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Vaping-associated lung injuries can be attributed to vitamin E acetate, CDC says – The Verge

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The outbreak of vaping-associated lung injuries this summer and fall can officially be attributed to vitamin E acetate in THC-containing vaping products, the Centers for Disease Control said today. The new confirmation of the link between the chemical and the injuries came after a new study found it in nearly all of the lung fluid samples from a new set of patients.

As of December 17, 2,506 people have been hospitalized with e-cigarette, or vaping, product use-associated lung injury (EVALI), according to the CDC. There have been 54 deaths. The injuries started increasing in June before peaking in September, new CDC data indicates, and the number of visits to emergency departments for vaping-associated injuries have been declining since.

“It is clear that the outbreak represented a new phenomenon,” said Anne Schuchat, principal deputy director of the CDC, during a press conference. “It’s not a recognition of a common syndrome that had evaded our attention.”

Vitamin E acetate was first identified as a key focus of a statewide investigation in New York in September. It was later described as a chemical of concern by the CDC in November, after it was found in every one of a set of 29 lung fluid samples tested by the agency. Investigators also found that most patients with EVALI reported using THC-containing vaping products before their injury. Product testing by the Food and Drug Administration has found many of those products are contaminated with the chemical. It hasn’t been found in nicotine-only vaping products.

In the new study, published today in the New England Journal of Medicine, clinicians collected lung fluid samples from 51 patients with either confirmed or probable EVALI. Vitamin E acetate was found in 48 of the samples — 94 percent. The majority of the patients also had THC in their lung fluid samples. Of the 11 patients who said they had not used THC products in the 90 days before their injury, nine had detectable levels of THC.

This set of patient samples was also compared to those from a group of 99 healthy people without EVALI, who were either e-cigarette smokers (with nicotine only), traditional cigarette smokers, or non-smokers. None of the samples from healthy people had vitamin E acetate, including those from the e-cigarette smokers.

The combination of this new data, along with previous reports and product analysis, allowed the CDC to conclude that the chemical was responsible for the outbreak. “The very large increase in cases is attributable to what was happening in this past year in the supply, with vitamin E acetate diluting or tainting THC products,” Schuchat said. In Minnesota, for example, THC-containing products from 2018 did not contain vitamin E acetate, but products from 2019 did.

Vitamin E acetate is a safe dietary supplement and ingredient in topical lotions and creams, but when it’s inhaled, it may interfere with proper lung function. Heating the chemical in a vaporizer can also cause it to break down into a compound called ketene, which can irritate the lungs. More studies are underway to figure out how vitamin E acetate might cause the type of damage seen in EVALI patients. “We don’t have to hold our breath for those results, but they’ll be helpful for us to go a little deeper in understanding the problem,” Schuchat said.

She stressed, though, that there may be more than one chemical causing these injuries. Not every patient with EVALI reported using THC-containing products, and not every tested product associated with an injury contained vitamin E acetate. “This does not mean there are not other substances in e-cigarettes or vaping products that have or are capable of causing lung injury,” she said.

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Health-care announcements expected with two weeks to go in N.B. election race

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New Brunswick‘s Liberal and Green parties are set to make announcements about health care on the campaign trail today as the provincial election race enters its second half.

Liberal leader Susan Holt is scheduled to hold her announcement this morning in Saint John, N.B., followed by lunch at the city’s market.

A spokesperson with the Progressive Conservative party shared few details about the event scheduled for leader Blaine Higgs in Fredericton this morning.

Green Party Leader David Coon will hold a news conference this morning about “local health-care decision-making” alongside deputy leader Megan Mitton in her Sackville, N.B. riding.

On Saturday, Coon said he was proud to put forward a gender-balanced slate among the party’s 46 candidates.

While the Liberals and Progressive Conservatives are running with full slates, the Greens are three candidates short and will not have full representation when the province’s residents go to the polls on Oct. 21.

This report by The Canadian Press was first published Oct. 7, 2024.

The Canadian Press. All rights reserved.

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Alberta Health Services’ snag leads to potential delay of patient referrals

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EDMONTON – The Health Quality Council of Alberta is investigating how some medical referrals weren’t properly processed, potentially affecting 14,000 patients over the last five years across the province.

The referrals were made to specialists outside of Alberta Health Services, such as physiotherapists and dietitians.

The health authority’s CEO, Athana Mentzelopoulos, says it does an average 100,000 referrals per year, but in some cases it can’t confirm if patients received referral services.

She says the problem was flagged in late September, and a preliminary estimate suggests 31 patients may have experienced a potential negative outcome due to the delays.

The provincial government requested the investigation, and the quality council is to find out how the snag occurred and how it can be prevented in the future.

The health authority says it has begun notifying patients who may have been affected by the disruption, and the cases could date back to 2019.

This report by The Canadian Press was first published Oct. 4, 2024.

The Canadian Press. All rights reserved.

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Don’t fall for fake dentists offering veneers and other dental work on social media

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WASHINGTON (AP) — If you have stained or chipped teeth, you might be considering veneers, customized teeth coverings that can restore a photogenic smile without more extensive dental work.

But dentists warn that these pricey cosmetic enhancements are at the center of a worrisome online trend: unlicensed practitioners without proper training or supervision offering low-cost veneers.

These self-described “veneer techs” often promote themselves on Instagram and TikTok, promising a full set of veneers for less than half of what dentists typically charge. Some also market their own training courses and certifications for people looking to get into the business.

It’s misleading, health professionals warn — and illegal. All states require dental work, including veneers, to be performed under the supervision of a licensed dentist.

On Thursday, Georgia law enforcement officials arrested Brandon Diller, who promoted himself to 158,000 Instagram followers as “Atlanta’s top veneer specialist and trainer.” Diller practiced dentistry without a license and sold “training and certificates, which were worthless” and “provided no legitimate or legal credentials,” according to an arrest warrant from Fulton County’s District Attorney’s office.

Here’s what to know about veneers and how to avoid bogus providers and services:

What are dental veneers?

Veneers are thin, custom-made dental coverings used to hide minor imperfections or to fill in gaps between teeth. Unlike crowns or more invasive dental implants, veneers are almost always considered cosmetic dentistry and generally aren’t covered by insurance.

Dentists usually charge between $1,000 and $2,000 per tooth for veneers, with higher prices for those made from porcelain compared with lower-grade materials.

Placing veneers involves stripping some of the natural enamel from the tooth and bonding the new covering into place. Because of that process, getting veneers is considered an irreversible procedure, according to the American Dental Association. They are not permanent, and can be expected to last between 5 to 15 years before they degrade and need to be replaced.

In recent months the ADA has been stepping up warnings about the risks of veneer procedures done by unlicensed individuals.

“Quality control is lost without the involvement of a licensed dentist,” said Dr. Ada Cooper, a New York-based dentist and ADA spokesperson. “We undergo years of education and training and need to be licensed by various regulatory bodies before we can practice.”

What are the risks of getting veneers from someone who isn’t licensed?

Improper veneer procedures can cause a range of health problems, including severe pain, nerve damage and tooth loss.

Patients need to be anesthetized before the enamel is removed from their teeth.

“It could be incredibly painful if they’re not anesthetized correctly,” said Dr. Zach Truman, who runs an orthodontics practice in Las Vegas. “You can also go too deep into the tooth and penetrate what’s called the pulp chamber, which contains blood vessels and nerves.”

One of the biggest problems Truman sees with unregulated veneer work is that customers aren’t getting screened for existing dental problems, such as gum disease and cavities.

“If you put a veneer on a tooth that has an active cavity, you’re just going to seal it in there and eventually it’s going to progress to tooth loss,” Truman said.

Dental veneers aren’t the only option for improving the appearance of teeth. Over-the-counter whitening kits can help with minor stains and discoloration. And dentists can sometimes use composite materials to reshape chipped or uneven teeth. But Truman says those fillings are prone to crack and won’t last as long as veneers.

How can I spot bogus veneer providers online?

One clue: Many individuals performing unlicensed dental work promote themselves on social media as “veneer technicians.”

Instead of working out of a dental office they often perform treatments at beauty salons, hotel rooms or private homes. Some advertise multi-city tours and encourage clients to message them to book an appointment in advance.

Much of the appeal of the services is in their pricing, with some offering a full set of veneers for a flat fee of $4,000 or $5,000. That’s less than half of what patients can generally expect to pay at a dental office.

Performing dental work without an appropriate license is illegal, the ADA notes.

Dentists and hygienists are licensed by state governments, who also define the work dental assistants can perform. But in all cases, veneers and other dental procedures must be supervised by a licensed dentist.

Earlier this year, Illinois law enforcement officials arrested a woman running a business called the Veneer Experts after she posted videos of herself fitting braces, veneers and other dental products without a license. She was previously arrested in Nevada on similar allegations of practicing dentistry without a license.

What are the best ways to find legitimate dental providers?

The ADA maintains a website detailing the training and licensing requirements for dentists across the U.S. Most states also maintain websites where you can lookup and verify licensure information and find any past disciplinary actions for dentists and other health professionals.

“It’s really critical to understand that dentistry is a regulated health care profession that requires formal educations and licensure,” Cooper said.

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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.

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