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("Health Catalyst", how do you get cipro Nasdaq. HCAT), a leading provider of data and analytics technology and services to healthcare organizations, today announced that Dan Burton, CEO, and Adam Brown, SVP of Investor Relations and FP&A, will participate in the 41st Annual William Blair Growth Stock Conference including a fireside chat on Wednesday, June 2, 2021 at 5:40 p.m. ET.

A webcast link will how do you get cipro be available at https://ir.healthcatalyst.com/investor-relations. About Health Catalyst Health Catalyst is a leading provider of data and analytics technology and services to healthcare organizations committed to being the catalyst for massive, measurable, data-informed healthcare improvement. Its customers leverage the cloud-based data platform—powered by data from more than 100 million patient records and encompassing trillions of facts—as well as its analytics software and professional services expertise to make data-informed decisions and realize measurable clinical, financial, and operational improvements.

Health Catalyst envisions a how do you get cipro future in which all healthcare decisions are data informed. Health Catalyst Investor Relations Contact. Adam BrownSenior Vice President, Investor Relations and FP&A+1 (855)-309-6800ir@healthcatalyst.com Health Catalyst Media Contact.

Amanda Hundtamanda.hundt@healthcatalyst.com+1 how do you get cipro (575) 491-0974SALT LAKE CITY, May 06, 2021 (GLOBE NEWSWIRE) -- Health Catalyst, Inc. ("Health Catalyst," Nasdaq. HCAT), a leading provider of data and analytics technology and services to healthcare organizations, today reported financial results for the quarter ended March 31, 2021.

€œIn the first quarter of 2021, I am pleased to share that we achieved strong how do you get cipro performance across our business, including exceeding the mid-point of our quarterly guidance for both revenue and Adjusted EBITDA,” said Dan Burton, CEO of Health Catalyst. €œI am also happy to report that in the most recent team member engagement and satisfaction survey, independently administered by the Gallup organization, team member satisfaction scores at Health Catalyst measured in the 96th percentile. This latest engagement level continues a pattern that has been in place for many years, of industry-leading engagement, consistently ranked between the 95th and 99th percentile in overall team member satisfaction scores.

This latest result is of particular significance given that it comes during a period where we were required to adapt to global cipro necessitating a remote-only work environment, as well as having welcomed nearly two hundred new teammates who came to us primarily through multiple recent acquisitions.” Financial Highlights for the Three Months Ended March 31, 2021 Key Financial Metrics Three Months Ended March 31, Year over Year Change 2021 2020 GAAP Financial Data:(in thousands, except percentages, unaudited)Technology revenue$33,839 $24,699 37%Professional services revenue$22,007 $20,417 8%Total revenue$55,846 $45,116 24%Loss from operations$(24,317) $(18,105) (34)%Net loss$(28,370) $(17,490) (62)%Other Non-GAAP Financial Data:(1) Adjusted Technology Gross Profit$23,388 $16,969 38%Adjusted Technology Gross how do you get cipro Margin69% 69% Adjusted Professional Services Gross Profit$6,929 $5,071 37%Adjusted Professional Services Gross Margin31% 25% Total Adjusted Gross Profit$30,317 $22,040 38%Total Adjusted Gross Margin54% 49% Adjusted EBITDA$(837) $(5,971) 86%________________________(1) These measures are not calculated in accordance with generally accepted accounting principles in the United States (GAAP). See the accompanying "Non-GAAP Financial Measures" section below for more information about these financial measures, including the limitations of such measures, and for a reconciliation of each measure to the most directly comparable measure calculated in accordance with GAAP. Financial Outlook Health Catalyst provides forward-looking guidance on total revenue, a GAAP measure, and Adjusted EBITDA, a non-GAAP measure.

For the second quarter how do you get cipro of 2021, we expect. Total revenue between $55.1 million and $58.1 million, andAdjusted EBITDA between $(4.8) million and $(2.8) millionFor the full year of 2021, we expect. Total revenue between $228.1 million and $231.1 million, andAdjusted EBITDA between $(15.0) million and $(13.0) millionWe have not reconciled guidance for Adjusted EBITDA to net loss, the most directly comparable GAAP measure, and have not provided forward-looking guidance for net loss, because there are items that may impact net loss, including stock-based compensation, that are not within our control or cannot be reasonably predicted.

Chair of the Board Transition On April 29, 2021, our board of directors (the board) accepted how do you get cipro Dr. Tim Ferris's resignation from the board and all board committees, effective May 1, 2021. Dr.

Ferris's resignation is not the result of any disagreement with Health Catalyst, but rather as a result of his new role as the how do you get cipro National Director of Transformation for England's National Health Service (NHS). NHS required Dr. Ferris to resign from our board in connection with his NHS appointment.

€œDr. Ferris provided a unique perspective that will continue to impact our company for years to come. We are grateful for the opportunity to have benefited from his wisdom and experience, and we congratulate him on his new role as National Director of Transformation at NHS,” said Dan Burton, CEO.

Health Catalyst is thrilled to announce that John A. (Jack) Kane has accepted the invitation to serve as chair of the board effective May 1, 2021. Mr.

Kane has been a director of the Company and has been the chair of the audit committee of the board since February 2016. Mr. Kane has more than 30 years’ experience in healthcare technology, including as a director and chairperson of the audit committee of Merchants Bancshares, Inc.

(MBVT) from 2005 until 2014 and athenahealth, Inc. From 2007 until February 2019. He previously occupied the position of CFO, Treasurer &.

Senior VP-Administration at IDX Systems Corp. €œJack has served on our board for many years. His valuable guidance and feedback often challenges us to think deeply about our solutions.

I am grateful for Jack’s dedication to our mission and his depth of financial leadership experience in healthcare and technology, which make him uniquely qualified to serve as our chair,” said Burton. Quarterly Conference Call Details The company will host a conference call to review the results today, Thursday, May 6, 2021, at 5:00 p.m. E.T.

The conference call can be accessed by dialing 1-877-295-1104 for U.S. Participants, or 1-470-495-9486 for international participants, and referencing participant code 9183315. A live audio webcast will be available online at https://ir.healthcatalyst.com/.

A replay of the call will be available via webcast for on-demand listening shortly after the completion of the call, at the same web link, and will remain available for approximately 90 days. About Health Catalyst Health Catalyst is a leading provider of data and analytics technology and services to healthcare organizations committed to being the catalyst for massive, measurable, data-informed healthcare improvement. Its customers leverage the cloud-based data platform—powered by data from more than 100 million patient records and encompassing trillions of facts—as well as its analytics software and professional services expertise to make data-informed decisions and realize measurable clinical, financial, and operational improvements.

Health Catalyst envisions a future in which all healthcare decisions are data informed. Available Information Health Catalyst intends to use its Investor Relations website as a means of disclosing material non-public information and for complying with its disclosure obligations under Regulation FD. Forward-Looking Statements This release contains forward-looking statements within the meaning of Section 27A of the Securities Act of 1933, as amended, and Section 21E of the Securities Exchange Act of 1934, as amended, and the Private Securities Litigation Reform Act of 1995, as amended.

These forward-looking statements include statements regarding our future growth and our financial outlook for Q2 and fiscal year 2021. Forward-looking statements are subject to risks and uncertainties and are based on potentially inaccurate assumptions that could cause actual results to differ materially from those expected or implied by the forward-looking statements. Actual results may differ materially from the results predicted, and reported results should not be considered as an indication of future performance.

Important risks and uncertainties that could cause our actual results and financial condition to differ materially from those indicated in the forward-looking statements include, among others, the following. (i) changes in laws and regulations applicable to our business model. (ii) changes in market or industry conditions, regulatory environment and receptivity to our technology and services.

(iii) results of litigation or a security incident. (iv) the loss of one or more key customers or partners. (v) the impact of buy antibiotics on our business and results of operations.

And (vi) changes to our abilities to recruit and retain qualified team members. For a detailed discussion of the risk factors that could affect our actual results, please refer to the risk factors identified in our SEC reports, including, but not limited to the Annual Report on Form 10-K for the year ended December 31, 2020 filed with the SEC on or about February 25, 2021 and the Quarterly Report on Form 10-Q for the fiscal quarter ended March 31, 2021 expected to be filed with the SEC on or about May 7, 2021. All information provided in this release and in the attachments is as of the date hereof, and we undertake no duty to update or revise this information unless required by law.

Condensed Consolidated Balance Sheets(in thousands, except share and per share data, unaudited) As ofMarch 31, As ofDecember 31, 2021 2020Assets Current assets. Cash and cash equivalents$132,627 $91,954 Short-term investments133,807 178,917 Accounts receivable, net45,905 48,296 Prepaid expenses and other assets12,404 10,632 Total current assets324,743 329,799 Property and equipment, net18,653 12,863 Intangible assets, net91,840 98,921 Operating lease right-of-use assets24,093 24,729 Goodwill107,822 107,822 Other assets4,068 3,606 Total assets$571,219 $577,740 Liabilities and stockholders’ equity Current liabilities. Accounts payable$4,626 $5,332 Accrued liabilities12,946 16,510 Acquisition-related consideration payable— 2,000 Deferred revenue51,634 47,145 Operating lease liabilities2,454 2,622 Contingent consideration liabilities15,902 14,427 Convertible senior notes, net171,864 — Total current liabilities259,426 88,036 Convertible senior notes, net of current portion— 168,994 Deferred revenue, net of current portion1,135 1,878 Operating lease liabilities, net of current portion23,083 23,669 Contingent consideration liabilities, net of current portion16,509 16837 Other liabilities2,230 2227 Total liabilities302,383 301,641 Commitments and contingencies Stockholders’ equity.

Common stock, $0.001 par value. 44,340,036 and 43,376,848 shares issued and outstanding as of March 31, 2021 and December 31, 2020, respectively44 43 Additional paid-in capital1,022,781 1,001,645 Accumulated deficit(754,020) (725,650)Accumulated other comprehensive income31 61 Total stockholders' equity268,836 276,099 Total liabilities and stockholders’ equity$571,219 $577,740 Condensed Consolidated Statements of Operations(in thousands, except per share data, unaudited) Three Months EndedMarch 31, 2021 2020Revenue. Technology$33,839 $24,699 Professional services22,007 20,417 Total revenue55,846 45,116 Cost of revenue, excluding depreciation and amortization.

Technology(1)10,825 7,906 Professional services(1)16,513 16,162 Total cost of revenue, excluding depreciation and amortization27,338 24,068 Operating expenses. Sales and marketing(1)15,651 13,487 Research and development(1)14,345 13,088 General and administrative(1)(2)(3)15,015 9,701 Depreciation and amortization7,814 2,877 Total operating expenses52,825 39,153 Loss from operations(24,317) (18,105)Interest and other expense, net(3,952) (621)Loss before income taxes(28,269) (18,726)Income tax provision (benefit)101 (1,236)Net loss$(28,370) $(17,490)Net loss per share, basic and diluted$(0.65) $(0.47)Weighted-average shares outstanding used in calculating net loss per share, basic and diluted43,870 37,109 Adjusted net loss(4)$(2,753) $(6,083)Adjusted net loss per share, basic and diluted(4)$(0.06) $(0.16) _______________(1) Includes stock-based compensation expense as follows. Three Months EndedMarch 31, 2021 2020 Stock-Based Compensation Expense:(in thousands)Cost of revenue, excluding depreciation and amortization.

Technology$374 $176 Professional services1,435 816 Sales and marketing4,818 3,182 Research and development2,257 1,882 General and administrative4,626 2,685 Total$13,510 $8,741 (2) Includes acquisition transaction costs as follows. Three Months EndedMarch 31, 2021 2020 Acquisition transaction costs:(in thousands)General and administrative$— $875 (3) Includes the change in fair value of contingent consideration liabilities, as follows. Three Months EndedMarch 31, 2021 2020 Change in fair value of contingent consideration liabilities:(in thousands)General and administrative$2,156 $(359)(4) Includes non-GAAP adjustments to net loss.

Refer to the "Non-GAAP Financial Measures—Adjusted Net Loss Per Share" section below for further details. Condensed Consolidated Statements of Cash Flows(in thousands, unaudited) Three Months Ended March 31,Cash flows from operating activities2021 2020Net loss$(28,370) $(17,490)Adjustments to reconcile net loss to net cash used in operating activities. Depreciation and amortization7,814 2,877 Amortization of debt discount and issuance costs2,870 285 Non-cash operating lease expense965 741 Investment discount and premium amortization417 (6)Provision for expected credit losses300 51 Stock-based compensation expense13,510 8,741 Deferred tax (benefit) provision2 (1,280)Change in fair value of contingent consideration liabilities2,156 (359)Other(34) (4)Change in operating assets and liabilities.

Accounts receivable, net2,090 (7,335)Deferred costs— 444 Prepaid expenses and other assets(2,173) (2,244)Accounts payable, accrued liabilities, and other liabilities(5,352) (4,283)Deferred revenue3,745 3,936 Operating lease liabilities(1,083) (843)Net cash used in operating activities(3,143) (16,769) Cash flows from investing activities Purchase of short-term investments(8,621) — Proceeds from the sale and maturity of short-term investments53,240 66,653 Acquisition of businesses, net of cash acquired— (15,249)Purchase of property and equipment(5,882) (428)Capitalization of internal use software(887) (78)Purchase of intangible assets(480) (758)Proceeds from sale of property and equipment6 6 Net cash provided by investing activities37,376 50,146 Cash flows from financing activities Proceeds from exercise of stock options6,488 9,046 Proceeds from employee stock purchase plan1,349 1,289 Payments of acquisition-related consideration(1,391) (748)Net cash provided by financing activities6,446 9,587 Effect of exchange rate on cash and cash equivalents(6) (31)Net increase in cash and cash equivalents40,673 42,933 Cash and cash equivalents at beginning of period91,954 18,032 Cash and cash equivalents at end of period$132,627 $60,965 Non-GAAP Financial Measures To supplement our financial information presented in accordance with GAAP, we believe certain non-GAAP measures, including Adjusted Gross Profit, Adjusted Gross Margin, Adjusted EBITDA, Adjusted Net Loss, and Adjusted Net Loss per share, basic and diluted, are useful in evaluating our operating performance. For example, we exclude stock-based compensation expense because it is non-cash in nature and excluding this expense provides meaningful supplemental information regarding our operational performance and allows investors the ability to make more meaningful comparisons between our operating results and those of other companies. We use this non-GAAP financial information to evaluate our ongoing operations, as a component in determining employee bonus compensation, and for internal planning and forecasting purposes.

We believe that non-GAAP financial information, when taken collectively, may be helpful to investors because it provides consistency and comparability with past financial performance. However, non-GAAP financial information is presented for supplemental informational purposes only, has limitations as an analytical tool and should not be considered in isolation or as a substitute for financial information presented in accordance with GAAP. In addition, other companies, including companies in our industry, may calculate similarly-titled non-GAAP measures differently or may use other measures to evaluate their performance.

A reconciliation is provided below for each non-GAAP financial measure to the most directly comparable financial measure stated in accordance with GAAP. Investors are encouraged to review the related GAAP financial measures and the reconciliation of these non-GAAP financial measures to their most directly comparable GAAP financial measures, and not to rely on any single financial measure to evaluate our business. Adjusted Gross Profit and Adjusted Gross Margin Adjusted Gross Profit is a non-GAAP financial measure that we define as revenue less cost of revenue, excluding depreciation and amortization and excluding stock-based compensation.

We define Adjusted Gross Margin as our Adjusted Gross Profit divided by our revenue. We believe Adjusted Gross Profit and Adjusted Gross Margin are useful to investors as they eliminate the impact of certain non-cash expenses and allow a direct comparison of these measures between periods without the impact of non-cash expenses and certain other non-recurring operating expenses. The following is a reconciliation of revenue, the most directly comparable GAAP financial measure, to Adjusted Gross Profit, for the three months ended March 31, 2021 and 2020.

Three Months Ended March 31, 2021 (in thousands, except percentages) Technology Professional Services TotalRevenue$33,839 $22,007 $55,846 Cost of revenue, excluding depreciation and amortization(10,825) (16,513) (27,338)Gross profit, excluding depreciation and amortization23,014 5,494 28,508 Add. Stock-based compensation374 1,435 1,809 Adjusted Gross Profit$23,388 $6,929 $30,317 Gross margin, excluding depreciation and amortization68% 25% 51%Adjusted Gross Margin69% 31% 54% Three Months Ended March 31, 2020 (in thousands, except percentages) Technology Professional Services TotalRevenue$24,699 $20,417 $45,116 Cost of revenue, excluding depreciation and amortization(7,906) (16,162) (24,068)Gross profit, excluding depreciation and amortization16,793 4,255 21,048 Add. Stock-based compensation176 816 992 Adjusted Gross Profit$16,969 $5,071 $22,040 Gross margin, excluding depreciation and amortization68% 21% 47%Adjusted Gross Margin69% 25% 49% Adjusted EBITDA Adjusted EBITDA is a non-GAAP financial measure that we define as net loss adjusted for (i) interest and other expense, net, (ii) income tax (benefit) provision, (iii) depreciation and amortization, (iv) stock-based compensation, (v) acquisition transaction costs, and (vi) change in fair value of contingent consideration liabilities when they are incurred.

We view acquisition-related expenses when applicable, such as transaction costs and changes in the fair value of contingent consideration liabilities that are directly related to business combinations as events that are not necessarily reflective of operational performance during a period. We believe Adjusted EBITDA provides investors with useful information on period-to-period performance as evaluated by management and comparison with our past financial performance and is useful in evaluating our operating performance compared to that of other companies in our industry, as this metric generally eliminates the effects of certain items that may vary from company to company for reasons unrelated to overall operating performance. The following is a reconciliation of our net loss, the most directly comparable GAAP financial measure, to Adjusted EBITDA, for the three months ended March 31, 2021 and 2020.

Three Months EndedMarch 31, 2021 2020 (in thousands)Net loss$(28,370) $(17,490)Add. Interest and other expense, net3,952 621 Income tax (benefit) provision101 (1,236)Depreciation and amortization7,814 2,877 Stock-based compensation13,510 8,741 Acquisition transaction costs— 875 Change in fair value of contingent consideration liabilities2,156 (359)Adjusted EBITDA$(837) $(5,971) Adjusted Net Loss Per Share Adjusted Net Loss is a non-GAAP financial measure that we define as net loss attributable to common stockholders adjusted for (i) stock-based compensation, (ii) amortization of acquired intangibles, (iii) acquisition transaction costs, (iv) change in fair value of contingent consideration liabilities, and (v) non-cash interest expense related to our convertible senior notes. We believe Adjusted Net Loss provides investors with useful information on period-to-period performance as evaluated by management and comparison with our past financial performance and is useful in evaluating our operating performance compared to that of other companies in our industry, as this metric generally eliminates the effects of certain items that may vary from company to company for reasons unrelated to overall operating performance.

Three Months Ended March 31, 2021 2020 Numerator:(in thousands, except share and per share amounts)Net loss attributable to common stockholders$(28,370) $(17,490)Add.

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15 December 2020 Congratulations to Debra Padgett who buy cipro with prescription has been confirmed as the cipro ulcerative colitis IBMS President Elect from 1st January 2021 Debra has been an HCPC registered Biomedical Scientist for twenty years. She has an MSc in Medical Microbiology and Post Grad qualifications in Leadership, Management and Organisational Development. She is a Chartered Scientist and a Fellow cipro ulcerative colitis of the IBMS.

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Debra started her career as a Medical Laboratory Assistant in Microbiology and has successfully worked her way through the career grades to her current role as Sciences Operational Manager in North Cumbria. She is proud of being able to understand the many routes available towards achieving a senior management position within the profession.Having spent 5 years as Pathology Quality Manager during the transition to ISO 15189, Debra was involved in delivering the inaugural Quality symposium at the IBMS Congress and the subsequent conferences held around the country to support our members. She is actively involved in shaping the how do you get cipro quality agenda for the Institute and is currently a module tutor on the CEP in Quality Management.On the announcement of her confirmation, Debra said.

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Congress.gov original site kidney treatment antibiotics cipro. €œH.R.1978 -- Protecting Seniors Through Immunization Act of 2021,” “S.912 -- Protecting Seniors Through Immunization Act of 2021.” EnergyCommerceHouse.gov. €œL.J. Tan, MS, PhD, Chief Strategy Officer, Immunization Action Coalition, Testimony Before the House Energy and Commerce Committee Subcommittee on Health.” Avalere. €œMedicare Part D Plans Continue to Require Cost Sharing for treatments.” Immunization Action Coalition.

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Because the central nervous system is affected, those symptoms can be wide-ranging. Among the most common are vision problems, muscle weakness, numbness and difficulty with balance and coordination. In recent years, there has been debate among specialists over whether MS has a "prodromal" phase -- a period where people have various non-specific symptoms before the typical characteristics of MS begin.Hemmer said the new findings suggest something else. At least in the five years before their diagnosis, patients are usually seeing doctors for actual MS symptoms.For the study -- recently published in the journal Neurology -- Hemmer's team examined insurance records from nearly 198,000 German adults, including 10,262 newly diagnosed with MS. The researchers looked at their medical visits and diagnoses for up to five years prior to their MS diagnosis, and compared them against the rest of the study group.That comparison group included people with certain other autoimmune diseases (Crohn's disease or psoriasis) and people with no history of autoimmune disorders.Overall, the study found, people ultimately diagnosed with MS had more medical appointments, to various specialists, than the comparison group.

The biggest difference was in visits to neurologists, but they also more often saw urologists, ophthalmologists, orthopedists and psychiatrists, among other specialists. When it came to diagnoses, 43 were more common among people later diagnosed with MS, versus people with no autoimmune disease. And, Hemmer said, they were often symptoms indicative of MS -- including urinary problems, visual disturbances, abnormal skin sensations, impaired movement and dizziness.MS can be difficult to diagnose early on, partly because there is no single test for it."MS symptoms are sometimes subtle and spontaneously remit without any treatment," Hemmer said. "Often these patients are not referred to a neurologist, or they cancel the appointment because the symptoms have disappeared."Dr. Andrew Solomon, a neurologist and associate professor at the Larner College of Medicine at the University of Vermont, coauthored an editorial published with the study."There's no question that diagnostic delay is a problem," he said, adding that the reasons "are probably many."For one, Solomon said, "MS can look like other things, and other things can look like MS."To diagnose the disease, he explained, doctors rely on symptoms -- not only what they are, but their pattern of occurrence -- along with MRI brain scans or lab tests that can detect signs of MS-related damage to the central nervous system.

Sometimes the process involves monitoring patients over time, Solomon said.But, he added, delays often start earlier on, with some patients not being referred to a specialist in a timely manner.Solomon said the new findings do not discount the notion that MS has a prodromal phase. Some study patients, for example, may have had such non-specific symptoms at some point before their initial neurological complaints.Experts want to know if there is indeed a prodromal period because understanding the earliest indicators of MS could aid in speedier diagnosis.Regardless of the existence of an MS prodrome, though, the earlier the disease is diagnosed, the better, Solomon said.A host of so-called disease-modifying drugs are available for MS that not only control symptom flares but can also slow the disease's progression. And earlier treatment, Solomon said, may have a bigger impact on the risk of disability over the long run. More InformationThe National Multiple Sclerosis Society has more on diagnosing MS.SOURCES. Bernhard Hemmer, MD, professor and director, neurology clinic, Technical University of Munich, Germany.

Andrew Solomon, MD, associate professor, Larner College of Medicine, University of Vermont, and neurologist, University of Vermont Medical Center, Burlington. Neurology, June 15, 2021Cholesterol is a waxy, fat-like substance that flows through your bloodstream. You’re at risk for a heart attack or stroke if your cholesterol numbers aren’t good. Statins might help. That’s a class of drugs designed to lower your body’s level of low-density lipoprotein (LDL) cholesterol, also known as “bad” cholesterol.Statins and Brain FogWhile statins have a lot of health benefits and are safe for most people to use, there are some side effects.

These can include:Brain fog is “a general level of confusion and disorientation,” says Robert Rosenson, MD, director of the Cardiometabolic Unit at Mount Sinai Hospital in New York City.The FDA approved label changes for statins that list memory loss and confusion as a “non-serious and reversible side-effect.”Cholesterol is an important part of your brain. In fact, 25% of the body’s cholesterol is found there. So it may seem like statins could affect how your brain works. But experts don’t think there’s cause for concern. Several studies on the drug’s side effects suggest there’s no direct link.

And the symptoms could be a sign of other problems, Rosenson says.“They forget where they put their keys down, they may open the refrigerator, put the keys in there, [and] they forget and can’t find them. But these are often signs of Alzheimer’s. And Alzheimer’s is a disease that develops over a long term,” he says.These types of memory issues usually happen to people who are middle-age or older and can be a sign of many conditions.“One might need to ask the question. €˜Is it really the drug?. €™ Or is there something else going on here that would require formal evaluation with a neuropsychiatric specialist,” Rosenson says.On the flip side, some research suggests statin use is linked to lowering the risk of dementia or improving brain function.

A 12-year study in Taiwan looked at 57,669 people over the age of 65 and found that high statin doses were “particularly effective” in preventing dementia. More research needs to be done on this.What to Do if You Have Brain FogDon’t stop taking your medication without talking to the doctor first. They may choose to:Stop your statin therapySwitch you to another type of statinLower your doseRosenson says he may switch someone to a non-statin drug like ezetimibe. It works by absorbing the cholesterol in your intestine. Or he might try a PCSK9 inhibitor.

It’s a class of drugs that don’t cross the blood-brain barrier. They break down LDL receptors and clear bad cholesterol from the bloodstream.Currently, the FDA has approved two PCSK9 inhibitors for use. They are:Alirocumab (Praluent)Evolocumab (Repatha)But Rosenson stresses that when it comes to statin therapy, the side effects like brain fog are rare and usually short-term. The pros often outweigh the cons, especially for people with high cholesterol or those at risk for:“You have to realize that there are not many drugs that can both reduce inflammation in the arteries and lower cholesterol,” he says. €œSo, one has to think of the big picture and the extensive data.”Things to Be Aware of When You’re on StatinsHere are a few things to keep in mind to avoid or ease side effects:Be careful with grapefruit.

The juice contains certain chemicals that may interrupt how statins metabolize in your gut. While you don’t have to give up grapefruit, ask your doctor what amount is safe to eat or drink.Tell your doctor about all the medications you’re on. Certain drugs can interact with statins and may cause side effects. These include:Take it easy when you exercise. One of the common side effects of statins is muscle aches and pain.

But too much exercise can raise your risk for muscle injury or make it worse. If you’re starting a new exercise routine, build up the intensity slowly.By Martha Bebinger, WBURFriday, June 25, 2021 (Kaiser News) -- One evening in late March, a mom called 911. Her daughter, she said, was threatening to kill herself. EMTs arrived at the home north of Boston, helped calm the 13-year-old, and took her to an emergency room.Melinda, like a growing number of children during the buy antibiotics cipro, had become increasingly anxious and depressed as she spent more time away from in-person contact at school, church and her singing lessons.KHN and NPR have agreed to use only the first names of this teenager and her mother, Pam, to avoid having this story trail the family online. Right now in Massachusetts and in many parts of the U.S.

And the world, demand for mental health care overwhelms supply, creating bottlenecks like Melinda’s 17-day saga.Emergency rooms are not typically places you check in for the night. If you break an arm, it gets set, and you leave. If you have a heart attack, you won’t wait long for a hospital bed. But sometimes if your brain is not well, and you end up in an ER, there’s a good chance you will get stuck there. Parents and advocates for kids’ mental health say that the ER can’t provide appropriate care and that the warehousing of kids in crisis can become an emergency itself.

What’s known as emergency room boarding of psychiatric patients has risen between 200% and 400% monthly in Massachusetts during the cipro. The CDC says emergency room visits after suicide attempts among teen girls were up 51% earlier this year as compared with 2019. There are no current nationwide mental health boarding numbers.“This is really unlike anything we’ve ever seen before, and it doesn’t show any signs of abating,” said Lisa Lambert, executive director of Parent/Professional Advocacy League, which pushes for more mental health care for children.Melinda spent her first 10 days in a hospital lecture hall with a dozen other children, on gurneys, separated by curtains because the emergency room had run out of space. At one point, Melinda, who was overwhelmed, tried to escape, was restrained, injected with drugs to calm her and moved to a small, windowless room. Day 12.

Cameras Track Her MovementsI met Melinda in early April, on her 12th day in the ER. Doctors were keeping her there because they were concerned she would harm herself if she left. Many parents report spending weeks with their children in hospital hallways or overflow rooms, in various states of distress, because hospital psychiatric units are full. While demand is up, supply is down. buy antibiotics precautions turned double rooms into singles or psych units into buy antibiotics units.

While those precautions are beginning to ease, demand for beds is not. Inside her small room, Melinda was disturbed by cameras that tracked her movement, and security guards in the hallways who were there, in part, for her safety.“It’s kinda like prison,” she said. €œIt feels like I’m desperate for help.”“Desperate” is a word both Melinda and Pam use often to describe the prolonged wait for care in a place that feels alien.“We occasionally hear screaming, yelling, monitors beeping,” said Pam. €œEven as the parent — it’s very scary.”But this experience is not new. This was Melinda’s fourth trip to a hospital emergency room since late November.

Pam said Melinda spiraled downward after a falling out with a close family member last summer. She has therapists, but some of them changed during the cipro, the visits were virtual, and she hasn’t made good connections between crises.“Each time, it’s the same routine,” Pam said. Melinda is rushed to an ER, where she waits. She’s admitted to a psych hospital for a week to 10 days and goes home. €œIt’s not enough time.” Pam said each facility has suggested a different diagnosis and adjusted Melinda’s medication.“We’ve never really gotten a good, true diagnosis as to what’s going on with her,” Pam said.

€œShe’s out of control. She feels out of control in her own skin.”Melinda waited six months for a neuropsychiatric exam to help clarify what she needs. She finally had the exam in May, after being discharged from the psychiatric hospital, but still doesn’t have the results. Some psychiatrists say observing a patient’s behavior is often a better way to reach a diagnosis. Lambert, the mental health advocate, said there are delays for every type of psychiatric care — both residential and outpatient.“We’ve heard of waits as long as five weeks or more for outpatient therapy,” Lambert said.

€œIf your child is saying they don’t want to live or don’t want to ever get out of bed again, you don’t want to wait five weeks.” Day 13. €˜The Longer She’s Here, the More She’s Going to Decline’As her stay dragged on, Melinda bounced from manic highs to deep emotional lows. The emergency room is a holding area. It isn’t set up to offer treatment or psychiatric therapy.On this day Melinda was agitated.“I just really want to get out of here,” she said in an audio diary she was keeping at the time for this story. €œI feel kind of helpless.

I miss my pets and my bed and real food.” She’d had a panic attack the night before and had to be sedated. Her mom, Pam, wasn’t there.“The longer she’s here, the more she’s going to decline,” Pam recorded in her own audio diary. €œShe has self-harmed three times since she’s been here.”The hospital and its parent network, Beth Israel Lahey Health, declined requests to speak about Melinda’s care. But Dr. Nalan Ward, the network’s chief medical officer for behavioral health services, hosts a daily call to discuss the best place for inpatient psychiatric treatment for each patient.

Some may have unique medical or insurance constraints, she said. Many insurers require prior approval before they’ll agree to pay for a placement, and that, too, can add delays. €œIt takes a case-by-case approach,” said Ward. €œIt’s really hands-on.”Day 14. Increasingly Isolated From School and FriendsFor Melinda, the issue keeping her from moving out of the ER and into an effective treatment program could have been her behavior.

Pam was told her daughter may be harder to place than children who don’t act out. Hospitals equipped to provide inpatient mental health care say they look for patients who will be a good fit for their programs and participants. Melinda’s chart included the attempted escape as well as some fights while she was housed in the lecture hall. €œShe’s having behaviors because she has a mental illness, which they’re supposed to help her with,” Pam said, “but yet they’re saying no to her because she’s having behaviors.”Secluding Melinda in the ER didn’t help, Pam said. €œShe’s, at times, unrecognizable to me.

She just is so sure that she’s never going to get better.” Melinda described feeling increasingly isolated. She lost touch with friends and most family members. She’d stopped doing schoolwork weeks earlier. The noise and commotion of a 24/7 ER was getting to Melinda.“I’m not sleeping well,” she noted in her diary. €œIt’s tough here.

I keep waking up in the middle of the night.”Day 15. Mom Retreats to Her Car to CryBoarding is difficult for parents as well. Pam works two jobs, but she visited Melinda every day, bringing a change of clothes, a new book or something special to eat.“Some days I sit and cry before I get out of the car, just to get it out of my system, so I don’t cry in front of her,” Pam said in her diary entry that day.Some hospitals say they can’t afford to care for patients with acute mental health problems because insurance reimbursements don’t cover costs. Massachusetts is spending $40 million this year on financial incentives to create more inpatient psychiatric care. But emergency rooms are still flooded with psychiatric patients who are in limbo, boarding there.

Day 16. €˜I Wish Someone Would Just Understand Me’“I never thought we’d be here this long,” said Pam.At the nurses’ station, Pam was told it could be two more weeks before there would be an opening at an appropriate hospital.In Massachusetts, Gov. Charlie Baker’s administration says it has a plan that will keep children out of ERs and reduce the need for inpatient care by providing more preventive and community-based services. Parents and providers say they are hopeful but question whether there are enough counselors and psychiatrists to staff proposed community clinics, therapy programs and more psychiatric hospital beds. Meanwhile, in the ER, Melinda was growing listless.“Life is really hard because things that should be easy for everyone are just hard for me,” she said.

€œWhen I ask for help, sometimes I picture going to the hospital. Other times I wish someone would just understand me.”Then, in the late evening on Day 16, the family got word that Melinda’s wait would soon end. Day 17. Limbo Ends and Real Treatment BeginsOn Day 17, Melinda was taken by ambulance to a Boston-area hospital that had added child psychiatric beds during the cipro. She was lucky to get a spot.

The day she arrived, there were 50 to 60 children on the waiting list.“That’s dramatically higher” than before the cipro, said Dr. Linsey Koruthu, one of Melinda’s doctors and a pediatric psychiatrist at Cambridge Health Alliance. €œAbout double what we would have seen in 2019.”Doctors there adjusted Melinda’s medications. She met with a psychiatrist and social worker daily and had group therapy and time for schoolwork, yoga and pet therapy. Hospital staff members met with Melinda and her family.

She stayed two weeks, a bit longer than the average stay.Doctors recommended that Melinda move from inpatient care to a community-based residential treatment program — a bridge between being in the hospital and returning home. But those programs were full and had weeks-long delays. So, Melinda went straight home. She now has three therapists helping her make the transition and use what she’s learned. And as buy antibiotics restrictions have begun to ease, some sessions are in person — which Koruthu said should be more effective for Melinda.Pam said the transition has been rough.

Police came to the house once and suggested Melinda go to an ER, but she was able to calm down before it came to that. Melinda has developed an eating disorder.The first available appointment with a specialist is in August. But, by mid-June, Melinda was able to graduate from middle school, after finishing a backlog of schoolwork.“If you had asked me two months ago, I would have said I don’t think she’ll make it,” Pam said. €œWe’re getting there.” If you or someone you know are in mental health crisis or may be considering suicide, contact the National Suicide Prevention Lifeline at 1-800-273-8255 (en Español. 1-888-628-9454.

For the deaf and hard of hearing. Dial 711 then 1-800-273-8255) or the Crisis Text Line by texting HOME to 741741.KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.By Robert PreidtHealthDay ReporterFRIDAY, June 25, 2021 (HealthDay News) -- Think the sex lives of Americans took a hit during the cipro?. Think again.

New research finds there's been a jump in sales of erectile dysfunction (ED) drugs, especially Cialis (tadalafil), in the United States over the past year."We saw a huge spike in sales of daily use erectile dysfunction drugs, which suggests that some people were having more spontaneous sex than ever -- with their partners at home, they wanted to always be ready," said senior study author Dr. Benjamin Davies, a professor of urology at the University of Pittsburgh's School of Medicine.His team compared sales of ED drugs before March 2020 and during the initial months of the cipro, March to December 2020.To account for other factors that might influence the sale of the drugs -- such as access to pharmacies -- the study authors also analyzed the sales of other urological drugs, which didn't change in the months after the cipro was declared. There was a short decrease in ED medication sales in March and April 2020, but sales of the drugs have steadily risen since then, according to the findings outlined in a research letter published June 25 in the Journal of Internal Medicine.In particular, sales of Cialis (tadalafil) -- a longer-acting drug that's taken daily to help with more spontaneous sexual activity -- nearly doubled between February and December of 2020, the researchers found."Changes in sales of erectile dysfunction drugs can indicate important problems and point out issues in people's general well-being," Davies said in a university news release. "People's sexual lives contribute to the psychosocial fabric of society." Davies also directs the Urologic Oncology Program at Hillman Cancer Center, which is part of the University of Pittsburgh Medical Center.More informationHarvard Medical School has more on erectile dysfunction drugs. SOURCE.

University of Pittsburgh, news release, June 25, 2021.

Congress.gov. €œH.R.1978 -- Protecting Seniors Through Immunization Act of 2021,” “S.912 -- Protecting Seniors Through Immunization Act of 2021.” EnergyCommerceHouse.gov. €œL.J. Tan, MS, PhD, Chief Strategy Officer, Immunization Action Coalition, Testimony Before the House Energy and Commerce Committee Subcommittee on Health.” Avalere.

€œMedicare Part D Plans Continue to Require Cost Sharing for treatments.” Immunization Action Coalition. €œIAC Funding.” Adult treatment Access Coalition. €œAVAC Protecting Seniors Support 3_15_21.” America's Health Insurance Plans. €œAHIP Statement EC Health Sub Hearing on treatments.” Medicare Payment and Advisory Commission.

€œMedicare Payment and Advisory Commission Releases Report on Medicare and the Health Care Delivery System.”By Amy Norton HealthDay ReporterMONDAY, June 28, 2021 (HealthDay News) -- Early symptoms of multiple sclerosis may commonly be missed for years before the right diagnosis is made, a new study suggests.Researchers found that patients with MS had a higher-than-average number of medical appointments, with doctors of various specialties, for up to five years before their diagnosis.And for the most part, those visits were for neurological symptoms consistent with MS -- pointing to missed opportunities for an earlier diagnosis, the researchers say."We found that many complaints that led to patient visits were compatible with first clinical relapses that were not recognized as such," said senior researcher Dr. Bernhard Hemmer, a neurologist and professor at the Technical University of Munich in Germany."Relapse" refers to the symptom flare-ups that mark MS -- a neurological disease caused by a misguided immune system attack on the body's own nerve tissue.Most often, MS follows a relapsing-remitting course, where symptoms flare for a time and then ease, according to the National MS Society. Because the central nervous system is affected, those symptoms can be wide-ranging. Among the most common are vision problems, muscle weakness, numbness and difficulty with balance and coordination.

In recent years, there has been debate among specialists over whether MS has a "prodromal" phase -- a period where people have various non-specific symptoms before the typical characteristics of MS begin.Hemmer said the new findings suggest something else. At least in the five years before their diagnosis, patients are usually seeing doctors for actual MS symptoms.For the study -- recently published in the journal Neurology -- Hemmer's team examined insurance records from nearly 198,000 German adults, including 10,262 newly diagnosed with MS. The researchers looked at their medical visits and diagnoses for up to five years prior to their MS diagnosis, and compared them against the rest of the study group.That comparison group included people with certain other autoimmune diseases (Crohn's disease or psoriasis) and people with no history of autoimmune disorders.Overall, the study found, people ultimately diagnosed with MS had more medical appointments, to various specialists, than the comparison group. The biggest difference was in visits to neurologists, but they also more often saw urologists, ophthalmologists, orthopedists and psychiatrists, among other specialists.

When it came to diagnoses, 43 were more common among people later diagnosed with MS, versus people with no autoimmune disease. And, Hemmer said, they were often symptoms indicative of MS -- including urinary problems, visual disturbances, abnormal skin sensations, impaired movement and dizziness.MS can be difficult to diagnose early on, partly because there is no single test for it."MS symptoms are sometimes subtle and spontaneously remit without any treatment," Hemmer said. "Often these patients are not referred to a neurologist, or they cancel the appointment because the symptoms have disappeared."Dr. Andrew Solomon, a neurologist and associate professor at the Larner College of Medicine at the University of Vermont, coauthored an editorial published with the study."There's no question that diagnostic delay is a problem," he said, adding that the reasons "are probably many."For one, Solomon said, "MS can look like other things, and other things can look like MS."To diagnose the disease, he explained, doctors rely on symptoms -- not only what they are, but their pattern of occurrence -- along with MRI brain scans or lab tests that can detect signs of MS-related damage to the central nervous system.

Sometimes the process involves monitoring patients over time, Solomon said.But, he added, delays often start earlier on, with some patients not being referred to a specialist in a timely manner.Solomon said the new findings do not discount the notion that MS has a prodromal phase. Some study patients, for example, may have had such non-specific symptoms at some point before their initial neurological complaints.Experts want to know if there is indeed a prodromal period because understanding the earliest indicators of MS could aid in speedier diagnosis.Regardless of the existence of an MS prodrome, though, the earlier the disease is diagnosed, the better, Solomon said.A host of so-called disease-modifying drugs are available for MS that not only control symptom flares but can also slow the disease's progression. And earlier treatment, Solomon said, may have a bigger impact on the risk of disability over the long run. More InformationThe National Multiple Sclerosis Society has more on diagnosing MS.SOURCES.

Bernhard Hemmer, MD, professor and director, neurology clinic, Technical University of Munich, Germany. Andrew Solomon, MD, associate professor, Larner College of Medicine, University of Vermont, and neurologist, University of Vermont Medical Center, Burlington. Neurology, June 15, 2021Cholesterol is a waxy, fat-like substance that flows through your bloodstream. You’re at risk for a heart attack or stroke if your cholesterol numbers aren’t good.

Statins might help. That’s a class of drugs designed to lower your body’s level of low-density lipoprotein (LDL) cholesterol, also known as “bad” cholesterol.Statins and Brain FogWhile statins have a lot of health benefits and are safe for most people to use, there are some side effects. These can include:Brain fog is “a general level of confusion and disorientation,” says Robert Rosenson, MD, director of the Cardiometabolic Unit at Mount Sinai Hospital in New York City.The FDA approved label changes for statins that list memory loss and confusion as a “non-serious and reversible side-effect.”Cholesterol is an important part of your brain. In fact, 25% of the body’s cholesterol is found there.

So it may seem like statins could affect how your brain works. But experts don’t think there’s cause for concern. Several studies on the drug’s side effects suggest there’s no direct link. And the symptoms could be a sign of other problems, Rosenson says.“They forget where they put their keys down, they may open the refrigerator, put the keys in there, [and] they forget and can’t find them.

But these are often signs of Alzheimer’s. And Alzheimer’s is a disease that develops over a long term,” he says.These types of memory issues usually happen to people who are middle-age or older and can be a sign of many conditions.“One might need to ask the question. €˜Is it really the drug?. €™ Or is there something else going on here that would require formal evaluation with a neuropsychiatric specialist,” Rosenson says.On the flip side, some research suggests statin use is linked to lowering the risk of dementia or improving brain function.

A 12-year study in Taiwan looked at 57,669 people over the age of 65 and found that high statin doses were “particularly effective” in preventing dementia. More research needs to be done on this.What to Do if You Have Brain FogDon’t stop taking your medication without talking to the doctor first. They may choose to:Stop your statin therapySwitch you to another type of statinLower your doseRosenson says he may switch someone to a non-statin drug like ezetimibe. It works by absorbing the cholesterol in your intestine.

Or he might try a PCSK9 inhibitor. It’s a class of drugs that don’t cross the blood-brain barrier. They break down LDL receptors and clear bad cholesterol from the bloodstream.Currently, the FDA has approved two PCSK9 inhibitors for use. They are:Alirocumab (Praluent)Evolocumab (Repatha)But Rosenson stresses that when it comes to statin therapy, the side effects like brain fog are rare and usually short-term.

The pros often outweigh the cons, especially for people with high cholesterol or those at risk for:“You have to realize that there are not many drugs that can both reduce inflammation in the arteries and lower cholesterol,” he says. €œSo, one has to think of the big picture and the extensive data.”Things to Be Aware of When You’re on StatinsHere are a few things to keep in mind to avoid or ease side effects:Be careful with grapefruit. The juice contains certain chemicals that may interrupt how statins metabolize in your gut. While you don’t have to give up grapefruit, ask your doctor what amount is safe to eat or drink.Tell your doctor about all the medications you’re on.

Certain drugs can interact with statins and may cause side effects. These include:Take it easy when you exercise. One of the common side effects of statins is muscle aches and pain. But too much exercise can raise your risk for muscle injury or make it worse.

If you’re starting a new exercise routine, build up the intensity slowly.By Martha Bebinger, WBURFriday, June 25, 2021 (Kaiser News) -- One evening in late March, a mom called 911. Her daughter, she said, was threatening to kill herself. EMTs arrived at the home north of Boston, helped calm the 13-year-old, and took her to an emergency room.Melinda, like a growing number of children during the buy antibiotics cipro, had become increasingly anxious and depressed as she spent more time away from in-person contact at school, church and her singing lessons.KHN and NPR have agreed to use only the first names of this teenager and her mother, Pam, to avoid having this story trail the family online. Right now in Massachusetts and in many parts of the U.S.

And the world, demand for mental health care overwhelms supply, creating bottlenecks like Melinda’s 17-day saga.Emergency rooms are not typically places you check in for the night. If you break an arm, it gets set, and you leave. If you have a heart attack, you won’t wait long for a hospital bed. But sometimes if your brain is not well, and you end up in an ER, there’s a good chance you will get stuck there.

Parents and advocates for kids’ mental health say that the ER can’t provide appropriate care and that the warehousing of kids in crisis can become an emergency itself. What’s known as emergency room boarding of psychiatric patients has risen between 200% and 400% monthly in Massachusetts during the cipro. The CDC says emergency room visits after suicide attempts among teen girls were up 51% earlier this year as compared with 2019. There are no current nationwide mental health boarding numbers.“This is really unlike anything we’ve ever seen before, and it doesn’t show any signs of abating,” said Lisa Lambert, executive director of Parent/Professional Advocacy League, which pushes for more mental health care for children.Melinda spent her first 10 days in a hospital lecture hall with a dozen other children, on gurneys, separated by curtains because the emergency room had run out of space.

At one point, Melinda, who was overwhelmed, tried to escape, was restrained, injected with drugs to calm her and moved to a small, windowless room. Day 12. Cameras Track Her MovementsI met Melinda in early April, on her 12th day in the ER. Doctors were keeping her there because they were concerned she would harm herself if she left.

Many parents report spending weeks with their children in hospital hallways or overflow rooms, in various states of distress, because hospital psychiatric units are full. While demand is up, supply is down. buy antibiotics precautions turned double rooms into singles or psych units into buy antibiotics units. While those precautions are beginning to ease, demand for beds is not.

Inside her small room, Melinda was disturbed by cameras that tracked her movement, and security guards in the hallways who were there, in part, for her safety.“It’s kinda like prison,” she said. €œIt feels like I’m desperate for help.”“Desperate” is a word both Melinda and Pam use often to describe the prolonged wait for care in a place that feels alien.“We occasionally hear screaming, yelling, monitors beeping,” said Pam. €œEven as the parent — it’s very scary.”But this experience is not new. This was Melinda’s fourth trip to a hospital emergency room since late November.

Pam said Melinda spiraled downward after a falling out with a close family member last summer. She has therapists, but some of them changed during the cipro, the visits were virtual, and she hasn’t made good connections between crises.“Each time, it’s the same routine,” Pam said. Melinda is rushed to an ER, where she waits. She’s admitted to a psych hospital for a week to 10 days and goes home.

€œIt’s not enough time.” Pam said each facility has suggested a different diagnosis and adjusted Melinda’s medication.“We’ve never really gotten a good, true diagnosis as to what’s going on with her,” Pam said. €œShe’s out of control. She feels out of control in her own skin.”Melinda waited six months for a neuropsychiatric exam to help clarify what she needs. She finally had the exam in May, after being discharged from the psychiatric hospital, but still doesn’t have the results.

Some psychiatrists say observing a patient’s behavior is often a better way to reach a diagnosis. Lambert, the mental health advocate, said there are delays for every type of psychiatric care — both residential and outpatient.“We’ve heard of waits as long as five weeks or more for outpatient therapy,” Lambert said. €œIf your child is saying they don’t want to live or don’t want to ever get out of bed again, you don’t want to wait five weeks.” Day 13. €˜The Longer She’s Here, the More She’s Going to Decline’As her stay dragged on, Melinda bounced from manic highs to deep emotional lows.

The emergency room is a holding area. It isn’t set up to offer treatment or psychiatric therapy.On this day Melinda was agitated.“I just really want to get out of here,” she said in an audio diary she was keeping at the time for this story. €œI feel kind of helpless. I miss my pets and my bed and real food.” She’d had a panic attack the night before and had to be sedated.

Her mom, Pam, wasn’t there.“The longer she’s here, the more she’s going to decline,” Pam recorded in her own audio diary. €œShe has self-harmed three times since she’s been here.”The hospital and its parent network, Beth Israel Lahey Health, declined requests to speak about Melinda’s care. But Dr. Nalan Ward, the network’s chief medical officer for behavioral health services, hosts a daily call to discuss the best place for inpatient psychiatric treatment for each patient.

Some may have unique medical or insurance constraints, she said. Many insurers require prior approval before they’ll agree to pay for a placement, and that, too, can add delays. €œIt takes a case-by-case approach,” said Ward. €œIt’s really hands-on.”Day 14.

Increasingly Isolated From School and FriendsFor Melinda, the issue keeping her from moving out of the ER and into an effective treatment program could have been her behavior. Pam was told her daughter may be harder to place than children who don’t act out. Hospitals equipped to provide inpatient mental health care say they look for patients who will be a good fit for their programs and participants. Melinda’s chart included the attempted escape as well as some fights while she was housed in the lecture hall.

€œShe’s having behaviors because she has a mental illness, which they’re supposed to help her with,” Pam said, “but yet they’re saying no to her because she’s having behaviors.”Secluding Melinda in the ER didn’t help, Pam said. €œShe’s, at times, unrecognizable to me. She just is so sure that she’s never going to get better.” Melinda described feeling increasingly isolated. She lost touch with friends and most family members.

She’d stopped doing schoolwork weeks earlier. The noise and commotion of a 24/7 ER was getting to Melinda.“I’m not sleeping well,” she noted in her diary. €œIt’s tough here. I keep waking up in the middle of the night.”Day 15.

Mom Retreats to Her Car to CryBoarding is difficult for parents as well. Pam works two jobs, but she visited Melinda every day, bringing a change of clothes, a new book or something special to eat.“Some days I sit and cry before I get out of the car, just to get it out of my system, so I don’t cry in front of her,” Pam said in her diary entry that day.Some hospitals say they can’t afford to care for patients with acute mental health problems because insurance reimbursements don’t cover costs. Massachusetts is spending $40 million this year on financial incentives to create more inpatient psychiatric care. But emergency rooms are still flooded with psychiatric patients who are in limbo, boarding there.

Day 16. €˜I Wish Someone Would Just Understand Me’“I never thought we’d be here this long,” said Pam.At the nurses’ station, Pam was told it could be two more weeks before there would be an opening at an appropriate hospital.In Massachusetts, Gov. Charlie Baker’s administration says it has a plan that will keep children out of ERs and reduce the need for inpatient care by providing more preventive and community-based services. Parents and providers say they are hopeful but question whether there are enough counselors and psychiatrists to staff proposed community clinics, therapy programs and more psychiatric hospital beds.

Meanwhile, in the ER, Melinda was growing listless.“Life is really hard because things that should be easy for everyone are just hard for me,” she said. €œWhen I ask for help, sometimes I picture going to the hospital. Other times I wish someone would just understand me.”Then, in the late evening on Day 16, the family got word that Melinda’s wait would soon end. Day 17.

Limbo Ends and Real Treatment BeginsOn Day 17, Melinda was taken by ambulance to a Boston-area hospital that had added child psychiatric beds during the cipro. She was lucky to get a spot. The day she arrived, there were 50 to 60 children on the waiting list.“That’s dramatically higher” than before the cipro, said Dr. Linsey Koruthu, one of Melinda’s doctors and a pediatric psychiatrist at Cambridge Health Alliance.

€œAbout double what we would have seen in 2019.”Doctors there adjusted Melinda’s medications. She met with a psychiatrist and social worker daily and had group therapy and time for schoolwork, yoga and pet therapy. Hospital staff members met with Melinda and her family. She stayed two weeks, a bit longer than the average stay.Doctors recommended that Melinda move from inpatient care to a community-based residential treatment program — a bridge between being in the hospital and returning home.

But those programs were full and had weeks-long delays. So, Melinda went straight home. She now has three therapists helping her make the transition and use what she’s learned. And as buy antibiotics restrictions have begun to ease, some sessions are in person — which Koruthu said should be more effective for Melinda.Pam said the transition has been rough.

Police came to the house once and suggested Melinda go to an ER, but she was able to calm down before it came to that. Melinda has developed an eating disorder.The first available appointment with a specialist is in August. But, by mid-June, Melinda was able to graduate from middle school, after finishing a backlog of schoolwork.“If you had asked me two months ago, I would have said I don’t think she’ll make it,” Pam said. €œWe’re getting there.” If you or someone you know are in mental health crisis or may be considering suicide, contact the National Suicide Prevention Lifeline at 1-800-273-8255 (en Español.

1-888-628-9454. For the deaf and hard of hearing. Dial 711 then 1-800-273-8255) or the Crisis Text Line by texting HOME to 741741.KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation).

KFF is an endowed nonprofit organization providing information on health issues to the nation.By Robert PreidtHealthDay ReporterFRIDAY, June 25, 2021 (HealthDay News) -- Think the sex lives of Americans took a hit during the cipro?. Think again. New research finds there's been a jump in sales of erectile dysfunction (ED) drugs, especially Cialis (tadalafil), in the United States over the past year."We saw a huge spike in sales of daily use erectile dysfunction drugs, which suggests that some people were having more spontaneous sex than ever -- with their partners at home, they wanted to always be ready," said senior study author Dr. Benjamin Davies, a professor of urology at the University of Pittsburgh's School of Medicine.His team compared sales of ED drugs before March 2020 and during the initial months of the cipro, March to December 2020.To account for other factors that might influence the sale of the drugs -- such as access to pharmacies -- the study authors also analyzed the sales of other urological drugs, which didn't change in the months after the cipro was declared.

There was a short decrease in ED medication sales in March and April 2020, but sales of the drugs have steadily risen since then, according to the findings outlined in a research letter published June 25 in the Journal of Internal Medicine.In particular, sales of Cialis (tadalafil) -- a longer-acting drug that's taken daily to help with more spontaneous sexual activity -- nearly doubled between February and December of 2020, the researchers found."Changes in sales of erectile dysfunction drugs can indicate important problems and point out issues in people's general well-being," Davies said in a university news release. "People's sexual lives contribute to the psychosocial fabric of society." Davies also directs the Urologic Oncology Program at Hillman Cancer Center, which is part of the University of Pittsburgh Medical Center.More informationHarvard Medical School has more on erectile dysfunction drugs. SOURCE. University of Pittsburgh, news release, June 25, 2021.