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How to Get Heart Patients to Take Their Pills? Give Them Just One.

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How to Get Heart Patients to Take Their Pills? Give Them Just One.

Coronary heart illness kills extra folks than every other situation, however regardless of advances in remedy and prevention, sufferers typically don’t keep on with their medicine regimens. Now researchers could have discovered an answer: a so-called polypill that mixes three medication wanted to stop cardiovascular hassle.

In what is outwardly the most important and longest randomized managed trial of this strategy, sufferers who have been prescribed a polypill inside six months of a coronary heart assault have been extra prone to preserve taking their medication and had considerably fewer cardiovascular occasions, in contrast with these receiving the same old assortment of capsules.

The individuals additionally skilled one-third fewer cardiovascular deaths, though their total danger of demise from all causes was not considerably modified.

The research of greater than two thousand coronary heart sufferers, who have been adopted for 3 years, was printed Friday morning in The New England Journal of Drugs, because the findings have been introduced on the European Society of Cardiology Congress in Barcelona.

The research is the fruits of 15 years of labor by researchers led by Dr. Valentin Fuster, director of Mount Sinai Coronary heart at Mount Sinai Hospital in New York Metropolis, and basic director of the Nationwide Middle for Cardiovascular Analysis in Spain.

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“Mixture capsules are simpler for the doctor and for the affected person, and the info are fairly clear — it interprets right into a profit,” stated Dr. Thomas J. Wang, chair of the division of inside drugs at UT Southwestern Medical Middle, who was not concerned within the analysis however wrote an editorial accompanying the research.

“It’s simpler to take one capsule versus a number of capsules, and it’s simpler to take them as soon as a day than a number of instances a day.”

The supply of a polypill additionally seems to nudge physicians to put in writing prescriptions extra consistent with observe pointers, Dr. Wang added: “Below strange circumstances, physicians typically under-prescribe medicines that needs to be given.”

The polypill combines a blood-pressure medicine, a cholesterol-lowering drug and aspirin, which helps forestall blood clots. The concept was first floated twenty years in the past in a extra radical type: Advocates proposed giving a day by day polypill to everybody as soon as they turned 55, saying it could slash cardiovascular occasions globally by 80 p.c.

That notion was roundly criticized and rapidly laid to relaxation. However the advantages of a polypill for sufferers vulnerable to coronary heart issues have been examined in quite a few research since. Polypills are already out there to deal with different medical situations, comparable to H.I.V. and hepatitis C, Dr. Wang famous.

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The polypill used within the research has not been permitted by the Meals and Drug Administration and isn’t out there to sufferers in america proper now. Dr. Fuster stated the outcomes of the brand new trial can be submitted to the company shortly in an effort to acquire approval.

He referred to as the outcomes of the brand new research “hanging,” and stated the advantage of the polypill for prevention rivaled that of low-dose aspirin, which is now routinely prescribed to individuals who have already had a coronary heart assault or different cardiovascular occasion.

And since individuals grew to become much more prone to preserve taking the polypill over time, he stated, “The potential outcomes might be even higher with extra follow-up.” A number of research have proven that solely about half of sufferers, and even much less, take all their medicines as instructed.

The brand new research, a randomized managed scientific trial, enrolled just below 2,500 sufferers at 113 websites in Spain, Italy, France, Germany, Poland, the Czech Republic and Hungary.

All enrollees had survived a coronary heart assault inside the earlier six months. They have been both older than 75, or a minimum of 65 with different well being situations like diabetes or kidney illness. General, about 80 p.c had hypertension, practically 60 p.c had diabetes, and over half had a historical past of smoking.

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Virtually the entire sufferers have been white, and fewer than one-third have been girls. A overwhelming majority weren’t highschool graduates.

Half of the trial individuals acquired the polypill, whereas the opposite half acquired common care. There have been a number of sorts of polypills, and remedy was tailor-made to particular person sufferers.

The entire polypills contained 100 milligrams of aspirin, however docs may select between three doses of ramipril, a blood strain drug, and between two doses of atorvastatin, a cholesterol-lowering medicine.

Adherence to medicine was increased among the many polypill customers, and elevated over time, the researchers discovered. At six months, 70.6 p.c of the polypill group have been sticking to their regimens, in contrast with 62.7 p.c of these taking common assortment of capsules.

At 24 months, about three-quarters of the sufferers have been nonetheless taking a polypill, in contrast with 63.2 p.c of the sufferers taking the same old capsules.

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Over three years, 12.7 p.c of the sufferers taking an assortment of capsules skilled one other coronary heart assault or stroke, or died of a cardiac occasion or wanted pressing remedy to open a blocked artery, in contrast with 9.5 p.c of sufferers taking a polypill, for a relative discount in danger of 24 p.c.

There was no distinction between the 2 teams in total mortality, nevertheless, because the discount in cardiovascular deaths within the polypill group was offset by deaths from different causes.

Requested why the polypill was efficient, and why adherence to medicine was so poor, Dr. Fuster stated, “Folks neglect when there are a selection of capsules to be taken, they don’t take all of them or they take none.”

Though most sufferers keep on with remedy within the fast aftermath of a coronary heart assault, adherence drops off after the primary few months, he stated.

The polypill could also be cheaper to provide and distribute than a sequence of various capsules. The findings could assist make cardiovascular prevention remedy extra accessible, particularly to people in low-income and middle-income nations.

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Though the affected person cohort within the European research was very homogeneous, different research have checked out polypill use in minority and underserved populations.

Dr. Wang led a research of a polypill prescribed for major prevention of heart problems in a low-income, principally Black group of adults in Alabama. Adherence was very excessive, and the individuals noticed higher decreases in ldl cholesterol and blood strain than these receiving medicines of their common type.

A evaluation of eight research that included over 25,000 sufferers, additionally led by Dr. Wang, discovered considerably improved adherence to drug regimens with a polypill and important reductions in cardiovascular danger components.

General mortality declined amongst sufferers assigned to take polypills, as did severe cardiac occasions, significantly amongst those that have been at low danger to start with and had no earlier coronary heart illness.

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Trump administration restores funds for HIV prevention following outcry

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Trump administration restores funds for HIV prevention following outcry

The Trump administration has lifted a freeze on federal funds for HIV prevention and surveillance programs, officials said, following an outcry from HIV prevention organizations, health experts and Democrats in Congress.

The Los Angeles County Department of Public Health received notice from the U.S. Centers for Disease Control and Prevention on Thursday that it had been awarded nearly $20 million for HIV prevention for the 12-month period that began June 1 — an increase of $338,019 from the previous year.

“Let’s be clear — the Trump administration’s move to freeze HIV prevention funding was reckless, illegal and put lives at risk,” said Rep. Laura Friedman (D-Glendale) in a statement. “I’m relieved the CDC finally did the right thing — but this never should have happened.”

The CDC didn’t immediately respond to a request for comment.

Friedman and other advocates for HIV prevention funding sent a letter to Health and Human Services Secretary Robert F. Kennedy Jr. last month, warning that proposed cuts to these programs would reverse years of progress combating the disease and cause spikes in new cases — especially in California and among the LGBTQ+ community.

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The letter cited estimates from the Foundation for AIDS Research, known as amfAR, suggesting the cuts could lead to 143,000 additional HIV infections nationwide and 127,000 additional deaths from AIDS-related causes within five years.

Los Angeles County, which stood to lose nearly $20 million in annual federal HIV prevention funding, was looking at terminating contracts with 39 providers. Experts said the dissolution of that network could result in as many as 650 new cases per year — pushing the total number of new infections per year in the county to roughly 2,000.

“Public Health is grateful for the support and advocacy from the Board of Supervisors, the Los Angeles County Congressional delegation, and all of our community based providers in pushing CDC to restore this Congressionally approved funding,” a spokeswoman for the county’s health department said.

“Looking forward, it is important to note that the President’s FY26 budget proposes to eliminate this funding entirely, and we urge our federal partners to support this critical lifesaving funding,” she said.

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Malaysia will stop accepting U.S. plastic waste, creating a dilemma for California

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Malaysia will stop accepting U.S. plastic waste, creating a dilemma for California

Malaysia will ban plastic waste imports from the U.S. starting Tuesday because of America’s failure to abide by the Basel Convention treaty on international waste transfers, in a move that could have significant consequences for California.

Malaysia emerged as a major destination for U.S. waste after China banned American waste imports in 2018. California shipped 864 shipping containers, or more than 10 million pounds of plastic waste, to Malaysia in 2024, according to the Basel Action Network, an advocacy group. That was second only to Georgia among U.S. states.

Under Malaysian waste guidelines announced last month, the country will no longer accept plastic waste and hazardous waste from nations that didn’t ratify the Basel Convention, the international treaty designed to reduce the international movement of hazardous and other waste. The U.S. is one of just a handful of countries, including Fiji and Haiti, that hasn’t signed the pact.

Malaysia will continue to accept plastic waste from Basel signatories. However, exports from those countries will be subject to pre-inspection at the nation of origin, according to the new guidelines

Steve Wong, the chief executive of Fukutomi, a Hong Kong-based global plastic recycling company, suggests it is already having an effect on shipping ports.

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“With scrap inventories building up at ports and yards, and no clear guidance yet on the enforcement discretion or timeline of Malaysia’s new system, the market for imported plastic waste has effectively frozen,” he wrote in an email to people who follow recycling trends, which was shared with The Times.

Much of California’s plastic waste is sent overseas. A Los Angeles port spokesman said he was unaware of the impending ban. Long Beach port officials didn’t immediately respond to requests for comment.

An Oakland port spokesman said that facility “hasn’t historically seen much volume in this commodity, so we don’t anticipate any impact from this change.”

Workers open the door of plastics waste shipment from Australia before sending back to the country of origin in Port Klang on May 28, 2019. A total of 3,000 metric tonnes of contaminated plastic waste will be shipping back to their countries of origin today, signalling Malaysias effort to take the lead in the global crusade against unscrupulous export of scrap. (Photo by

(Adli Ghazali/Anadolu Agency via Getty Images)

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According to Wong’s email, the coming ban has already disrupted trash export routes significantly, particularly for the plastics used in grocery bags, trash can liners and food wrap.

“The scrap plastics market in Malaysia has come to a virtual standstill amid tightening import regulations and widespread uncertainty ahead of the new control regime taking effect on 1 July 2025,” Wong wrote in the email. “Recyclers, traders, and suppliers are all reporting minimal or no movement of plastic waste.”

Jim Puckett of the Seattle-based Basel Action Network cheered Malaysia’s decision.

“The ‘recycling’ is doing more harm than good as only a fraction of the exports ever get recycled,” said Puckett, the group’s founder and chief of strategic direction. “The plastics that are not feasible to be recycled are often hazardous, or contain microplastics, which are commonly dumped, burned, or released into waterways. The export of plastic waste for recycling is a complete sham and it is a relief that the U.S. contribution to this plastic waste shell game is increasingly outlawed.”

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According to California’s waste agency, CalRecycle, the state exported 11.3 million tons of recyclable materials overseas to places such as Malaysia, Thailand, Vietnam, China, Taiwan, South Korea, Mexico and Canada — in 2022.

That number includes 100 million pounds of scrap plastic. Although the Basel Action Network’s numbers indicate more than 10 million pounds went to Malaysia, CalRecycle’s 2022 report didn’t break down plastic exports to individual nations.

A spokesperson for CalRecycle said that California “is working to reduce plastic pollution in our state and around the world” and that exports of scrap plastic have significantly declined over the last 10 years.

Maria West, the agency’s communications director, said that in 2018, California exported roughly 421,000 tons, or nearly 842 million pounds of plastic scrap to Malaysia. She said that number dropped 98% in 2024 to 8,000 tons, or about 16 million pounds.

Several major waste companies in California, including Athens Services and Recology, didn’t immediately respond to requests for comment.

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Critics of California’s waste system say a 1989 state law that requires cities and jurisdictions to divert waste from landfills led to an increase in the export of waste overseas.

Until 2018, China was the major importer of U.S. plastic waste. However, after China implemented it’s National Sword policy — which banned the import of most plastic waste — nations began sending their waste elsewhere, often to less economically advantaged nations such as Malaysia, Vietnam and Thailand.

Although some of the plastic is recycled in these nations, much of it is incinerated or placed in landfills, where it chokes rivers and flows into the ocean.

Waste advocates such as the Basel Action Network and participants in the Basel Convention are working to reduce the international movement of contaminated, nonrecyclable plastic from economically advantaged countries, such as the United States, to less advantaged nations.

Jan Dell, the president of LastBeachCleanUp, a Laguna Beach-based anti-plastic waste organization, praised the Malaysian decision.

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“We’re calling on cities, waste companies, brokers, and shipping companies to respect Malaysia’s sovereign law and STOP all plastic waste shipments,” she wrote in an email. The plastic waste must NOT be re-rerouted to other poor countries.”

In 2022, Gov. Gavin Newsom signed Senate Bill 54, a landmark plastic law that is designed to establish a circular economy for single-use plastic products and packaging. The law addresses the export of plastic waste and requires product manufacturers to certify that their products are being recycled or composted in ways that reduce environmental pollution and minimize health effects for people who live near where the product is sent.

CalRecycle is currently working on drafting regulations that will enable the implementation of the law, but West, the agency’s spokeswoman, said the law requires that for any material to be considered recycled, it “must go to responsible end markets, ensuring material actually gets recycled instead of becoming waste in landfills or the environment.”

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One in five U.S. food and beverage products is made with synthetic dyes

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One in five U.S. food and beverage products is made with synthetic dyes

Odds are, something in your pantry is colored with petroleum.

Synthetic dyes — which give fruit snacks their bright colors and cereals their rainbow crunch — are embedded into the everyday foods that fill grocery store shelves, often in ways consumers don’t realize. However, concern over their health effects has been growing in recent years, fueled by mounting evidence that certain synthetic dyes may harm children’s long-term health.

A new study shows that the use of these chemicals in the manufacturing of foods and beverages in the U.S. is more widespread than many might expect. Nearly 1 in 5 food items and beverages sold in the U.S. contain synthetic dyes, and many of them are commonly marketed to children.

For many Americans, synthetic dyes such as Red 40 and Yellow 5 have become invisible staples of their diet. These petroleum-derived additives are commonly added to processed food and beverages to increase visual appeal and maintain color consistency. However, emerging research has made it clear that they also increase the risk of a range of adverse neurobehavioral effects — to which children are especially susceptible.

A national study published Tuesday in the Journal of the Academy of Nutrition and Dietetics looked at nearly 40,000 products produced by the top 25 U.S. food and beverage manufacturers, and found that synthetic food dyes were present in 19% of them.

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The study also determined that products using synthetic dyes were significantly more likely to be high in added sugars and low in nutritional quality. Even more concerning, researchers found that 28% of the products in categories most commonly marketed to children, including breakfast cereals, candy and sugar-sweetened beverages, contained synthetic dyes.

Although the study focuses on the prevalence of synthetic dyes in U.S. food and beverages, Elizabeth Dunford, a lecturer at the University of New South Wales and co-author of the study, noted that its findings reinforce concerns among parents and public health experts about the potential neurological and behavioral effects of these additives.

A 2021 assessment from the California Office of Environmental Health Hazard Assessment concluded that these additives can “cause or exacerbate neurobehavioral problems in children.” Similarly, a 2022 review found that 52% of studies found a significant association between synthetic dye consumption and adverse behavioral outcomes in children, both those with and without existing behavioral disorders.

These health concerns are not limited to behavioral problems. Red 3, for example, has been shown to cause cancer in laboratory rats, and Yellow 5 has been associated with allergic reactions in some individuals. However, despite decades of concern, current U.S. Food and Drug Administration registrations are still based on studies performed 35 to 50 years ago.

In the recent study, the most common dyes that Dunford and her team found were Red 40, Yellow 5, and Blue 1, appearing in 14%, 11%, and 11% of products, respectively. Synthetic dyes were found in such products as blueberry bagels, guacamole, corn chips and hot dog buns — items that consumers might not expect them. “Even as an educated person, I’ve been tricked,” Dunford said. “Consumers can be misled … when there are all these claims on the front of the pack that say ‘healthy’ or ‘made with real fruit juice,’ but it still has dyes.”

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The study found that foods and beverages containing synthetic dyes, on average, had 141% more sugar than dye-free products. The correlation between sugar and synthetic dyes was even more pronounced when it came to products marketed to kids: foods and beverages in the five categories most heavily marketed to children had a mean total sugar content of 42.6 grams per 100 grams — 264% higher than comparable products in other categories.

This marketing strategy, which pairs bright colors with high sugar content, may be part of the reason these foods are so appealing to kids.

But Dunford said that in her personal experience, children won’t notice if they’re given replacement options without those additives. When buying snacks for one of her kid’s parties, she opted for a version of a common brand of corn chips with no synthetic dyes or preservatives. “I gave them to kids at a party, and no one said anything.” Dunford said. “This just goes to show that it’s really the marketing that drives the desire for these products and causes the problems.”

Some steps have been taken to remove synthetic dyes from food and beverages. California banned Red 3 from all foods in 2023 and prohibited six other synthetic food dyes in foods sold in schools in 2024. More recently, in January of this year, the FDA announced that Red 3 will be banned nationwide in all food products by 2027. Warning labels are another potential option to limit synthetic dye consumption, and are being used in the European Union to identify foods containing Red 40, Yellow 5, and Yellow 6.

However, the burden still falls largely on consumers to scrutinize ingredient lists and marketing claims. For many families, that means navigating a colorful and oftentimes misleading food landscape, armed with little more than the fine print on the back of a box.

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