By Avani Kalra, Chicago Tribune

CHICAGO — For decades, double lung transplants were not considered a viable option for treating lung cancer.

“It had been done, but it had always failed,” said Ankit Bharat, chief of thoracic surgery at Northwestern Medicine. “When you took out the lungs, the cancer cells would spread to the rest of the body, and it would come back a matter of months after the transplant.”

But after developing a new technique to replace damaged lungs during the height of the COVID-19 pandemic, Northwestern Medicine’s Canning Thoracic Institute has now performed more than 40 successful lung transplants on cancer patients in just two and a half years.

The operation has a 100% success rate for lung cancer patients today, and in January the hospital completed its first transplant on a patient with lungs affected by both COVID-19 and lung cancer.

Art Gillespie, a captain with the University of Chicago Police Department, contracted COVID-19 in March 2020 while visiting his uncle in a nursing home. While hospitalized with the virus, Gillespie discovered he had Stage 1 lung cancer.

Though he received treatment for COVID and chemotherapy, he developed pulmonary fibrosis, a disease that causes scarring in the lungs and makes it difficult to breathe. Ultimately, Gillespie had two-thirds of his right lung removed to treat the cancer, and, despite the operation, needed daily oxygen.

Later, Gillespie received a one-to-two-year life expectancy prognosis.

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“2022 was primarily me just becoming much more sick,” Gillespie said. “My quality of life at that point was pretty impacted. My ability to do anything, even speaking, was very taxing.”

Bharat said that Gillespie was a good candidate for a double lung transplant, especially because the transplant treatment for lung cancer had been directly developed from the technique for COVID-affected lungs.

While lung transplants had typically been performed by removing the lungs one by one, cutting first the vein that takes blood from the heart to the lungs and then the vein that takes it back, surgeons had to figure out a way that would prevent COVID bacteria from moving from the lungs to the heart, according to Bharat.

Doctors developed a technique to cut the veins simultaneously and later discovered the same technique could stop the spread of cancer cells.

“We had to make the same modifications for lung cancer,” said Rade Tomic, a pulmonologist at Northwestern Medicine who also worked on the transplant treatment. “We had to make sure we didn’t spread the cancer, or let it enter the bloodstream.”

Doctors also implemented a second step that worked to ensure the removal of cancerous cells and COVID-19 bacteria from the rest of the chest. After the lungs are removed, doctors irrigate the remaining airway and chest cavity.

Gillespie said he was initially resistant to the double transplant. He’d already had a lung surgery, and did not want to undergo another major operation. But it ultimately seemed like the only option.

Gillespie had the operation in January after being placed on the transplant list in September. He is on the way to a full recovery, he said, and hopes to return to work in the near future.

“I’m a grandfather,” Gillespie said. “The first thing I thought about was having that additional time to spend with (my grandkids), and watch them grow. That’s just an indescribable benefit.”

Tomic said these new transplant techniques will have a far-ranging and widespread impact. The treatment is already being used for other conditions such as pulmonary fibrosis, and is a lifesaving intervention for later-stage lung cancer patients who may not have another option, he said.

“The goal is to help the patient, give them a chance at a new life and an opportunity to get their life back,” Tomic said. “They are going to have a much, much longer survival than they would’ve had without the lung transplantation.”

©2024 Chicago Tribune. Visit at chicagotribune.com. Distributed by Tribune Content Agency, LLC.

By Karen Kaplan, Los Angeles Times

LOS ANGELES — Adding fluoride to drinking water is widely considered a triumph of public health. The Centers for Disease Control and Prevention says the cavity-prevention strategy ranks alongside the development of vaccines and the recognition of tobacco’s dangers as signal achievements of the 20th century.

But new evidence from Los Angeles mothers and their preschool-age children suggests community water fluoridation may have a downside.

A study published in JAMA Network Open links prenatal exposure to the mineral with an increased risk of neurobehavioral problems at age 3, including symptoms that characterize autism spectrum disorder. The association was seen among women who consumed fluoride in amounts that are considered typical in Los Angeles and across the country.

The findings do not show that drinking fluoridated water causes autism or any other behavioral conditions. Nor is it clear whether the relationship between fluoride exposure and the problems seen in the L.A.-area children — a cohort that is predominantly low-income and 80% Latino — would extend to other demographic groups.

However, the results are concerning enough that USC epidemiologist Tracy Bastain said she would advise pregnant people to avoid fluoridated water straight from the tap and drink filtered water instead.

“This exposure can impact the developing fetus,” said Bastain, the study’s senior author. “Eliminating that from drinking water is probably a good practice.”

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About 63% of Americans receive fluoridated water through their taps, including 73% of those served by community water systems, according to the CDC. In Los Angeles County, 62% of residents get fluoridated water, the Department of Public Health says.

The data analyzed by Bastain and her colleagues came from participants in an ongoing USC research project called Maternal and Developmental Risks from Environmental and Social Stressors, or MADRES. Women receiving prenatal care from clinics in Central and South Los Angeles that cater to low-income patients with Medi-Cal insurance were invited to join.

Between 2017 and 2020, 229 mothers took a test to measure the concentration of fluoride in their urine during their third trimester of pregnancy. Then, between 2020 and 2023, they completed a 99-question survey to assess their child’s behavior when their sons and daughters were 3 years old.

Among other things, the survey asked mothers whether their children were restless, hyperactive, impatient, clingy or accident-prone. It also asked about specific behaviors, such as resisting bedtime or sleeping alone, chewing on things that aren’t edible, holding their breath, and being overly concerned with neatness or cleanliness.

Some of the questions the mothers answered addressed heath problems with no obvious medical cause, including headaches, cramps, nausea and skin rashes.

Among the 229 children — 116 girls and 113 boys — 35 were found to have a collection of symptoms that put them in the clinical or borderline clinical range for inward-focused problems such as sadness, depression and anxiety. In addition, 23 were in the clinical or borderline clinical range for behaviors directed at others, such as shouting in a classroom or attacking other kids, and 32 were deemed at least borderline clinical for a combination of inward and outward problems.

What interested the researchers was whether there was any correlation between a child’s risk of having clinical or borderline clinical behavioral problems and the amount of fluoride in his or her mother’s urine during pregnancy.

They found that compared to women whose fluoride levels placed them at the 25th percentile — meaning 24% of women in the study had levels lower than theirs — women at the 75th percentile were 83% more likely to have their child score in the “clinical” or “borderline clinical” range for inward and outward problems combined. When the researchers narrowed their focus to children in the clinical range only, that risk increased to 84%, according to the study.

The researchers also found that the same increase in fluoride levels was associated with an 18.5% increase in a child’s symptoms related to autism spectrum disorder, as well as an 11.3% increase in symptoms of anxiety.

The amount of fluoride needed for mothers to go from the 25th to the 75th percentile was 0.68 milligrams per liter. As it happens, that’s nearly identical to the 0.7 mg per liter standard that federal regulators say is optimal for preventing tooth decay.

Bastain said that allowed the researchers to compare what might happen to children in two parallel universes: a typical one where their mothers consumed fluoridated water during pregnancy, and an alternate one where they didn’t.

“You can use it as a proxy for if they lived in a fluoridated community or not,” she said.

What that thought experiment shows is that children in the fluoridated community face a higher level of risk. That said, it’s not clear when that risk becomes high enough to be worrisome.

“We don’t know what the safe threshold is,” Bastain said. “It’s not like you can say that as long as you’re under the 75th percentile, there are no effects.”

The study authors’ concerns about the effects of fluoride on developing brains didn’t come out of nowhere.

The National Toxicology Program — a joint effort of the CDC, the National Institutes of Health, and the Food and Drug Administration — has been investigating the issue since 2016. In a report last year that reviewed an array of evidence from humans and laboratory animals, a working group concluded “with moderate confidence” that overall fluoride exposure at levels at or above 1.5 mg per liter “is consistently associated with lower IQ in children.”

The working group added that “more studies are needed to fully understand the potential for lower fluoride exposure to affect children’s IQ.”

A 2019 study of hundreds of mothers in Canada — where 39% of residents have fluoridated water — found that a 1-mg increase in daily fluoride intake during pregnancy was associated with a 3.7-point reduction in IQ scores in their 3- and 4-year-old children.

And among hundreds of pregnant women in Mexico, a 0.5-mg-per-liter increase in urinary fluoride went along with a 2.5-point drop in IQ scores for their 6- to 12-year-old children, researchers reported in 2017.

Bastain and her colleagues write their study is the first they are aware of that examines the link between prenatal fluoride exposure and neurobehavioral outcomes in children in the United States. The results are sure to be controversial, Bastain said, but there’s a straightforward way for pregnant people to reduce the possible risk.

“It’s a pretty easy intervention to get one of those tabletop plastic pitchers” that filter out metals, she said. “Most of them do a pretty good job of filtering out fluoride.”

©2024 Los Angeles Times. Visit at latimes.com. Distributed by Tribune Content Agency, LLC.

BY HILLEL ITALIE (AP National Writer)

NEW YORK (AP) — Albert S. Ruddy, a colorful, Canadian-born producer and writer who won Oscars for “The Godfather” and “Million Dollar Baby,” developed the raucous prison-sports comedy “The Longest Yard” and helped create the hit sitcom “Hogan’s Heroes,” has died at age 94.

Ruddy died “peacefully” Saturday at the UCLA Medical Center, according to a spokesperson, who added that among his final words were, “The game is over, but we won the game.”

Tall and muscular, with a raspy voice and a city kid’s swagger, Ruddy produced more than 30 movies and was on hand for the very top and very bottom, from the “Godfather” and “Million Dollar Baby” to “Cannonball Run II” and “Megaforce,” nominees for Golden Raspberry awards for worst movie of the year.

Otherwise, he had a mix of successes such as “The Longest Yard,” which he produced and created the story for, and such flops as the Arnold Schwarzenegger thriller “Sabotage.” He worked often with Burt Reynolds, starting with “The Longest Yard” and continuing with two “Cannonball Run” comedies and “Cloud Nine.” Besides “Hogan’s Heroes,” his television credits include the movies “Married to a Stranger” and “Running Mates.”

Nothing looks better on your resume than “The Godfather,” but producing it endangered Ruddy’s job, reputation and his very life. Frank Sinatra and other Italian Americans were infuriated by the project, which they feared would harden stereotypes of Italians as criminals, and real-life mobsters let Ruddy know he was being watched. One night he heard gunfire outside his home and the sound of his car’s windows being shot out.

On his dashboard was a warning that he should close the production, immediately.

Ruddy saved himself, and the film, through diplomacy; he met with crime boss Joseph Colombo and a couple of henchmen to discuss the script.

“Joe sits opposite me, one guy’s on the couch, and one guy’s sitting in the window,” Ruddy told Vanity Fair in 2009. “He puts on his little Ben Franklin glasses, looks at it (the script) for about two minutes. What does this mean “fade in?” he asked.’”

Ruddy agreed to remove a single, gratuitous mention of the word “mafia” and to make a donation to the Italian American Civil Rights League. Colombo was so pleased that he urged Ruddy to appear with him at a press conference announcing his approval of the movie, a gathering that led to Ruddy’s being photographed alongside members of organized crime.

With the stock of parent company Gulf & Western dropping fast, Paramount fired Ruddy, only to have director Francis Coppola object and get him rehired. In the end, mobsters were cast as extras and openly consulted with cast members. Ruddy himself made a cameo as a Hollywood studio guard.

“It was like one happy family,” Ruddy told Vanity Fair. “All these guys loved the underworld characters, and obviously the underworld guys loved Hollywood.”

With a cast including Marlon Brando, Al Pacino and Robert Duvall, “The Godfather” was a critical and commercial sensation and remains among the most beloved and quoted movies in history. When Ruddy was named winner of the best picture Oscar at the 1973 ceremony, the presenter was Clint Eastwood, with whom he would produce “Million Dollar Baby,” the best picture winner in 2005. Upon the 50th anniversary of “The Godfather,” in 2022, Ruddy himself became a character. Miles Teller played him in “The Offer,” a Paramount+ miniseries about the making of the movie, based on Ruddy’s experiences.

“Al Ruddy was absolutely beautiful to me the whole time on ‘The Godfather’; even when they didn’t want me, he wanted me,” Pacino said in a statement. “He gave me the gift of encouragement when I needed it most and I’ll never forget it.”

Ruddy was married to Wanda McDaniel, a sales executive and liaison for Giorgio Armani who helped make the brand omnipresent in Hollywood, whether in movies or at promotional events. They had two children.

Born in Montreal in 1930, Albert Stotland Ruddy moved to the U.S. as a child and was raised in New York City. After graduating from the University of Southern California, he was working as an architect when he met TV actor Bernard Fein in the early 1960s. Ruddy had tired of his career, and he and Fein decided to develop a TV series, even though neither had done any writing.

Their original idea was a comedy set in an American prison, but they soon changed their minds.

“We read in the paper that … (a) network was doing a sitcom set in an Italian prisoner of war camp and we thought, ‘Perfect,’” Ruddy later explained. “We rewrote our script and set it in a German POW camp in about two days.”

Starring Bob Crane as the wily Col. Hogan, “Hogan’s Heroes” ran from 1965-71 on CBS but was criticized for trivializing World War II and turning the Nazis into lovable cartoons. Ruddy remembered network head William Paley calling the show’s concept “reprehensible,” but softening after Ruddy “literally acted out an episode,” complete with barking dogs and other sound effects.

While Fein continued with “Hogan’s Heroes,” Ruddy turned to film, overseeing the low-budget “Wild Seed” for Brando’s production company. His reputation for managing costs proved most useful when Paramount Pictures head Robert Evans acquired rights to Mario Puzo’s bestselling novel “The Godfather” and sought a producer for what was supposed to be a minor, profit-taking gangster film.

“I got a call on a Sunday. ‘Do you want to do The Godfather?’” Ruddy told Vanity Fair. “I thought they were kidding me, right? I said, ‘Yes, of course, I love that book’ — which I had never read.”

By AYANNA ALEXANDER (Associated Press)

WASHINGTON (AP) — During the presidential election four years ago, the Equal Ground Education Fund hired over 100 people to go door-to-door and attend festivals, college homecomings and other events to help register voters across Florida. Their efforts for this year’s elections look much different.

A state law passed last year forced them to stop in-person voter registration, cut staff and led to a significant drop in funding. Organizers aren’t sure how robust their operations will be in the fall.

Genesis Robinson, the group’s interim executive director, said the law has had a “tremendous impact” on its ability to host events and get into communities to engage directly with potential voters.

“Prior to all of these changes, we were able to operate in a space where we were taking action and prepare our communities and make sure they were registered to vote — and help if they weren’t,” he said.

Florida is one of several states, including Kansas, Missouri and Texas, where Republicans have enacted voting restrictions since 2021 that created or enhanced criminal penalties and fines for those who assist voters. The laws have forced some voter outreach groups to cease operations, while others have greatly altered or reduced their activities.

The Florida law, signed by Republican Gov. Ron DeSantis last May, imposed a $50,000 fine on third-party voter registration organizations if the staff or volunteers who handle or collect the forms have been convicted of a felony or are not U.S. citizens. It also raised the fines the groups could face, from $1,000 to $250,000, and reduced the amount of time they are able to return registration applications from 14 days to 10 days.

A federal judge blocked portions of the law earlier this month, including the one targeting felons and those who are not citizens. Even so, the law had a direct effect on the operations of Equal Ground and other voter advocacy organizations in the state before the ruling.

The League of Women Voters in Florida, one of the plaintiffs, shifted away from in-person voter registration to digital outreach. Cecile Scoon, the league’s co-president, said the law stripped the personal connection between its workers and communities. Digital tools aren’t easy to use when registering voters and can be expensive, she said.

These organizations are needed because local election officials don’t always provide adequate support and information, said Derby Johnson, a voter in Ormond Beach who attended a recent community event in Daytona Beach organized by Equal Ground. He said it appeared the Florida Legislature was just trying to make it harder for certain communities to register and cast ballots.

“There are parties actively working to suppress the vote, particularly in Black and brown communities, and these groups help educate and register voters to mitigate that,” she said.

MOVE Texas, a voting rights group that focuses on voters who are 30 or younger, adjusted to that state’s 2021 election overhaul with additional training for their staff and volunteers. Among the provisions drawing concern was one that increased criminal penalties for anyone who receives compensation for assisting a voter, which especially affected the ability to recruit high school and college students for voter registration drives.

“The law contributed to this culture of fear in our elections and being a person who registers voters,” said Stephanie Gomez, the group’s political director.

Republicans in Kansas overrode a veto by Democratic Gov. Laura Kelly to pass a bill that made it a felony if anyone registering voters impersonated or was assumed to impersonate an election official.

That forced Loud Light Kansas, a voter outreach group that focuses on minority communities, to stop its registration efforts. Would-be voters typically perceived their staff and volunteers as election workers even when told otherwise, said Anita Alexander, the organization’s vice president.

“We’re trying to engage impacted people, but we weren’t willing to risk anyone getting charged by doing voter engagement work,” she said.

Loud Light and other local voter registration groups sued the Legislature. The Democratic governor said there has been no evidence in the state of widespread voter fraud or instances of individuals impersonating election officials.

In Missouri, the state chapter of the League of Women Voters and the Missouri State Conference of the NAACP sued after the state enacted wide-ranging election legislation in 2022.

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Among other things, the new law bans compensation for those who register voters and requires that anyone who helps more than 10 people register must also register with the secretary of state’s office and be a voter themselves. Violators can face criminal penalties.

The completed secretary of state’s forms are public, which presents a privacy concern for many people who might otherwise want to help with voter registration efforts, said Denise Lieberman, director and general counsel of the Missouri Voter Protection Coalition.

“Historically, when those membership lists have been obtained, they’ve been used to intimidate. So, there’s a lot of trepidation, especially in groups that are targeting low-income or communities of color,” she said. “If you just want to volunteer for one hour on a Saturday morning to help out on your college campus or on an Earth Day or anything, you have to go through this whole process.”

The Missouri law is on hold while the legal challenge plays out, with a trial set for August.

Voting rights experts expect to see continued attempts to restrict voting and the activities of voter outreach groups in Republican-controlled states, said Megan Bellamy, vice president of law and policy at the Voting Rights Lab.

“The effort to target third-party voter registration groups is just, unfortunately, one of many policy areas that state legislatures are moving to address,” she said.

The Associated Press receives support from several private foundations to enhance its explanatory coverage of elections and democracy. See more about AP’s democracy initiative here. The AP is solely responsible for all content.