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Two centuries after its invention, the stethoscope — the very symbol of the medical profession — is facing an uncertain prognosis.It is threatened by hand-held devices that are also pressed against the chest but rely on ultrasound technology, artificial intelligence and smartphone apps instead of doctors’ ears to help detect leaks, murmurs, abnormal rhythms and other problems in the heart, lungs and elsewhere. Some of these instruments can yield images of the beating heart or create electrocardiogram graphs.Dr. Eric Topol, a world-renowned cardiologist, considers the stethoscope obsolete, nothing more than a pair of “rubber tubes.”It “was OK for 200 years,” Topol said. But “we need to go beyond that. We can do better.”In a longstanding tradition, nearly every U.S. medical school presents incoming students with a white coat and stethoscope to launch their careers. It’s more than symbolic — stethoscope skills are still taught, and proficiency is required for doctors to get their licenses.Over the last decade, though, the tech industry has downsized ultrasound scanners into devices resembling TV remotes. It has also created digital stethoscopes that can be paired with smartphones to create moving pictures and readouts.Proponents say these devices are nearly as easy to use as stethoscopes and allow doctors to watch the body in motion and actually see things such as leaky valves. “There’s no reason you would listen to sounds when you can see everything,” Topol said.At many medical schools, it’s the newer devices that really get students’ hearts pumping.“Wow!” ″Whoa!” ″This is awesome,” Indiana University medical students exclaimed in a recent class as they learned how to use a hand-held ultrasound device on a classmate, watching images of his lub-dubbing heart on a tablet screen.The Butterfly iQ device, made by based by Guilford, Connecticut-based Butterfly Network Inc., went on the market last year. An update will include artificial intelligence to help users position the probe and interpret the images.Students at the Indianapolis-based medical school, one of the nation’s largest, learn stethoscope skills but also get training in hand-held ultrasound in a program launched there last year by Dr. Paul Wallach, an executive associate dean. He created a similar program five years ago at the Medical College of Georgia and predicts that within the next decade, hand-held ultrasound devices will become part of the routine physical exam, just like the reflex hammer.The devices advance “our ability to take peek under the skin into the body,” he said. But Wallach added that, unlike some of his colleagues, he isn’t ready to declare the stethoscope dead. He envisions the next generation of physicians wearing “a stethoscope around the neck and an ultrasound in the pocket.”Modern-day stethoscopes bear little resemblance to the first stethoscope, invented in the early 1800s by Frenchman Rene Laennec, but they work essentially the same way.Laennec’s creation was a hollow tube of wood, almost a foot long, that made it easier to hear heart and lung sounds than pressing an ear against the chest. Rubber tubes, earpieces and the often cold metal attachment that is placed against the chest came later, helping to amplify the sounds.When the stethoscope is pressed against the body, sound waves make the diaphragm — the flat metal disc part of the device — and the bell-shaped underside vibrate. That channels the sound waves up through the tubes to the ears. Conventional stethoscopes typically cost under 0, compared with at least a few thousand dollars for some of the high-tech devices.But picking up and interpreting body sounds is subjective and requires a sensitive ear — and a trained one.With medical advances and competing devices over the past few decades, “the old stethoscope is kind of falling on hard times in terms of rigorous training,” said Dr. James Thomas, a cardiologist at Northwestern Medicine in Chicago. “Some recent studies have shown that graduates in internal medicine and emergency medicine may miss as many of half of murmurs using a stethoscope.”Northwestern is involved in testing new technology created by Eko, a Berkeley, California-based maker of smart stethoscopes. To improve detection of heart murmurs, Eko is developing artificial intelligence algorithms for its devices, using recordings of thousands of heartbeats. The devices produce a screen message telling the doctor whether the heart sounds are normal or if murmurs are present.Dennis Callinan, a retired Chicago city employee with heart disease, is among the study participants. At age 70, he has had plenty of stethoscope exams but said he feels no nostalgia for the devices.“If they can get a better reading using the new technology, great,” Callinan said.Chicago pediatrician Dr. Dave Drelicharz has been in practice for just over a decade and knows the allure of newer devices. But until the price comes down, the old stalwart “is still your best tool,” Drelicharz said. Once you learn to use the stethoscope, he said, it “becomes second nature.”“During my work hours in my office, if I don’t have it around my shoulders,” he said, “it’s as though I was feeling almost naked.” 5223

Vice President Mike Pence canceled a previously scheduled event in New Hampshire on Tuesday to return to the White House, two White House officials told CNN, though the reason for scrapping the event was not immediately clear.The vice president's spokeswoman said Pence never left the Washington area and that the event will be rescheduled."Something came up that required the @VP to remain in Washington, DC. It's no cause for alarm. He looks forward to rescheduling the trip to New Hampshire very soon," Alyssa Farah wrote in a tweet.An official close to the vice president told CNN that there was no emergency, saying, "the VP was called back to the White House but no cause for alarm."Pence was scheduled to travel to Manchester, New Hampshire, to participate in a roundtable discussion with patients at the Granite Recovery Center headquarters and deliver remarks on the opioid crisis and illegal drug flow into the state. 939

Where the Mississippi River nears its end, sits a city that nearly faced its own end.“It’s a different kind of place,” said Louisiana native Hosea LaFleur.Nearly 15 years after Hurricane Katrina, New Orleans remains a city where the past never strays too far from the present. The storm is still felt by every homeowner here on their homeowners’ insurance bills.After the storm, insurance companies no longer wanted to offer homeowners insurance in parts of Louisiana that were vulnerable to hurricanes. They thought it was a money-loser.So, the state created Citizens Insurance. Initially controversial, it was funded by all the property owners in the state, including people who didn’t live anywhere near the damaged areas.“That certainly was a hard sell for those folks,” said Louisiana Insurance Commissioner Jim Donelon.Louisiana’s Citizens Insurance eventually helped stabilize the insurance market after Katrina and attracted more than 30 new insurance companies to the state. The number of homeowners on Citizens has also since plummeted, from 174,000 in 2008 to about 38,000 today, representing about 0.4 percent of the market there.“The policyholders are contributing fees, as well as the companies writing business contribute fees,” said Joey O’Connor, owner of the O’Connor Insurance Group and president of the Independent Insurance Agents and Brokers of Louisiana.Hosea LaFleur’s coastal home is on Citizens Insurance.“Just fell in love with it,” he said of the home. “Fell in love with the people, the things, the atmosphere.”It’s been hit by hurricanes twice: first Katrina in 2005 and then Gustav, three years later.“Knocked our walls down, everything down,” LaFleur said.Despite the repeated rebuilding, he wouldn’t dream of giving it up.“It's home to us,” LaFleur said. “We love it. We love everything about it.”Robert Allen is an adjunct professor at the School of Professional Advancement at Tulane University. His courses specialize in risk management and threat assessments. “That's going to start adding up,” he said, of rebuilding in vulnerable natural disaster areas. “Who foots the bill at the end of the day? You do. I do. Everybody else does.”Last year, the U.S. experienced 14 separate billion-dollar natural disasters: two hurricanes, two winter storms, eight severe storms, wildfires and a drought.From California wildfires to Midwest floods to coastal hurricanes, Allen said that as some insurance companies pull back from covering some areas, taxpayers will need to figure out if they want to keep footing the rebuilding bill.“At the end of the day is going to come down to money,” he said. “I mean, how much money is being put into that and at what point again do you decide this is enough?”Allen said one idea that’s been floated is to create a federal natural disaster insurance program, similar to the national flood insurance program. Taxpayers everywhere would be responsible for keeping it solvent.“There was talk or there is some kind of undertones about doing that with all hazards threats -- like doing that with the fires and just underwriting some of this stuff,” Allen said.It’s a challenge that taxpayers will have to confront, if they chose to rebuild areas hit over and over again by nature’s fury. 3259

UPDATE 11 P.M.: The mother of a 6-month-old boy who was missing says she had no way to reach the babysitter, who was a family friend, which is why she reported him missing.“Just the relief, I can’t explain how relieved I am,” Sharissa Robinson said.Robinson told 13 Action News that Monique is a family friend and that’s why she asked her to babysit him.The mother said later she realized that she had no way to reach her.Reporter: “Why did you not have a way to contact her?”Sharissa: “I was told she had a number, she didn’t have one, miscommunication on several ends or whatever.”Reporter: “Well at what point did you realize you didn’t have a way to reach this woman to get her baby?”Sharissa: “When it was five I’m wondering where my kid is, it's about to get dark.”Around 2 p.m. Wednesday, Atreu was found. CCSD police said he was dropped off at the front desk of Eldorado High School and then taken to Sunrise Hospital.“I don’t know who dropped him off,” Robinson said.Police are trying to track the man who reportedly dropped Atreu at the high school, and no word yet if it was the same man who witnesses told police picked the baby and the babysitter up.Atreu remains at Sunrise Hospital as North Las Vegas police and CPS continue their investigation into what happened.UPDATE: The baby has been located. According to police, the baby was dropped off at Eldorado High School. The baby is being taken to Sunrise Hospital to be checked out. North Las Vegas police say that the baby was dropped off by a man. The man is facing charges if located. ORIGINAL STORYNorth Las Vegas police are seeking the public’s assistance in locating 6-month-old Atreyu Drewry.On March 5 around 11:40 p.m., officers responded to a home near Bruce Street and Putnam Avenue, in reference to a report of a missing 6-month-old boy. Police say Atreyu’s mother, 42-year-old Sharissa Robinson, asked 27-year-old Monique Sims (a.k.a. Monique Reese) and two of her friends to babysit Atreyu at another location. According to witnesses, Atreyu was last seen on March 5 at about 3 p.m. at a home near Nelson Avenue and Donna Street in the company of Monique. He was wearing a white onesie with polar bears on it. 2203

US Border Patrol agents are searching the Rio Grande River for a missing 2-year-old girl.The toddler, a national of Brazil, was crossing into the US from Mexico, according to a statement from US Customs and Border Protection.The agency was alerted to the missing girl late Monday after a woman from Haiti was detained by agents at the Del Rio Border Patrol Station, the statement said. She told agents that she lost her 2-year-old daughter while crossing the Rio Grande River near Del Rio, Texas."Any time a child is lost it is a tragic event," said Del Rio Sector Chief Patrol Agent Raul L. Ortiz. "I can not imagine the anguish the parents of this young girl must be feeling and I hope our search efforts pay off with a positive outcome."Border Patrol agents and law enforcement teams from Ciudad Acuna, Mexico have been searching for the missing girl since Monday night, the statement said. The search went through the day Tuesday with an underwater vehicle, a dive team and boats, CBP said.The search effort comes a little more than a week after a Salvadoran father and daughter drowned in the Rio Grande trying to cross into the US near Brownsville, Texas.The child, Angie Valeria, was a month away from her second birthday.They were hoping for an appointment to receive political asylum in the US, according to Julia Le Duc, who captured a haunting image of their bodies in the river.The photo served as a reminder of the dangers migrants face as they journey to the US, which advocates have warned will only increase as US policies make it harder for asylum seekers to come through ports of entry. 1616