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Tag: Healthcare

  • Significant variations in hip fracture health costs and care between NHS hospitals and regions, study finds

    Significant variations in hip fracture health costs and care between NHS hospitals and regions, study finds

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    Newswise — There are significant variations in healthcare spending and care delivery across NHS hospitals in England and Wales following hip fracture, a new study aimed at understanding how hospital care impacts patients’ outcomes and costs has revealed. 

    The study, led by the University of Bristol and funded by Versus Arthritis, highlights the urgent need for evidence-based quality improvement strategies to reduce healthcare spending and improve patient outcomes in the year following a hip fracture.  The research is published online in The Lancet Healthy Longevity today [10 July].

    Hip fracture is a serious health concern, with more than 70,000 older adults admitted to a UK hospital each year. This study highlights the high healthcare burden associated with breaking a hip.

    The research analysed data from national databases for 178,757 hip fracture patients aged 60 years and above in England and Wales, who broke their hip between 2016 and 2019, followed up to just before the pandemic. More than one in four patients died within a year of their hip fracture.

    Patients spent an average of 32 days in hospital in the year following a hip fracture, resulting in substantial inpatient costs of on average £14,642 per patient – a cost similar to that incurred in the year after a stroke, and that exceeds costs of many common cancers. But this cost varied substantially between hospitals, with more than a two-fold difference in spending, ranging from £10,867 to £23,188 per patient, between 172 NHS hospitals studied in England and Wales.

    The researchers identified that in hospitals where patients are up and about quickly after their operation and where physiotherapy is provided seven days a week, patient costs were lower, and patients spent fewer days in hospital in the year following hip fracture.

    The research further highlighted the crucial role of orthogeriatricians – consultant geriatricians who specialise in the care of people with fractures – in hip fracture care.

    Dr Petra Baji, Senior Research Associate in Health Economics at Bristol Medical School: Translational Health Sciences (THS) and the paper’s first author, explained: “The findings suggest that having all patients assessed by an orthogeriatrician within the first days of admission could cut healthcare spending by £529 per patient, as well as reduce the chance of dying by 15% in the year following hip fracture.”

    Dr Rita Patel, Senior Research Associate in Medical Statistics at Bristol and statistician for the study, added: “If a consultant orthogeriatrician attends hospital clinical governance meetings, a further cost saving of £356 per patient could potentially be achieved, as well as patients spending fewer days spent in the hospital in the year following hip fracture.”

    “Hospitals with fracture liaison services also have lower mortality rates and patients spend fewer days in hospital. Our study suggests that rather than increasing the burden on the NHS, providing additional care for patients with orthogeriatrician and fracture liaison services may actually improve NHS efficiency.”

    The study highlights the importance of addressing the way hospitals deliver hip fracture care to improve the effectiveness and efficiency of hip fracture services, and the need to develop evidence-based quality improvement strategies across the UK, to achieve financial savings while also improving patient outcomes.

    Celia Gregson, Professor in Clinical Epidemiology in the Musculoskeletal Research Unit at the University of Bristol and Chief Investigator of the study, commented, “The variation we have seen in patient outcomes and health spending following hip fracture are difficult to justify on purely clinical grounds, it tells us that the way we organise the delivery of care can be improved nationally.

    “By prioritising orthogeriatrician assessment, getting patients out of bed promptly after surgery, providing seven-day physiotherapy, reducing delirium risk for patients, and holding monthly multidisciplinary clinical governance meetings, hospitals stand to improve patient outcomes and reduce their healthcare spending.”

    Caroline Aylott, Head of Research Delivery at Versus Arthritis, said: “This research shows the unacceptable state of care for older people who break their hip. The findings show that older people have a high chance of dying within a year of a hip fracture, and that quality of care varies hugely between NHS hospitals in England and Wales.

    “As hip fractures mainly affect older people, many of whom live with multiple long-term conditions, this research suggests we are not getting older people’s care right. That must change.

    “The study found that better, faster access to orthogeriatricians and fracture liaison services would not only reduce people’s risk of dying and improve chances of a better recovery, but also reduce NHS spending. Just weeks after publication of the NHS workforce plan, the study provides yet further evidence of the desperate and immediate need for a properly resourced NHS.”

    The research team has already developed a potential solution, after working with the Royal Osteoporosis Society to develop an innovative toolkit – REDUCE hip fracture service implementation toolkit – informed by the results of their research.

    The toolkit is freely available to all healthcare professionals and service managers to support the quality improvement of fracture service provision within the 172 acute hospital settings across England and Wales.

    This study follows previous work from the REDUCE study (REducing unwarranted variation in the Delivery of high-qUality hip fraCture services in England and Wales), published last year in Age and Ageing, the journal of the British Geriatrics Society, which focused on patient outcomes of hip fracture patients in the short term.

    The study was funded by Versus Arthritis (ref: 22086), the UK’s biggest charity supporting people with arthritis and musculoskeletal conditions, and supported by the National Institute for Health and Care Research Bristol Biomedical Research Centre (NIHR Bristol BRC).

    Paper

    ‘Organisational factors associated with hospital costs and patient mortality in the 365 days following hip fracture in England and Wales (REDUCE): a record-linkage cohort study’ by Petra Baji, Elsa M R Marques, Celia L Gregson et al. in The Lancet Healthy Longevity [open access]

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    University of Bristol

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  • أظهرت جراحة طفيفة التوغل لتحديد مرحلة سرطان البنكرياس نتائج إيجابية في تحديد سير المرض، وذلك وفقًا لدراسة أجرتها مايو كلينك.

    أظهرت جراحة طفيفة التوغل لتحديد مرحلة سرطان البنكرياس نتائج إيجابية في تحديد سير المرض، وذلك وفقًا لدراسة أجرتها مايو كلينك.

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    Newswise — روتشستر، مينيسوتا— أظهرت دراسة نُشرت في مجلة الكلية الأمريكية للجراحين أن إجراء جراحة بسيطة للمرضى الذين شُخصت إصابتهم حديثًا بمرض سرطان البنكرياس قد يساعد في تحديد مدى انتشار السرطان مبكرًا ومعرفة مرحلته. وأضاف الباحثون أنه يفضل أن تُجرى هذه الجراحة قبل أن يبدأ المريض العلاج الكيميائي.

    يقول مارك تورتي، دكتور في الطب، اختصاصي جراحة الأورام في مركز مايو كلينك الشامل لعلاج السرطان، ورائد هذا البحث: “هذه دراسة مهمة لأنها تدعم أسلوب تحديد مرحلة المرض باستخدام التنظير البطني للمساعدة في تحديد سير المرض ومعرفة العلاج المناسب حتى يتفادى المرضى العلاج الجراحي غير الفعّال أو الذي يحتمل أن يكون ضارًا.” وأضاف: “إن نسبة النجاة من سرطان البنكرياس ضئيلة للغاية مقارنةً بأنواع السرطان الأخرى، كما أنه ينتشر بسرعة. لذلك فإن الحصول على هذه المعلومات في حالة انتشار السرطان سيفيد المرضى ويساعد الأطباء على تحديد العلاج الصحيح للمريض في أسرع وقت ممكن.”

    يُسمى العلاج الجراحي طفيف التوغل التنظير البطني المرحلي حيث يُدخل الجراح مصدر ضوئي وكاميرا (منظار بطني) إلى داخل البطن عبر شقوق رفيعة وصغيرة ليرى ما إذا كان السرطان قد انتشر داخل التجويف البطني. وقد يدمج الطبيب مع هذا الإجراء الغسيل البريتوني، حيث يُدخل سائل إلى داخل التجويف البطني ثم يخرجه ويفحصه تحت الميكروسكوب بحثًا عن خلايا سرطانية.

    خلال دراسة استمرت خمس سنوات، قام فريق الدراسة بتقييم بيانات أكثر من 1000 مريض، وأظهر البحث أن مريضًا واحدًا من كل 5 مرضى ممن خضعوا للتنظير البطني المرحلي لسرطان البنكرياس كان مصابًا بسرطان منتشر في الكبد أو بطانة البطن (الصفاق). 

    بالإضافة إلى ذلك، اكتشف الباحثون مجموعة متنوعة من العوامل التي تحدد المرضى الأكثر عرضة لانتشار السرطان. وشملت هذه العوامل عمر المريض وموضع الورم والواسمات الورمية (CA 19-9) في الدم. يقول الباحثون أنه كلما زادت عوامل الخطر الموجودة، زادت مخاطر انتشار السرطان.

    تقول هالبيرا جودموندسدوتير، دكتور في الطب، طبيبة جراحة عامة مقيمة، وباحثة في مركز روبرت د. وباتريشيا إي. كيرن لتقديم الرعاية الطبية في مايو كلينك: “نوصي، بناءً على هذه النتائج، أن يُجرى التنظير البطني المرحلي قبل بدء العلاج الكيميائي لأغلبية المرضى المصابين بسرطان البنكرياس والمرشحين للخضوع للجراحة.” يمكن أن تساعد نتائج التنظير البطني المرحلي في تحديد الخيار الأمثل لكل مريض، مثل الاستئصال الجراحي أو العلاج الكيميائي.

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    نبذة عن مايو كلينك
    مايو كلينك هي مؤسسة غير ربحية تلتزم بالابتكار في الممارسات السريرية والتعليم والبحث وتوفير التعاطف والخبرة لكل مَن يحتاج إلى الاستشفاء والرد على استفساراته. لمعرفة المزيد من أخبار مايو كلينك، تفضَّل بزيارة شبكة مايو كلينك الإخبارية.

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    Mayo Clinic

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  • Medicaid Expansion Associated with Increased, But Not High Quality, Screening for Alcohol Use

    Medicaid Expansion Associated with Increased, But Not High Quality, Screening for Alcohol Use

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    Newswise — People living in states with expanded Medicaid access were more likely to be screened by their doctor for alcohol use compared to people who lived in states that did not expand Medicaid access, but they did not necessarily receive effective interventions. A study published in Alcohol: Clinical and Experimental Research found that living in a state with expanded Medicaid access was associated with a higher prevalence of lower-income adults’ receiving some alcohol screening at a recent checkup but not receiving higher quality screening or brief counseling. The authors suggest that expanded Medicaid access may increase screening via increased access to primary care but that policies that target healthcare provider constraints are also needed to increase high-quality, evidence-based screening and counseling around alcohol use.

    The study is the first to examine whether an increased likelihood of receiving alcohol screening and brief counseling among nonelderly low-income adults was associated with living in a state that expanded Medicaid eligibility under the Affordable Care Act (ACA). After the passage of the ACA, the federal government offered states subsidies to expand eligibility for Medicaid to include all nonelderly adults with incomes up to 138% of the federal poverty level. Researchers reviewed responses to the 2017 and 2019 National Behavioral Risk Factor Surveillance System from nearly 16,000 low-income adults aged 18 to 64 living in 14 states that expanded Medicaid eligibility before 2017 and nine states that did not.

    Researchers found that living in a state that expanded Medicaid eligibility is associated with a slightly higher prevalence of receiving general alcohol screening at a primary care checkup within the past two years. However, it found no significant associations between living in Medicaid expansion states and evidence-based interventions for alcohol misuse, including being asked about the quantity of drinking and, among respondents who drank heavily, receiving advice about what harmful drinking is or how to reduce or quit drinking.

    The study also explored the relationship between expanded access to Medicaid and alcohol interventions for people with chronic health conditions caused or worsened by moderate or heavy alcohol use, such as high blood pressure and diabetes. For these adults, living in a state with expanded Medicaid eligibility was associated with a greater prevalence of receiving more thorough alcohol screening, such as being asked how much they drink and being screened for binge drinking. Expanded access to Medicaid was not associated with an increased prevalence of receiving brief counseling about reducing or stopping drinking.

    The researchers noted that the rates of receiving screening and counseling were low across the study sample, with only 60 percent of respondents reporting being asked whether they drink and, of people who reported drinking within the last month, only half reported being asked how much they drank and a third were asked about binge drinking. Of people who reported drinking heavily, less than a third had been offered advice about what constitutes risky drinking, and less than 20 percent were advised to reduce or quit drinking. The authors suggest that healthcare provider and system barriers, such as limited training, lack of tools for screening and referral, and time constraints, may be responsible for the low rates of screening and counseling and should be addressed.

    Residence in a Medicaid-expansion state and receipt of alcohol screening and brief counseling by adults with lower incomes: Is increased access to primary care enough? A. Phillips, K. Karriker-Jaffe, K. Bensley, M. Subbaraman, J. Delk, N. Mulia. (p. x-xx)

    ACER-23-5604.R2

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    Research Society on Alcoholism

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  • Tip Sheet: Understanding cancer-related pain, newborn screening for deadly immune disorder — and new Fred Hutch leadership

    Tip Sheet: Understanding cancer-related pain, newborn screening for deadly immune disorder — and new Fred Hutch leadership

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    Newswise — SEATTLE — July 6, 2023 — Below are summaries of recent Fred Hutchinson Cancer Center research findings and other news.

    If you’re looking for resources who can comment on skin cancer awareness and skin protection during the summer months, see our list of experts and reach out to [email protected] to set up interviews.

    Cancer research and care

    Pinpointing pain: Is it cancer or cancer treatment? Distinguishing side effects of cancer treatment from potential metastatic recurrence can be difficult. In a Q&A, Dr. Hanna Hunter, medical director of cancer rehabilitation at Fred Hutch, s best practices on how doctors and patients can work together to manage pain symptoms.     

    American Society of Clinical Oncology Annual Meeting 2023 highlights: Fine-tuning cancer care Fred Hutch researchers at ASCO’s annual meeting d their latest findings in cellular immunotherapy, early detection cancer screening tests, interplays between the microbiome and genetics in colorectal cancer and more.    

    Cancer Health Equity Podcast: Nurses in cancer care The latest episode of Fred Hutch’s Office of Community Outreach and Engagement’s monthly podcast explores the role of nurses in cancer care and how they’re part of working toward health and well-being for everyone. Two Fred Hutch nurses on the blood and bone marrow transplant team — Arlyce Coumar and Jennifer Lynch — their stories of working with patients and families, as well as educating other nurses. They also discussed how nurses are getting more engaged in advocating for policies in health care. Fred Hutch community health educators Aden Afework, who works with African-American populations, and Snowy Johnson, who works with Indigenous populations, moderated the discussion.

    Severe combined immunodeficiency A new analysis published in The Lancet shows that newborn screening is the biggest factor in preventing deaths from the rare inherited disorder called severe combined immunodeficiency, also known as “bubble boy disease.” Babies born with SCID appear healthy at birth but are vulnerable to infections and usually die within the first two years of life unless they’re treated with immune-restoring treatment, such as stem cell transplant. Dr. Monica Thakar, pediatric bone marrow transplant physician, led the analysis which was published June 20. Read more in a National Institute of Allergy and Infectious Disease news release.

    Diversity, equity and inclusion

    Me Loving You: Themes of healing and moving forward Fred Hutch celebrated the start of Pride month with its fourth art installation as part of the Public Art & Community Dialogue Program featuring artist Ariadne Campanella. Initiated by Fred Hutch’s DEI Core, the program commissions artwork from artists representing diverse communities with the aim of engaging Fred Hutch employees and the broader community in conversations of solidarity with underrepresented groups. Campanella, a queer, non-binary trans woman and mixed media artist, was selected to create a piece focusing on LGBTQIA+ communities as they reflect on healing and moving from surviving to thriving.    

    New Fred Hutch leaders

    Dr. Sara Hurvitz joins Fred Hutch, University of Washington Breast oncologist Dr. Sara Hurvitz has been named the new senior vice president of the Clinical Research Division at Fred Hutch and head of the Division of Hematology and Oncology at the University of Washington Department of Medicine. She will begin her role Aug. 1. Currently at UCLA, Hurvitz is an international expert in breast oncology and a leader in clinical and laboratory-based oncology research, with extensive experience in leading clinical trials spanning all phases.   

    Fred Hutch announces new member, leadership on board of directors Fred Hutch announced one new member of its board of directors and its newly elected chair and vice chair. Pete Shimer, chief operating officer at Deloitte, will join the board. Leigh Morgan, chief strategy and operating officer at the Nia Tero Foundation, has been appointed the new chair of the board of directors, and Sean Boyle, chief operating officer at Omniva, has been appointed vice chair.    

    Awards and grants

    Dr. Mroj Alassaf named a 2023 Helen Hay Whitney Fellow Dr. Mroj Alassaf, postdoctoral fellow in Dr. Akhila Rajan’s lab, received a 3 year $215,000 Helen Hay Whitney foundation fellowship. Her work focuses on how mitochondrial components from fat can reach the brain and what influence they have on its health. A neurobiologist by training, Alassaf joined Rajan’s team after showing in her graduate work how a new mitochondrial protein contributes to neuronal health.    

    Dr. Sita Kugel receives V Foundation Translational Research Award Pancreatic cancer researcher Dr. Sita Kugel has received an inaugural Translational Research Award from the V Foundation for Cancer Research. The $800,000, four-year grant will allow Kugel to pursue an innovative Phase 1b clinical trial to translate from the lab to the clinic breakthroughs her group has made in developing a tailored treatment for a subtype of pancreatic cancer.    

    Dr. Cecilia Moens elected inaugural member of the Society for Developmental Biology Academy Developmental biologist Dr. Cecilia Moens joins nine other scientists elected to the newly created Society for Developmental Biology Academy. Moens work focuses on using zebrafish as a model to study the genes that control the brain’s early development. Her current research looks at how immature neurons make their connections to muscles and other neurons in the process of building functional circuits.    

    Lung cancer expert Dr. McGarry Houghton receives Satya and Rao Remala Family Endowed Chair Dr. McGarry Houghton, a pulmonary physician-scientist, studies the immune system’s role in cancer and lung cancer early detection. He was named the first recipient of the Satya and Rao Remala Family Endowed Chair, which provides support for a researcher working on both lung cancer and the promotion of equitable access to health and education. Houghton is pursuing a plasma-based diagnostic tool that would be used in conjunction with CT screening for lung cancer early detection.   

    Virus researchers Cohn and Blanco-Melo win coveted grants Drs. Lillian Cohn and Daniel Blanco-Melo are both early career scientists studying viruses and recently received support for their work through scholar programs. Cohn was named a biomedical scholar by the Pew Charitable Trust and Blanco-Melo was named a Searle scholar. Cohn’s research focuses on finding ways to cure HIV/AIDS by eradicating reservoirs of latently infected blood cells that persist despite continuous therapy with antiviral drugs. Blanco-Melo focuses on exploring how viruses evolve and how the human immune response to them changes over time.    

    Science spotlight Science Spotlight is a monthly installment of articles written by postdoctoral fellows at Fred Hutch that summarize new research papers from Fred Hutch scientists. If you’re interested in learning more or covering these topics, contact: [email protected]

    # # #

    Fred Hutchinson Cancer Center unites individualized care and advanced research to provide the latest cancer treatment options and accelerate discoveries that prevent, treat and cure cancer and infectious diseases worldwide.

    Based in Seattle, Fred Hutch is an independent, nonprofit organization and the only National Cancer Institute-designated cancer center in Washington. We have earned a global reputation for our track record of discoveries in cancer, infectious disease and basic research, including important advances in bone marrow transplantation, immunotherapy, HIV/AIDS prevention, and COVID-19 vaccines. Fred Hutch operates eight clinical care sites that provide medical oncology, infusion, radiation, proton therapy and related services and has network affiliations with hospitals in four states. Fred Hutch also serves as UW Medicine’s cancer program.

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  • FDA approves Alzheimer’s treatment Leqembi, clearing the way for Medicare coverage

    FDA approves Alzheimer’s treatment Leqembi, clearing the way for Medicare coverage

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    The U.S. Food and Drug Administration on Thursday granted full approval to the Biogen BIIB and Eisai Co. Ltd. ESALF Alzheimer’s treatment Leqembi, a step that secures Medicare reimbursement for the first drug shown to slow the progress of the disease, rather than just treating its symptoms.

    Leqembi, also known as lecanemab, is a monoclonal antibody designed to reduce the buildup of amyloid beta plaque in the brain, a marker of Alzheimer’s disease.

    The…

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  • La determinación temprana de la etapa del cáncer de páncreas con cirugía de invasión mínima muestra resultados positivos en el pronóstico del paciente, según estudio de Mayo Clinic

    La determinación temprana de la etapa del cáncer de páncreas con cirugía de invasión mínima muestra resultados positivos en el pronóstico del paciente, según estudio de Mayo Clinic

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    Newswise — ROCHESTER, Minnesota — Un estudio publicado en el Journal of the American College of Surgeons revela que realizar un procedimiento quirúrgico menor en pacientes con un diagnóstico reciente de cáncer de páncreas ayuda a identificar la diseminación temprana del cáncer y determinar la etapa del cáncer. Los investigadores agregan que lo ideal sería que la cirugía se realice antes de que el paciente comience la quimioterapia.

    “Es un estudio importante porque respalda el hecho de que la laparoscopia de estadificación puede ayudar a determinar el pronóstico de un paciente y brindar más información para el tratamiento con el fin de que los pacientes eviten un tratamiento quirúrgico inútil o potencialmente dañino”, dice el Dr. Mark Truty, oncólogo cirujano del Centro Oncológico Integral de Mayo Clinic, quien dirigió esta investigación. “El cáncer de páncreas es el más difícil de combatir de todos los tipos de cáncer y se disemina rápido. Por lo tanto, contar con la información de si el cáncer se ha diseminado beneficiará a los pacientes y ayudará a los médicos a determinar el tratamiento adecuado para el paciente lo antes posible”.

    El procedimiento quirúrgico de invasión mínima se denomina laparoscopia de estadificación y lo realiza un cirujano insertando una luz y una cámara (laparoscopio) en el abdomen a través de hendiduras pequeñas y delgadas para ver si el cáncer se ha diseminado dentro de la cavidad abdominal. El cirujano también puede combinarlo con lavados peritoneales, donde se inserta líquido en la cavidad abdominal y después se extrae y evalúa con un microscopio en busca de células cancerosas.

    Durante el estudio de cinco años, los autores evaluaron datos de más de 1000 pacientes, y la investigación mostró que 1 de 5 pacientes que se sometieron a una laparoscopia de estadificación para el cáncer de páncreas tenía cáncer que se había diseminado al hígado o al revestimiento del abdomen (peritoneo). 

    Además, los investigadores hallaron una variedad de factores que identificaron qué pacientes tenían más probabilidades de que el cáncer se diseminara. Estos factores incluían la edad del paciente, la ubicación del tumor y los marcadores tumorales (CA 19-9) en la sangre. Los investigadores sostienen que cuantos más factores de riesgo estén presentes, mayor será el riesgo de encontrar cáncer diseminado.

    “En función de estos resultados, recomendamos que la laparoscopia de estadificación se realice antes de comenzar la quimioterapia en la mayoría de los pacientes que padecen cáncer de páncreas y que se está considerando para cirugía”, destaca el primer autor, el Dr. Hallbera Gudmundsdottir, médico residente de cirugía general y académico del Centro Robert D. y Patricia E. Kern para la Ciencia de Brindar Atención Médica de Mayo Clinic. Los hallazgos sobre la laparoscopia de estatificación pueden orientar sobre qué tratamiento será la mejor opción para cada paciente, como la extirpación quirúrgica o la quimioterapia.

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    Información sobre Mayo Clinic
    Mayo Clinic es una organización sin fines de lucro, dedicada a innovar la práctica clínica, la educación y la investigación, así como a ofrecer pericia, compasión y respuestas a todos los que necesitan recobrar la salud. Visite la Red Informativa de Mayo Clinic para leer más noticias sobre Mayo Clinic.

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  • Mayo Clinic Healthcare en Londres incorpora médicos en varias especialidades médicas

    Mayo Clinic Healthcare en Londres incorpora médicos en varias especialidades médicas

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    Newswise — LONDON — Mayo Clinic Healthcare incorpora varios médicos, entre ellos cardiólogos, un gastroenterólogo, expertos en salud femenina y masculina, y radiólogos especializados en diversas afecciones y técnicas de obtención de imágenes. Varios de los médicos son multilingües.

    Mayo Clinic Healthcare, ubicada en 15 Portland Place, en el área médica de Harley Street, ofrece asistencia médica personalizada que incluye atención especializada, segundas opiniones, obtención de imágenes médicas avanzadas y planes de bienestar a medida. La clínica también funciona como puerta de entrada a los aproximadamente 4000 médicos de Mayo Clinic en los Estados Unidos.

    Los siguientes profesionales forman parte de Mayo Clinic Healthcare:

    • Dr. Stephen Brecker, cardiólogo especializado en enfermedades de las válvulas cardíacas y en la relación entre las enfermedades cardíacas y las afecciones cerebrovasculares, o del cerebro y los vasos sanguíneos, como el accidente cerebrovascular. El Dr. Brecker trata una amplia gama de afecciones cardíacas, como angina de pecho, dolor de pecho causado por la reducción del flujo de sangre al corazón; síncope neurocardiogénico, desmayo debido a una disminución repentina de la frecuencia cardíaca y la presión arterial; trastornos del ritmo cardíaco; insuficiencia cardíaca congestiva; y defectos del tabique auricular, orificios en el corazón que aumentan el flujo de sangre a través de los pulmones.
    • Tito Kabir, Licenciado en Medicina y Cirugía, cardiólogo intervencional cuyas áreas de interés incluyen angioplastía, procedimiento que se utiliza para abrir arterias cardíacas obstruidas; síndrome coronario agudo, reducción repentina del flujo de sangre al corazón; trastornos del ritmo cardíaco; insuficiencia cardíaca congestiva; y ateroesclerosis, acumulación de placa en las paredes arteriales; síncope; e presión arterial alta.
    • Dr. Ricardo Petraco, cardiólogo especializado en angina de pecho, dificultad respiratoria, dolor de pecho, enfermedad de las arterias coronarias e insuficiencia cardíaca. El Dr. Petraco habla inglés y portugués con fluidez.
    • Dr. Pradeep Bhandari, gastroenterólogo que trata afecciones, como función hepática anormal; reflujo de ácido gástrico; esófago de Barrett; cambios en los hábitos intestinales; enfermedad de Crohn; úlceras pépticas; dispepsiao indigestión; enfermedad inflamatoria intestinal; síndrome de colon irritable; obesidad; sangrado rectal; y pérdida de peso. El Dr. Bhandari habla inglés e hindi con fluidez.
    • May Al-Araji, Licenciada en Medicina y Cirugía, médica en medicina general cuyas áreas de interés incluyen la medicina familiar y la salud femenina, incluida la menopausia. La Dra. Al-Araji habla inglés y árabe con fluidez.
    • Vikas Mehta, Licenciado en Medicina y Cirugía, médico en medicina general cuyas áreas de interés incluyen la salud masculina, la salud femenina y la medicina relacionada con el estilo de vida. El Dr. Mehta trata afecciones, como el asma y otras afecciones respiratorias crónicas; diabetes; afecciones de oído, nariz y garganta; salud familiar; salud sexual; afecciones gástricas; afecciones musculoesqueléticas; y afecciones urológicas. Habla inglés, hindi, punjabi, swahili y urdu con fluidez.
    • Ashok Adams, Licenciado en Medicina y Cirugía, radiólogo especializado en afecciones de oído, nariz y garganta; afecciones de las glándulas salivales; y enfermedades de la tiroides. El Dr. Adams habla inglés y español con fluidez.
    • Muaaze Ahmad, Licenciado en Medicina y Cirugía, radiólogo cuyas áreas de interés incluyen obtención de imágenes musculoesqueléticas, artritis, tendinitis y tumores de tejidos blandos.
    • David Rohan Evans, Licenciado en Medicina y Cirugía, radiólogo especializado en radiología mamaria, incluido los exámenes de detección de cáncer de mama.  
    • Hatef Mansoubi, Licenciado en Medicina y Cirugía, radiólogo cardiotorácico. El Dr. Mansoubi habla inglés, farsi y griego con fluidez.
    • Graham Munneke, Licenciado en Medicina y Cirugía, radiólogo especializado en obtención de imágenes torácicas, abdominales y oncológicas.
    • Niall Power, Membresía del Royal College of Physicians of Ireland, radiólogo cuyas áreas de interés incluyen la obtención de imágenes abdominales, gastroenterológicas y hepatobiliares. El Dr. Power habla inglés e irlandés con fluidez.

    Mayo Clinic Healthcare ofrece una variedad de herramientas de diagnóstico, como obtención de imágenes cardíacas avanzadas, colonoscopias y otros exámenes de detección de cáncer, ecografías abdominales, pruebas de densidad ósea, angiografías coronarias por tomografía computarizada, imágenes por resonancia magnética (IRM), radiografías, electrocardiogramas y ecocardiogramas.

    ###

    Información sobre Mayo Clinic Healthcare
    Mayo Clinic Healthcare, ubicada en Londres, es una subsidiaria de propiedad absoluta de Mayo Clinic, un centro médico académico sin fines de lucro. En los Estados Unidos, según Newsweek, Mayo Clinic ocupa el puesto n.º 1 en el mundo y, según U.S. News & World Report, ocupa el primer puesto en la nación por un motivo: la calidad de la atención médica. Mayo Clinic Healthcare es la puerta de entrada del Reino Unido a esa experiencia incomparable. Visite Mayo Clinic Healthcare para obtener más información. 

    Información sobre Mayo Clinic
    Mayo Clinic es una organización sin fines de lucro, dedicada a innovar la práctica clínica, la educación y la investigación, así como a ofrecer pericia, compasión y respuestas a todos los que necesitan recobrar la salud. Visite la Red Informativa de Mayo Clinic para leer más noticias sobre Mayo Clinic.

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  • NUS pharmacists develop a “cheeky” and pain-free solution for drug delivery

    NUS pharmacists develop a “cheeky” and pain-free solution for drug delivery

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    Newswise — Singapore, 4 July 2023 – Conventional ways of administering medication – by swallowing tablets, consuming bitter syrups, injections or rectal insertions – could be distressing and unpleasant for some patients, especially young children or the elderly. A team of researchers led by Associate Professor Chan Sui Yung, Honorary Fellow at the Department of Pharmacy under the Faculty of Science at the National University of Singapore (NUS), has recently developed easy-to-use oral films that enable painless, efficient, and discreet drug administration.

    This patient-friendly drug delivery method is now being commercialised through an NUS start-up PharLyfe+ founded by Assoc Prof Chan and her students, Dr Tan Poh Leng and Ms Chua Qi Shan, who are the Business Lead and Clinical Lead of PharLyfe+ respectively. The start-up is supported by NUS Graduate Research Innovation Programme (GRIP), a venture creation programme which encourages NUS researchers and postgraduate students to start their own deep-tech companies.

    The novel oral film releases drugs into the bloodstream via the mucosal membrane – the moist, inner lining of the mouth. Each oral film can be easily placed onto the inner cheek of the patient’s mouth, and medication will be released into the bloodstream over pre-determined period of time.

    This method of medication administration reduces the risk of choking, aspiration, and rejection. Moreover, the manufacturing method of the films eliminates dosing errors commonly associated with multi-dose bottles of liquid medicine.

    Patient-centric, personalised drug delivery

    Assoc Prof Chan said, “Our oral film marks a significant milestone in patient-centric and personalised medicine, offering a safer and eco-friendly alternative to traditional drug delivery methods. The film is very easy to use, so patients are empowered with dignity and independence in managing their treatment from the comfort of their homes. We look forward to collaborating with healthcare providers to develop and apply the oral films to improve patient care and treatment outcomes.”

    Each oral film is very thin and round, and it comes in two sizes – 10- and 20-cent coin sizes – making it convenient to be carried around, distributed, or stored in larger quantities at healthcare institutions. Additionally, the films have a low water content, so they have a longer shelf life compared to compounded liquid medicines, hence they could be a reliable option for patients and healthcare providers.

    The oral film developed by NUS researchers is convenient to use, and enables painless, efficient, and discreet drug administration.

    The team’s first oral film product will focus on administering medications for patients suffering from end-of-life delirium and anxiety. The process of treating end-of-life symptoms can be painful as injections are often administered, when comfort care should be the top priority. “We hope that our solution can help improve the quality of care for these patients,” said Ms Chua. The film may also benefit epileptic patients, with more studies underway.

    A sustainable and cost-effective solution

    The oral films are easy to produce. Each film comprises a customised premix of ingredients formulated for a specific medication. These ingredients are added to the drug solution, and an accurate volume of the required drug dosage is pipetted onto a mould. The resulting mixture is dried using a light-duty oven. This method of production uses fewer ingredients and smaller quantities of materials compared to traditional drug-delivery methods, particularly those that require costly, single-use applicators and devices such as syringes, needles, inhalers, and auto-injectors.

    Without the need for bulky packaging, or the use of dosage-measuring devices such as syringes and spoons, which are made of plastic and supplied with each treatment course, the oral film is therefore more environmentally friendly and cost-effective.

    Dr Tan, whose PhD work focused on oral films, explained, “Our films are compounded on-demand to ensure that they contain the precise dosage and strength for each patient, and then sealed in minimal packaging. This streamlined approach to drug delivery not only saves time and money, but also reduces the environmental impact.”

    Associate Professor Lita Chew, President of the Singapore Pharmacy Council, and a clinical faculty member at NUS Pharmacy who is not involved in the start-up, said, “The innovative approach to compound prescribed drug into oral film is a game-changer for delivery of medication, especially to segment of populations that have difficulty taking traditional dosage forms such as tablets, capsules, syrups and injections. I look forward to the day when the oral film premix kits can be extended to home use, like the many self-test kits on pharmacy shelves.”

    After drying the films using a light-duty oven, the research team seals them in compact packaging so that they can be carried around conveniently.

    Future plans

    The NUS team has filed a provisional patent for this innovative approach. Currently, the researchers are developing and evaluating their film products for different medications, such as for antidotes, general medication, and medication for pets, to prepare for regulatory filing in Singapore and the United States of America.

    They plan to supply the premix of the oral film to healthcare institutions for pharmacists and clinic staff to prepare oral film medications when doctors prescribe them to patients. HCA Hospice Care is one of the healthcare institutions whom they partnered for the initial launch of their ready-to-market package comprising facilities set-up and staff training for preparing film medicines using PharLyfe+ premix.

    The team also aims to work with investors, regulatory experts, contract manufacturers, and pharmaceutical marketers to commercialise their technology.

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    National University of Singapore (NUS)

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  • Find the latest expert commentary on the recent U.S. Supreme Court decisions here

    Find the latest expert commentary on the recent U.S. Supreme Court decisions here

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    This Thursday, the United States Supreme Court rejected affirmative action at colleges and universities around the nation, declaring that the race-conscious admissions programs at Harvard and the University of North Carolina were unlawful. Now on Friday, the Supreme Court decided to block the Biden administration’s student debt relief program and sided with a Christian web designer in Colorado who refuses to create websites to celebrate same-sex weddings out of religious objections. Despite their limited federal elected power, Conservatives have racked up more huge wins in the great political battles of the early 21st century.

    Newswise is your source for expert commentary. Below is a roundup of recent expert pitches concerning the United States Supreme Court.

    Sociologists Available to Discuss Affirmative Action Ruling in College Admissions

    – American Sociological Association (ASA)

    Law and diversity experts react to Supreme Court’s affirmative action decision

    – Tulane University

    Three important takeaways from SCOTUS decision in Groff v. DeJoy

    – University of Georgia

    SCOTUS decision on race-based admission: experts can comment

    – Indiana University

    U law expert available to comment on Supreme Court decision on affirmative action

    – University of Utah

    Recent SCOTUS decision puts to rest extreme 2020 presidential election claims, confirms state judicial input on states’ election rules

    – University of Georgia

     

     

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  • Half of global prison tuberculosis cases remain undetected

    Half of global prison tuberculosis cases remain undetected

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    Newswise — In 2019, incarcerated people across the globe developed tuberculosis (TB) at nearly 10 times the rate of people in the general population, according to a new study led by Boston University School of Public Health (BUSPH).

    Published in The Lancet Public Health, the study found that 125,105 of the 11 million people incarcerated worldwide developed tuberculosis in 2019, a rate of 1,148 cases per 100,000 persons per year.

    Despite this high case rate, nearly half of TB cases among incarcerated people were not detected.

    The findings reveal the first global and regional estimates of new TB cases among incarcerated people, a population at high risk of developing this life-threatening disease. Collectively, the high case rate and low detection underscore the need for greater awareness and resources to reduce the burden of TB in prisons and other high-risk settings.

    “Our study showed that only 53 percent of people that develop tuberculosis in prisons are diagnosed, which suggests that incarcerated people are neglected and have minimal healthcare services to diagnose tuberculosis,” says study lead and corresponding author Dr. Leonardo Martinez, assistant professor of epidemiology at BUSPH.

    To better understand TB rates among this population, Dr. Martinez and colleagues acquired data from published research and from countries’ federal officials to analyze TB prevalence and incidence in 193 countries at the country, regional, and global level between 2000-2019. The team also calculated TB case detection rates per year in each country for 193 countries.

    The African region had the highest rate of new TB cases in 2019, at 2,242 cases per 100,000 persons per year, but the Americas region—largely driven by Central and South America—had the greatest number of total cases, which increased nearly 90 percent since 2000. The countries with the highest number of new cases in prisons in 2019 were Brazil, Russia, China, the Philippines, and Thailand.

    Importantly, the team found that new TB case rates remained consistently between 1,100 and 1,200 cases per 100,000 persons per year from 2012-2019.

    “This stagnation suggests that current tuberculosis control policy in prisons is insufficient to decrease the tuberculosis burden and that supplementary interventions and policy implementation are needed,” says Dr. C. Robert Horsburgh, professor of global health at BUSPH.

    Mass incarceration is one major driver of TB transmission—both inside and outside of prisons.  Overcrowding, where some prison cells contain up to 30 people, causes TB to “spread like wildfire,” Dr. Martinez says, and this transmission can spill over easily into the community.

    “Contrary to popular belief, persons that are incarcerated are a mobile population, and in many countries, the duration of incarceration is very short,” he says. “People go into prison, then come out, then may go back in again. So, very often, people that develop tuberculosis in prison end up transmitting the disease to many people outside of prison once they are released. Since almost half of people with tuberculosis in prisons are not diagnosed, many still remain infectious when they enter back into the general community.”

    The team hopes that these findings will encourage global and regional health organizations to develop routine monitoring of TB among incarcerated people, as they do for other high-risk populations such as people with HIV and household contacts. The researchers say that their comprehensive compilation of TB case notifications—which they retrieved directly from federal officials, national and regional organizations, and non-governmental organizations—is a clear indication that information about TB in prisons is both accessible and retrievable by global organizations such as the World Health Organization.

    The team is currently working with several health organizations to attempt to update global guidelines on how to manage and reduce TB in prisons, as the most recent guidelines were written in the year 2000.

    “One of the reasons this population is so neglected is because of the lack of data,” Dr. Martinez says. “Our hope is that these results can help stakeholders understand the urgency of the issue and the amount of people in prisons that develop tuberculosis and remain undiagnosed for long periods of time and can spur them to take action.”

    **

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    Boston University School of Public Health

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  • AACC and National Kidney Foundation Release Guidance to Combat Racial and Gender Inequalities in Chronic Kidney Disease Care

    AACC and National Kidney Foundation Release Guidance to Combat Racial and Gender Inequalities in Chronic Kidney Disease Care

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    Newswise — WASHINGTON—Today, AACC—in collaboration with the National Kidney Foundation (NKF)—released guidance to reduce racial and gender disparities in the care of patients with chronic kidney disease (CKD). The document gives members of the healthcare team actionable, evidence-based tools to improve equity in kidney health, including recommendations for using an updated algorithm that does not disproportionately affect any one group of individuals. 

    Read the guidance document here: https://www.aacc.org/science-and-research/aacc-academy-guidance/improving-equity-in-chronic-kidney-disease-care

    In the United States, 37 million adults—or 1 in 7 people—are affected by kidney disease. The AACC/NKF guidance builds on the progress of a joint task force of the NKF and the American Society of Nephrology, which in 2021 recommended new equations for determining estimated glomerular filtration rate (eGFR), a gauge of kidney function. Previously, eGFR was calculated using a variable for Black race because study participants who described themselves as African American were found to have higher blood levels of creatinine, a marker for kidney disease, than other groups. The new equations don’t include this variable.

    As the guidance explains, factoring race into clinical algorithms can lead to unintentional biases because race and ethnicity are social, rather than biological, constructs. While genetic variants may influence kidney disease risk in some Black individuals, definitions of race vary widely and have changed over time. Moreover, Black and Hispanic people are more likely to experience lower quality of care and poorer outcomes due to inequitable access to health and social resources.

    The guidance includes recommendations for integrating race-free equations into laboratory information systems and communicating the change to providers. It also calls on clinical laboratory professionals to help reduce racial and ethnic disparities in CKD by participating in multidisciplinary teams to improve disease detection, particularly in high-risk populations, and working to standardize biomarker testing and reporting.

    “Race and ethnicity are imprecise, nebulously defined systems of classification as they pertain to genetic ancestry, physiological characteristics, and socioeconomic status, and therefore should not be used to classify individuals into distinct biological categories,” said the guidance lead authors Drs. Christina C. Pierre and Mark A. Marzinke.

    The AACC/NKF document also recommends incorporating a marker called cystatin C into eGFR equations in addition to creatinine, because equations that use both markers show superior performance over those that use one or the other.

    In addition, the guidance provides recommendations to improve the management of CKD in gender-diverse patients. Because biological sex impacts creatinine levels, the eGFR equations include a variable to account for sex. But applying a binary sex variable is problematic for transgender people because gender-affirming hormones can cause changes in muscle mass and fat distribution that affect creatinine. For gender-diverse patients, the authors of the guidance suggest calculating eGFR using male and female variables, and taking an inclusive, holistic approach to disease management.

    About AACC

    Dedicated to achieving better health through laboratory medicine, AACC brings together more than 70,000 clinical laboratory professionals, physicians, research scientists, and business leaders from around the world focused on clinical chemistry, molecular diagnostics, mass spectrometry, translational medicine, lab management, and other areas of progressing laboratory science. Since 1948, AACC has worked to advance the common interests of the field, providing programs that advance scientific collaboration, knowledge, expertise, and innovation. For more information, visit www.aacc.org.

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  • KU Cancer Center receives historic $100 million gift from Sunderland Foundation to support new cancer research and care facility

    KU Cancer Center receives historic $100 million gift from Sunderland Foundation to support new cancer research and care facility

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    Newswise — The University of Kansas Cancer Center has received a $100 million lead gift to build a new, state-of-the-art destination cancer center. This gift is both the largest gift ever given by the Sunderland Foundation and the largest ever received by the University of Kansas and The University of Kansas Health System.

    This gift raises the total to $143 million for a building to bring together cancer research, treatment and patient care teams, transforming cancer care in the region.

    “We believe The University of Kansas Cancer Center is poised to change cancer research and care for generations,” said Charlie Sunderland, trustee of the Sunderland Foundation and former chair of The University of Kansas Hospital Authority Board’s Quality Committee. “Giving people the opportunity to receive such a high level of quality cancer treatment close to home is a gift like no other. I’m grateful for the foundation’s role in making this possible.”

    The Sunderland Foundation gift is one of several significant investments in the new building. Earlier this year, it was announced that U.S. Senator Jerry Moran (Kan.) — a member of the Senate Committee on Appropriations — secured $43 million in congressionally directed spending to plan and help build research aspects of the new facility.

    “After years of hard work and dedication, The University of Kansas Cancer Center was awarded the NCI’s comprehensive cancer center designation, opening up new possibilities and greater federal investment,” said Moran. “The KU Cancer Center is already a nationally recognized leader in the fight to treat and cure cancer. With a new, state-of-the-art cancer center, The University of Kansas Cancer Center can expand its legacy and capabilities to conduct a greater number of innovative research projects, which will undoubtedly lead to improved treatments for patients.”

    University of Kansas Chancellor Douglas A. Girod, M.D., recognized the importance of such investments to the future of the cancer center.

    “The funding provided by the Sunderland Foundation, combined with the appropriation secured by Senator Moran, will enable the KU Cancer Center to enhance its work in research and patient care while fulfilling its duty to provide public education and outreach programs, especially to diverse communities and high-risk populations,” said Girod. “More broadly, by strengthening the KU Cancer Center, this funding elevates the entire university and strengthens KU’s position as a leading national research institution and proud member of the Association of American Universities. We deeply appreciate the Sunderland Foundation and Senator Moran’s continued support of the KU Cancer Center and the university, and we look forward to partnering with them in the future on initiatives that benefit Kansas.”

    KU Cancer Center leadership has long had a vision to bring the entire cancer community — from physician-scientists to researchers to physicians and clinical staff — all under one roof. Doing so enables spontaneous and serendipitous collaborations, which often lead to fresh, new thinking needed to solve cancer’s most complex puzzles, a belief closely held by Roy Jensen, M.D., vice chancellor and director of the KU Cancer Center.

    “Our vision is for The University of Kansas Cancer Center to be a beacon of hope and a global destination for both those with cancer and for scientists and clinicians seeking to cure cancer,” Jensen said. “This building will be a hub that brings together leading-edge patient care and innovation as we seek to transform both cancer care and cancer research in our quest to cure cancer — together. Patients treated at NCI-designated cancer centers have a 25% greater chance of survival compared to other cancer centers because of the enhanced relationship between patient care and research. This building will advance our goals even further, serving as a catalyst for breakthroughs that will change cancer care on the national level.”

    Currently, The University of Kansas Cancer Center’s labs and researchers are scattered across multiple campuses in the Kansas City metro area and Lawrence, Kansas. There is a need to provide options to expand space for patient care and cancer research, as well as foster multidisciplinary collaborative research efforts. On the heels of the KU Cancer Center’s NCI comprehensive cancer center designation, a world-class research and clinical space putting patients at the center of science and clinical care will make it a global destination for the best cancer treatment.

    “Advancing the KU Cancer Center through this funding and this new building will continue to benefit the University of Kansas Medical Center, its researchers and its students,” said Robert D. Simari, M.D., executive vice chancellor of KU Medical Center. “It also means more collaboration, more cutting-edge research and more opportunities to pursue team science with researchers, scientists and faculty members throughout our schools of Medicine, Nursing and Health Professions.”

    “The University of Kansas Cancer Center is a transformative engine, which will not only reshape how cancer care is delivered but also our community as a destination for the very best cancer care available anywhere,” said Tammy Peterman, M.S., FAAN, president, Kansas City division, and health system executive vice president, chief operating officer and chief nursing officer. “We are doing things at the cancer center not done anywhere else in the country. With our nationally recognized specialists and world-class care teams, we will deliver even more groundbreaking treatments and innovations.”

    The new facility will be located on the 39th and Rainbow campus. It will be built in phases, with the goal of breaking ground on the first phase by the earliest in the fall of 2024. The new building will bring expanded cancer care and research together in one place. Patients will have access to more innovative clinical trials and groundbreaking therapies developed on site. In addition, the whole patient experience — from nutrition and social workers to pathology and imaging, and everything in-between — will happen in one place. Researchers also will be able to collaborate in real time with physicians on personalized treatment options, making them more quickly available to patients.

    “We do big things in Kansas City, due in large part to the generosity and vision of people like Charlie and Kent Sunderland and the Sunderland Foundation,” said Bob Page, president and CEO of The University of Kansas Health System. “The commitment of our community and elected officials like Senator Moran have placed The University of Kansas Health System and The University of Kansas Cancer Center at the center of Kansas City’s transformation. This new building is more than a building; it is about taking a bold step to say, ‘We believe we can transform the way cancer research and care is provided in our region, across this country and around the globe.’ We not only will save more lives, we will change more lives and our community for the better.”

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  • توصلت أبحاث Mayo Clinic أن من يعانون من السُمنة المفرطة وأحد المتغيرات الجينية، عرضة أكثر للإصابة بارتفاع ضغط الدم

    توصلت أبحاث Mayo Clinic أن من يعانون من السُمنة المفرطة وأحد المتغيرات الجينية، عرضة أكثر للإصابة بارتفاع ضغط الدم

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    Newswise — روتشستر ، مينيسوتا – تعتبر السمنة وما يرتبط بها من مشاكل في القلب والأوعية الدموية مصدر قلق كبير في جميع أنحاء العالم. وجدت دراسة أجرتها Mayo Clinic أن الأشخاص الذين يعانون من السمنة ولديهم متغير جيني معين معرضون بشكل متزايد لخطر الإصابة بارتفاع ضغط الدم. 

    مع السمنة ، يزداد خطر الإصابة بأمراض القلب والأوعية الدموية ، والتي تشمل السكتة الدماغية وفشل القلب الاحتقاني واحتشاء عضلة القلب. السمنة مرض متعدد العوامل ينتج عن اختلال توازن الطاقة. السمنة عامل خطر قابل للتعديل لأمراض القلب والأوعية الدموية. 

    وضحت ليزيث سيفينتس، دكتور في الطب “الباحثة في علم الجهاز الهضمي في Mayo Clinic “يتم التحكم في وزن الجسم من خلال مجموعة معقدة ومتعددة من التفاعلات بين العوامل الوراثية والعوامل البيئية. “تتراوح احتمالية الإصابة بالسُمنة الوراثية بين 40% إلى 70%، ولكن فقط 10% من حالات السُمنة المفرطة المبكرة تحدث بسبب جيني.” 

    تلك المتغيرات هي نتيجة لحدوث طفرات متنحية في الجينات المسؤولة عن مسار الليبتين والميلانوكورتين، وهو المسار المسؤول عن تنظيم تناول الطعام ووزن الجسم. وتعد هذه التغيرات الجينية الأكثر انتشارًا، حيث لوحظ وجودها في 6% من الأطفال و2.5% من البالغين الذي يعانون من السُمنة المفرطة المبكرة. 

    وفي برنامج الطب الدقيق للسُمنة التابع لـ Mayo Clinic، أرادت د. سيفينتس وزملاؤها دراسة الاختلافات بين عوامل الخطر للمرض القلبي الوعائي وبين الأمراض التي تصيب من يعانون من السُمنة المفرطة، سواءً كان لديهم المتغير الجيني أو لم يكن. ووضحت “بفهم تأثير هذه المتغيرات على صحة القلب والأوعية الدموية يمكننا مساعدة الأطباء لعلاج عوامل الخطر القابلة للتعديل في مرضى السُمنة المفرطة.” 

    لتحقيق ذلك، قام الباحثون بعمل دراسة مستعرضة على المشاركين في البنك الحيوي التابع لـ Mayo Clinic ممن يعانون من سمنة مفرطة. تم تعريف السمنة المفرطة على أنها زيادة مؤشر كتلة الجسم عن 40، أو الحاجة إلى إجراء جراحة علاج السُمنة بعد ثبوت وجود متغير جيني في مسار الليبتين والميلانوكورتين للمريض. يتكون الينك الحيوي التابع لـ Mayo Clinic من مجموعة من العينات الطبية والتي تشمل عينات الدم ومشتقاته، والمعلومات الطبية التي تبرع بها مرضى Mayo Clinic لاستخدامها في الأبحاث الطبية المستمرة. 

    تم تحديد 168 حامل للمتغير الجيني MC4R. ووجد الباحثون في مايو كلينك أن الحاملين لهذا المتغير كانوا أكثر عرضة للإصابة بارتفاع ضغط الدم، كما كان لديهم عدد أكبر من عوامل الخطر لأمراض القلب والأوعية الدموية مقارنة بغير الحاملين للمتغير الجيني وعددهم 2039. ووضح د. أندريس أكوستا، دكتور في الطب، الباحث الرئيسي في معمل الطب الدقيق للسُمنة “لم يؤثر العمر أو الجنس أو مؤشر كتلة الجسم -وكلها عوامل خطر لأمراض القلب والأوعية الدموية- على النتائج، وتوصلنا في النهاية إلى أن الحاملين للمتغير الجيني أكثر عرضة للإصابة بارتفاع ضغط الدم”. 

    مع ذلك، وتبعًا للنتائج، فالحاملين للمتغير الجيني MC4R ليسو أكثر عرضة للإصابة بالمرض القلبي الوعائي أو للوفاة، تبعًا للنتائج التي عُرضت في إحدى أبحاث مجلة “مايو كلينيك بروسيدنجز – Mayo Clinic Proceedings”. استكمل د. أكوستا، كبير الباحثين، قائلًا: “توقعنا وجود زيادة أكبر في ارتفاع ضغط الدم، لأن زيادة الوزن تنبئ بالإصابة بارتفاع ضغط الدم”. 

    وأعربت د. سيفينتس عن تفاجؤ الباحثين من عدم وجود علاقة ثابتة مع المرض القلبي الوعائي. ووضحت ” نظرًا لمدى تعقيد مسببات المرض القلبي الوعائي، فببساطة قد يكون هناك قدر ضخم من البيانات التي لم يتم قياسها في تحليلاتنا”. 

    تكمن أهمية هذا البحث بالنسبة للأطباء في إدراك أن مرضى السُمنة الذين أظهر تنميطهم الوراثي وجود متغيرات متباينة الزيجوت في مسار اللبتين والميلانوكورتين قد لا يكونون محميين من ارتفاع ضغط الدم كما كان يعتقد سابقًا. ووضحت د. سيفينتس “يحتاج هؤلاء المرضى إلى مزيد من الاهتمام بعوامل الخطر القابلة للتعديل لارتفاع ضغط الدم، بما فيها أنواع العلاج الفردية للسُمنة”. 

    قد يصاب الأفراد الحاملين للمتغير الجيني بالسُمنة منذ الطفولة، لكن لم يتم توثيق الفترة الزمنية في الورقة التي قدمها الباحثون في Mayo Clinic. نحتاج إلى أبحاث أخرى لتحديد مخاطر الإصابة طويلة المدى للسمنة وللمرض القلبي الوعائي في الحاملين للمتغير الجيني. 

    من بين قيود هذا البحث أن 90% من المشاركين في بنك الحيوي لـ Mayo Clinic من البيض، لذا لا يمكننا تعميم نتائج هذا البحث على الأعراق الأخرى. 

    تلقى بحث د. أكوستا الدعم من المعاهد الوطنية للصحة، ومن البنك الحيوي التابع لـ Mayo Clinic، وشركة Rhythm لدراسة الأنماط الجينية. لم يتم الإعلان عن أي تضارب في المصالح. يقدم مركز Mayo Clinic للطب الفردي الدعم للبنك الحيوي لـ Mayo Clinic. 

    يمكنكم الرجوع إلى الورقة البحثية للتعرف على القائمة الكاملة للمؤلفين، والتمويل وتضارب المصالح، والإفصاحات. 

    لمزيد من المعلومات، يمكنك الرجوع إلى مدونة مركز Mayo Clinic للطب الفردي.  

    ###   

     نبذة عن مايو كلينك للرعاية الصحية   مايو كلينك للرعاية الصحية، الموجودة في لندن، هي شركة فرعية مملوكة بالكامل لمؤسسة مايو كلينك، وهو مركز طبي أكاديمي غير هادف للربح. تُصنَّف مايو كلينك في المرتبة الأولى بين المستشفيات وفقًا لتقرير يو إس نيوز آند وورد ريبورت بسبب: جودة الرعاية. مايو كلينك للرعاية الصحية هي المدخل الرئيسي في المملكة المتحدة لتلك التجربة التي لا مثيل لها. تفضل بزيارة مايو كلينك للرعاية الصحية لمزيد من المعلومات.   

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  • No more needles? A daily pill may work as well as Wegovy shots to treat obesity

    No more needles? A daily pill may work as well as Wegovy shots to treat obesity

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    That’s a notion that has long fueled hope for many of the more than 40% of Americans who are considered obese — and fueled criticism by those who advocate for wider weight acceptance. Soon, it may be a reality.

    High-dose oral versions of the medication in the weight-loss drug Wegovy may work as well as the popular injections when it comes to paring pounds and improving health, according to final results of two studies released Sunday night. The potent tablets also appear to work for people with diabetes, who notoriously struggle to lose weight.

    Drugmaker Novo Nordisk
    NOVO.B,
    +0.22%
    plans to ask the U.S. Food and Drug Administration to approve the pills later this year.

    “If you ask people a random question, ‘Would you rather take a pill or an injection?’ People overwhelmingly prefer a pill,” said Dr. Daniel Bessesen, chief of endocrinology at Denver Health, who treats patients with obesity but was not involved in the new research.

    That’s assuming, Bessesen said, that both ways to take the medications are equally effective, available and affordable. “Those are the most important factors for people,” he said.

    There have been other weight-loss pills on the market, but none that achieve the substantial reductions seen with injected drugs like Wegovy. People with obesity will be “thrilled” to have an oral option that’s as effective, said Dr. Katherine Saunders, clinical professor of medicine at Weill Cornell Health and co-founder of Intellihealth, a weight-loss center.

    Novo Nordisk already sells Rybelsus, which is approved to treat diabetes and is an oral version of semaglutide, the same medication used in the diabetes drug Ozempic and Wegovy. It comes in doses up to 14 milligrams.

    But results of two gold-standard trials released at the American Diabetes Association’s annual meeting looked at how doses of oral semaglutide as high as 25 milligrams and 50 milligrams worked to reduce weight and improve blood sugar and other health markers.

    A 16-month study of about 1,600 people who were overweight or obese and already being treated for Type 2 diabetes found the high-dose daily pills lowered blood sugar significantly better than the standard dose of Rybelsus. From a baseline weight of 212 pounds, the higher doses also resulted in weight loss of between 15 and 20 pounds, compared to about 10 pounds on the lower dose.

    Another 16-month study of more than 660 adults who had obesity or were overweight with at least one related disease — but not diabetes — found the 50-milligram daily pill helped people lose an average of about 15% of their body weight, or about 35 pounds, versus about 6 pounds with a dummy pill, or placebo.

    That’s “notably consistent” with the weight loss spurred by weekly shots of the highest dose of Wegovy, the study authors said.

    But there were side effects. About 80% of participants receiving any size dose of oral semaglutide experienced things like mild to moderate intestinal problems, such as nausea, constipation and diarrhea.

    In the 50-milligram obesity trial, there was evidence of higher rates of benign tumors in people who took the drug versus a placebo. In addition, about 13% of those who took the drug had “altered skin sensation” such as tingling or extra sensitivity.

    Medical experts predict the pills will be popular, especially among people who want to lose weight but are fearful of needles. Plus, tablets would be more portable than injection pens and they don’t have to be stored in the refrigerator.

    But the pills aren’t necessarily a better option for the hundreds of thousands of people already taking injectable versions such as Ozempic or Wegovy, said Dr. Fatima Cody Stanford, an obesity medicine expert at Massachusetts General Hospital.

    “I don’t find significant hesitancy surrounding receiving an injection,” she said. “A lot of people like the ease of taking a medication once a week.”

    In addition, she said, some patients may actually prefer shots to the new pills, which have to be taken 30 minutes before eating or drinking in the morning.

    Paul Morer, 56, who works for a New Jersey hospital system, lost 85 pounds using Wegovy and hopes to lose 30 more. He said he would probably stick with the weekly injections, even if pills were available.

    “I do it on Saturday morning. It’s part of my routine,” he said. “I don’t even feel the needle. It’s a non-issue.”

    Some critics also worry that a pill will also put pressure on people who are obese to use it, fueling social stigma against people who can’t — or don’t want to — lose weight, said Tigress Osborn, chair of the National Association to Advance Fat Acceptance.

    “There is no escape from the narrative that your body is wrong and it should change,” Osborn said.

    Still, Novo Nordisk is banking on the popularity of a higher-dose pill to treat both diabetes and obesity. Sales of Rybelsus reached about $1.63 billion last year, more than double the 2021 figure.

    Other companies are working on oral versions of drugs that work as well as Eli Lilly and Co.’s
    LLY,
    +0.25%
    Mounjaro — an injectable diabetes drug expected to be approved for weight-loss soon. Lilly researchers reported promising mid-stage trial results for an oral pill called orforglipron to treat patients who are obese or overweight with and without diabetes.

    Pfizer
    PFE,
    -1.11%    ,
    too, has released mid-stage results for dangulgipron, an oral drug for diabetes taken twice daily with food.

    Novo Nordisk officials said it’s too early to say what the cost of the firm’s high-dose oral pills would be or how the company plans to guarantee adequate manufacturing capacity to meet to demand. Despite surging popularity, injectable doses of Wegovy will be in short supply until at least September, company officials said.

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  • The expanded Child Tax Credit led to improved health and nutrition among adults

    The expanded Child Tax Credit led to improved health and nutrition among adults

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    EMBARGOED FOR USE UNTIL:

    1:30 p.m. (EDT) on June 24, 2023

    Newswise — Monthly cash payments to eligible families under the temporary pandemic-era expansion of the federal Child Tax Credit led to better adult health and food security, new UCLA-led research suggests.

    The policy, which expired at the end of 2021, has not been renewed due to concerns among legislators over the credit being overly generous, particularly to lower-income families with limited tax liability, and the lack of an associated work requirement. The findings, to be published June 24 in JAMA Health Forum, could inform the debate over the policy’s future, said Dr. Jordan Rook, a fellow in the National Clinician Scholars Program at UCLA and the study’s lead author.

    “Cash transfer programs like the 2021 Child Tax Credit expansion may be powerful tools in improving the health, wellbeing, and nutrition of families,” said Rook, who is also a general surgery resident at the David Geffen School of Medicine at UCLA.  “Evidence like this can help guide the public, the media, and politicians as they advocate for and debate the policy’s future.

    Currently about one in six U.S. families with children lives in poverty, leading to poorer health and shorter life expectancy, according to the research team.

    Prior to the pandemic, the Child Tax Credit provided up to $2,000 per child ages 16 or younger for families with eligible incomes. Under the pandemic-era American Rescue Plan signed into law on March 11, 2021, the credit increased to $3,600 per child ages five or younger, and $3,000 per child ages 6 to 17. Families were eligible to receive half of this amount in the form of monthly checks, which each month were worth between $250 to $300 per child. The credit was fully refundable, meaning that all low-income families with children were eligible to receive the entire credit, regardless of their work status or income.

    These monthly payments reduced poverty by 40% in households with children, according to the researchers. But the policy, a temporary measure to assist families during the pandemic, expired on December 31, 2021.

    The researchers used data taken from about 39,500 respondents to the National Health Interview Survey from January 2019 to December 2021. They found that prior to initiation of the monthly payments, 60% of credit-eligible adults reported excellent or very good health and 88% reported having food security– that is, access to sufficient food to meet normal dietary needs. Among ineligible adults, 55% said they had excellent or very good health and 89% reported food security.

    They then used a study design known as a “difference-in-differences” technique to compare changes in health and food security between credit-eligible families and credit-ineligible families to estimate the impact of the Child Tax Credit monthly payments. Based on this technique, they estimate that following the start of the payments, eligible adults were 3 percentage points more likely to report excellent or very good health and 1.9 percentage points more likely to report food security than ineligible adults.

    “Assuming the conservative estimate of one adult per household, this represents improved health for 1.08 million adults, and newfound food security for 684,000 households,” Rook said. “These changes potentially represent important gains in health and nutrition for hundreds of thousands of US families because of this pandemic-era policy.”

    The study has some limitations, among them the possibility that job losses and expansions to other social programs such as unemployment and SNAP during the pandemic might have affected the findings.

    Additional study authors are Dr. Cecile Yama, Dr. Adam Schickedanz, Dr. Steven Lee, and Lauren Wisk of UCLA; and Dr. Alec Feuerbach of SUNY Downstate /Kings County.

    The study was funded by the VA Office of Academic Affiliations and the Los Angeles County Department of Health Services, both through the National Clinician Scholars Program Fellowship; the National Institute of Diabetes and Digestive and Kidney Diseases (K01 DK116932 and R03 DK132439); the Eunice Kennedy Shriver National Institute of Child Health and Human Development (K23HD099308); and the Health Resources and Services Administration of the U.S. Department of Health and Human Services (UA6MC32492, the Life Course Intervention Research Network). The contents do not represent the views of the U.S. Department of Veterans Affairs or the United States Government.

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  • ‘Take Care of Maya’: What to Read and Watch After Netflix’s Doc

    ‘Take Care of Maya’: What to Read and Watch After Netflix’s Doc

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    In 2015, nine-year-old Maya Kowalski developed an illness that immobilized her and left her in excruciating pain. The new Netflix documentary Take Care of Maya begins with her family’s desperate search for an answer. They visit specialist after specialist until they finally find a doctor with a diagnosis and a miracle cure; the family travels to Mexico for an experimental treatment, and Maya emerges with her life, ready to begin healing.

    In a different movie, this might be the end of the story. But a tragedy is set into motion when a 2016 trip to a new hospital for a relapse of pain, when Maya is 10 years old, leads a team of doctors to decide that Maya’s mother might be guilty of medical child abuse, also known as Munchausen syndrome by proxy. Maya is separated from her parents, who are interrogated by doctors and police officers, and the hospital even resorts to video surveillance of Maya for evidence that she is faking her illness.

    We’ve become accustomed to stories of monstrous mothers and horrific maltreatment of children, but Take Care of Maya asks if that pop psychology has led to false accusations and medical disregard for a family’s real suffering. Director Henry Roosevelt keeps a tight focus on the devastating story of Maya’s time in state custody—which ended after her mother, Beata, took her own life, writing in an email that she could no longer bear the pain of being apart from Maya and treated as a criminal—and the legal battle that ensued. Still, the documentary eventually makes the case that the Kowalskis were far from the only family to be torn apart by the child welfare system.

    “At a certain point, you have to stop filming,” producer Caitlin Keating recently told Vanity Fair, noting that even Maya’s story hadn’t yet come to a conclusion. “But this is their truth, that the trial [against the children’s hospital] hasn’t happened yet. And we think that’s important to show that they are still fighting.”

    Of course, the fight is too complex to fully capture in just one documentary. If you finished Take Care of Maya and are still curious about the forces that converged in that Florida children’s hospital seven years ago, these recent books, podcasts, features, and documentary series are a natural next stop.

    “Bad Medicine,” USA Today (2020) and “What Happened to Maya,” New York magazine (2022)

    After Sarasota Herald-Tribune reporter Daphne Chen wrote her first story about the Kowalski family in January 2019, other families contacted her about their own experiences with the Pinellas County child protection team and its lead child abuse pediatrician, Sally Smith. In “Bad Medicine,” a later investigation for USA Today, Chen delved deeper into other cases that Smith had overseen, illustrating the sway her medical judgments held in the county’s courtroom and hospitals, even when other experts disagreed.

    In 2022, reporter Dyan Neary used a trove of new documents and interviews to tell Maya’s story more fully in New York magazine. Her story explored how Maya’s admission to Johns Hopkins All Children’s Hospital in St. Petersburg escalated into an accusation of Munchausen syndrome by proxy, and why the state doubled down on the fight against the Kowalski family even after further evidence indicated Maya’s mother was not responsible for her condition. Neary also reported that Smith and her employer in the privatized Florida child welfare system had settled their part of a suit with the Kowalskis for $2.5 million.

    NBC News’ “Do No Harm” feature series and podcast (2019)

    After Maya Kowalski’s story inspired Chen to investigate the system in Florida, NBC News and the Houston Chronicle released a gripping series of stories examining the child welfare system in Texas and the plights of parents mistakenly accused of abuse. By analyzing abuse reports that were later judged to be unsupported by evidence, the writers document the close links between hospitals and the agencies that often fund their child protection teams. One mother in the series made harrowing recordings of her interactions with the doctors and social workers who decided that her child’s head injury must have been caused by abuse, and her tapes form the backbone of a companion podcast about a byzantine system that seems to especially punish the parents who want to prove their innocence.

    In 2020, a joint Marshall Project and Atlantic investigation examined the cooperation between doctors and the child welfare system, with a close eye on the small but influential field of child abuse pediatrics. That subspecialty has existed only since 2009, when the American Board of Pediatrics first certified doctors who had been trained in diagnosing abuse-related injuries, and now certified child abuse pediatricians work closely with prosecutors and testify in high-profile trials across the country. By examining two heartbreaking cases in which doctors dismissed potential genetic causes of health issues in children or preexisting conditions, the investigation asks whether close ties to the legal system can lead doctors to villainize parents instead of searching for the truth.

    Abusive Policies: How the American Child Welfare System Lost Its Way by Mical Raz (2020)

    In her comprehensive history of the child welfare system in the late 20th century, Mical Raz, a professor of public health and policy at the University of Rochester, illustrates how a movement that aimed to support families in need began to emphasize prosecutions and family separations. Though the book focuses on the racial and class dynamics that shaped the system as it formed, it also tells the story of the doctors who first tried to get the nation to focus on child abuse, and the policymakers who turned that rising awareness into a harmful legal strategy.

    The Battle for Justina Pelletier (2022)

    In this Peacock documentary, director David Metzler tells the story of 14-year-old Justina Pelletier, who was taken into state custody in 2013 after a fight between her parents and a hospital system. As in Maya Kowalski’s case, one team of doctors believed she had a rare disorder, but another had decided that her parents were fabricating or causing her symptoms. Ultimately, Pelletier spent nearly a year in a locked psychiatric ward as her parents fought the court—and promoted her case ceaselessly in the media. After she returned to her family’s care in 2014, questions still remained about the true nature of her illness and what really happened behind the scenes at the hospital. By revisiting the Pelletier family, the journalists who covered the case, and a handful of her far-flung supporters nearly a decade later, the docuseries tries to answer them.

    We Believe the Children: A Moral Panic in the 1980s by Richard Beck (2015)

    Throughout Take Care of Maya, the filmmakers depict many paradoxical moments in which doctors and social workers claim to speak for Maya’s best interests while disbelieving her description of her pain and her pleas to be reunited with her family. In We Believe the Children, Beck tells a history of child protection that focuses on the group psychology of adults who come together with the best interests of children in mind—and all the ways that concern can go awry. Though the book is centered on the lurid day care abuse trials of the 1980s, Beck connects the lessons of that moment to ideas about abuse and protecting children that still ring true.

    The School for Good Mothers by Jessamine Chan (2022)

    In her best-selling novel about a dystopian reeducation program for substandard mothers, Chan hauntingly dramatizes the aftermath of a report of child neglect. Inspired by a feature about the traumatic experiences one mother faced in family court, Chan began writing about a fictional mother named Frida who, after a lapse in judgment, is sentenced to time at a facility where she must practice mothering with a robot baby under total surveillance. “After I started reading more about these issues, I learned that her story is one of many,” she later told PEN America. “The injustice I felt on that mother’s behalf, as well as my own intense ruminating on motherhood, fueled the development of Frida’s story.”

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  • Working toward Black reproductive justice from the Library of Congress

    Working toward Black reproductive justice from the Library of Congress

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    Newswise — Historian Tamika Nunley can see the U.S. Supreme Court through the window of her office in the Library of Congress in Washington, D.C., where she is serving as the library’s Cary and Ann Maguire Chair in Ethics and American History this summer. It’s a great vantage point, she said, not only for looking out at landmarks of American government, but also for reflecting on the ways laws and judgements have negatively influenced Black maternal health throughout American history.

    “I think the Library of Congress is one of the most democratic institutions we have, one of the best examples of what is possible in our democracy,” said Nunley, associate professor of history in the College of Arts and Sciences (A&S). “It’s been a great synergy for me to be in the library and to think about the relationship between what the government does and the work that I’m trying to capture … . The building is glamorous, but the work itself – I think we don’t oftentimes value what it means to live the life of the mind, that in order to produce this knowledge, we really do have to get quiet and we have to read, we have to study, and we have to try to understand.”

    Nunley is using her time at the Library of Congress to build the historical context for The Black Reproductive Justice Archive, a digital collection of oral histories from people at the forefront of addressing the Black maternal health and reproductive crisis. The archive will be housed on a website available to the public and feature a database of oral histories, critical essays, and multimedia forms of storytelling from medical and legal professionals, doulas, organizers and others. Her project is supported by a New Frontier Grant (NFG) from A&S.

    Today in the United States, Black women are three to five times more likely to face maternal death than white women, regardless of social, educational and economic status, Nunley said; Black infants are more likely to face life-threatening complications or mortality, and both are likely to receive poor treatment from America’s hospital systems.

    While this has become more understood in this contemporary moment, what’s less understood is Black women’s reproductive lives during the earlier periods of American history, said Nunley, who is writing a book on the subject as well as building the oral history archive.

    “I’m thinking about the history of Black women’s relationship to reproduction, which includes reproductive history, law and medicine,” she said. “It’s been fascinating research to conduct while simultaneously launching an oral history project on Black women activists, providers, doula collectives, who are on the front lines of addressing the crisis. There is the historical component to it, and there is the very present on-the-ground moment we’re trying to capture through this project with the New Frontier Grant.”

    The Black Reproductive Justice Archive will focus, at first, on Cleveland. Named one of the worst places in the U.S. for Black women in terms of health, economic, social and political outcomes, Nunley said, it also has a Black middle class that’s been affected by the crisis in Black maternal health.

    “In Cleveland, there are interesting dynamics happening with advancements in medicine and also rampant levels of poverty, bureaucratic challenges and barriers to accessing health care benefits,” Nunley said. “It is an important place to begin because it captures ways that other American cities might be struggling with this issue, as well.”

    Cornell doctoral candidate Arielle Rochelin, a specialist in Black women’s history, together with undergraduate researchers, will collect oral histories. The goal is to eventually expand to other American cities.

    Black women’s historical struggle for reproductive justice is far from over, Nunley said, a reminder, as America just celebrated Juneteenth as a national holiday, that “legal freedom is only the beginning of a long, long, rigorous fight for equality.”

    “I think the fight for reproductive justice, particularly for Black families, is a testament to that fight and the persistent fight that has to remain ongoing until we realize more equitable conditions,” Nunley said. “I think it’s a sobering reminder of the work that still remains.”

    But Juneteenth is also a celebration, she said, of the creative ways Black people have found to “embody joy in the face of incomplete revolution.”

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  • UCLA Health seeks applicants for next TechQuity Accelerator to support startups with solutions for health inequity

    UCLA Health seeks applicants for next TechQuity Accelerator to support startups with solutions for health inequity

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    Newswise — UCLA Health is now accepting applications for a new cohort of innovators to be part of its TechQuity Accelerator for 2023, an initiative that supports startups and other fledgling companies with technologies that can improve health equity among underserved and vulnerable patient populations.

    Launched in 2022 in response to COVID-19’s disproportionate impact on minority communities, the TechQuity Accelerator strives to strengthen health security by targeting four overall areas: prevention, diagnosis, treatment and community impact.

    “Following last year’s highly successful inaugural program, we are excited to launch a new accelerator to support early-stage companies driven by a commitment to develop inclusive technologies and boost health equity within diverse populations,” said Jennifer McCaney, executive director of UCLA Biodesign and associate director of the UCLA Clinical and Translational Science Institute. “We look forward to receiving applications from across our region’s robust tech ecosystem.”

    UCLA Health operates the TechQuity Accelerator in partnership with UCLA Biodesign and BioscienceLA, with a laser focus on supporting teams that feature innovative concepts and a mission to improve long-term community health resilience. The four-month program provides selected startups with personalized mentorship, access to clinical expertise and product-development support, culminating in a final pitch showcase with UCLA Health leaders and community stakeholders.

    Selected accelerator companies are paired with student interns subsidized by BioscienceLA through its BioFutures Internship Program. This collaboration also represents a shared commitment with UCLA Health and UCLA Biodesign to build a diverse life science workforce by providing career-building opportunities for people from historically underrepresented backgrounds.

    For 2023, the initiative seeks companies that have developed solutions to overcome any of the following barriers to more equitable health outcomes:

    Healthcare Access – The pandemic strained an existing health system fraught with challenges for people with cultural, geographic or financial limitations to access care and services. Prospective applicants may have innovations in these areas:

    • Telemedicine
    • Wearables, remote monitoring devices
    • Online pharmacies
    • Direct-to-consumer healthcare delivery
    • Encrypted mobile communication software
    • Medical translation and transcription
    • Gender-affirming care

    Environmental Justice – Traditionally, underserved communities are mostly likely to suffer the health, financial and political consequences caused by global climate change. Prospective applicants might have solutions for:

    • Removing, reducing or preventing pollution in vulnerable communities
    • Improving access to healthy food options
    • Leveraging community leaders to ensure equitable environmental and land-use decisions
    • Safe housing and recreational facilities
    • Expanding social service programs

    Mental Health and Youth Wellbeing – Limited resources are available for low-income residents and adolescent patients to ensure their long-term care and access to mental health professionals. Potential areas of focus include:

    • Pediatric healthcare delivery in collaboration with schools
    • Broadening medication access for substance-abuse patients
    • Teletherapy
    • Self-care mobile applications
    • Platforms to better identify resources, including mental health experts and treatment centers

    For more information or to apply, visit the UCLA Health TechQuity Accelerator website.

     

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  • TOMS Shoes founder is pledging $100 million for psychedelic research – Here’s why he’s doing it.  

    TOMS Shoes founder is pledging $100 million for psychedelic research – Here’s why he’s doing it.  

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    A nascent category of mental health treatments is getting a major cash infusion. 

    Blake Mycoskie, founder of the canvas-footwear phenomenon TOMS Shoes, has committed to giving $100 million to support psychedelic research and access, Mycoskie told MarketWatch in an exclusive interview. The money will help fund academic institutions investigating psychedelics’ potential to treat anxiety, depression, post-traumatic stress disorder and other mental-health issues, as well as nonprofits helping to connect patients in need with psychedelic treatments. 

    Traditional psychedelics include hallucinogens like LSD and psilocybin, or “magic” mushrooms–recently legalized in Oregon and Colorado. Other drugs that can alter mood and perception–such as ketamine and MDMA, also known as ecstasy–aren’t classical psychedelics but are broadly included in the research and policy discussions generating a surge of interest in this class of treatments. The U.S. Food and Drug Administration, for example, has granted psilocybin and MDMA “breakthrough therapy” status, a designation designed to expedite development and review of drugs for serious conditions, and could approve MDMA for treatment of PTSD as soon as next year.

    Given the rapid developments in the field, ”we really need to get this right, and we really need to have these foundations and nonprofits funded properly,” therapists trained, and clinics open and running smoothly, Mycoskie said. “I felt a real sense of urgency,” he said, and asked his wealth manager, “what’s the most that I can give?”  

    The $100 million answer to that question amounts to about a quarter of Mycoskie’s net worth and marks a major milestone in psychedelics’ delicate image transformation. Shedding some of their dangerous-party-drug reputation, psychedelics are gaining attention from top pharmacologists, the scientific community, biotech companies and investors who see them as a critical part of the solution to America’s mental health crisis. 

    Cracked open 

    Mycoskie, 46, said his interest in psychedelics dates back to 2017, when a friend returning from a trip to Central America described his incredible experience with ayahuasca, a plant-based psychedelic brewed into a tea. As an entrepreneur under intense pressure to perform, Mycoskie said, he decided to try it for himself. The experience “cracked me open, and it connected me more to my faith in God, made me feel that we were all connected and everything was fine and perfect,” he said. “I came back just feeling like, wow, that was more powerful than any therapy I’d ever done.” He later tried MDMA-assisted therapy, he said, which also helped him process issues that traditional talk therapy had left unresolved. 

    Realizing how many people could benefit from similar treatments, Mycoskie started giving money to academic groups and the Multidisciplinary Association for Psychedelic Studies, or MAPS, a nonprofit organization. He also got involved in last year’s Colorado ballot initiative, which legalized psilocybin and several other psychedelic substances, including ibogaine, which has shown potential to treat substance-use disorders. Mycoskie has already given about $10 million to psychedelic research and access, he said, and plans to give about $5 million annually for 18 more years. 

    Mycoskie was a bit squeamish at first, he acknowledges, about publicly backing research on drugs that are largely illegal. “Am I going to get held up at TSA every time I go through the airport?” he remembers thinking. The U.S. Drug Enforcement Administration categorizes LSD and MDMA alongside heroin as “schedule one” drugs, defined as “drugs with no currently accepted medical use and a high potential for abuse.” But with growing public awareness and acceptance of the drugs’ potential as mental-health treatments, he said, he felt emboldened to make a big public commitment, and “the research has caught up,” he said. “It’s important that people like myself put their name out there and their money out there to show that this really is a path forward,” he said. 

    Mycoskie’s $100 million commitment “is the biggest that we’ve ever seen in the psychedelics space,” said Joe Green, president of the Psychedelic Science Funders Collaborative, a nonprofit supporting philanthropy in the field, and a MAPS board member. Now that research has made great strides to support use of the medicines as mental-health treatments, that money can help ensure that “these actually come to the world in a safe and beneficial way,” Green said. With certain treatments legalized in Oregon and Colorado, for example, “the system requires licensed guides, facilitators, licensed service centers,” he said. “It’s not like cannabis medical–you won’t be able to take the mushrooms outside the service center.” 

    Psychedelic therapeutics market could be worth more than $8.3 billion by 2028

    Mycoskie plans to publicize his pledge at the Multidisciplinary Association for Psychedelic Studies’ psychedelic science conference–billed as “the largest psychedelic conference in history”–this week in Denver. On the agenda: Sessions ranging from state policy and regulatory considerations to clinical trials of psilocybin- and MDMA-assisted therapy and “sex and psychedelics: weaving altered states for healing and pleasure.”   

    The news comes as lawmakers on both sides of the aisle are pushing for new funding for research into the use of psychedelics to treat PTSD in military service members as part of the fiscal year 2024 National Defense Authorization Act, which the House Armed Services Committee will consider Wednesday.  

    Already, public companies like Atai Life Sciences
    ATAI,
    -6.91%    ,
    Compass Pathways
    CMPS,
    -3.37%
    and Cybin
    CYBN,
    +6.81%
    are developing therapies based on psychedelic substances. The psychedelic therapeutics market could be worth more than $8.3 billion by 2028, according to InsightAce Analytic. Even the federal government is throwing money at this niche, funding efforts to develop psychedelic mental-health treatments without the hallucinogenic side effects. 

    More than one in five U.S. adults live with a mental illness, according to the National Institute of Mental Health, and less than half of the roughly 58 million adults with any mental illness are receiving treatment. Suicide rates, which have been on a long upward trajectory, declined briefly between 2018 and 2020 before returning to peak levels in 2021, according to the Centers for Disease Control and Prevention. Nine out of 10 U.S. adults believe the country is suffering a mental health crisis, according to a survey last year by CNN and KFF, a health policy nonprofit. And commonly prescribed antidepressants, such as selective serotonin reuptake inhibitors (SSRIs) don’t work well for many patients.  

    Nushama, a New York City wellness center offering ketamine-based therapy.


    Courtesy of Nushama and Costas Picadas

    Mental illness “is truly an epidemic, and we are losing the fight,” said Dylan Beynon, CEO and founder of Mindbloom, which offers a telehealth ketamine treatment program. While there are some existing solutions that are helping to bend the curve, he said, more research and educational support for providers and patients is needed, he said.

    Indeed, some substantial hurdles still separate psychedelic mental-health treatments from many of the patients they might benefit, including a lack of insurance coverage for the currently legal treatments and debate over how to administer them safely. In the case of ketamine, for example, which is FDA-approved as an anesthetic and used off-label as a mental-health treatment, some providers favor in-person guided sessions while others, like Beynon, advocate for telehealth prescribing–a model that boomed during the pandemic.

    Some experts have lately warned that the practice of psychedelic medicine may be getting ahead of the science. Given the growing public and commercial interest, “there is the risk that use of psychedelics for purported clinical goals may outpace evidence-based research and regulatory approval,” the American Psychiatric Association said last year in a position statement on psychedelic and “empathogenic” agents–a category that includes MDMA.

    Mycoskie has also made some investments in the psychedelics space, although he said profits aren’t his motivation. He has invested in Mind Medicine Inc.
    MNMD,
    -0.50%    ,
    which says it is developing “psychedelic inspired medicines” that aim to treat the underlying causes of distress in the brain. And Mycoskie helped fund a public benefit corporation linked with MAPS, which is taking MDMA through the FDA approval process–an investment that will pay dividends when the treatment is commercialized, he said.        

    Providers currently offering ketamine treatments say they’re eager to expand into MDMA and other therapies in the category as soon as they’re legal. Mindbloom, for example, currently offers a ketamine treatment program that’s available through telehealth in several dozen states and aims to start offering MDMA-assisted therapy late next year after FDA approval is finalized, Beynon said. Psilocybin-assisted therapy could come a couple of years after that, he said. 

    Nushama, a New York City psychedelic wellness center that offers ketamine-based therapy, delivered through in-person IV infusions, also hopes to expand into MDMA when it’s approved, said co-founder Jay Godfrey. 

    Treatment without the trip 

    Still on the horizon: New treatments that could produce psychedelic medicines’ mental-health benefits without the trip. University of North Carolina School of Medicine pharmacology professor Dr. Bryan Roth is leading an effort to create new medications for depression, anxiety and substance abuse that work similarly to psychedelics but without the hallucinogenic, disorienting side effects. His effort is backed by a $27-million grant from the Defense Advanced Research Projects Agency. Such treatments, Roth said, could help the many patients for whom such psychedelic effects are unappealing or ill-advised–such as military service members. “You would never want to give psilocybin or ketamine to somebody who has a gun,” Roth said. 

    Having worked with Vietnam veterans suffering from PTSD while training as a psychiatrist earlier in his career, Roth said, he’s keenly aware of the need for safe and effective treatments. “There was nothing we could give them for their symptoms,” he said. “The most we could do was give them medications to stop their ability to have dreams, so they wouldn’t have nightmares. That was basically it.” 

    “Undoing 52 years of propaganda is a heavy lift,” said Nushama co-founder Jay Godfrey.


    Costas Picadas

    Roth’s team has already developed compounds that have shown antidepressant effects without psychedelic side effects in mice, he said. The team is now working to find a clinical candidate suitable for testing in humans, he said. 

    Treatments that can help “break bad emotional or psychological patterns without scary, high-friction psychedelic experiences would be a great thing for patients, providers and the healthcare system,” said Mindbloom’s Beynon. 

    Much more remains to be done to reduce the stigma associated with psychedelics, experts say. It has been 52 years since President Richard Nixon declared drug abuse “public enemy number one,” and billions of dollars have been spent since then telling people that “these medicines are dangerous, that they’re addictive, and that they’ll fry your brains,” Godfrey said. “Undoing 52 years of propaganda is a heavy lift, but one thing I’m optimistic about is that the outcomes are starting to speak for themselves.” 

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  • Walter R. Frontera, MD, PhD, Selected to Speak at 2023 AANEM Annual Meeting

    Walter R. Frontera, MD, PhD, Selected to Speak at 2023 AANEM Annual Meeting

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    Newswise — Rochester, Minn. (June 19, 2023)- The American Association of Neuromuscular & Electrodiagnostic Medicine (AANEM), is excited to announce Walter R. Frontera, MD, PhD, as a 2023 plenary speaker at the AANEM Annual Meeting Nov. 1-4 in Phoenix, Arizona. Dr. Frontera is a professor in the departments of PM&R, sports medicine, and physiology at the University of Puerto Rico School of Medicine, and serves as the editor-in-chief of the American Journal of PM&R. His primary research interest is in geriatric rehabilitation, particularly the study of the mechanisms underlying muscle atrophy and weakness in elderly and the potential benefits of exercise training in older men and women. Dr. Frontera’s plenary session titled, “Sarcopenia: Aging of Skeletal Muscle and Benefits of Exercise,” will examine the diagnostic criteria for sarcopenia and discuss the most recent research related to the cellular and physiological changes associated with it. The potential contribution of different types of exercise to the rehabilitation of older adults will also be discussed. According to Dr. Frontera, this topic is important to address because, “There are significant demographic changes globally with more people in the older adult group and a longer life expectancy. Sarcopenia is highly prevalent in this population.” Dr. Frontera is excited to connect with other clinicians and investigators at the 2023 AANEM Annual Meeting in Phoenix. “I’m looking forward to the opportunity to share recent research on the topic of aging skeletal muscle that hopefully will provoke some discussion on this topic.”

    About American Association of Neuromuscular & Electrodiagnostic Medicine (AANEM)

    Based in Rochester, MN, AANEM is the premier nonprofit membership association dedicated to the advancement of neuromuscular (NM), musculoskeletal, and electrodiagnostic (EDX) medicine. The organization and its members work to improve the quality of patient care and advance the science of NM diseases and EDX medicine by serving physicians and allied health professionals who care for those with muscle and nerve disorders. For more information about AANEM, visit aanem.org or find us on Facebook, Twitter, LinkedIn, Instagram, and YouTube.

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    American Association of Neuromuscular and Electrodiagnostic Medicine (AANEM)

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