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Health

A Nearer Have a look at the Colon Situation That Hospitalized the Pope

A Closer Look at the Colon Condition That Hospitalized the Pope

On Sunday evening, Pope Francis was operated on for a colon disease called “symptomatic stenotic diverticulitis”. The elective surgery, performed at the Gemelli Hospital in Rome, took about three hours, according to the Holy See Press Office.

Francis, 84, is generally healthy and this is the first time he has been hospitalized since he became Pope in 2013. He is vigilant and breathing alone, according to a Vatican spokesman, and is expected to be for. stay in the hospital seven days.

To a man his age, the illness, surgery, and expected recovery sound reasonable, doctors said, and he should be able to make a full recovery.

“I’m a little surprised, but not worried, about seven days in the hospital,” said Dr. Philip S. Barie, Professor Emeritus of Surgery at Weill Cornell Medical College. “That’s probably out of caution and the fact that he’s 84.”

Despite its intimidating name, symptomatic stenotic diverticulitis is a relatively common and treatable condition.

It starts out as a mild condition called diverticulosis, which is essentially a collection of bags in the wall of the colon, usually on the left side. Diverticulosis is very common: around two in three people have the pouches by the time they are 60 or 70 years old.

For most people, the bags do not cause any problems, other than occasional blood in the stool. But about 10 to 15 percent of people with diverticulosis have their pouches clogged and inflamed, which can bring patients to the emergency room.

This inflammation, called diverticulitis, “is also incredibly common,” said Dr. David R. Flum, professor of surgery at the University of Washington at Seattle.

Diverticulitis affects 3 to 5 million people each year in the United States alone and is usually treated with only antibiotics. However, in some severe cases, surgery may be required – which is also not uncommon.

“Diverticulitis is one of the most common reasons for colon surgery in the United States,” said Dr. Flum.

It is believed that diverticulosis is the result of a Western diet that is low in fiber and high in processed foods. It is common in the United States and certain countries like Scotland, and much less common in African countries, for example.

Dr. Barie recalled a senior United Nations official from Africa who had been stationed in New York for more than 20 years. The man’s dietary change during this time was enough to “develop a disease that he probably would not have gotten if he had stayed in his home country,” said Dr. Barie.

A low-fiber diet, especially if too little water is consumed, can lead to constipation. “The stool becomes smaller, harder, and harder to pass. In order to pass it, you have to create more pressure in your colon and push more, ”explained Dr. Barie.

The pressure causes the lining of the colon to sag. And if leftovers like cucumber or tomato seeds get stuck in the bags, they can ignite the food.

Each episode of diverticulitis can gradually scar and thicken the colon wall, eventually shrinking the passage about 90 percent from its typical width to just a quarter of an inch – the diameter of a # 2 pencil.

If there is no movement at all, the patient can develop a colon obstruction that requires emergency surgery. But more often, people like Francis have symptoms that are so debilitating that they consider elective surgery.

Diverticulosis causes few symptoms and can go unnoticed. The symptoms become noticeable in the inflamed state of diverticulitis.

The spectrum of symptoms varies depending on the severity of the stricture and its location in the colon. If symptoms are bad enough, doctors may order a colonoscopy to identify the stricture.

Francis could have had gas or abdominal cramps and possibly had enough pain to consider elective surgery, said Dr. Barie.

In milder stages, diverticulitis can be treated on an outpatient basis with oral antibiotics. More severe cases may require hospitalization and intravenous antibiotics.

Some severe cases could be treated long-term with only medical-grade fiber, probiotics to alter gut bacteria, and an aspirin-like drug that reduces inflammation in the colon. Dr. Flum is leading a large study comparing medical management to surgery. The start of the study was delayed by the pandemic, but is expected to be completed by 2025.

When a patient has had many attacks of diverticulitis, surgery is often the only option. “Until it gets to the point where it’s scarred and too tight, we don’t have a lot of medical options,” said Dr. Flum.

In operations like the one Francis most likely underwent, doctors remove a portion of the colon called the sigmoid colon, where diverticulitis is most common. You can remove up to a few inches to a foot of the colon and sew the cut ends.

The Pope’s operation was most likely performed using laparoscopy, which requires far fewer incisions than traditional methods. Still, up to one in five people who have this surgery can develop infections, so “infection prevention is an important thing,” said Dr. Barie.

For the first month, Francis can follow a low residue diet aimed at avoiding large bowel movements. Then he may be advised to eat a high-fiber diet to prevent diverticulitis elsewhere in the colon – although this is unlikely at his age as it takes time to develop.

It’s also a good sign that he’s fine overall. In 1957, an upper lung lobe was removed from him due to complications from tuberculosis. And for the past few years, his breathing seemed to be strained while he was speaking. In 2019, a cataract was removed from him and he was vaccinated against the coronavirus in January.

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Politics

Biden orders nearer evaluation of Covid origins as U.S. intel weighs Wuhan lab leak concept

Biden orders closer review of Covid origins as U.S. intel weighs Wuhan lab leak theory

Security personnel stand guard outside the Wuhan Institute of Virology in Wuhan as members of the World Health Organization (WHO) team investigating the origins of the COVID-19 coronavirus make a visit to the institute in Wuhan in China’s central Hubei province on February 3, 2021.

Hector Retamal | AFP | Getty Images

WASHINGTON – President Joe Biden on Wednesday announced that he has ordered a closer intelligence review of what he said were two equally plausible scenarios of the origins of the Covid-19 pandemic.

Biden revealed that earlier this year he tasked the Intelligence Community with preparing “a report on their most up-to-date analysis of the origins of Covid-19, including whether it emerged from human contact with an infected animal or from a laboratory accident.”

“As of today, the U.S. Intelligence Community has ‘coalesced around two likely scenarios’ but has not reached a definitive conclusion on this question,” Biden said in a statement.

“Here is their current position: ‘while two elements in the IC leans toward the former scenario and one leans more toward the latter – each with low or moderate confidence – the majority of elements do not believe there is sufficient information to assess one to be more likely than the other,” said the president.

Biden used the Intelligence Community’s traditional language when they provide assessments to a president. This includes explaining to the president when different agencies within the IC disagree, and always giving the president the level of confidence they have in the accuracy of the raw intelligence.

Biden issued the new directives as the origins of the coronavirus pandemic, still officially unknown, come under increasing scrutiny.

The hypothesis that the virus may have escaped from a laboratory, while initially dismissed by some as a conspiracy theory, has in recent months gained more mainstream traction.

Centers for Disease Control and Prevention Director Dr. Rochelle Walensky last week said in Senate testimony that a lab-leak origin “certainly” was “one possibility.”

White House officials told reporters Tuesday that China hasn’t been “completely transparent” in the global investigation into the origins of Covid-19, and that a full investigation is needed to determine whether the virus that’s killed almost 3.5 million people came from nature or a lab.

“We need to get to the bottom of this, whatever the answer may be,” White House senior covid-19 advisor Andy Slavitt told reporters at a covid briefing Tuesday. “We need a completely transparent process from China, we need the [World Health Organization] to assist in that matter and we don’t feel like we have that now.”

The World Health Organization said in March that it was “extremely unlikely” that the virus was introduced to humans through an accidental lab leak. But that report was heavily criticized by scientists who said the WHO gave the possibility of a lab accident short shrift compared with a natural-origin scenario..

“The report lacks crucial data, information, and access. It represents a partial and incomplete picture,” White House press secretary Jen Psaki said at the time when asked about WHO’s stance on Covid’s origins.

The Office of the Director of National Intelligence, which leads the nation’s 18 intelligence agencies, did not immediately respond to CNBC’s request for comment.

The Chinese Embassy in Washington, D.C., did not immediately respond to CNBC.

This is breaking news. Please check back for updates.

—- CNBC’s Kevin Breuninger and Amanda Macias contributed to this story.

Categories
Business

U.S. and Europe Transfer Nearer to Truce in Trump-Period Commerce Spat: Dwell Updates

Working on a steel pipe at the Iron S.p.A. factory in Assisi, Italy. Former President Donald J. Trump’s administration imposed steel tariffs on several countries in 2018.

Here’s what you need to know:

Credit…Gianni Cipriano for The New York Times

The United States and the European Union said Monday they had begun discussions to resolve a conflict over steel and aluminum imports that was a major front in the Trump administration’s trade wars and a serious burden on trans-Atlantic relations.

As part of a truce announced Monday, the European Union will not, as planned, increase tariffs on products like United States whiskey, orange juice and motorcycles, which the bloc imposed in 2018 in retaliation for duties that the Trump administration imposed on European steel and aluminum. The higher tariffs were scheduled to take effect June 1.

The talks about steel and aluminum are part of an effort by the Biden administration to rebuild relations between the United States and Europe after the Trump administration treated the bloc like an adversary, sometimes threatening to leave NATO and citing national security as a justification for charging 25 percent tariffs on imports of European steel and 10 percent on aluminum.

In March, the United States and European Union temporarily suspended tariffs on billions of dollars of each others’ aircraft, wine, food and other products as they worked to settle a long-running dispute involving Boeing and Airbus, the two leading airplane manufacturers. The United States also temporarily suspended retaliatory tariffs against British products like Scotch whisky that had been imposed as part of the dispute over aircraft subsidies.

Some European officials had hoped President Biden would simply lift the Trump-era tariffs, which are unpopular with businesses on both sides of the Atlantic. But the administration is moving cautiously and is likely to seek something in return, mindful that the tariffs are welcomed in steelmaking regions like Pennsylvania.

In a joint statement, Katherine Tai, the U.S. trade representative; Gina M. Raimondo, the secretary of commerce; and Valdis Dombrovskis, the top European Union trade official, said they would discuss how to address a global glut in steel products that poses “a serious threat to the market-oriented E.U. and U.S. steel and aluminum industries and the workers in those industries.”

The United States and European Union are “allies and partners, sharing similar national security interests as democratic, market economies,” the officials said, adding that they would work together to “hold countries like China that support trade-distorting policies to account.”

Starbucks has announced that masks will be optional for vaccinated customers as of Monday, unless local regulations require them.Credit…Eze Amos for The New York Times

Target on Monday joined a growing list of retailers, restaurants and theme parks that will allow fully vaccinated customers to go mask free, following new coronavirus safety guidance from the federal government last week that said vaccinated people rarely transmit the virus.

[Answers to your questions about vaccines and masks at work.]

The Centers for Disease Control and Prevention on Thursday took many businesses by surprise when it said that people who are vaccinated could go maskless in most places, including indoors. For businesses, the announcement was complicated by the fact that C.D.C. guidance does not override state and local rules. But several major companies have already moved to relax mask requirements. Businesses for the most part have not said they would require customers to show proof that they have been vaccinated.

Here’s the latest on companies that are changing their mask policies.

Costco, which has more than 500 U.S. stores, said it would allow fully vaccinated customers to go mask-free where state and local guidance allowed. The retailer said it would “not require proof of vaccination” but would ask for its customers’ “responsible and respectful cooperation with this revised policy.”

Publix, which has 1,270 grocery stores in the Southeast, said “face coverings are optional for fully vaccinated individuals inside Publix stores” subject to local regulations.

Starbucks, which has 32,000 cafes worldwide, said that facial coverings would be optional for vaccinated customers beginning on Monday, unless local regulations requireed them. Employees at Starbucks locations in the United States and Canada will still be required to wear masks.

Target, which has 1,909 stores in the United States, said it would no longer require fully vaccinated customers and employees to wear face coverings, except where required by local ordinances. The retailer said that it masks would still be “strongly recommended” for both shoppers and staff members who were not fully vaccinated.

Trader Joe’s, which operates 517 grocery stores across the country, said that customers who were fully vaccinated no longer needed to wear masks in its stores. It will not require proof of vaccination “as we trust our customers to follow C.D.C. guidelines,” a spokeswoman, Kenya Friend-Daniel, said in an email. Masks are still required for store employees.

Walmart said that vaccinated customers were allowed to go maskless starting May 18 in areas that did not have stricter mandates. A spokesman for the company, which operates more than 4,000 Walmart and nearly 600 Sam’s Club stores in the United States, said it expected its customers to abide by the honor system. Employees can also go mask-free by answering “yes” to a vaccination question that is part of a daily health assessment.

Walt Disney World Resort in Florida said that it was no longer requiring visitors to wear masks in most outdoor areas as of this weekend, though masks are still required in indoor locations. Disneyland in California continues to require masks indoors and out because of state mandates. Disney’s chief executive, Bob Chapek, said on an earnings call Thursday that the company had begun to increase capacity and that the C.D.C.’s new guidance “is very big news for us, particularly if anybody’s been in Florida in the middle of summer with a mask on.” About 150 million people visited Disney’s parks in 2019.

Hershey Park in Pennsylvania said it would no longer require masks nor social distancing for fully vaccinated guests. The theme park, which drew 3.4 million visitors in 2019, said it would rely on its guests to “accurately follow the guidelines based on their vaccination status.”

Universal Orlando Resort said masks were no longer required when outdoors but still must be used in “all indoor locations.” Its theme park in California will still require masks both outside and inside because of the state rules.

One of the 40,000 DVD rental kiosks operated by Redbox in the United States.Credit…Stuart Isett for The New York Times

Redbox, the company best known for its DVD-rental kiosks, is going public by merging with a special purpose acquisition company, or SPAC, in a deal that values the company at $693 million, the DealBook newsletter was the first to report.

Redbox’s parent, Outerwall, was acquired by the private equity firm Apollo Global Management in 2016 at a $1.6 billion valuation; it later separated the group’s businesses, which included Redbox, Coinstar and ecoATM. Apollo is rolling over all of its equity in Redbox as part of the deal, which also includes a $50 million investment led by Ophir Asset Management.

Redbox has some 40,000 kiosks across the United States, more than there are McDonald’s and Starbucks combined. Are they needed in the age of Netflix? Redbox gets its DVDs long before many movies arrive on subscription services, said its chief executive, Galen Smith, and its customers are more value-conscious than the typical Netflix streamer. Many are also late adopters to streaming, perhaps because they can’t afford broadband access, Mr. Smith said.

The physical rental business was in decline at the time of Apollo’s acquisition, and revenue from DVDs fell more than a third last year, to around $500 million, as the pandemic held up new releases. As the backlog clears, the company is expecting a rebound. There is a “very long tail for the physical business,” Mr. Smith said.

Redbox is also hoping to convert loyal customers to its own streaming business, which accounted for about 8 percent of its revenue last year. It partners with brands like Showtime and is also creating its own content. Once seen as a threat to the studios, Redbox is now considered an important buyer. “We can create value in helping these studios reach consumers that they otherwise wouldn’t be able to reach through our platform,” Mr. Smith said.

The Internal Revenue Service delayed the tax filing deadline by a month, to May 17.Credit…Susan Walsh/Associated Press

It’s May 17 and it’s Tax Day, the deadline for filing your 2020 taxes. The Internal Revenue Service in March said that Americans who needed it could take extra time to file their taxes. That time has arrived.

The one-month delay from the usual April deadline did not offer as much extra time as the I.R.S. gave people last year, when the filing deadline was pushed to July 15. But the aim was the same: to make it easier for taxpayers to get a handle on their finances — as well as tax changes that took effect this year with the signing of the American Rescue Plan.

Still have questions? Here are some articles that might help.

How the Pandemic Has Changed Your Taxes

New rules for a new reality, from stimulus payments to retirement withdrawals to unemployment insurance, could cut your bill or even generate extra refunds.

The Tax Filing Deadline Was Delayed, but Read the Fine Print

The federal government and most states pushed back the date to May 17, but others have gone their own way. It’s a good idea to double-check deadlines.

The Tax Headaches of Working Remotely

“Each state has its own rules,” one tax expert says. So if you worked in a state other than your usual one in 2020, here are some tips on dealing with the tax season.

For Gig Workers and Business Owners, Taxes Are Even Trickier Now

Filing taxes has never been simple for freelancers and business owners, but the pandemic has made it far more complex.

A Break for Working Families

The government is allowing people who qualify for the earned-income tax credit to use income from either 2020 or 2019, whichever will result in a bigger credit.

Ryanair, the Irish low-cost airline, said it has seen signs that a recovery in air travel and tourism “has already begun.”Credit…Albert Gea/Reuters

U.S. stocks slipped in early trading on Monday and most European equity indexes were lower, reversing some of Friday’s rally.

The S&P 500 fell about 0.2 percent, while the Stoxx Europe 600 dropped 0.1 percent.

The Wall Street benchmark rose on Friday, but the increase was not enough to reverse a decline of 1.4 percent for the week, when faster-than-expected inflation data rattled markets.

Traders are watching inflation data closely because if it shows signs of a substantial and sustained rise central bank policymakers might pull back on monetary stimulus. On Wednesday, the central bank will publish minutes of its April policy meeting.

  • Discovery shares rose 8 percent in early trading after confirming it would merge with AT&T’s media business, including the WarnerMedia assets, to create a new giant company. AT&T shares rose more than 3 percent.

  • The FTSE 100 in Britain fell 0.4 percent even as England entered the next stage of its exit from lockdown. Indoor dining and hotels reopened as well as entertainment venues such as museums and cinemas. But an increase in the number of cases of the coronavirus variant first detected in India has raised concerns about the easing of restrictions.

  • Ryanair shares rose slightly after the airline reported a loss of 815 million euros (or $991 million) in the year through March but said that it expected a “strong recovery” in air travel and tourism in the second half of this fiscal year. “The recent strong increases in weekly bookings since early April suggests that this recovery has already begun,” the earnings release said.

  • Taiwan’s stock index dropped 3 percent as the island battles its worst coronavirus outbreak. Its government imposed tougher restrictions, including closing cinemas and limiting the size of gatherings, and encouraged people not to panic buy essentials.

  • Oil prices rose slightly. The West Texas Intermediate, the U.S. benchmark, rose 0.3 percent to $65.58 a barrel.

  • Bitcoin fell to about $45,000 on Monday morning, though it recovered some of its losses from the weekend after Elon Musk said Tesla hadn’t sold any Bitcoin. The electric carmaker bought $1.5 billion of the cryptocurrency earlier this year but Mr. Musk recently suspended plans to accept Bitcoin for car payments.

The paper’s conclusions suggest that economic programs embraced by President Biden may be useful in raising wages.Credit…Stefani Reynolds for The New York Times

Two economists at the liberal Economic Policy Institute conclude in a new paper that the government is to blame for the fact that pay for middle-income workers has increased only slightly since the 1970s.

“Intentional policy decisions (either of commission or omission) have generated wage suppression,” write Lawrence Mishel and Josh Bivens.

Included among these decisions are policymakers’ willingness to tolerate high unemployment and to let employers fight unions aggressively, trade deals that force workers to compete with low-paid labor abroad and the tacit or explicit blessing of new legal arrangements, like employment contracts that make it harder for workers to seek new jobs.

Dr. Mishel and Dr. Bivens argue that a decades-long loss of leverage largely explains the gap between the pay increases that workers would have received had they benefited fully from rising productivity, and the smaller wage and benefit increases that workers actually received, Noam Scheiber reports for The New York Times.

Drawing on existing measures of the relationship between unemployment and wages, Dr. Mishel and Dr. Bivens estimate that excess unemployment lowered wages by about 10 percent since the 1970s, explaining nearly one-quarter of the gap between wages and productivity growth.

They perform similar calculations for other factors that undermined workers’ bargaining power: the decline of unions; a succession of trade deals with low-wage countries; and increasingly common arrangements like “fissuring,” in which companies outsource work to lower-paying firms, and noncompete clauses in employment contracts, which make it hard for workers to leave for a competitor.

Together, Dr. Mishel and Dr. Bivens conclude, these factors explain more than three-quarters of the gap between the typical worker’s actual increases in compensation and their expected increases, given the productivity gains.

The C.D.C.’s new guidance on masks comes with caveats.Credit…Whitten Sabbatini for The New York Times

Are companies responsible for making sure that every employee without a mask is vaccinated against the coronavirus?

What if unvaccinated employees infect their co-workers — is the company potentially liable? Will companies ask their employees to take Covid-19 tests?

Millions of office workers who have been able to do their job from home during the pandemic are now thinking seriously about returning to work. The prospect raises myriad health safety and workplace protocol questions for employees and companies.

Lauren Hirsch of The New York Times’s DealBook team spoke to lawyers, employers and human resources professionals about some of the questions.

Generally, employers are allowed to require employees to be vaccinated. The Equal Employment Opportunity Commission issued guidance in December stating that vaccine mandates are legal. But this is complicated by proposed legislation in a number of states that would restrict companies’ abilities to set such requirements.

Whether executives are prepared to follow through on the implications of a vaccine mandate is also up for debate.

“If they want to permit employees to remove masks indoors, yes, I believe it does put the burden on the employer to verify,” said Kristin White, a lawyer at Fisher Phillips who specializes in workplace safety regulations.

The White House is also reviewing a new emergency standard on Covid workplace protections from the Occupational Safety and Health Administration. Labor groups have been pushing for new rules for about a year. OSHA suggests social distancing and masks in the workplace — but a temporary standard would establish requirements. Any new standard now needs to consider the new C.D.C. guidance.

As vaccination numbers rise and the number of Covid-19 cases drop, it’s natural for companies to rethink their workplace plans, said Joseph Allen, who is the director of Harvard’s Healthy Buildings Program and advises companies on Covid-19 strategy.

“What was state-of-the-art last year is not state-of-the-art right now,” he said. “The science has changed, the plans should change.”

Categories
Business

GrowGeneration seems to be east with New York nearer to legalizing hashish

Senators say they will push pot bill in 2021

Darren Lampert, CEO of GrowGeneration, told CNBC on Thursday that the company is focused on expansion on the east coast as New York State gets just inches closer to legalizing recreational marijuana.

“You will see us shortly enter the markets on the east coast,” he said in an interview with Jim Cramer about “Mad Money”.

New York lawmakers could put a bill to legalize marijuana for a vote in the congregation as early as next week, Associated Press reports. If passed, the bill is expected to be signed by Democratic Governor Andrew Cuomo.

Next door in New Jersey, marijuana is now legal for recreational use, though the state still has rules and regulations for its sale. GrowGeneration, which operates dozen of grow businesses across the country, plans to open stores in New Jersey soon.

“We are still waiting for the licensing to confirm how big the licensing will be, how restrictive it will be,” he said. “More importantly, craft licensing … unlimited craft licensing, which is great for GrowGeneration.”

GrowGeneration operates more than 50 grow shops in 12 states. Most are in the western part of the country, many in California. The company operates a handful of stores in Maine, Florida and Massachusetts.

The company sells the “picks and shovels” products like lights and hydroponics that are used to grow cannabis indoors, Lampert said.

“What you are seeing now, Jim, is a fundamental change [in] controlled environment ag, “he said.” We sell the inputs. We sell the technologies, the solutions that control the environment in which plants live. “

On Wednesday, GrowGeneration reported total annual sales of $ 193.0 million in 2020, up 143% year over year. It was the third year in a row that the company had posted triple-digit sales growth. Executives expect business to more than double again this year.