Health
A First: New Guidelines Back Device for Treating Strokes
This undated photo provided by Covidien, part of Minneapolis-based Medtronic Inc., shows their stent used to clear blood clots in the brain that cause strokes. The American Heart Association has endorsed using removable stents to open clogged arteries causing a stroke. It’s the first new stroke treatment to be backed by the group in nearly 20 years and the first device ever recommended for this purpose. (Stan Sholik/Covidien, Medtronic, via AP)
MARILYNN MARCHIONE, AP Chief Medical Writer
Many stroke patients have a new treatment option — if they seek help fast enough to get it. New guidelines endorse using a removable stent to open clogged arteries causing a stroke.
The guidelines, issued Monday by the American Heart Association, are the first time the group has recommended a device for treating strokes, and it’s the first new stroke treatment in two decades to win the group’s strongest backing. The federal government no longer issues guidelines like these, so the Heart Association’s advice clears the way for more doctors to offer the treatment.
“It is pretty exciting,” and many patients will benefit if they seek help when symptoms first appear, said the head of the guidelines panel, Dr. William J. Powers, neurology chief at the University of North Carolina at Chapel Hill.
Most of the 800,000 strokes in the U.S. each year are caused by a blood clot lodged in the brain. The usual treatment is a clot-dissolving medicine called tPA, and it remains the first choice.
But the drug must be given within 4½ hours after symptoms start, and most people don’t seek help in time. The drug also fails to work in one or two of every four cases, Powers said.
The device is called a stent retriever. It’s a tiny mesh cage that is pushed through a tube into a blood vessel and guided to the clot, like the stents long used to treat blocked heart arteries. But unlike heart stents, which are left in place to prop the artery open, brain stents trap the clot and are removed with it.
Earlier this year, several major studies found these devices dramatically cut the risk of death or disability in people whose clots persisted after treatment with tPA.
The guidelines say these patients now can be treated with a stent retriever if it can be done within six hours of symptom onset, they have a severe stroke caused by a clot in a large artery, and have brain imaging showing that at least half of the brain on the side of the stroke is not permanently damaged.
The benefit of stent retrievers beyond six hours, or for people not treated first with tPA, is unknown.
“We think it probably works in some of them but we just don’t have the hard evidence” to recommend it, Powers said.
Where patients seek help matters. Only major stroke centers can do the technically difficult procedure with stent retrievers.
Two brands are sold in the U.S. — Trevo, made by Stryker Corp. of Kalamazoo, Michigan, and Solitaire, made by Covidien, now part of Minneapolis-based Medtronic Inc.
Medtronic and Covidien help sponsor an American Heart Association/American Stroke Association program aimed at helping people recognize stroke symptoms — sudden onset of any of these: numbness or weakness on one side, severe headache with no known cause, confusion, and trouble walking, speaking or seeing.
But the companies had no role in shaping the guidelines. Two of the 19 experts involved in the guidelines have consulted for device makers.
___
Online:
Guideline: http://my.americanheart.org/statements
Stroke info: http://stroke.nih.gov/
and http://www.strokeassociation.org
___
Marilynn Marchione can be followed at http://twitter.com/MMarchioneAP
Copyright 2015 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.
Community
As Part of Your Back-to- School Checklist, Vaccinate
POST NEWS GROUP — Vaccines protect your household and also limit the spread of diseases such as measles and polio. The higher the vaccination rate in a community, the greater the protection for everyone – especially the most vulnerable.
Berkeley Public Health recommends families catch up on immunizations before the new school year begins
Parents, check that your children return to school up to date on vaccinations. If necessary, schedule a visit with your family’s doctor or with the City of Berkeley’s Immunization Clinic to catch up.
Vaccines protect your household and also limit the spread of diseases such as measles and polio. The higher the vaccination rate in a community, the greater the protection for everyone – especially the most vulnerable.
Families are encouraged to:
- Check their child’s vaccination records. Ask their health care provider or check California’s Digital Vaccine Record portal.
- Schedule a check-up with your child’s doctor.
If your child doesn’t have a health care provider, you may be able to access free vaccinations through the City of Berkeley’s Immunization Clinic. Make an appointment by calling (510) 981-5350, emailing phmailbox@berkeleyca.gov, or booking online.
See what shots are required for pre-kindergarten or TK-12th grade, and check that your kids have all their recommended vaccines.
FREE VACCINE CLINICS AUG. 4-13
Children without health insurance or whose insurance doesn’t cover vaccines can get them for free:
City of Berkeley Immunization Clinic
West Berkeley Family Wellness Center
1900 Sixth St.
Hours: Tuesdays–Thursdays, 9 a.m.–3 p.m.
Closed 12 p.m.–1 p.m.
Make an appointment between Aug. 4–6 or Aug. 11–13 for back-to-school vaccine clinics:
- Call: (510) 981-5350
- Email: phmailbox@berkeleyca.gov
- Book online
Children 18 years and under are eligible for free City vaccines if they are:
- Medicaid-eligible
- Uninsured
- Underinsured (insurance does not cover vaccines)
- American Indian or Alaska Native
If you are unsure whether you or your child is up to date, the City of Berkeley Vaccination Clinic can help review records and provide recommended vaccines.
FAMILY WELLNESS RESOURCES
Vaccines are just one of the many public health services you can access at the West Berkeley Family Wellness Center. The center is home to the Women, Infants, and Children program, nutrition support, case management services, and a variety of family support services, plus free classes throughout the year.
Vaccinations aren’t just for kids. Throughout adult life, everyone should keep up with their vaccination needs. See recommended vaccines for adults.
Get a healthy start to the school year. Check your child’s vaccinations. Make an appointment with your doctor or get free vaccines at the City clinic.
VACCINE INFORMATION AND FAMILY RESOURCES
- City of Berkeley Immunization Clinic
- TK–12 school vaccine requirements:
- Family support services:
Get trusted information about the City of Berkeley by bookmarking berkeleyca.gov, subscribing to our newsletter, and following us on Bluesky and Instagram.
Community
As Part of Your Back-to- School Checklist, Vaccinate
POST NEWS GROUP — Vaccines protect your household and also limit the spread of diseases such as measles and polio. The higher the vaccination rate in a community, the greater the protection for everyone – especially the most vulnerable.
Berkeley Public Health recommends families catch up on immunizations before the new school year begins
Parents, check that your children return to school up to date on vaccinations. If necessary, schedule a visit with your family’s doctor or with the City of Berkeley’s Immunization Clinic to catch up.
Vaccines protect your household and also limit the spread of diseases such as measles and polio. The higher the vaccination rate in a community, the greater the protection for everyone – especially the most vulnerable.
Families are encouraged to:
- Check their child’s vaccination records. Ask their health care provider or check California’s Digital Vaccine Record portal.
- Schedule a check-up with your child’s doctor.
If your child doesn’t have a health care provider, you may be able to access free vaccinations through the City of Berkeley’s Immunization Clinic. Make an appointment by calling (510) 981-5350, emailing phmailbox@berkeleyca.gov, or booking online.
See what shots are required for pre-kindergarten or TK-12th grade, and check that your kids have all their recommended vaccines.
FREE VACCINE CLINICS AUG. 4-13
Children without health insurance or whose insurance doesn’t cover vaccines can get them for free:
City of Berkeley Immunization Clinic
West Berkeley Family Wellness Center
1900 Sixth St.
Hours: Tuesdays–Thursdays, 9 a.m.–3 p.m.
Closed 12 p.m.–1 p.m.
Make an appointment between Aug. 4–6 or Aug. 11–13 for back-to-school vaccine clinics:
- Call: (510) 981-5350
- Email: phmailbox@berkeleyca.gov
- Book online
Children 18 years and under are eligible for free City vaccines if they are:
- Medicaid-eligible
- Uninsured
- Underinsured (insurance does not cover vaccines)
- American Indian or Alaska Native
If you are unsure whether you or your child is up to date, the City of Berkeley Vaccination Clinic can help review records and provide recommended vaccines.
FAMILY WELLNESS RESOURCES
Vaccines are just one of the many public health services you can access at the West Berkeley Family Wellness Center. The center is home to the Women, Infants, and Children program, nutrition support, case management services, and a variety of family support services, plus free classes throughout the year.
Vaccinations aren’t just for kids. Throughout adult life, everyone should keep up with their vaccination needs. See recommended vaccines for adults.
Get a healthy start to the school year. Check your child’s vaccinations. Make an appointment with your doctor or get free vaccines at the City clinic.
VACCINE INFORMATION AND FAMILY RESOURCES
- City of Berkeley Immunization Clinic
- TK–12 school vaccine requirements:
- Family support services:
Get trusted information about the City of Berkeley by bookmarking berkeleyca.gov, subscribing to our newsletter, and following us on Bluesky and Instagram.
Black History
Closing the Gap: What the Data and Frontline Experiences Reveal About Cancer in Black California
OAKLAND POST — According to a UC Davis study, “The Burden of Cancer Among Black/African Americans in California,” Black cancer patients were more likely than White patients to be diagnosed at a later stage and to have multiple health conditions, making treatment more difficult. They were also far more likely to live in low-income communities and rely on public insurance—evidence that economic inequality and barriers to care are helping drive disparities in the state’s cancer crisis.
Photo
Kris Benz, a disabled Black veteran, is no stranger to cancer. In 2012, he was diagnosed with salivary duct carcinoma, a cancer so rare it strikes only about 1 in a million people each year.” But he beat it after six weeks of radiation and removal of his right salivary gland.
“I was cancer-free after six months,” he said.
Now, a new concerning mass has appeared in his neck despite months of scans. His doctor suspects it is cancerous, but Benz, who lives near Palm Springs, will not know for certain until a biopsy.
Compounding that uncertainty is a gap in his coverage. Benz is two work credits short of qualifying for Medicare, but returning to work could jeopardize his Department of Veterans Affairs (VA) disability status and funding. Buying Medicare Part A would cost $568 a month, leaving him “winging it.”
Benz is also frustrated that the VA will not schedule his scan and biopsy before his consultation, which will require another round of appointments afterward.
“It’s about money,” he said. “Doctor’s appointments, they get the money. There’s no preventive medicine here anymore.”
Although he calls the VA “a great organization,” he believes it is hampered by bureaucracy. For now, he remains “in limbo” waiting to complete his appointments.
His experience reflects one of the most persistent health equity challenges facing Black communities: access to care.
According to a UC Davis study, “The Burden of Cancer Among Black/African Americans in California,” Black cancer patients were more likely than White patients to be diagnosed at a later stage and to have multiple health conditions, making treatment more difficult. They were also far more likely to live in low-income communities and rely on public insurance—evidence that economic inequality and barriers to care are helping drive disparities in the state’s cancer crisis.
That same study reports that between 2014 and 2018, the ten cancers most frequently diagnosed among Black/African American women in California were, from one to ten, breast, lung, colorectal, uterine, pancreatic, kidney, non-Hodgkin lymphoma, thyroid, myeloma, and ovarian cancers. During the same period, the ten most commonly occurring cancers among Black/African American men in California were, from one to ten, prostate, lung, colorectal, kidney, bladder, liver, non-Hodgkin lymphoma, pancreatic, myeloma, and oropharyngeal cancers.
Researchers attribute the gaps not to biology but to social and economic inequality connected to structural racism. An American Cancer Society analysis found educational attainment was a stronger predictor of the mortality gap than race alone.
“These disparities are not because Black people are inherently less healthy,” said Rhonda Smith, executive director of the California Black Health Network. “They are the result of decades of inequitable policies, structural racism, unequal access to quality care, and chronic underinvestment in our communities.”
Dr. Flojaune Cofer, an epidemiologist and public health policy expert, said health outcomes are shaped as much by circumstances as by biology. She traced her understanding of disparities to her father’s death from heart disease at age 47. He began smoking as a child when tobacco companies marketed cigarettes aggressively and disproportionately to Black communities.
“My father’s story is not about individual choices,” Cofer said. “My father’s story speaks to institutional and systemic harm.”
“Health is not just what happens in the doctor’s office,” she added. Social determinants include neighborhood conditions, housing stability, nutritious food, transportation, and the ability to take time off work for care.
At federally qualified health centers, tight appointment schedules can make it difficult for medical providers to detect cancer early and earn the trust patients need to discuss troubling symptoms.
“We have only 15 minutes when you are working in a federally qualified health center — you have 15 minutes to assess, diagnose, treat, and write your note per patient,” said Jamie Garcia, a registered nurse who has been certified in oncology nursing for more than a decade and works at AdventHealth White Memorial in East Los Angeles.
Garcia said the rushed pace, driven partly by billing requirements tied to federal funding, leaves little time for providers to build relationships with patients. It can also allow health care professionals’ implicit biases to go unrecognized and unchallenged.
For Garcia’s patients, who are predominantly Black and Latino residents of surrounding communities, the consequences can be immediate and alarming. Many arrive with visibly advanced tumors after going without insurance, adequate coverage, a primary care physician or routine screenings.
Garcia recalled treating one patient whose tumor had grown large enough to be visible through the skin.
“The fact that I even got to see that is a failure and an atrocity,” she said.
Assemblymember Lori D. Wilson (D-Suisun City) sought to reduce another barrier through Assembly Bill 1570, which would have eliminated out-of-pocket costs for medically necessary diagnostic and supplemental breast imaging. It passed the Assembly Health Committee 16-0 but died in the Appropriations Committee. Wilson plans to reintroduce it during the next legislative session without biopsy coverage.
Wilson announced her breast cancer diagnosis in April 2023. She received timely, quality care but “saw others with similar diagnoses face different outcomes.”
“Some people who got diagnosed at the same time as me — their timing of their surgeries and treatment was delayed in comparison to my own,” she said. “Watching people go through and suffering unnecessarily was heartbreaking to me.”
Her follow-up imaging required only a $10 copay. “I’ve had friends have to pay $1,000 to get that secondary screening,” Wilson said.
Smith warned that policy changes could further erode access. California’s Every Woman Counts screening program is losing funding and being scaled back, she said. About one in three Black Californians relies on Medi-Cal, according to the state.
Smith also cited federal Medi-Cal work requirements projected to cause 1.1 million Californians to lose coverage by 2029-30. “Health equity is no longer simply about improving outcomes,” she said. “It’s about protecting access.”
Californians seeking low-cost cancer screening can contact a local federally qualified health center or the California Department of Public Health’s Every Woman Counts program. The California Black Health Network also offers referrals and advocacy resources.
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As Part of Your Back-to- School Checklist, Vaccinate
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