California considers funding controversial research: editing genes in human embryos

first_img By Charles Piller Feb. 8, 2016 Reprints Global summit opens door to controversial gene-editing of human embryos OAKLAND, Calif. — The California Institute of Regenerative Medicine was created in 2004 to fund stem cell research, after the federal government stopped paying for most experiments with human embryos. Now the state agency is considering underwriting another controversial use of embryos that the federal government won’t support — editing their genes.Officials of the state agency, known as CIRM, discussed guidelines and safeguards for this type of research last week at a meeting of an internal committee that evaluates standards for research funding but made no decision about supporting such work. A new gene-editing technology called CRISPR-Cas9 has revolutionized biomedical research and is thought to hold great promise for eventually helping scientists cure hereditary ailments such as Parkinson’s or Huntington’s disease.Laws about embryo research are in flux around the globe, as nations struggle to keep up with quickly changing science. Following the first official government approval of an experiment that would alter human embryo DNA — in the United Kingdom last week — scientists there might soon use the cells during the first two weeks of embryonic development to study genetic factors in infertility.advertisement A donated human embryo seen through a microscope. Sandy Huffaker/Getty Images Related: The California stem cell agency has opened the prospect that state or private groups might take the lead in underwriting germline editing experiments in this country. CIRM spokesman Kevin McCormack said in an interview that his group’s standards panel will assess the issues and report to the full board within about two months. The agency might conclude that current rules are adequate to cover such work if the group chooses to fund it.“The science is evolving so rapidly, even if we don’t make any changes to our (standards), it’s important to look and see if they are good enough, strong enough the way they are,” McCormack said. This kind of research is legal in the United States, but the National Institutes of Health said last year that it won’t fund research involving gene editing of human embryos, eggs, or sperm. Changes to these “germline” genes are inherited by offspring.So far, no researchers have publicly announced experiments to implant altered embryos in a woman’s uterus, let alone use them to create a fully developed baby. But finding the right balance of risks and benefits for genetic changes that can be passed on to future generations remains a central dilemma — and fear — for scientists and the public. In December, an international summit on human gene editing endorsed germline editing research in non-human animals and left open the door to modifying the genomes of early human embryos, eggs, or sperm as long as they’re not used to establish a pregnancy.advertisementcenter_img CIRM, which already funds research using human embryos, is deciding whether to strengthen rules governing informed consent for embryo donors. Its standards experts are considering, for example, whether CRISPR can ethically be used on embryos obtained before the recent emergence of the gene-editing technology, or if it should be used only on newly donated biomaterials.The agency is considering the use of gene-edited embryos for research that allows them to develop no longer than two weeks, as in the UK experiment.California voters authorized $3 billion in bond sales to create CIRM, in response to a 2001 decision by President George W. Bush to sharply restrict federal funding for embryonic stem cell research. So far, CIRM’s board has committed about $1.9 billion to universities, individual researchers, and companies, although only $1.4 billion has actually been spent.Among state agencies that support stem cell research — including in Texas, Connecticut, New York, and Maryland — only California’s has publicly contemplated human embryo gene editing. The Cancer Prevention and Research Institute of Texas and Bioinnovation Connecticut have not yet considered funding such experiments, their spokespersons said. The Maryland Stem Cell Research Fund has taken no position on this issue, and New York officials could not be reached for comment.Some important private groups that support stem cell research also have moved cautiously. Russ Campbell, a spokesman for the Burroughs Wellcome Fund in Research Triangle Park, N.C., said “this is not an area that we are pursuing or supporting.”Nancy Wexler, president of the New York-based Hereditary Disease Foundation, said her funds are currently committed to other priorities, and she does not anticipate supporting gene-editing of human embryos in the foreseeable future. But she called the recent move in the United Kingdom to promote this work “fantastic.”“Their ability to do that is going to help all of us,” Wexler said, “so I say bravo.” In the LabCalifornia considers funding controversial research: editing genes in human embryos Tags CRISPRgene editinggenetics Related: UK government agency approves editing genes in human embryos last_img read more

Bacon, soda, and too few nuts tied to big portion of US deaths

first_img Joe Raedle/Getty Images Replace bad fats with good foods for heart health, study says A journal editorial said public health policies targeting unhealthy eating could potentially help prevent some deaths, while noting that the study isn’t solid proof that “suboptimal” diets were deadly.The study’s recommended amounts, based on US government guidelines, nutrition experts’ advice, and amounts found to be beneficial or harmful in previous research:‘Good’ ingredientsFruits: 3 average-sized fruits dailyVegetables: 2 cups cooked or 4 cups raw vegetables dailyNuts/seeds: 5 1-ounce servings per week — about 20 nuts per servingWhole grains: 2 ½ daily servingsPolyunsaturated fats, found in many vegetable oils: 11 percent of daily caloriesSeafood: about 8 ounces weekly‘Bad’ ingredientsRed meat: 1 serving weekly — 1 medium steak or the equivalentProcessed meat: None recommendedSugary drinks: None recommendedSodium: 2,000 milligrams daily — just under a teaspoon of salt.— Lindsey Tanner Associated Press “Bad” foods or nutrients that were over-eaten include salt and salty foods; processed meats including bacon, bologna, and hot dogs; red meat including steaks and hamburgers; and sugary drinks.The research is based on US government data showing there were about 700,000 deaths in 2012 from heart disease, strokes, and diabetes and on an analysis of national health surveys that asked participants about their eating habits. Most didn’t eat the recommended amounts of the foods studied.advertisement About the Author Reprints HealthBacon, soda, and too few nuts tied to big portion of US deaths The 10 ingredients combined contributed to about 45 percent of those deaths, according to the study.It may sound like a familiar attack on the typical American diet, and the research echoes previous studies on the benefits of heart-healthy eating. But the study goes into more detail on specific foods and their risks or benefits, said lead author Renata Micha, a public health researcher and nutritionist at Tufts University.The results were published Tuesday in the Journal of the American Medical Association.Micha said the 10 foods and nutrients were singled out because of research linking them with the causes of death studied. For example, studies have shown that excess salt can increase blood pressure, putting stress on arteries and the heart. Nuts contain healthy fats that can improve cholesterol levels, while bacon and other processed meats contain saturated fats that can raise levels of unhealthy LDL cholesterol.In the study, too much salt was the biggest problem, linked with nearly 10 percent of the deaths. Overeating processed meats and under-eating nuts and seeds and seafood each were linked with about 8 percent of the deaths.The Food and Drug Administration’s recent voluntary sodium reduction guidelines for makers of processed foods and taxes that some US cities have imposed on sugar-sweetened beverages are steps in the right direction, Micha said.center_img Related: CHICAGO — Gorging on bacon, skimping on nuts? These are among food habits that new research links with deaths from heart disease, strokes, and diabetes.Overeating or not eating enough of the 10 foods and nutrients contributes to nearly half of US deaths from these causes, the study suggests.“Good” foods that were under-eaten include: nuts and seeds; seafood rich in omega-3 fats including salmon and sardines; fruits and vegetables; and whole grains.advertisement Related: Restaurant meals are packed with calories, and we still keep eating them Tags nutrition By Associated Press March 7, 2017 Reprintslast_img read more

Pharmaceutical firms ask court to stop their drugs from being used in Arkansas executions

first_img Tags pharmaceuticals By Associated Press April 13, 2017 Reprints BusinessPharmaceutical firms ask court to stop their drugs from being used in Arkansas executions A 2015 state law keeps the source of Arkansas’ three lethal injection drugs secret. The Department of Correction, Governor Asa Hutchinson’s office and the attorney general’s office declined to comment on Thursday’s filing by the companies.“We have made repeated as of yet unsuccessful representations in writing and in person to the governor’s office, office of the attorney general and the Department of Corrections to confirm if they are in possession of our product which they intend to use in lethal injections, and if so to return it to us,” Brooke Clarke, a spokeswoman for Hikma, West-Ward’s parent company, said in a statement.Fresenius said it has made similar overtures to Hutchinson and state officials, but hasn’t received any response.Both companies said they’ve put strict controls on their supplies to ensure the drugs aren’t used in capital punishment. Fresenius said its information indicated no sales of its potassium chloride directly or through its authorized distributors to the state’s prison system.“So we can only conclude Arkansas may have acquired this product from an unauthorized seller,” Matt Kuhn, a spokesman for the company, said in a statement. “Pharmaceuticals obtained in this manner are at risk of adulteration or chemical change due to improper handling such as failure to maintain proper temperature levels during storage and transport.”US District Court Judge Kristine Baker is expected to rule Friday in the inmates’ request to halt the executions. The inmates are challenging the compressed execution timetable, as well as the use of midazolam.Arkansas has not executed an inmate since 2005 because of drug shortages and legal challenges. If carried out, the executions would mark the most inmates put to death by a state in such a short period in modern history.— Andrew DeMillo LITTLE ROCK, Ark. — Two pharmaceutical companies asked a federal judge Thursday to prevent Arkansas from using their drugs to execute seven inmates by the end of the month, saying they object to their products being used for capital punishment.Fresenius Kabi USA and West-Ward Pharmaceuticals Corp. were granted permission to file a friend of the court brief in a lawsuit by the inmates aimed at halting the unprecedented execution schedule, set to begin Monday with the lethal injection of two condemned killers.Fresenius Kabi said it appeared that it had manufactured the potassium chloride the state plans to use, while West-Ward had previously been identified by the Associated Press as the likely manufacturer of the state’s supply of midazolam.advertisement About the Author Reprints Associated Press Arkansas inmates Jack Harold Jones Jr., left, and Marcel Williams, are scheduled to be executed later this month. Arkansas Department of Correction via AP “The use of the medicines in lethal injections runs counter to the manufacturers’ mission to save and enhance patients’ lives, and carries with it not only a public-health risk, but also reputational, fiscal, and legal risks,” the companies said in a filing with the court.Arkansas prison officials announced last month they had obtained a new supply of potassium chloride, clearing the way for the executions to begin. The executions are scheduled to occur before Arkansas’ supply of midazolam, a sedative used in flawed executions in other states, expires at the end of April.advertisementlast_img read more

Sick people may ‘face extremely high premiums’ under House bill, CBO says

first_img By Julie Rovner — Kaiser Health News May 24, 2017 Reprints Sick people may ‘face extremely high premiums’ under House bill, CBO says Politics What is it? Daily reporting and analysis The most comprehensive industry coverage from a powerhouse team of reporters Subscriber-only newsletters Daily newsletters to brief you on the most important industry news of the day STAT+ Conversations Weekly opportunities to engage with our reporters and leading industry experts in live video conversations Exclusive industry events Premium access to subscriber-only networking events around the country The best reporters in the industry The most trusted and well-connected newsroom in the health care industry And much more Exclusive interviews with industry leaders, profiles, and premium tools, like our CRISPR Trackr. Chip Somodevilla/Getty Images Log In | Learn More STAT+ is STAT’s premium subscription service for in-depth biotech, pharma, policy, and life science coverage and analysis. Our award-winning team covers news on Wall Street, policy developments in Washington, early science breakthroughs and clinical trial results, and health care disruption in Silicon Valley and beyond. Unlock this article — plus daily intelligence on Capitol Hill and the life sciences industry — by subscribing to STAT+. First 30 days free. GET STARTED Tags CongressinsuranceMedicaidpolicy The Republican overhaul of the federal health law passed by the House this month would result in slightly lower premiums and slightly fewer uninsured Americans than an earlier proposal. But it would leave as many as one-sixth of Americans living in states where older and sicker people might have to pay much more for their health care or be unable to purchase insurance at all, the Congressional Budget Office said Wednesday.In some states, said the report, “less healthy people would face extremely high premiums, despite the additional funding that would be available” in the bill to help offset those increases. GET STARTED Julie Rovner — Kaiser Health News About the Author Reprints What’s included?last_img read more

How beagles and goldens could help researchers find the next cancer therapy for humans

first_img Dr. Michael Kent, radiation oncologist When she started in the field about a decade ago, Lawrence focused solely on her animal patients. Better treatments for cancer in dogs are an urgent need; the disease kills some half of dogs over age 10. But as she’s encountered more and more people who have dealt with cancer, Lawrence has become increasingly interested in working to benefit humans as well.The fact that canine clinical trials might help improve human cancer treatment also goes over well with pet owners. “Everyone knows someone with cancer,” she said.But working with companion animals can be more challenging than studies of mice and rats. Care given as part of a clinical trial is not always completely free because vet schools have little of the hefty pharmaceutical industry funding that can help defray the cost of research. Animal patients often come with fiercely devoted pet owners who want to do anything to save the lives of their pets; the informed consent process is taken seriously, Kent said, so that pet owners understand all risks.While Kent is excited about the potential of his research on cancer, he makes it clear that the subjects of his research are patients first.“I’m not going to do anything to advance science at the cost of my patients. The first thing is do no harm,” said Kent, speaking in his office near a wall covered with dozens of photos his patients’ owners have given him over the years. “But if we can learn from them, and help them as well, that’s a really good goal. And if we can help humans as well, that’s great.” National Science Correspondent Usha covers the toll of Covid-19 as well as people and trends behind biomedical advances in the western U.S. Trending Now: @ushamcfarling Newsletters Sign up for Cancer Briefing A weekly look at the latest in cancer research, treatment, and patient care. “For a long time, we’ve looked at humans to see how to treat dogs. We’re starting to do a little bit of the reverse now.” By Usha Lee McFarling Oct. 4, 2017 Reprints 4 ways dogs might be able to sniff out disease Dr. Michael Kent (center) positions a dog for a CT scan at the UC Davis veterinary hospital. Don Preisler/UC Davis School of Veterinary Medicine Please enter a valid email address. This field of comparative medicine — using animals to better understand and treat human disease — is not new; creatures such as mice, rats, and actual guinea pigs have long been the mainstay of medical research and studies of experimental drugs. What’s different is that veterinarians are now conducting rigorous clinical trials of new treatments with the hope they might eventually benefit humans as well as the family pet. Increasingly, they’re using dogs and cats and other companion animals in these experiments, as medical researchers recognize the limitations of traditional lab animals. Meurs, a veterinary cardiologist, studies inherited cardiomyopathy and is trying to understand why members of the same family with the same inherited genetic defect can exhibit widely different manifestations of the disease. But it’s hard to tackle such a question in humans, who get the disease so late in life and usually have few siblings for comparison. So she uses dogs.“Individual variation is much easier to study in an animal model that might have 10 offspring in one litter,” she said.Companion animals offer numerous other benefits for medical researchers, she said. For example, pets are often exposed to the same disease-causing environmental factors as humans. (In fact, many veterinary schools refer to their work in comparative medicine as “One Health,” a philosophy that sees animal, human and environmental health as closely interconnected.)Dogs and cats get cancer spontaneously, like humans, so their cancers are more biologically relevant to humans than the cancers that are artificially induced in lab animals. In some cancers, dog and human tumors are indistinguishable under a microscope. Surgical techniques can easily be adapted from dogs to humans, as they have been in limb-saving bone cancer surgery. And dogs are much closer in size to humans than are lab animals.“We use the same diagnostics, the same treatment. These are all the same drugs and approaches we would use in people,” said Dr. Jessica Lawrence, an associate professor at the University of Minnesota Veterinary Medical Center, who said her colleagues at the University of Minnesota Medical School are often startled to learn how advanced the cancer care she offers her animal patients is.No one is suggesting throwing mice and rats out of the lab. They’re pervasive in medical research because of their short lifespans and because they’re easy to keep and breed in captivity. Reliance on the rodents increased in the 1980s after transgenic technologies allowed scientists to alter the genes of mice and even insert human genes into the animals. [email protected] Usha Lee McFarling Privacy Policy HealthHow beagles and goldens could help researchers find the next cancer therapy for humans Comparing the Covid-19 vaccines developed by Pfizer, Moderna, and Johnson & Johnson About the Author Reprints DAVIS, Calif. — Radiation oncologist Dr. Michael Kent desperately wants to beat cancer. He’s testing the latest high-tech treatments in clinical trials and using a multimillion-dollar linear accelerator so he can offer the best care to patients — whether they’re beagles, golden retrievers, or the black and white terrier mix named Moo he’s now treating for a recurrent tumor in her paw.Kent is a veterinarian. Frustrated by the lack of treatment options for dogs with certain tumors and cancers that have metastasized, he’s searching hard for new treatments to extend the lives of his patients. But because the biology of dogs and humans is so similar, what he finds here at the UC Davis School of Veterinary Medicine could well help treat human cancers as well.“For a long time, we’ve looked at humans to see how to treat dogs,” Kent said. “We’re starting to do a little bit of the reverse now.”advertisement “There’s things we find in the lab that we think might be helpful, then we get to the clinic and they either don’t work or are toxic,” said Dr. Arta Monjazeb, a radiation oncologist at UC Davis Comprehensive Cancer Center who’s partnered with Kent to test new treatments in dogs. One immune therapy that the two recently tested to shrink metastatic lung cancer in his dog patients will soon enter clinical trials in humans at Davis.While Monjazeb never expected to be working alongside veterinarians when he entered medicine two decades ago, he said he’s embraced work with pets in hopes it will speed discovery of new drugs, a process he finds painfully slow. “There’s a sense of urgency,” he said. “A lot of patients still need new treatments.”Other vets are testing stem cell treatments on pets, as well as cutting-edge CAR-T cell therapy, which harnesses a patient’s own immune system to kill cancer cells. Kent has a new paper coming out soon on using a dog’s own natural killer cells, a type of blood cell, to attack osteosarcoma, a bone cancer that’s remarkably similar in humans and dogs.At many of the nation’s top veterinary schools — and even at prestigious medical schools such as Stanford — veterinarians are working closely with M.D.s and Ph.D.s to further clinical research in a host of intractable diseases using a broad range of animals.“The field is building momentum,” said Dr. Kathryn M. Meurs, associate dean at the North Carolina State College of Veterinary Medicine, which is part of a large Comparative Medicine Institute where veterinarians regularly collaborate with doctors at Duke University and the University of North Carolina. “It’s taking on more substantial problems like cancer, infectious disease, cardiology and neurology,” she said. Leave this field empty if you’re human: This work comes at a critical time, those in the field say, because so few oncology drugs — or drugs for many diseases for that matter — end up getting approved for use in humans after showing early promise in lab studies.advertisement Related: They’re still critical for understanding basic pathways and molecular targets, for example. But more than 90 percent of drug treatments tested in mice have failed to translate to humans.“Mice and rats have been great, but they’re not always the right model,” said Dr. Megan Albertelli, a veterinarian and assistant professor in Stanford’s department of comparative medicine. “When you hit a wall, you’ve got to start looking for something new.”Albertelli’s department works on a variety of animals, from transgenic mice to African clawed frogs; Albertelli is in the early phases of a project to investigate whether a tiny Madagascar primate, the mouse lemur, might be a useful new model for studying human disease. She notes that CRISPR gene-editing technology is likely to allow genetic manipulations in a wide range of animals not traditionally used in lab work.She often sees raised eyebrows when she tells people she’s a vet who works at Stanford, which has no veterinary school. But Albertelli said she brings an important viewpoint to clinical research there.“I’m always thinking about different species. How is an animal going to be similar [to humans] and how is it going to be different?” she said.Vets have taken at least one page from human clinical research. They are starting to run larger and more sophisticated studies of new therapies. Tags cancercardiologydrug developmentresearchlast_img read more

California court says Novartis — and pharma — can be sued over generic drug warnings

first_img What is it? California court says Novartis — and pharma — can be sued over generic drug warnings STAT+ is STAT’s premium subscription service for in-depth biotech, pharma, policy, and life science coverage and analysis. Our award-winning team covers news on Wall Street, policy developments in Washington, early science breakthroughs and clinical trial results, and health care disruption in Silicon Valley and beyond. Tags legalpharmaceuticalsSTAT+ In a blow to the pharmaceutical industry, the California Supreme Court ruled that Novartis (NVS) can be held responsible for injuries blamed on versions of its drugs made by generic manufacturers.The ruling contradicted most decisions in courts elsewhere around the country and, importantly, may create new liability for drug makers, which could be sued in California for failing to warn patients about the risks posed by generic versions of their medicines. Log In | Learn More What’s included? Pharmalot Columnist, Senior Writer Ed covers the pharmaceutical industry. Daily reporting and analysis The most comprehensive industry coverage from a powerhouse team of reporters Subscriber-only newsletters Daily newsletters to brief you on the most important industry news of the day STAT+ Conversations Weekly opportunities to engage with our reporters and leading industry experts in live video conversations Exclusive industry events Premium access to subscriber-only networking events around the country The best reporters in the industry The most trusted and well-connected newsroom in the health care industry And much more Exclusive interviews with industry leaders, profiles, and premium tools, like our CRISPR Trackr. [email protected] center_img Unlock this article — plus daily coverage and analysis of the pharma industry — by subscribing to STAT+. First 30 days free. GET STARTED @Pharmalot By Ed Silverman Dec. 22, 2017 Reprints Pharmalot GET STARTED MARK RALSTON/AFP/Getty Images About the Author Reprints Ed Silvermanlast_img read more

Traveling over the holidays? Follow these tips to stay healthy

first_imgHealthTraveling over the holidays? Follow these tips to stay healthy Helen Branswell William Vanderson/Fox Photos/Getty Images Senior Writer, Infectious Disease Helen covers issues broadly related to infectious diseases, including outbreaks, preparedness, research, and vaccine development. Admit it. There are few things worse than being sick over the holidays.So we have some advice. Well, Dr. Gary Brunette has some advice. Brunette heads the travelers’ health branch at the Centers for Disease Control and Prevention. He gave STAT some recommendations to maximize your chances of healthy holidays, especially if you’re traveling.(Confession: We should have done this sooner. Because for those of you who are traveling overseas for the holidays, some of this advice may be coming too late. But we know some of you are probably also thinking about winter or spring break holidays — maybe Santa is slipping cruise tickets under the tree? — so it’s still worthwhile. Read on.)advertisement By Helen Branswell Dec. 22, 2017 Reprints Norovirus: An illness that strikes cruise ships, Chipotle, and maybe now the RNC Privacy Policy Related: About the Author Reprints If you haven’t had a flu shot yet, you can still get one. But it takes about two weeks for the antibodies it generates to develop, so you’ve waited a little too long to be protected at Christmas. Still, even after the season peaks, there will be flu viruses around for a few more months, so you will get some protection.There are other shots, tooPeople who are heading abroad over the holidays (or later this winter) ought to make sure their vaccinations are up to date, Brunette stressed. Diseases that won’t often spread here — because of high vaccination coverage — can still be contracted elsewhere.For instance, Greece has had a large measles outbreak this fall. And this highly contagious virus is also spreading in parts of England right now. It’s a miserable disease, and the vaccine is very protective.If you’re going further afieldPeople planning travel abroad should talk to their health care provider well in advance of their trip, Brunette said. That allows time to make sure your vaccination status is up to date and you can stock up on medicines your doctor might prescribe, such as anti-malarial drugs if you should take them.You might also ask for — or be offered — a prescription for just-in-case antibiotics, if you are going to a place where it’s quite likely you won’t be able to avoid picking up a stomach bug from the local food or water.“If we think someone is at high risk for getting traveler’s diarrhea, we might suggest they take some antibiotics with them to self-treat if they get traveler’s diarrhea,” Brunette noted. Trending Now: Please enter a valid email address. @HelenBranswell Comparing the Covid-19 vaccines developed by Pfizer, Moderna, and Johnson & Johnson Newsletters Sign up for Daily Recap A roundup of STAT’s top stories of the day. The flu season gets off to an early start — and may shift into high gear around the holidays Related: Leave this field empty if you’re human: For destinations like these, there is some simple and oft-repeated advice. Drink bottled water. Ask for ice-free drinks. Choose food sources with care.“Boil it, peel it, or forget it,” Brunette said. “It’s always safer to drink bottled water. It’s always safer to eat cooked stuff.”If you are combining the holidays with a little nip and tuckIt might not seem terribly festive, but apparently traveling to the Caribbean for plastic surgery over the holidays is a thing.“We’ve been seeing a lot of people will go down to the Dominican Republic, for example, to get elective cosmetic surgery,” Brunette said. “And they’ll often do it during the holiday season. … They can sit on the beach while they’re recovering.”The reason this has come to the CDC’s attention is because some of these folks come home with more than they bargained for — namely, drug-resistant infections. Brunette said some need surgery to repair the damage these tissue infections cause. There is no norovirus vaccine, so the main way to protect yourself is by washing your hands frequently while on board, Brunette said.The CDC has a ton of information about cruise ships and noroviruses on its website. You can even search the inspection scores of cruise lines and individual ships before you book. That tool is here.Good advice, wherever you areThe admonition to wash your hands a lot is good all-around advice for a variety of reasons, especially in winter. Germs on hands can contaminate food and spread colds and influenza.A related recommendation: Keep your fingers away from your nose and your mouth. Seriously. Someone with a cold sneezes into his hands and a little while later shakes yours. You reach up to rub the underside of your nose or pick something from your teeth and voila! You’ve put the viruses right where they want to go.About the fluInfluenza season started early this year, and there are a lot of infected people around. Holidays are an ideal time for viruses to spread — the mixing of generations makes it easy for sick kids to infect elderly relatives and others. If you get medical care abroad — either elective procedures like cosmetic surgery, or emergency surgery because you’ve fallen ill or been in a vehicle accident — tell you doctor on your return, he said.Some of the popular medical tourism destinations have higher rates of antibiotic-resistant bugs than are found in the U.S. Knowing where you got the care will help your doctor back home know how to treat an infection that arises after your return.Attention sun seekersThe CDC is still urging pregnant women to avoid travel to places where Zika may be circulating, which includes a lot of Caribbean and Latin American locations. You can find information on that here.Other mosquito-transmitted infections — dengue, chikungunya — also circulate in some of these warm locales, so remember to take precautions against bug bites, Brunette said.And Northern Hemisphere skin probably hasn’t been exposed to much sunlight for a while, so remember the sunscreen. Santa’s hat should be red. Your back should not.Best wishes for happy and healthy holidays! Speaking of cruisesA few years ago, norovirus outbreaks on cruise ships threatened to tank the industry. The industry got really serious about the problem and now pretty much sets the standard for how to clear these horrible viruses out of an environment so the following cruise is a healthy one.Still, there are occasional outbreaks. Earlier this month, people on a cruise departing from Port Everglades, Fla., came down with what’s suspected to be norovirus infections.advertisement Tags infectious diseasepublic healthVaccineslast_img read more

Caring for the caregiver in the emergency department

first_img Related: When death is imminent, end-of-life care decisions sometimes go out the window Poll: Adult caregivers undertrained and overwhelmed Privacy Policy Her mother rolls her eyes.“She’s stubborn,” Rosa says, smiling. “I try everything to get her to drink. Water. Tea. Juice.” About the Author Reprints Newsletters Sign up for First Opinion A weekly digest of our opinion column, with insight from industry experts. Adobe Comparing the Covid-19 vaccines developed by Pfizer, Moderna, and Johnson & Johnson Tags caregivingpatientsphysicians Related: Mrs. G has been in the emergency department for hours. An exhaustive workup didn’t find any serious cause for her weakness, the reason her daughter Rosa (not her real name) brought her in. I tell them that Mrs. G seems to be a bit dehydrated and, after we give her some intravenous fluids, she can go home. Mrs. G’s eyes light up. Her daughter’s go blank. Rosa dabs at a tear rolling down her cheek.  I sense that she expected, maybe even hoped, that her mother would need to stay in the hospital, even just for the night.A brick of paperwork that Rosa gave me when they arrived chronicles what has become of Mrs. G’s life — enduring the unforgiving fates of congestive heart failure, diabetes, high blood pressure, mild kidney failure, osteoporosis, depression, and early dementia. It also details her last hospital admission for pneumonia, a long stay that left her with an open ulcer on the skin over her tailbone that, months later, still hasn’t healed. Rosa was worried that another pneumonia was brewing.“I’d like to see your mom drink something,” I tell Rosa, then catch myself. I was disrespecting Mrs. G by talking around her and directing the conversation to her daughter. After decades of doctoring, I should know better. That an older patient sits in silence doesn’t mean she hasn’t a strong voice in her own care; that she carries a diagnosis of dementia doesn’t necessarily imply she can’t comprehend what I’m saying.advertisement Caring for patients sometimes requires that we reach into the shadows and shine a light on their caregivers. Even if emergency clinicians lack the time and resources to fully implement these assessment strategies, at the very least we can recognize that caregiving is difficult and that seeking help or a break isn’t a sign of weakness or failure. We must also remember that overwhelmed caregivers are often reluctant to accept assistance.Rosa doesn’t want to discuss the caregiving challenges she’s experiencing with me or a social worker. I wonder about her stiff resolve, whether my offer of assistance also invites judgement, that her siblings might consider the need for outside help to be a failure on her part.So I do what I can. I make a point of saying she is doing a great job with her mother. I home in on the pressure sore in her mother’s lower back. It is clean and healing, at least as well as those things heal. “That’s a tough wound to care for,” I say. “Really tough.”It looks for a second like Rosa will crumble into her seat. “It is,” she says. “Thank you for saying that.”Jay Baruch, M.D., is associate professor of emergency medicine and director of the Medical Humanities and Bioethics Scholarly Concentration at the Warren Alpert Medical School of Brown University in Providence, R.I. Some of the details of this case have been changed. Trending Now: Please enter a valid email address. Leave this field empty if you’re human: Caregivers often do their noble work in the shadows. It’s embarrassing to admit this, but it wasn’t until I asked Rosa what she was anxious about that I appreciated how worn down she looked with her uncombed hair, lack of makeup, loose sweatshirt, baggy sweatpants, and Crocs.Despite the negative test results, Rosa still worries that the slight fever her mother had spiked earlier in the day might point to something serious, like pneumonia. “Wouldn’t it be safer to keep her in the hospital?” she asks. Moving her mother to and from the car is a chore. She doesn’t want to get home only to have to bring her back to the hospital.I feel myself taking a different look at Mrs. G’s daughter. Is she hoping to leverage her mother’s symptoms for a break, a soft version of what has been called granny dumping?I was introduced to that concept during the first Thanksgiving of my emergency medicine residency. Families drop off elderly relatives in the emergency department with a packed bag and nebulous complaints and then take off, expecting the hospital to care for them. Other judgement-filled euphemisms include positive tail-light sign and packed suitcase syndrome. It isn’t unique to the U.S.Over the course of my training, I became angry with these families, especially when they didn’t stick around to talk to the physicians. Eventually, though, experience taught me that this problem is typically the result of systems that don’t provide enough resources for caregivers who often face daunting tasks. These obligations are equivalent to unpaid full-time jobs. Could anyone blame them for seeking a breather?Caring for caregivers can be difficult, too. It’s not easy for them to think of their own troubles when they’ve been so focused on someone else’s needs. I once cared for a middle-aged woman with signs of a heart attack, including a worrisome electrocardiogram. She refused to stay in the hospital for further evaluation because she was caring for her mother with dementia.I turn so I’m addressing both Mrs. G and Rosa. “I’d like to consult a social worker,” I say. First OpinionCaring for the caregiver in the emergency department In situations like these, a social worker can be an essential member of the treatment team. She or he can explore whether the patient is eligible for services and, if so, help arrange them. I think that might lighten Rosa’s load. But she quickly refuses. She has everything under control, she says, adding that they can’t afford extra services.Actually, it might be in Mrs. G’s best interests for Rosa to agree to get some caregiving help. One study suggests that Medicare patients who are looked after by caregivers who score high for fatigue and low for health status and depression incur higher health care costs, including more emergency department visits.An estimated 14.7 million older adults receive assistance with daily activities from spouse and family caregivers. Only one-quarter of caregivers take advantage of supportive services, possibly because many of them may not perceive themselves as caregivers, a term with professional connotations.In the emergency department, caregivers are more than the other people in the room. Their assistance can be a treasure trove of information and insight when the patient has trouble communicating with the medical staff. But when the strain of caregiving reveals itself, clinicians like me have a responsibility to pursue those worrisome cracks.Assessing a caregiver’s roles, capacities, vulnerabilities, and strengths, when done well, is a nonjudgmental process conducted by expert staff members who have the time and training to appreciate these often complex situations as well as a deep, practical understanding of possible solutions. These experts are typically social workers or nurses, but there are valuable assessment tools that serve as useful guides for busy health professionals in emergency departments and elsewhere.Implementing these tools in health care practice is an intervention strategy that one expert believes could be done today. Her brothers and sisters don’t understand how hard it is, Rosa says, and they’re not around much to find out. This time her smile can’t disguise the strain.I realize that the most acutely distressed person in the exam room isn’t Mrs. G but her daughter, her caregiver.In the emergency department, the patient receives the bulk of the attention. Physicians spend far less energy probing the caregiver’s experience. As common courtesy, I try to introduce myself to everyone when I enter the exam room. Yet this recognition of caregivers’ presence isn’t necessarily recognition of the challenges they face, and often doesn’t lead to a discussion of the burdens of such work.Caregivers are individuals, usually family members, who regularly look after one or more sick, frail, or disabled individuals. Caregiving tasks can be all-consuming. They include feeding, dressing, grooming, assistance with toiletry, bathing, shopping, cooking, housekeeping, and doing laundry. The work can extend to transportation, handling financial matters, arranging doctor visits, and sometimes making the decision to come to the emergency department.Even when undertaken from a wellspring of generosity and love, caregiving can be a source of burnout, with physical, emotional, and psychological exhaustion. Caregiver burnout occurs when individuals don’t get the help they need, try to handle too much, or take on things they aren’t capable of doing. When caregivers do carve out time for themselves, they may feel guilty about it, resulting in a paradoxical worsening of their burnout.The psychological distress and physical demands of caregiving are reflected in a wide range of biological responses that include slower wound healing, elevated blood pressure, and an impaired immune response. These can take a toll, leading to an overall increase in caregiver mortality. @JBaruchMD Jay Baruch “Can you try to drink something?” I ask Mrs. G, pointing to a Styrofoam cup half-filled with ice and water.Rosa folds a sheet and slips it behind her mother’s back as a pillow. “Drink up,” she says. “Did you hear what the doctor said? You have to drink more.”advertisement By Jay Baruch Feb. 12, 2018 Reprintslast_img read more

What Sarepta’s game-changing data mean for biotech’s other Duchenne players

first_img @damiangarde National Biotech Reporter Damian covers biotech, is a co-writer of The Readout newsletter, and a co-host of “The Readout LOUD” podcast. STAT+ is STAT’s premium subscription service for in-depth biotech, pharma, policy, and life science coverage and analysis. Our award-winning team covers news on Wall Street, policy developments in Washington, early science breakthroughs and clinical trial results, and health care disruption in Silicon Valley and beyond. By Damian Garde June 19, 2018 Reprints Unlock this article — plus daily coverage and analysis of the biotech sector — by subscribing to STAT+. First 30 days free. GET STARTED Dominic Romito, who has Duchenne muscular dystrophy, attends a 2016 FDA advisory committee hearing on an experimental treatment that has since been approved. John Boal for The Boston Globe About the Author Reprints Tags biotechnologySTAT+ Sarepta Therapeutics became the toast of biotech on Tuesday after revealing early data on a gene therapy for Duchenne muscular dystrophy that far outstripped Wall Street’s expectations.But Sarepta is hardly alone in the field, and nothing in biotech happens in a vacuum. Here’s a look at what the latest DMD results mean for the company’s competitors. Daily reporting and analysis The most comprehensive industry coverage from a powerhouse team of reporters Subscriber-only newsletters Daily newsletters to brief you on the most important industry news of the day STAT+ Conversations Weekly opportunities to engage with our reporters and leading industry experts in live video conversations Exclusive industry events Premium access to subscriber-only networking events around the country The best reporters in the industry The most trusted and well-connected newsroom in the health care industry And much more Exclusive interviews with industry leaders, profiles, and premium tools, like our CRISPR Trackr.center_img What’s included? Damian Garde Log In | Learn More GET STARTED What Sarepta’s game-changing data mean for biotech’s other Duchenne players [email protected] Biotech What is it?last_img read more

Fewer U.S. teens smoking, doing drugs, and drinking milk

first_imgOne trend that stood out was the drop in drinking milk, which started falling for all Americans after World War II. In recent decades, teens have shifted from milk to soda, then to Gatorade and other sports drinks, and recently to energy drinks like Monster and Red Bull. Comparing the Covid-19 vaccines developed by Pfizer, Moderna, and Johnson & Johnson HealthFewer U.S. teens smoking, doing drugs, and drinking milk One caveat: Most students were not asked about energy drinks so how many kids drink them now isn’t known. A study from a decade ago estimated that nearly a third of kids between the age of 12 and 17 were regularly drinking energy drinks.Kids have shifted from a dairy product rich in calcium and vitamin D to beverages laden with sugar and caffeine, which is likely contributing to the nation’s obesity problem, said Barry Popkin, a University of North Carolina researcher who studies how diets change.“This is not a healthy trend for our long-term health,” he said.For teens, the government recommends 3 cups daily of dairy products — milk, yogurt or cheese.The survey by the Centers for Disease Control and Prevention is conducted every two years. About 15,000 students at 144 high schools were surveyed last year. The surveys are anonymous and voluntary, and there’s no check of medical records or other documents to verify answers.Some of the findings:Not as many teen are having sex, although there wasn’t much change from the 2015 survey results. Last year, about 40 percent said they’d ever had sex, down from 48 percent a decade ago.There was no substantial recent change for cigarette smoking, either. About 9 percent are current smokers, down from more than 27 percent when the survey started in 1991. Ditto alcohol, with 30 percent saying they currently use alcohol, down from 51 percent in 1991.Marijuana use seems to hovering, with about 36 percent of students saying they had ever tried it. But overall, illegal drug use seems to be falling, including for synthetic marijuana, ecstasy, heroin, inhalants, and LSD and other hallucinogenic drugs. For the first time, the survey asked if they had ever abused prescription opioid medications. About 14 percent did.Another first-time question: Have you had a concussion from a sport or physical activity at least once in the previous year? Nationally, 15 percent said they had. The finding may sound high but it’s not far off from what’s been reported by some other researchers, said Michael Collins, who runs a University of Pittsburgh-affiliated sports concussion program.— Mike StobbeThe Associated Press Health & Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content. By Associated Press June 14, 2018 Reprints About the Author Reprints Tags nutritionsexual healthcenter_img NEW YORK — Fewer U.S. teens are smoking, having sex and doing drugs these days. Oh, and they’re drinking less milk, too.Less than one-third of high school students drink a glass of milk a day, according to a large government survey released Thursday. About two decades ago, it was nearly half.Last year’s survey asked about 100 questions on a wide range of health topics, including smoking, drugs, and diet. Researchers compared the results to similar questionnaires going back more than 25 years.advertisement Gerald Herbert/AP Associated Press Trending Now: The survey showed slightly fewer kids are drinking soda and sports drinks now, compared to the last survey in 2015.advertisementlast_img read more