Tom Price, President Donald Trump's secretary of health and human services, resigned Friday afternoon in the wake of revelations he had used charter flights at taxpayers' expense.
The announcement came shortly after Trump had told reporters he considered Price a "fine man" but that he "didn't like the optics," the Washington Post reported.
"I'm not happy, I can tell you that. I'm not happy," Trump said.
Price will be replaced for the time being by Don Wright, who was announced as acting secretary. Wright had been serving as deputy assistant secretary for health and director of the Office of Disease Prevention and Health Promotion.
In a four-page letter of resignation to Trump, Price said he regretted "that the recent events have created a distraction" from the administration's objectives. "Success on these issues is more important than any one person," the Post reported.
A one-time congressman from the Atlanta suburbs, Price served less than eight months.
The revelation of Price's use of charter jets instead of commercial ones has prompted scrutiny of other Cabinet members' travel.
Price wrote a check for $51,887.31 for his own travel costs. The total cost of his travels, including his entourage, was unclear, but could be as high as several hundred thousand dollars, the Associated Press reported.
Makers of Quick-Release Opioid Painkillers Must Provide Doctor Training: FDA
Makers of quick-release prescription opioid painkillers will have to provide doctors with training, the U.S. Food and Drug Administration says.
The aim is to reduce the number of patients who become addicted to the drugs and combat the opioid crisis in the U.S., the Associated Press reported Thursday.
The 74 manufacturers of immediate-release opioids such as Vicodin and Percocet were notified this week of the new regulation. Doctors won't be forced to participate in the training, which must include consideration of non-opioid alternatives.
Quick -release opioid painkillers account for 90 percent of all opioid painkiller prescriptions. The requirement to train doctors has been in place since 2012 for manufacturers of long-acting opioids such as OxyContin, the AP reported.
About 2 million Americans are addicted to prescription opioids, and more than 15,000 died from prescription opioid overdoses in 2015.
Actress Julia Louis-Dreyfus Diagnosed With Breast Cancer
Actress Julia Louis-Dreyfus has breast cancer.
Louis-Dreyfus, who stars in "Veep" and was a key member of "Seinfeld," revealed her diagnosis Thursday on social media. Her spokeswoman confirmed the posts, the Associated Press reported.
"The good news is that I have the most glorious group of supportive and caring family and friends, and fantastic insurance through my union," she posted on Twitter. "The bad news is that not all women are so lucky, so let's fight all cancers and make universal health care a reality."
Louis-Dreyfus' publicist said no further details would be forthcoming at this time. The actress "is incredibly grateful for the outpouring of support and well wishes."
WebMD News from HealthDayCopyright © 2013-2017 HealthDay. All rights reserved.
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September 29, 2017 at 06:24PM
Our Weekend in The Thousand Islands and Adirondacks, NY
Our Weekend in The Thousand Islands and Adirondacks, NY
posted September 29, 2017 by Gina
Lighthouses, castles, boating, farms and more – here’s a recap (and a video!) from an incredible 4-day weekend in The Thousand Islands and Lake Placid, NY! We crammed a lot in this short weekend and had such an amazing time, we plan on returning really soon, hopefully in the winter when everything is covered in a blanket of snow.
The Thousand Islands
How We Got There
Although it’s driving distance in just a few hours from my house in Long Island, we preferred to take a direct light to Syracuse from JFK which was only 1 hour and 12 minutes. From there we rented a car and took a scenic drive to the Thousand Islands.
Where We Stayed in the Thousand Islands
The 1000 Islands Harbor Hotel located on the Lawrence River in Clayton, NY. The hotel was spacious, and the location was perfect with fire pits outside, beautiful landscaping and walking distance to everything.
Highlights of Our Trip in Thousand Islands
We started our trip in Sackets Harbor at the Old MacDonald’s Farm House, a family run business with 1000 animals you can feed, touch and walk among. Madison LOVED it there, and so did we quite frankly! The animals were so friendly they came right up to us and followed us around.
Lunch we went to Tin Pan Galley in Sackets Harbor, a quaint restaurant in a cute little town. I ordered a Fried Green Tomato Salad and a Cream of Asparagus Soup. Tommy got a French Onion Burger, both were great!
That afternoon we went on a private wine and cheese cruise with Classic Island Cruises directly from the Harbor Hotel to Rock Island Lighthouse which is a MUST! Jeff, our captain was so great, he gave us so much history about the Thousand Islands, the lighthouse and more.
Rock Island Lighthouse is a must is you visit the Thousand Islands. This gorgeous lighthouse on the crystal clear waters of the St Lawrence River is accessible only by boat. There’s picnic tables, a gift shop, great views and a very friendly staff.
One of the many Thousand Islands…
This is the first US Post Office which you can see by boat.
Jeff also gave us a bottle of the original Thousand Island Dressing!
For dinner, we dined at The Chateau, we LOVED this restaurant. The food, the service, the sunsets views – everything was excellent. I had an amazing duck breast, and Tommy had short ribs. The lighting was bad because it was late and dark inside, but I wish I could have captured my dish, but I did shoot Tommy’s.
Saturday morning we headed to Boldt Castle on Heart Island, a short ferry ride away from the Boldt Yacht House on Wellesley Island. The shuttle from the Yacht House to the castle runs every 30 minutes on the quarter hour.
Boldt castle was built on Heart Island for his beloved wife, but after her sudden tragic death, he stopped the construction and was so distraught, he never spent a single night there.
After the castle, we drove to the Adirondacks for the next two days.
Where We Stayed in the Adirondacks
We stayed at the Mirror Lake Inn Resort and Spa in Lake Placid, a charming Inn with beautiful lake views, an indoor and outdoor pool. We loved the smell of the fireplace in the lobby, Madison loved the unlimited supply of fresh baked chocolate chip cookies and the board games we played together when it rained. The suite we stayed in had rocking chairs in front of the sliding glass doors so we can just sit back and enjoy the view.
Highlights of Our Trip in the Adirondacks
Aside from relaxing at Mirror Lake Inn Resort and Spa, there’s plenty to do in the Adirondacks year round. We didn’t have much time there, but we made the most out of our time there.
We hiked up a trail of suspended bridges to see the world from a different perspective at the Wild, Walk and Wild Center in the Adirondacks, not to be missed if you’re in the area if you’re traveling with kids!
We took a drive up Whiteface Veterans Memorial Highway to the top of Whiteface Mountain—New York’s fifth-highest peak at 4,867’. It was cold at the top and the clouds didn’t let us see to much at the very top because of the rain from the day before, but the views on the way up were stunning! The leaves were just starting to change color, I can only imagine how pretty this will be in the next few weeks with all the colors!
And we wanted to go tubing on the Ausable Chasm but it rained, so instead we got some ponchos and went to the High Falls Gorge which had some pretty spectacular views.
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September 29, 2017 at 05:17PM
'ICU Grandpa' cradles babies when their parents can't
The child's mother stood at the door, David Deutchman later recalled. She'd gone home to take care of her older daughter, all the while worrying about the baby boy whom she'd left the previous night at the Children's Healthcare of Atlanta hospital. Now she was back.
"Who are you?" the mother asked, peering at this stranger holding her swaddled son, life-sustaining wires taped to his tiny cheek.
"I'm the ICU grandpa," Deutchman replied.
Aphoto posted Friday morning on Children's Facebook page
shows Deutchman holding Logan, the sleeping infant, who was born at 25 weeks. Within hours, the post had been shared more than 160,000 times.
From board rooms to bear hugs
After retiring from his job as an international marketing executive in 2000, Deutchman became a guest lecturer at Atlanta-area universities, mostly Georgia Tech and Emory, he said. But it didn't fill enough of his time.
As he left a rehab appointment for a leg injury, Deutchman stopped into Children's nearby.
"I decided to walk in there, just wondering if they had volunteer opportunities," he told CNN. "They did, and they were happy to take me on board."
With experience at the helm of a classroom, Deutchman first went to work in the hospital's school for long-term patients. Then one day, he was startled by encounters with two patients' mothers.
"I went to help escort a child to the school room, and the mom said she's going into surgery," Deutchman said. "She followed me into the hallway and proceeded to tell me every detail of the child's condition and what's going on."
Awed that the mom told a virtual stranger all about her child's condition, he then saw another mother walking out of the pediatric intensive care unit, looking upset. Her son had been flown to the hospital the previous night, she said, and his condition was dire.
"She comes into my arms and starts crying," Deutchman said. "After that day, I went to the volunteer office and told them, 'I now know what I want to do at the hospital.'"
Comfort and warmth
Now, twice a week, Deutchman spends the day in the pediatric and neonatal ICUs, holding babies and helping their parents.
"Sometimes I get puked on, I get peed on. It's great," he says in a video posted by Children's.
Deutchman's friends ask why he'd put up with that.
"They just don't get it, the kind of reward you can get from holding a baby like this," he says.
Cradling fragile babies has been shown to improve their health, said Elizabeth Mittiga, a NICU nurse at Children's.
"It definitely helps just feeling that comfort, that warmth," Mittiga said in recorded remarks provided to CNN by the hospital. "It definitely helps them to, I think, grow faster and put more weight on, and feeding-wise, can help them digest their feeds better and things like that."
Some children Deutchman meets don't have promising prognoses.
"Some leave with developmental disabilities and lifelong special needs," he told CNN. "And that's tough. That's a memory that's not necessarily a positive one."
The best cases end with kids who go home healthy -- and grow up strong.
"The good times have been spending six months with a family, and the kid had ups and downs, and the kid came out great," he said. "Now the kid is 4 or 5 years old and is terrific. Those are the stories I love."
With his new social media fame, Deutchman has been reliving those stories, as thousands of parents have commented on the photo of him with Logan, reminiscing about the times the ICU Grandpa held their child.
"It was very worthwhile doing," he said. "It was important doing."
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September 29, 2017 at 04:48PM
Survivors of Hurricane Maria desperately need aid
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September 28, 2017 at 11:27PM
Consumer group warns against common flame retardant
They have been linked to cancer, hormone disruption, infertility, and neurological deficits in children, according to the commission's guidance document.Some studies
, cited in this commission report, substantiate these claims.
The chemicals are especially hazardous to pregnant women and young children, studies find.
, a government agency charged with protecting the public from unreasonable risks of injury or death associated with the use of thousands of consumer products, also recommended manufacturers stop using these chemicals in products where they are currently found. These include upholstered furniture, mattresses, electronic cases, and children's toys.
Commissioner Bob Adler said there's a "whole host of dangers" these organohalogen flame retardants carry.
"These chemicals are added to products to keep them from catching fire in smolder or open flame situations," said Adler.
He acknowledged, though, that the commission has not yet done careful and exhaustive studies of every single chemical within this class, but "every (chemical) that we've done careful and exhaustive study of has proven to be toxic -- and hazardously toxic -- to consumers."
The commission had a "big debate" about this, he said, the evidence of which is contained in aMay briefing document
Essentially, the commission's technical staff said the organohalogens should not be treated as a single class under the Federal Hazardous Substances Act due to their differing physicochemical properties and toxicological profiles, and recommended against advancing a rule.
Ultimately, though, the commission voted to publish the guidance and begin the process of developing a new regulation with regard to the chemicals.
Bryan Goodman, a spokesperson for the North American Flame Retardant Alliance, said because these regulations help promote public safety "there is a need for international, national and regional code consistency." He said it is fortunate the guidance is non-binding and the new action merely constitutes "a recommendation." He added that the association will communicate to members that this is guidance and does not need to be followed.
"The guidance needs to be evaluated based on the state of the science and the need to fully consider all aspects of product safety, including fire safety," wrote Goodman. He added businesses should feel confident in continued use of these chemicals in certain applications "consistent with existing national and international regulations," while the commission conducts further analysis.
Adler acknowledged the limits of the guidance, and said binding regulation is "going to take years, by almost all accounts," because of the various rules that must be followed.
As part of the "long and drawn out process," he said, the commission needs to "convene a body of outside experts that are recommended to us by the National Academy of Sciences to look into the exact scope of the hazards and to help us fill in the data gaps through an accepted protocol."
"In the meantime, consumers need to be alerted and the market itself needs to be alerted to the commission's concerns about these products," said Adler.
And, while that's happening, the commission could face both legal and political challenges, he said.
"We could be sued by the industry, they could go to the hill and have prohibitions on commission actions being passed," said Adler. "We could have a group of commissioners appointed to the agency that don't want to proceed along those lines."
No matter what may come in the days ahead, issuing the guidance is worth it if it protects consumers, said Adler.
"Dangerous chemicals present a much more serious concern than fire in the home," said Adler. It's not that there isn't great concern about home fires, he added. "The issue is: Do these chemicals give us the answer to this risk? And my answer is they do not."
Others agree that organohalogens are too dangerous for home use. The groups that petitioned the commission to begin developing regulations for organohalogens include the American Academy of Pediatrics, American Medical Women's Association, and the International Association of Fire Fighters.
"What our staff has told us -- and what a number of academic experts and a number of health experts said -- is that the concentration of these flame retardants in things like furniture and children's products are not great enough to do very much to protect us from fire or smoldering hazards," said Adler.
Too small maybe to prevent fires, but still large enough to cause health hazards, he said.
Fire safety, though, is not just about chemistry, said Goodman. Product designers typically take a multi-layered approach, he said. "There is no one, single fire safety tool."
And not all products are the same, said Goodman. Some pose a greater fire risk than others.
"It is critical that manufacturers have access to safe and effective flame retardants in the future and the flexibility to utilize the fire safety tools that best meet their needs," said Goodman.
Dollars and sense?
Adler said the commission has been told "there are a host of other flame retardants" that work but don't have issues of toxicity.
"They're more expensive," he said.
Goodman acknowledged that "flame retardants include a broad range of substances."
That said, flame retardants "are not readily interchangeable," said Goodman. Different materials have very different physical and chemical properties. "Similarly, end-use performance requirements, including certification to national standards, must be considered when choosing a flame retardant," said Goodman. A manufacturer cannot simply swap one chemical for another without "significant time and cost devoted to formulation, performance testing, certification," and other factors.
Adler said the proposed rule will level the playing field and "everybody will have the same cost if they feel the need to add flame retardants."
No one will be able to put a dangerous but cheap flame retardant in a product to save costs while "those who are being more conscientious are penalized in the marketplace," said Adler.
Consumers -- and the government -- have always had to weigh the need for fire safety against chemical safety, said Adler. "In this situation it's not even a close call as far as I'm concerned."
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September 28, 2017 at 07:45PM
Global Health: They Swallowed Live Typhoid Bacteria — On Purpose
It is the only effective vaccine that is also safe for infants, and already it is made cheaply and used widely in India. The Oxford Vaccine Group, which ran the trial, and the Bill & Melinda Gates Foundation, which paid for it, hope the World Health Organization will endorse the vaccine soon.
“These are great results,” said Dr. Anita Zaidi, the foundation’s director of diarrheal diseases. “And challenge tests are a great way to short-circuit the process of proving it works.
“If we’d done this in the field, we would have had to follow children for three or four years.”Photo Credit Andrew Testa for The New York Times
So-called challenge tests involve giving subjects an experimental vaccine and then deliberately infecting them with the disease to see if it protects them.
These tests can only be done with illnesses — like cholera or malaria — that can be rapidly and completely cured, or with diseases — like seasonal flu — that normally do not damage healthy adults.
Still, there was a good chance that the participants in Oxford would be unpleasantly sick with typhoid fever for several days until their antibiotics kicked in.
So what would motivate dozens of well-educated Britons to swallow a vial full of the germs that made Typhoid Mary famous? In interviews, they gave various reasons.
Some, like Mr. Duggan, were curious. Some wanted to help poor people. And some mostly wanted the cash.
Participants who followed all the steps, which included recording their temperatures online, making daily clinic visits and providing regular blood and stool samples, received about $4,000.
They all said they understood the risks.
Typhoid got its fearsome reputation in the pre-antibiotic age, but these days it normally can be driven out of the body with common antibiotics, like ciprofloxacin or azithromycin.
All participants had to be healthy adults, ages 18 to 60, with ultrasound scans proving their gallbladders were stone-free.
(The bacteria can persist for decades by clinging to gallstones — which is probably how Typhoid Mary, working as a cook in grand houses and a maternity hospital, infected so many people between 1900 and 1915 without ever feeling ill herself.)Photo Credit Andrew Testa for The New York Times
Different participants had very different experiences.
Mr. Duggan was sick for three days with flulike symptoms: “proper flu, where you don’t want to get out of bed,” he said. His temperature rose to 102 degrees, and he had joint pains and a bad headache.
Once a blood culture proved he had typhoid, he got antibiotics right away; he was not released from treatment until three typhoid-free blood and stool samples proved he was out of danger.
He later was told that he had been in the trial’s placebo arm and had received a meningitis vaccine instead. (Modern ethics boards frown on useless “sugar pill” placebos.)
Nick J. Crang, 24, a graduate student in proteomics, also got the placebo. But somehow he never got sick, even after two typhoid challenges a year apart.
“It turns out I’ve got innate immunity to typhoid,” he said.
So does he feel superhuman? “No, I’m the lab rat who’s screwing with the figures.”
He did give extra blood samples to researchers curious about his immune system.
The bacterial doses were offered by nurses wearing plastic aprons, gloves and face shields to prevent splashing. Participants also donned aprons and goggles, and were asked to first drink bicarbonate of soda to neutralize their stomach acid.
But there were no steaming beakers out of Vincent Price movies. “It was all quite underwhelming,” said Daina Sadurska, 26, a grad student in biology. “It was served in a typical laboratory tube. I expected it to taste more ‘typhoidy.’ Not like poop, that is – the things that make poop smell like poop are absolutely different bacterially.”
“But I expected something. A lot of cultures have a typical smell. It was clear, I think, and it tasted like nothing particular.”
Ms. Sadurska never fell ill and later learned that she had gotten the vaccine. She had a unique reason for joining: her great-great-grandmother and one of her aunts died during a typhoid epidemic in Latvia during World War I.Photo Credit Andrew Testa for The New York Times
“When I told my mother I was doing this, she reminded me of that episode,” she said. “When I signed up, I thought, ‘Why on Earth am I doing this?’ But I’m a biologist. All sorts of boogeymen become a lot less scary when you know more about them.”
The $4,000 was also “a welcome addition,” she said. Oxford students get only $17,600 a year to live in a city with costs almost as high as London’s.
She and Mr. Crang, her boyfriend, used the money to visit Croatia, Israel and her family in Latvia. They have both signed up for a second vaccine trial that will pay for his laser eye surgery and then a trip together to Australia.
Faye Francis, a 42-year-old psychiatric nurse, said she felt “happy to be doing something that could help millions of poor people who haven’t got antibiotics.”
“But I won’t lie,” she added. “The money was a big part of it.”
She used it to take her husband and three children on a vacation in Cornwall “and buy a few bits for the car and the house.”
Her mother was not happy. “She said, ‘That’s ridiculous – don’t think about the money, think about your health!’ ” Mrs. Francis said. “And people were telling me horror stories about things they’d seen on TV. So I didn’t go on about it to my parents after that.”
She got sick and “felt rotten for about a week” with a 101-degree fever, headache and nausea.
“But I still went to work,” she said. “I felt a bit guilty about not going when I had an illness I’d given myself.”
Because her job is to distribute medicine on home visits, no patients were endangered, she said. (Mr. Duggan, the medical student, was also quick to say that he took part during a period when he was not assigned to hospital rounds.)
“They don’t let you do it if you’ve got preschoolers or children in nappies,” Mrs. Francis said. “And you’re not allowed to handle food, so my husband did all the cooking.”
During the worst week, “you feel sorry for yourself and you say ‘I’m never doing that again,’ ” she said. “And then it’s like childbirth – you get amnesia, and you do it again. I’ve just signed up for a second trial.”Continue reading the main story
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September 28, 2017 at 05:39PM
Otto Warmbier Suffered Extensive Brain Damage, Coroner Confirms
His parents requested that a full autopsy not be performed. On Tuesday, during an appearance on the television show “Fox & Friends,” Fred Warmbier said that his son had been “tortured” and described North Korean officials as “terrorists.”
After the interview, President Trump said in a tweet that Mr. Warmbier “was tortured beyond belief by North Korea.”
On Thursday, North Korea’s Foreign Ministry issued a statement denying again that Mr. Warmbier had been tortured and accusing the United States of “employing even a dead person” in a “conspiracy campaign” against North Korea.
In the full text of the pathology report, the coroner's office in Hamilton County, Ohio, described the cause of death for Mr. Warmbier, a university student who was detained in North Korea.
Dr. Sammarco’s examination, which was concluded earlier this month, did not find signs of torture but could not rule out the possibility.
“There are a lot of horrible things you can do to a human body that don’t leave external signs behind,” Dr. Sammarco said.
“One of the frustrating things is the lack of information about what happened to him in North Korea,” she added.
In a virtual autopsy, pathologists rely on an examination of the body and on scans to determine what has happened to it. Mr. Warmbier was returned with brain scans done in North Korea in April 2016 and again in July 2016.
M.R.I. scans were done at the medical center after he arrived, which also performed a whole-body CT scan after Mr. Warmbier’s death.
The images clearly showed that his brain had been starved of oxygen and that large tracts of cells had died, Dr. Sammarco said. The medical diagnosis is anoxic-ischemic encephalopathy.
That condition differs from the damage that occurs during a stroke, when a single blood vessel is blocked, said Dr. Lee H. Schwamm, executive vice chairman of neurology at Massachusetts General Hospital.
With an injury like Mr. Warmbier’s, “blood flow is reduced everywhere — the pump is turned off,” said Dr. Schwamm, who reviewed the coroner’s report at The Times’s request.Photo Credit John Minchillo/Associated Press
In the United States, the most common cause is a cardiac arrest, often precipitated by a heart attack. While cardiac arrests are unlikely in healthy young men, they can happen if the victim is malnourished and suffers an imbalance of blood electrolytes, such as potassium, calcium, or magnesium, Dr. Schwamm said.
The damage is quick: It takes just four minutes without blood for brain cells to start to die.
Blood flow to the brain can be interrupted for any number of reasons. The whole-body CT scan did not find injuries associated with hanging, for example, but Dr. Schwamm said the evidence might not be visible if a bedsheet were used and the spine were not dislocated.
Mr. Warmbier had a scar at the base of his neck that was probably caused by the insertion of a tube into his trachea as he was hooked up to a ventilator. This may indicate that he was not breathing on his own for a long period of time, Dr. Sammarco said.
He was weaned from the ventilator in North Korea, though; he was not using it when he was returned.
There were few other signs of injury on Mr. Warmbier’s body. There were no bedsores, and his skin condition was excellent, Dr. Sammarco said. “His muscle volume was pretty good for someone who was bedridden for over a year,” she said.
In the United States, most families would opt for palliative care for a relative in a vegetative state resembling Mr. Warmbier’s, she added. That would consist of providing pain medications and sedatives to soothe them.
Doctors do not know whether these patients suffer from pain and anxiety, Dr. Sammarco said. But they often groan and make jerky movements.
The case has attracted global attention and inflamed international tensions. Dr. Sammarco said she offered to turn the examination over to federal authorities.
“If there were national or international implications, we would be happy to relinquish jurisdiction and cooperate in any way necessary,” she said.
Federal officials declined, she added.Continue reading the main story
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September 28, 2017 at 04:27PM