Adults with periodontitis, a severe gum infection, may be significantly more likely to have higher blood pressure compared to individuals who had healthy gums, according to new research published today in Hypertension, an American Heart Association journal.
Previous studies have found an association between hypertension and periodontitis, however, research confirming the details of this association is scarce. Periodontitis is an infection of the gum tissues that hold teeth in place that can lead to progressive inflammation, bone or tooth loss. Prevention and treatment of periodontitis is cost effective and can lead to reduction of systemic markers of inflammation as well as improvement in function of the endothelium (thin membrane lining the inside of the heart and blood vessels).
“Patients with gum disease often present with elevated blood pressure, especially when there is active gingival inflammation, or bleeding of the gums,” said lead study author Eva Muñoz Aguilera, D.D.S., M.Clin.Dent., senior researcher at UCL Eastman Dental Institute in London, United Kingdom. “Elevated blood pressure is usually asymptomatic, and many individuals may be unaware that they are at increased risk of cardiovascular complications. We aimed to investigate the association between severe periodontitis and high blood pressure in healthy adults without a confirmed diagnosis of hypertension.”
The study included 250 adults with generalized, severe periodontitis (≥50% of teeth measured with gum infection) and a control group of 250 adults who did not have severe gum disease, all of whom were otherwise healthy and had no other chronic health conditions. The median age of the participants was 35 years, and 52.6% were female. The research was completed in collaboration with the department of dentistry at the Universitat Internacional de Catalunya in Barcelona, Spain.
All participants underwent comprehensive periodontal examinations including detailed measures of gum disease severity, such as full-mouth dental plaque, bleeding of the gums and the depth of the infected gum pockets. Blood pressure assessments were measured three times for each participant to ensure accuracy. Fasting blood samples were also collected and analyzed for high levels of white blood cells and high sensitivity C-reactive protein (hsCRP), as both are markers of increased inflammation in the body. Additional information analyzed as confounders included family history of cardiovascular disease, age, body mass index, gender, ethnicity, smoking and physical activity levels.
The researchers found that a diagnosis of gum disease was associated with higher odds of hypertension, independent of common cardiovascular risk factors. Individuals with gum disease were twice as likely to have high systolic blood pressure values ?140 mm Hg, compared to people with healthy gums (14% and 7%, respectively). Researchers also found: The presence of active gum inflammation (identified by bleeding gums) was associated with higher systolic blood pressure. Participants with periodontitis exhibited increased glucose, LDL (“bad” cholesterol), hsCRP and white blood cell levels, and lower HDL (“good” cholesterol) levels compared to those in the control group. Nearly 50% of participants with gum disease and 42% of the control group had blood pressure values for a diagnosis of hypertension, defined as ?130/80 mmHg.”This evidence indicates that periodontal bacteria cause damage to the gums and also triggers inflammatory responses that can impact the development of systemic diseases including hypertension,” said corresponding author Francesco D’Aiuto, D.M.D., M.Clin.Dent., Ph.D., professor of periodontology and head of the periodontology unit at the UCL Eastman Dental Institute. “This would mean that the link between gum disease and elevated blood pressure occurs well before a patient develops high blood pressure. Our study also confirms that a worryingly high number of individuals are unaware of a possible diagnosis of hypertension.”
D’Aiuto added, “Integration of hypertension screening by dental professionals with referrals to primary care professionals and periodontal disease screening by medical professionals with referrals to periodontists could improve detection and treatment of both conditions to improve oral health and reduce the burden of hypertension and its complications. Oral health strategies such as brushing teeth twice daily are proven to be very effective in managing and preventing the most common oral conditions, and our study’s results indicate they can also be a powerful and affordable tool to help prevent hypertension.”
This study did not account for other factors that may also impact blood pressure, such as abdominal obesity, salt intake, use of anti-inflammatory medications, hormone treatments or stress, or any other oral health conditions.
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Each human being is made of billions of cells. In order to ensure his survival, cells must coordinate with each other and attach in the right place to perform their tasks. Scientists from the University of Geneva (UNIGE), Switzerland, in collaboration with the University of Tampere in Finland, have highlighted the key role of a protein called paxillin, which enables cells to perceive their environment and anchor at the right place with the help of cellular “crampons.” Indeed, without functional paxillin, the cell is unable to attach properly and slips continuously. These results, to be read in the journal Communications Biology, shed new light on how cells adhere or migrate, mechanisms essential to the good functioning of our organs, but also involved in the development of metastatic tumors.
To ensure our survival, each cell performs specific functions in coordination with their neighbours. In such a dynamic system, the migration of cells and their anchoring at the right place are essential. But how do cells manage to coordinate with each other? Scientists have long believed that cells communicate mainly through chemical signals, such as hormones. However, recent discoveries suggest that mechanical signals play a major role in cell coordination. “This is why we started to study the ability of cells to decipher and respond to their physical environment,” explains Bernhard Wehrle-Haller, Professor at the Department of cell physiology and metabolism at UNIGE Faculty of Medicine. “Especially as it could help us to understand how cancer cells use these mechanisms to invade other organs and form metastases.”
From a mechanical cue to a biological signal
When a cell has to move, it “senses” its environment with the help of proteins on its surface, the integrins. When the cell detects a suitable location, a complex network of proteins, called focal adhesion, is then set up to form cellular crampons that anchor the cell to its environment. “But how is this anchoring mechanism regulated? This is what we wanted to find out,” explains Marta Ripamonti, researcher in the laboratory of Prof. Bernhard Wehrle-Haller and first author of the study.
By studying paxillin, one of the many proteins that make up these crampons, researchers were able to unravel the mystery. “We knew that this protein played a role in the assembly of focal adhesions, but we didn’t expect it to be the key regulator,” says Prof. Bernhard Wehrle-Haller with enthusiasm. Without functional paxillin, cells are unable to anchor, regardless of the suitability of their environment. In addition, paxillin has also the function of informing the cell that anchoring has taken place correctly, thus transforming a mechanical response into a biological signal that the cell can understand.
Disrupting the crampons to prevent metastases?
These in vitro experiments highlight the major role of paxillin in the migration and adhesion of healthy cells, but they could also be a starting point for a better understanding of cancer development. “It is indeed likely that cancer cells use paxillin to find a place that enhance their survival. Would it be possible to block this mechanism in tumor cells and prevent the formation of metastases? Yes, we think so! ” concludes Prof. Bernhard Wehrle-Haller.
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As NASA seeks to build a lunar outpost, visit Mars and commercialize spaceflight, the long-term effects of weightlessness on the human heart are of critical importance, according to researchers. By analyzing data from astronaut Scott Kelly’s year in space and comparing it to information from extreme long distance, which simulates weightlessness, swimming of Benoît Lecomte, researchers found that low-intensity exercise was not enough to counteract the effects of prolonged weightlessness on the heart, according to new research published today in the American Heart Association’s flagship journal Circulation.
Each time a person sits or stands, gravity draws blood into the legs. The work the heart does to keep blood flowing as it counters Earth’s gravity helps it maintain its size and function. Removing gravitational effects causes the heart to shrink.
Researchers examined data from retired astronaut Scott Kelly’s stint aboard the International Space Station from 2015 to 2016 and elite endurance swimmer Benoît Lecomte’s swim across the Pacific Ocean in 2018.
In this new study, researchers evaluated the effects of long-term weightlessness on the structure of the heart and to help understand whether extensive periods of low-intensity exercise can prevent the effects of weightlessness.
“The heart is remarkably plastic and especially responsive to gravity or its absence. Both the impact of gravity as well as the adaptive response to exercise play a role, and we were surprised that even extremely long periods of low-intensity exercise did not keep the heart muscle from shrinking,” said Benjamin D. Levine, M.D., the study’s senior author and a professor of internal medicine at UT Southwestern Medical Center and director of Texas Health Presbyterian’s Institute for Exercise and Environmental Medicine, both in Dallas.
The research team examined the health data of Kelly’s year in space aboard the International Space Station and Lecomte’s swim across the Pacific Ocean to investigate the impact of long-term weightlessness on the heart. Water immersion is an excellent model for weightlessness since water offsets gravity’s effects, especially in a prone swimmer, a specific swimming technique used by long-distance endurance swimmers.

SharecloseShare pageCopy linkAbout sharingimage copyrightAFPA French drug maker has been found guilty of aggravated fraud and involuntary manslaughter over a weight loss pill at the centre of a major health scandal.The drug Mediator was developed for use in overweight diabetics and was on the market for 33 years.It was eventually withdrawn in 2009 over concerns it could cause serious heart problems.Hundreds of people are believed to have died as a result of the drug.Around five million people were prescribed the medicine over the course of 33 years, despite various warnings over its side effects.French trial on fatal weight-loss drug beginsFrance braced for drug scandal reportFrance pledges drug system reformThousands of plaintiffs were involved in the trial, which began in 2019.Drug maker Servier had denied any knowledge of Mediator’s side effects but a court on Monday issued it with a fine of €2.7m (£2.3m, $3.2m).The company’s former chairman Jean-Philippe Seta was also given a four-year suspended prison sentence.France’s medical regulator, meanwhile, was fined more than €300,000 for its role in the scandal. The judge found the body had “seriously failed” in its duties, according to the AFP news agency.Ahead of Monday’s verdict, French pulmonologist Dr Irène Frachon, who is credited with exposing the drug’s side effects, told AFP that she hoped the ruling would “give us the tools to understand how such deceit could have gone on for so long”.A number of other European countries, including Italy and Spain, banned Mediator in the early 2000s.In France, however, it continued to be offered to diabetics and other patients as an appetite suppressant.One study concluded that 500 deaths could be linked to Mediator between 1976 and 2009. A second one put the figure at 2,000.

New research has linked growth hormone treatment to serious adverse health effects years later.An 8-year-old boy I know is small for his age, shorter and slighter than his friends, even smaller than his 5-year-old sister. Concerned about the increasing use and possible risks of growth hormone, I asked his mother if she’d considered treating him with it. She replied, “Not really. He’s built like his father, who was short and slight as a boy and didn’t shoot up until college.”Their son, she said, has no sign of a hormone deficiency. “He’s in the third percentile for height and has maintained the same growth trajectory for years, so there’s no reason to do something about it,” she said. “He’s very athletic, physically capable and can keep up with his friends in other ways.”His father, at 41, is now 6 feet tall, though still very slender. He recalls being a reasonably athletic child but without the physical power of his friends, making up for what he lacked in mass with speed and agility. “I enjoyed competitive sports and worked on skills others didn’t have,” he told me, and said he encourages his son to recognize and capitalize on the skills he has.If only every parent with a short but healthy child approached the matter as sensibly. Experts estimate that 60 percent to 80 percent of children who are short for their age do not have a growth hormone deficiency or other medical condition that limits growth. But knowing there’s a therapy available to increase height, some parents seek a medical solution for a perceived problem, even when there is no medical abnormality. They should also know, however, that new research has linked growth hormone treatment to serious adverse health effects years later.Undue shortness may have many causes in addition to a deficiency of growth hormone, including malnutrition, Crohn’s disease or celiac disease, and potential medical conditions should be ruled out or, if present, treated. But height is most often related to the child’s genetics. Like father or mother, like son or daughter. Given the height of my parents — a 5-foot-1 mother and a 5-foot-6 father — I was not likely to become a forward for the Knicks at 4 feet 11.Dr. Adda Grimberg, a pediatric endocrinologist at Children’s Hospital of Philadelphia, recalled that “20 years ago, families were focused on health. They came in with a child who was not growing right and wanted to know if there was an underlying disease. Now, more and more, they’re focused on height. They want growth hormone, looking for a specific height. But this is not like Amazon; you can’t just place an order and make a child the height you want.”Originally, growth hormone was used to treat children with an established deficiency, which can result in a host of serious health problems. Cadavers were the initial limited source of the hormone until 1985, when scientists succeeded in producing recombinant human growth hormone in the laboratory, greatly increasing the supply and its use to treat growth hormone deficiency.Estimates of the incidence of this deficiency range from one in 3,000 to one in 10,000 children. According to the Pediatric Endocrine Society, those affected are usually much shorter than their peers — well below the third percentile — and over time fall increasingly behind.In 2003, the Food and Drug Administration approved use of recombinant human growth hormone for the condition known as “idiopathic short stature,” or short stature of unknown cause, which is not a disease. But it has prompted a growing number of parents to consider using the hormone to boost the height of their children. The resulting rush to therapy reflects concerns about a widespread societal bias against shortness, rather than a true medical need, Dr. Grimberg said.Parents considering treatment for this otherwise medically benign condition should know what it entails: daily injections for years until the child’s growth is completed, rotating injection sites in the body to minimize scarring. Although few children experience side effects, which can include severe headaches and hip problems, treatment requires repeated doctor visits, X-rays and blood work and, Dr. Grimberg said, “gives the child a powerful message that there’s something wrong with him that needs fixing.”According to the Pediatric Endocrine Society, the decision to administer growth hormone for idiopathic short stature should be made on a case-by-case basis in which benefits and risks are carefully considered for each child.What, then, are the benefits and risks? Although manufacturers have supported monitoring drug safety beyond the 10 years mandated by the U.S. government, reporting is voluntary and necessarily incomplete. However, a far more reliable assessment is available from Sweden, where population-wide data are routinely collected.In JAMA Pediatrics in December, pediatric endocrinologists from Karolinska University Hospital reported that among 3,408 patients who were treated with recombinant growth hormone as children and adolescents and followed for up to 25 years, the risk of developing a cardiovascular event like a heart attack or stroke was two-thirds higher for men and twice as high for women than among 50,036 untreated but otherwise similar people.The Swedish finding follows a report last June from a research team in Tokyo that growth hormone promotes biomedical pathways that stimulate the development of atherosclerosis, the basis for most cardiovascular events.Not yet known is whether other long-term adverse effects will become apparent in the years ahead. Based on its known action, giving growth hormone when no deficiency exists might raise the risk of cancer, respiratory disease and diabetes. In an editorial in JAMA Pediatrics, Dr. Grimberg wrote that “indirect evidence suggests that the potential for untoward effects of growth hormone treatment is sufficiently plausible” to warrant further study.Equally important for parents to know is how much height their children might gain from years of daily hormone injections. Though impossible to predict in advance for an individual child, the average benefit for children with idiopathic short stature is about two inches in adult height. Dr. Grimberg suggested that if there is no measurable benefit within a year of therapy, parents should consider stopping it.In discussing the psychological aspects of growth hormone therapy when no deficiency exists, experts have noted that the practice perpetuates the notion that short stature is unacceptable, leading to a spiraling demand for therapy. It is far better, one group suggested, to help a short child develop coping skills than to buy inches through pharmacological means.In a report in Hormone Research in Pediatrics, Dr. Talia Hitt and colleagues at Children’s Hospital of Philadelphia and the University of Pennsylvania wrote that parents’ high expectations that growth hormone therapy will improve the quality of life for their children are unlikely to be met if the children are not hormone deficient. They urged clinicians to “support families in other ways that promote positive development in children with short stature.”Dr. Philippa Gordon, a pediatrician in Brooklyn, N.Y., urges parents to make sure their children know “that people can be all different sizes and shapes and that their love for them is unconditional.”

Hispanic people across the United States continue to be especiallyunderrepresented among those vaccinated for Covid-19, according to a New York […]

“I did not really understand when people would ask, ‘Why me and why my family?’” a hospice chaplain said. “Now I was asking the same questions.”Hanane Saoui is used to death. Sudden deaths and slow deaths. Painful deaths and peaceful deaths.This year was different.The coronavirus pandemic dramatically changed Ms. Saoui’s work as a home hospice nurse in New York. Safety precautions created a physical distance between her and her patients and even cut some of her hospice colleagues off from their clients’ homes altogether last year. It deprived families and caretakers of ways to grieve together, and confronted hospice workers, however familiar with death, with a staggering scale of loss.Through all the pressures, Ms. Saoui and other workers continued to provide solace and even moments of happiness to dying patients and their families.Hanane Saoui, a home hospice nurse in Queens, meeting with her colleagues on a video call while in her car.James Estrin/The New York Times“You sit down and you listen,” she said. “They express their fear, they express their emotions, and you guide them and tell them what to expect.” After a patient dies, she added, “I often want to hug the family members, but I cannot do that now.”Instead, Ms. Saoui said, “I pray and do the best I can.”More than half a million Americans have died from the coronavirus, and many have died in pain, isolated from their families. Ms. Saoui contrasted those conditions with what she called a good death: “peaceful, pain-free, at home and surrounded by their loved ones.”While nurses have continued in-person home visits, some chaplain, social work and therapy sessions moved online because families preferred it. By August, most of that care switched back to in-person visits but with strict precautions, including wearing full P.P.E. at times and keeping six feet apart whenever possible.Ms. Saoui examining Pedro Torres, while his wife, Gloria, and his son, Darron, look on.James Estrin/The New York TimesThough a vast majority of Ms. Saoui’s patients in the last year did not have the coronavirus when they entered hospice, challenging restrictions have been placed on all patients and caregivers. Home hospice care can last for many months, and workers often develop close relationships with patients and their families.But the pandemic has meant fewer occasions for families — and hospice workers — to mourn together in person at funerals or memorial services. For over a year, the size of those gatherings has been strictly limited by many states to try to stem the spread of the virus.Nurse Hanane Saoui visits Diane Wilcox at her home in Queens.James Estrin/The New York TimesWhen hospice patients die, their caretakers often work through their own grief and loss in weekly staff meetings and gatherings with colleagues who shared the same client. These staff meetings are now online, but the loss of being able to hold each other and shed tears together has deeply affected hospice workers, said Melissa Baguzis, a social worker who specializes in pediatric cases. She has developed her own ways to handle the loss of her young patients.“I take a moment, light a candle and read their favorite book or listen to their favorite song,” she said. “I have my own time for them. We do become connected with their families, but when I’m in their houses, that is their grief and I’m going to support them. I need to process my own loss outside of that.”A nurse, Ozail Bennett, dressing in protective equipment before going to see a home hospice patient that has the coronavirus. Mr. Bennett also contracted the virus last April.James Estrin/The New York TimesThe hospice workers in the MJHS Health System, a nonprofit that covers New York and Nassau County, are comfortable around death in a way that many Americans are not. But the pandemic has put an extra weight on them and their patients, Ms. Baguzis said. “We all share in each other’s grief now more than ever,” she said.The Rev. Christopher Sigamoney, an Episcopal priest who is a hospice chaplain, said he has tried to be there for his patients “even with their frustration, anger, hopelessness, depression and anxiety.”Father Christopher Sigamoney talks with Joseph Lai.James Estrin/The New York TimesHe often told patients’ family members that it was “OK to be angry at God” over the loss of their loved one. But he said that the death of a beloved cousin from the coronavirus had changed his understanding of his work.Father Sigamoney and his family were unable to be with his cousin, a retired doctor visiting from India, during the three days while she was on a ventilator in the hospital at the end of her life. He and a handful of relatives said “a few prayers” in the funeral home, he said, but they were unable to have a “proper burial” or ship the body home to India because of virus restrictions.Father Christopher Sigamoney prays with patient Diane Wilcox at her home in Queens.James Estrin/The New York Times“I did not really understand when people would ask, ‘Why me and why my family?’” he said of the time before his cousin’s death. “Now I was asking the same questions. I said to God, ‘Now I’m angry at you, and I hope you can forgive me.’” Father Sigamoney said he was slowly recovering through prayer and helping his patients.Last month, Josniel Castillo was hooked up to a battery of medical machines and monitors, surrounded by his parents and a multitude of stuffed animals, as Javier Urrutia, a music therapist, and Ms. Baguzis entered his cramped bedroom. Despite his declining medical condition because of a rare genetic disease, this was a happy day. It was Josniel’s 11th birthday. Mr. Urrutia launched into “Las Mañanitas,” a traditional Mexican birthday song. Josniel’s mother and father, Yasiri Caraballo and Portirio Castillo, joined in. Ms. Caraballo wiped away tears. They were, she said, “tears of joy” because she had not expected her son would live to be 11.She requested another tune, and played tambourine as Mr. Urrutia launched into “Que Bonita Es Esta Vida.” They sang the final chorus together, part of which can translate to:Oh, this life is so beautifulThough it hurts so much sometimesAnd in spite of its sorrowsThere’s always someone who loves us, someone who takes care of us.Afterward, Mr. Urrutia said most people are “unaware of what’s happening behind closed doors, both the difficulty and the beauty.”Melissa Baguzis, a MJHS hospice social worker, visiting Josniel Castillo on his 11th birthday.James Estrin/The New York TimesThis year in countless homes, there has been “a lot of pain and suffering, it cannot be denied,” he said. But in hospice work, he said, “you also see all of the heroes out there doing the simple things of life, caring for each other. The husband taking care of his wife or the mother taking care of her son.”“Dying is a part of life,” he added. “Only living things die.”

SharecloseShare pageCopy linkAbout sharingimage copyrightGetty ImagesA single dose of the Pfizer or AstraZeneca vaccine was effective at stopping 62% of coronavirus infections in care homes, a study has found.A team at University College London (UCL) looked at data from 10,000 adults in England with an average age of 86.The research also suggested those who did catch the virus after vaccination may be less infectious.”Our data suggests that both vaccines are effective in frail, older adults,” said UCL’s Dr Maddie Shrotri.The study analysed coronavirus test-result data for 10,412 long-term residents, all aged over 65, at 310 care homes.Highly transmissible variantThe group had routine monthly PCR tests for the virus as well as further targeted tests if an outbreak was suspected. Of the 36,352 tests carried out between December 2020 and mid-March, 1,335 came back positive for the disease.By comparing those with the number of cases before vaccination, the researchers estimated both jabs were effective at preventing 56% of infections after four weeks, rising to 62% after five weeks.Past infection boosts Covid jab response six-foldSlight Covid uptick in secondary school childrenMore than 6,000 ‘lives saved by Covid jabs’The timing and scale of the protective effect was similar for both the Pfizer and AstraZeneca vaccines. “Our findings show that a single dose has an effect that persists from four weeks to at least seven weeks after vaccination,” said Dr Laura Shallcross, a public health medicine consultant at the Institute of Health Informatics at UCL. “We can also infer that the vaccines protect against the highly transmissible UK variant, as this was prevalent during the study period.”Around a quarter of coronavirus deaths in England and Wales have occurred in care homes, according to the latest data from the Office of National Statistics. Other elderly residents are likely to have caught the virus in a home before being transferred to hospital and dying there. Potentially less infectiousAround 11% of care home residents in the study had already been infected with coronavirus in the past.A single dose of either vaccine appeared to have little impact on that group, indicating those with a previous infection were already well-protected. A small proportion did catch the disease in the weeks after being given a single jab. But researchers said laboratory tests on samples from that group suggested they might be less infectious than those who had not yet received a vaccine. “It’s early data but we think that is potentially very significant, especially in a care home setting,” said Dr Shallcross.Although protection from a first dose in the study was described as “substantial”, the research team said a second follow-up shot would still be important to increase the duration of immunity, and to maximise protection that is provided by vaccination.The UCL research, which was funded by the Department of Health and Social Care, is part of the continuing Vivaldi study, investigating Covid-19 infections in care homes.Prof Chris Whitty, Chief Medical Officer for England, said: “These data add to the growing evidence that vaccines are reducing Covid-19 infections and doing so in vulnerable and older populations, where it is most important that we provide as much protection from Covid as possible.”

Chris Adams, 36, has spent the past year of the pandemic living with his grandparents in Wichita, Kan., and being “extremely strict” about social distancing. “I never went out,” he said.But starting Monday, when all adults in Kansas become eligible for the coronavirus vaccine, Mr. Adams plans to find a vaccination site where there is an available appointment. “What I’m looking forward to is seeing my friends again,” he said.Kansas is one of six states — Louisiana, North Dakota, Ohio, Oklahoma and Texas are the others — that are expanding eligibility for the vaccine to all adults on Monday. Minnesota will follow on Tuesday, and Indiana on Wednesday.Gov. Laura Kelly of Kansas urged residents last week to seek out appointments, saying, “With the anticipated increase in supply from the federal government, we must get every dose of vaccine into arms quickly.”Even as vaccine eligibility continues to expand across America — nearly all states have pledged to make every adult eligible by May 1 — the United States has also reported an increase in new cases over the past week. About 75,000 new cases were reported on Friday, a significant increase from the 60,000 added the Friday before.States in the Northeast have accounted for about 30 percent of the nation’s new cases over the past two weeks, up from 20 percent in the first couple of weeks in February.In New York, there has been an average of 8,426 new cases a day, an 18 percent increase from the average two weeks earlier, according to a New York Times database. In New Jersey over the past week, there have been an average of 4,249 new cases reported daily, a 21 percent increase from the average two weeks earlier. And on Friday, Vermont set a single-day case record with 283 new infections; it is the first state to set a case record since Jan. 18.For many, the vaccine cannot come soon enough.Nicole Drum, 42, a writer in the Kansas City, Kan., metro area, cried on Friday when she found out that she would be eligible to get the vaccine as early as Monday. She started calling pharmacies and looking online for available appointments “within minutes of the news breaking,” she said.Ms. Drum called about 10 places without success. She had more luck on a county website, and booked an appointment for Wednesday.She said she planned to wear a special T-shirt saying “I believe in science” to her appointment. “I got myself a fun I’m-getting-the-vaccine outfit,” she said, laughing.She also plans to take her 4-year-old son with her, because she wants him to see “how research and science and people coming together can really help stem these kinds of things,” she said.“I want him to know that there’s no need to be afraid all the time of big scary things, because there are always helpers trying to figure this out,” Ms. Drum said. “While the solution might be something that’s a jab in the arm that hurts a little bit, it’s worth it.”See How the Vaccine Rollout Is Going in Your County and StateSee where doses have gone, and who is eligible for a shot in each state.

She was passionate — and relentless — about making the city she loved navigable for everyone.Edith Prentiss, a fierce and fiery advocate for the disabled who fought to make the city she loved more navigable for everyone, died on March 16 at her home in the Washington Heights neighborhood of Manhattan. She was 69.The cause was cardiopulmonary arrest, her brother Andrew Prentiss said.In 2004, the city’s taxi fleet had only three wheelchair-accessible cabs — minivans with ramps — and people like Ms. Prentiss had a less than one in 4,000 chance of hailing one. “They’re like unicorns,” she told The New York Times that year. “You have to be pure to catch one.”The number of accessible vehicles would eventually inch up to 231, but it took nearly a decade and a class-action lawsuit — of which Ms. Prentiss was a plaintiff — before the city’s Taxi and Limousine Commission agreed to make the fleet 50 percent accessible by 2020. (That deadline was pushed back amid the pandemic and other issues; the fleet is now at 30 percent.)Ms. Prentiss also fought for accessibility on subways and in police stations, restaurants and public parks. And she fought for issues that didn’t affect her directly, like those that might impede people with mental, visual, auditory or other disabilities.When the city held a hearing in 2018 on banning plastic straws, a cause that is a darling of environmentalists but not those in the disability community, she made sure to gather a group and present an opinion. There are those who cannot hold a cup, the group wanted to point out, and straws are essential tools to their visiting a restaurant.At the meeting, group after group testified in favor of the ban. But Ms. Prentiss and her colleagues were not called on.“It’s hard to miss us — most of the people are in wheelchairs,” said Joseph G. Rappaport, executive director of the Brooklyn Center for Independence of the Disabled and the communications and strategy director of the Taxis for All Campaign, of which Ms. Prentiss was the chair, “but it went on and on and finally Edith had had it. She said, ‘Hey, we’re here to speak. We have an opinion about this bill.’” The group was allowed to speak.“She worked the inside, she worked the angles, and if she had to yell, that’s what she did,” Mr. Rappaport added. “And she did it well.”Ms. Prentiss in 2004. She pushed for accessibility on public transportation, and in police stations, restaurants and public parks.Frances Roberts for The New York TimesShe was bristly and relentless and always prepared. Woe to the city officials who had not kept their promise, or done their homework. She knew to an inch the proper length of a ramp, and how high a curb should be cut. She drove her motorized wheelchair as she spoke, with enormous confidence, and sometimes a bit of intentional recklessness; she was not above riding over the toes of those in her way.Among the many New York City officials to issue statements upon Ms. Prentiss’s death were Gale Brewer, the Manhattan borough president, and, in a joint statement, Mayor Bill de Blasio and Victor Calise, commissioner of the Mayor’s Office for People with Disabilities.In May, Ms. Prentiss will be inducted into the New York State Disability Rights Hall of Fame, and Mr. Calise will appear at the virtual ceremony in her place.“She was brilliant,” Ms. Brewer said in a phone interview. “She took no prisoners. She dispensed with the niceties, but her heart was so generous.”Edith Mary Prentiss was born on Feb. 1, 1952, in Central Islip, N.Y., on Long Island. She was one of six children (and the only daughter) of Robert Prentiss, an electrician, and Patricia (Greenwood) Prentiss, a social worker. Edith was asthmatic, and later diabetic. She began using a wheelchair once her asthma became severe when she was in her late 40s.After earning a degree in sociology from Stony Brook University on Long Island, she attended the College of Arts and Science at Miami University in Oxford, Ohio.Early in her career, Ms. Prentiss was an outreach caseworker for ARC XVI Fort Washington, a senior services center. Working from the Port Authority Bus Terminal, she conducted blood pressure screenings and helped older people apply for city services and other benefits. She later worked with Holocaust survivors. Fern Hertzberg, the executive director of ARC, said Ms. Prentiss’s last job, before she retired in about 2006, was with a physical therapy center in her neighborhood.Ms. Prentiss was president of the 504 Democratic Club, which focuses on disability rights, and held positions with many other advocacy groups.She wasn’t known just for her bullying ways. Years ago, Susan Scheer, now chief executive of the Institute for Career Development, an employment and training group for the disabled, was a New York City government official, and she met Ms. Prentiss in the usual way: being yelled at in various hearings. Yet when Ms. Scheer, who has spina bifida, began using a wheelchair about a decade ago, she called Ms. Prentiss for help. She realized she had no idea how to navigate from her East Village apartment to her job at City Hall by bus.Ms. Prentiss in 2019 in a scene from the forthcoming documentary “Edith Prentiss: Hell on Wheels.” Arlene Schulman“Don’t worry,” she recalled Ms. Prentiss saying. “I’m on my way.” (It did take a while, with the usual impediments, like broken subway elevators.)Once there, Ms. Prentiss led Ms. Scheer out of her building and through the snarls of traffic on 14th Street, blocking the vehicles that menaced them, as she coached Ms. Scheer through her first bus launch, which was rocky. As she ping-ponged down the aisle, she ran over the driver’s toes. “Not your problem,” Ms. Prentiss called out behind her.Ms. Prentiss then directed the less-than-enthusiastic driver to secure Ms. Scheer’s chair (drivers are not always diligent about this step). And as the passengers groaned and rolled their eyes, Ms. Scheer said, Ms. Prentiss stared them down and announced: “We are learning here, folks. Let’s be patient.”In her extensive travels, her brother Andrew said, Ms. Prentiss had many traffic accidents and was hit by numerous vehicles, including taxis, a city bus and a FedEx truck. She was often in the emergency room, but if there was a community board meeting or a city hearing, she made sure to phone in from the hospital.In addition to her brother Andrew, Ms. Prentiss is survived by her other brothers, Michael, Robert Anthony, William John and David Neil.In early January, Ms. Prentiss received her first dose of the Covid-19 vaccine at the Fort Washington Armory. Needless to say, she had some complaints, as she told Ms. Hertzberg: The pencils to fill out the health questionnaire were the kind known as golf pencils, and too small for people with certain manual disabilities. The typeface on the questionnaire wasn’t big enough. And the chairs set out in the post-vaccination waiting area had no arms, which many people need as an aid to stand up with. She called the hospital that was administering the program there — and, Ms. Hertzberg said, you can be sure that it didn’t take long for the problems to be fixed.For the last three years, Arlene Schulman, a photographer, writer and filmmaker, has been working on a documentary called “Edith Prentiss: Hell on Wheels,” a title its subject initially quibbled with. She didn’t think it was strong enough.