Women report more bad side effects from medicines than men do. Researchers say the discrepancy may stem in part from how biomedical research is conducted at its earliest stages in animals.
By Michael Ollove
A handful of federal lawsuits against states that have denied highly effective but costly hepatitis C drugs to Medicaid patients and prisoners could cost states hundreds of millions of dollars.
The drugs boast cure rates of 95 percent or better, compared to 40 percent for previous treatments. But they cost between $83,000 and $95,000 for a single course of treatment.
The class actions, all filed in the last eight months in federal courts in Indiana, Massachusetts, Minnesota and Pennsylvania, present a series of extremes: a deadly epidemic, a treatment that can stop the disease in its tracks, and an enormous price tag.
At least 3.5 million Americans have hepatitis C, a virus spread through blood-to-blood contact that is usually contracted through the sharing of needles or other equipment to inject drugs.
Left untreated, hepatitis C slowly destroys the liver. Medicaid beneficiaries, a low-income population, have a slightly higher rate of hepatitis C infection than the privately insured, and the rate among prisoners is 30 times higher than in the general population.
The U.S. Food and Drug Administration approved the first of the new drugs, Sovaldi, in 2013. Since then, the FDA has also approved two other drugs, Viekira Pak and Harvoni.
But because the drugs are so expensive, state Medicaid programs and prisons have been restricting them to people in the advanced stages of the disease. Continue reading
From the National Institutes of Health
Scientists at the National Institutes of Health have identified a genetic mutation responsible for a rare form of inherited hives induced by vibration, also known as vibratory urticaria.
Running, hand clapping, towel drying or even taking a bumpy bus ride can cause temporary skin rashes in people with this rare disorder.
By studying affected families, researchers discovered how vibration promotes the release of inflammatory chemicals from the immune system’s mast cells, causing hives and other allergic symptoms.
Their findings, published online in the New England Journal of Medicine on Feb. 3, suggest that people with this form of vibratory urticaria experience an exaggerated version of a normal cellular response to vibration.
“The findings from this study uncover intriguing new facets of mast cell biology, adding to our knowledge of how allergic responses occur.” — Anthony S. Fauci, M.D, Director, NIAID Director.
Suspect gene may trigger runaway synaptic pruning during adolescence
From the National Institutes of Health
Versions of a gene linked to schizophrenia may trigger runaway pruning of the teenage brain’s still-maturing communications infrastructure, NIH-funded researchers have discovered.
People with the illness show fewer such connections between neurons, or synapses. The gene switched on more in people with the suspect versions, who faced a higher risk of developing the disorder, characterized by hallucinations, delusions and impaired thinking and emotions.
“Normally, pruning gets rid of excess connections we no longer need, streamlining our brain for optimal performance, but too much pruning can impair mental function.”
By Michael Ollove
CONROE, Texas — Texas prison psychiatrist Pradan Nathan recalls an unsettling face-to-face session with a dissatisfied patient about a dozen years ago at a maximum security prison in East Texas.
The large man, a member of a notorious prison gang, insisted Nathan prescribe him a particular medication. Nathan said he didn’t need it.
“I’m going to stab you to death the next time you come in here,” the prisoner growled.
Nathan feels a lot safer these days. He sees up to 16 patients a day from a suburban Houston office here, using an audio console, a camera and a monitor to treat inmates at two state prisons — including one with a death row — at least 30 miles from where he sits. He’s still threatened occasionally, but now it’s from a comforting distance.
Though some prisons used telemedicine as early as the 1980s, its use has dramatically increased with the arrival of vastly improved technology, electronic medical records, and pressure to control ever rising medical costs.
He’s not the only one. Most states have turned to telemedicine to some extent for treating prisoners — often in remote areas, where many prisons are located — because it allows doctors to examine them from a safe distance. It enables corrections officers keep potentially dangerous inmates behind bars for treatment rather than bearing the cost and security risk of transporting them to hospitals. And because more doctors are willing to participate, it makes health care more available for inmates. Continue reading
The news website Vox.com has created a searchable database which you can use to find out if the supplement you’re taking (or thinking about taking) contain an illegal drugs.
From Vox’s story:
Americans spend more than $30 billion on supplements each year. Supplements are now the most common form of alternative medicine, and many of these pills promise to do incredible things, from boosting memory and building muscles to burning fat fast.
There’s just one problem: These pills are barely regulated. Supplement makers don’t need to prove their products are safe or even effective before putting them on store shelves.
And while supplements are supposed to be accurately labeled, a Vox review of government databases, court documents, and scientific studies uncovered more than 850 products that illegally contain hidden ingredients — including banned drugs, pharmaceuticals like antidepressants, and other synthetic chemicals that have never been tested on humans.
To read the Vox article and search its database go here.
By Sandra G. Boodman
Jean Hanvik decided that enough was enough.
When a painful intestinal inflammation flared in 2014, the 55-year-old benefits communications consultant balked at her doctor’s recommendation that she undergo another abdominal CT scan — her fourth in eight years.
“I’d just read about how abdominal CTs are one of the highest-risk tests [in terms of radiation exposure] and should not be repeated unless there was a major change,” said Hanvik, who lives in Minneapolis.
In the past, antibiotics and a bland diet had quelled her recurrent diverticulitis.
Like X-rays and PET scans, CT scans use ionizing radiation, which can damage DNA and cause cancer.
Hanvik’s newfound assertiveness and her questions about the necessity of a CT scan reflect a growing awareness of the potential pitfalls of diagnostic imaging, which in the past two decades has exploded into a $100 billion-a-year business.
Imaging has aided diagnosis and helped many patients avoid exploratory surgery, but it has also spawned concerns about misuse. Experts cite ballooning costs, including from duplicate procedures, potential harm from the tests themselves and the overtreatment of harmless conditions found during scans.
These “incidentalomas” — so named because they are found unexpectedly — include benign lung and thyroid nodules and other common conditions that can lead to unnecessary and expensive workups as well as treatment that can cause complications.
Much of the attention has focused on computed tomography, or CT, scans, which use hundreds of X-rays to create detailed three-dimensional images that enable doctors to see things previously visible only through a biopsy or surgery.
Like X-rays and PET scans, CT scans use ionizing radiation, which can damage DNA and cause cancer. Two other imaging technologies, MRI scans and ultrasound, do not use radiation. CTs are used for a plethora of reasons, among them finding kidney stones, evaluating chest pain and detecting tumors or other abnormalities. Continue reading
Infertility treatments do not appear to contribute to developmental delays in children
From the National Institutes of Health
NIH researchers find no risk by age 3 from in vitro fertilization, other widespread treatments.
Children conceived via infertility treatments are no more likely to have a developmental delay than children conceived without such treatments, according to a study by researchers at the National Institutes of Health, the New York State Department of Health and other institutions.
The findings, published online in JAMA Pediatrics, may help to allay longstanding concerns that conception after infertility treatment could affect the embryo at a sensitive stage and result in lifelong disability.
The authors found no differences in developmental assessment scores of more than 1,800 children born to women who became pregnant after receiving infertility treatment and those of more than 4,000 children born to women who did not undergo such treatment.
“When we began our study, there was little research on the potential effects of conception via fertility treatments on U.S. children,” said Edwina Yeung, Ph.D., an investigator in the Division of Intramural Population Health Research at NIH’s Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD). “Our results provide reassurance to the thousands of couples who have relied on these treatments to establish their families.” Continue reading
By Sarah Jane Tribble
As anyone who needs insulin to treat diabetes can tell you, that usually means regular checkups at the doctor’s office to fine-tune the dosage, monitor blood-sugar levels and check for complications. But here’s a little known fact: Some forms of insulin can be bought without a prescription.
Carmen Smith did that for six years when she didn’t have health insurance, and didn’t have a primary care doctor. She bought her insulin without a prescription at WalMart.
“It’s not like we go in our trench coat and a top hat, saying, ‘Uh I need the insulin,’” says Smith, who lives in Cleveland. “The clerks usually don’t know it’s a big secret. They’ll just go, ‘Do we sell over-the-counter insulin?’”
Once the pharmacist says yes, the clerk just goes to get it, Smith says. “And you purchase it and go about your business.”
But it’s still a pretty uncommon purchase.
Smith didn’t learn from a doctor that she could buy insulin that way. In fact, many doctors don’t know it’s possible.
When she no longer had insurance to help pay for doctors’ appointments or medicine, Smith happened to ask at WalMart if she could get vials of the medicine without a prescription. To figure out the dose, she just used the same amount a doctor had given her years before.
It was a way to survive, she says, but no way to live. It was horrible when she didn’t get the size of the dose or the timing quite right. Continue reading
Where Are STDs Rampant? Google Wants To Help Researchers Find Out
By Mary Chris Jaklevic
With sexually transmitted diseases on the rise, researchers at the University of Illinois at Chicago think they might have a powerful new weapon to fight their spread: Google searches.
The nation’s leading search engine has quietly begun giving researchers access to its data troves to develop analytical models for tracking infectious diseases in real time or close to it. UIC is one of at least four academic institutions that have received access so far, along with the U.S. Centers for Disease Control and Prevention.
Researchers can mine Google data to identify searched phrases that spiked during previous upticks in a particular disease. Then, they measure the frequency of those searches in real time to estimate the number of emerging cases. For instance, a jump in gonorrhea might coincide with more people searching “painful urination” or other symptoms.
“If this works, it could revolutionize STD surveillance,” said Supriya Mehta, an associate professor of epidemiology at the UIC School of Public Health. Continue reading
By Sarah Breitenbach
Each month Monty Scheele, a pharmacist in Lincoln, Nebraska, sends a big box of unused medications to be incinerated.
He collects the drugs at his three pharmacies from customers who may be cleaning out their medicine cabinets or abandoning a prescription after an adverse reaction. His effort is part of a program using state and local funds to keep medications from polluting water supplies and out of the hands of people who might misuse them.
New rules allow pharmacies to collect unwanted controlled substances; some local officials want drugmakers to pay for drug disposals.
Six municipalities in California require drugmakers to pay for take-backs. Nine states — California, Florida, Maine, Maryland, Minnesota, New York, Oregon, Pennsylvania and Washington — have considered similar measures. Another such proposal is in front of the Massachusetts Legislature.
Proponents say these laws, which are similar to programs that require manufacturers to pay for electronics recycling, would make it easier for patients to dispose of prescriptions. But drugmakers oppose the local mandates and warn that disposal costs could be passed on to patients through higher drug prices. Continue reading