Category Archives: Biotechnology

To combat disease, states make it harder to skip vaccines

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Vaccine SquareBy Sarah Breitenbach
Stateline

When Jennifer Stella’s two children were babies, she made sure they got all the usual vaccines.

But when one started having seizures and the other developed eczema after they’d gotten immunizations, the Vermont woman decided her kids would no longer get shots required to attend school.

Stella, a co-founder of the Vermont Coalition for Vaccine Choice, is among a growing number of parents who are opting out of childhood vaccinations because they’re worried about their safety. Public health experts say the movement is leading to outbreaks of nearly eradicated dangerous diseases, such as measles and whooping cough, among clusters of unvaccinated kids.

All states require children to get vaccinated to attend school, and immunization rates across the nation remain high, with 92 percent of children between 19 months and 35 months getting the shots to protect against potentially deadly measles, mumps and rubella (MMR).

But even a small number of unvaccinated people can undermine the immunity of the larger population, which is leading public health officials and vaccine advocates to push for changes.

Some want to educate parents about the risks of forgoing vaccines and fight what they say is misinformation about the risks posed by the vaccines.

Others have pushed lawmakers to eliminate exemptions from state vaccine requirements and sought to make it more difficult for families to qualify for the exemptions that remain. Continue reading

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Shortages of emergency drugs increase, study

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Vaccine SquareBy Michelle Andrews
Kaiser Health News

At some hospitals, posters on the wall in the emergency department list the drugs that are in short supply or unavailable, along with recommended alternatives.

The low-tech visual aid can save time with critically ill patients, allowing doctors to focus on caring for them rather than doing research on the fly, said Dr. Jesse Pines, a professor of emergency medicine and director of the Office for Clinical Practice Innovation at the George Washington University School of Medicine and Health Sciences, who has studied the problems with shortages.

The need for such workarounds probably won’t end anytime soon. According to a new study, shortages of many drugs that are essential in emergency care have increased in both number and duration in recent years even as shortages for drugs for non-acute or chronic care have eased somewhat.

The shortages have persisted despite a federal law enacted in 2012 that gave the Food and Drug Administration regulatory powers to respond to drug shortages, the study found. Continue reading

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Ovarian cancer mutations found in healthy women, UW study finds

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From the University of Washington

In a study of 36 women – 16 diagnosed with ovarian cancer and a control group of 20 with no cancer diagnosis – nearly all of the women were found to carry cancer-associated gene mutations.

“Cancer mutations are supposed to indicate the presence of cancer. This study suggests that if we sequence deeply enough, we will find cancer mutations in nearly everyone,” said Rosana Risques, a UW assistant professor of pathology, who led the study with Jeff Krimmel, a medical student.

This study suggests that if we sequence deeply enough, we will find cancer mutations in nearly everyone.

The study is a caution for scientists and clinicians trying to detect cancer based on mutations, said Michael Schmitt, a co-author of the study and co-inventor of duplex sequencing. He is an oncology fellow at UW Medicine and Fred Hutch Cancer Research Center.

Among cells stained for the P53 mutation, the brown dots are nuclei of high-grade serous ovarian cancer cells. The blue represents normal Fallopian tube epithelial cells. Photo: Courtesy of Rosana Risques

Among cells stained for the P53 mutation, the brown dots are nuclei of high-grade serous ovarian cancer cells. The blue represents normal Fallopian tube epithelial cells. Photo: Courtesy of Rosana Risques

“Because healthy tissue frequently carries low-frequency cancer-like mutations, we need exquisitely sensitive technologies to accurately define the mutational load and differentiate between truly cancerous changes versus age-associated mutations,” he said.

The study was an early test of the power of DNA duplex sequencing, a technology developed at the University of Washington. Duplex sequencing independently tags molecules along both strands of DNA. In terms of a prospective diagnostic, its accuracy is thought to be unmatched.

This research, marking the technology’s first published application in human cancer detection, was posted online today by the Proceedings of the National Academy of SciencesContinue reading

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Synthetic drugs send states scrambling

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By Sarah Breitenbach
Stateline

626a9a5d49384bf599c632587887dc1a (1)Vials of a confiscated synthetic amphetamine called flakka that killed 61 people in Broward County in a little more than a year. States have been reworking drug laws to make it easier to classify synthetic drugs as illegal.

It’s been four months since anyone in Broward County, Florida, has died from an overdose of alpha-PVP, known as flakka, a crystal-like synthetic drug meant to imitate cocaine or methamphetamine. But the drug has already taken a deadly toll, and left health and law enforcement officials scrambling to stem a new public health crisis.

In small doses, flakka elicits euphoria. But just a little too much sends body temperatures rocketing to 105 degrees, causing a sense of delirium that often leads users to strip down and flee from paranoid hallucinations as their innards, quite literally, melt. If someone survives an overdose, they are often left with kidney failure and a life of dialysis.

Because the drugs were largely unregulated when they first hit the market, some states have struggled to combat them.

Flakka is among a growing number of addictive and dangerous synthetic drugs being produced easily and cheaply with man-made chemicals in clandestine labs in China.

But because the drugs were largely unregulated when they first hit the market, some states have struggled to combat them. Now legislators, health professionals and police are trying to eradicate the drugs by making it easier to qualify them as illegal and ramping up the criminal penalties for selling them.  Continue reading

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Why are so few kids getting the HPV vaccine

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9400_loresBy Michael Ollove
Stateline

Ten years after the federal government approved the first vaccines to combat the cancer-causing human papillomavirus, nine years after those vaccines were recommended for all adolescent girls, and five years after they were recommended for all adolescent boys, less than half of girls and only a fifth of boys are getting immunized.

In 2014, only 40 percent of girls ages 13 to 17 have completed the three-vaccine course of HPV immunization. (And just 22 percent of boys.)

Despite state efforts to raise vaccination rates, public health officials say that for a variety of reasons, mainly wariness over the HPV’s association with sex, parents and especially doctors have not embraced the potentially life-saving vaccine.

According to the Centers for Disease Control and Prevention, as of 2014, only 40 percent of girls ages 13 to 17 had completed the three-vaccine course of HPV immunization. (And just 22 percent of boys had done so.)

That’s well short of the 80 percent goal set in 2010 by the federal government in its Healthy People 2020 report, which established health objectives for the nation.

Even states that require HPV inoculation for school admission or mandate that schools teach students about the virus have fallen far short of the federal benchmark.

“We think the rates are dismally low and very alarming,” said Amy Pisani, executive director of Every Child by Two, a nonprofit that aims to reduce instances of vaccine-preventable illnesses. “We clamor and clamor for a vaccine to get rid of these terrible diseases and yet we aren’t implementing them.”

Some states fare significantly worse. In Tennessee, for example, the vaccination rate for girls was 20 percent — the lowest rate in the nation — and 14 percent for boys.

Even the best performing state, Rhode Island, one of only two states plus the District of Columbia that require HPV inoculation for school admission, has rates well below the national goal, with 54 percent of girls and 43 percent of boys receiving all three HPV vaccinations. Continue reading

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Hospital safety software often fails to flag unsafe prescriptions, report

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Photo by Creativity103 under creative commons license.

By Shefali Luthra
Kaiser Health News

Medical errors are estimated to be the third-highest cause of death in the country.

Experts and patient safety advocates are trying to change that.

But at least one of the tools that’s been considered a fix isn’t yet working as well as it should, suggests a report released Thursday.

That’s according to the Leapfrog Group, a nonprofit organization known for rating hospitals on patient safety.

Almost 40 percent of potentially harmful drug orders weren’t flagged as dangerous by the systems.

Leapfrog, working with San Francisco-based Castlight Health, conducted a voluntary survey of almost 1,800 hospitals to determine how many use computerized-physician-order-entry systems to make sure patients are prescribed and receive the correct drugs, and that medications won’t cause harm.

The takeaway? While a vast majority of hospitals surveyed had some kind of computer-based medication system in place, the systems still fall short in catching possible problems.

(Photo by Creativity103 under creative commons license.)
Continue reading

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Device maker Olympus hiked prices for scopes as superbug infections spread

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FILE - This undated file photo provided by the U.S. Food and Drug Administration shows the tip of a duodenoscope. U.S. Food and Drug Administration officials on Tuesday, Aug. 4, 2015 laid out extra safety measures that hospitals can take to clean the specialized medical scopes that have been linked to sometimes deadly bacterial outbreaks across the U.S., but acknowledged that not all hospitals have the staff, expertise and resources to take the steps, including sterilizing scopes with toxic gas to kill bacteria. (U.S. Food and Drug Administration via AP)

By Chad Terhune and Melody Petersen
Kaiser Health News

LOS ANGELES — Soon after doctors at UCLA’s Ronald Reagan Medical Center traced deadly infections to tainted medical scopes last year, they pressed the device maker to lend them replacements.

But Olympus Corp. refused. Instead, the Tokyo company offered to sell UCLA 35 new scopes for $1.2 million — a 28 percent increase in price from what it charged the university just months earlier, according to university emails obtained from a public-records request.

Olympus sales manager Vincent Hernandez told UCLA that the company’s previous discounts no longer applied. “Supplies are already low, where demand is high with all academic institutions expanding their inventories,” Hernandez wrote to the medical center.

Page 1 of Olympus-Salesman-Email-2-11-15

The emails show how Olympus continued to push sales even as the devices it previously sold to UCLA and other medical institutions were linked to illnesses and deaths. Continue reading

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Pharmaceutical company has hiked price on aid-in-dying drug

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By April Dembosky, KQED
Kaiser Health News

When California’s aid-in-dying law takes effect this June, terminally ill patients who decide to end their lives could be faced with a hefty bill for the lethal medication. It retails for more than $3,000.

Valeant Pharmaceuticals, the company that makes the drug most commonly prescribed by physicians to aid patients who want to end their lives, doubled the drug’s price last year, one month after California lawmakers proposed legalizing the practice.

“It’s just pharmaceutical company greed,” said David Grube, a retired a family doctor in Oregon, where physician-assisted death has been legal for 20 years. Continue reading

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Building a ground army to fight heroin deaths

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sln_overdoseReversalLine
By Christine Vestal
Stateline

BALTIMORE — A crowd quickly gathers here on one of West Baltimore’s many drug-infested street corners. But it isn’t heroin they’re seeking. It’s a heroin antidote known as naloxone, or Narcan.

Two city health department workers are holding up slim salmon-colored boxes and explaining that the medication inside can be used to stop someone from dying of a heroin overdose. Most onlookers nod solemnly in recognition. They’ve heard about the drug. They want to know more.

Nationwide, more than 150,000 people received naloxone kits from community outreach programs like Baltimore’s between 1996 and 2014, and more than 26,000 overdoses were reversed using those kits, according to a recent survey funded by the U.S. Centers for Disease Control and Prevention.

In addition, police, emergency medical technicians and emergency room physicians have used the drug to save tens of thousands of lives. Baltimore police officers started carrying the kits last year.

But as the opioid epidemic seeps into nearly every small town and suburb across the country, state, local and federal officials are trying to make the life-saving prescription drug available everywhere, particularly at local pharmacies. Continue reading

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The stethoscope: Timeless tool or relic?

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Some doctors say clinicians can now get much more information from newer technology than they can get from a stethoscope. Clinging to the old tool isn't necessary, they say. (Kimberly Paynter/WHYY)

By Taunya English, WHYY
Kaiser Health News

To hear a patient’s heart, doctors used to just put an ear up to a patient’s chest and listen. Then, in 1816, things changed.

Lore has it that 35-year-old Paris physician Rene Laennec was caring for a young woman who was apparently plump, with a bad heart and large breasts.

Dr. George Davis, an obstetrician at East Tennessee State University who collects vintage stethoscopes, said the young Dr. Laennec didn’t feel comfortable pressing his ear to the woman’s bosom.

Kidney specialist Steven Peitzman, a professor at Drexel University College of Medicine, says physicians who are now in their 60s and 70s used to get praise if they had the 'ear' to hear and interpret subtle sounds through a stethoscope. (Kim Paynter/WHYY)

Kidney specialist Steven Peitzman, a professor at Drexel University College of Medicine, says physicians who are now in their 60s and 70s used to get praise if they had the ‘ear’ to hear and interpret subtle sounds through a stethoscope. (Kim Paynter/WHYY)

“So he took 24 sheets of paper and rolled them into a long tube and put that up against her chest, listened to the other end and found that not only could he hear the heart sounds very, very well, but it was actually better than what he could hear with his ear,” Davis said.

Or, maybe it was poor 19th century hygiene — lice and the smell of an unwashed body — that kept Laennec from getting too close to his patient.

Either way, he went home and crafted a wooden cylinder with a hole down the middle and that became the first stethoscope. Continue reading

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R2D2’s next assignment: hospital orderly

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A tug enters the kitchen of the UCSF Benioff Children’s Hospital in San Francisco, Calif., on Thursday, January 28, 2016. (Heidi de Marco/KHN)

A tug enters the kitchen of the UCSF Benioff Children’s Hospital in San Francisco, Calif., on Thursday, January 28, 2016. (Heidi de Marco/KHN)

By Jenny Gold
KHN/MarketPlace

Meet the Tugs — a team of 27 robots now zooming around the hallways of the new University of California-San Francisco hospital at Mission Bay.

But not everyone in the hospital is such a big fan . . .

They look a bit like R2D2, dragging a platform around behind them. Instead of drones, think of them more as little flatbed trucks, ferrying carts of stuff around the vast hospital complex — food, linens, medications, medical waste and garbage. And they do it more efficiently than humans.

“This one is going up to one of the floors. It’s carrying meals that were ordered in probably the last 20 minutes,” said Dan Henroid, who is in charge of this elite fleet, as he pointed to a robot motoring by him.

Henroid, who is also director of nutrition and food services for the USCF Medical Center, says each Tug travels about 35 miles each day. Over the past year, they have made more than 157,000 trips through the hospital.

Henroid said no one in the hospital has lost a job to the robots. UCSF was in the midst of a hiring spree for the new hospital, and the Tugs allowed him to hire about 30 fewer workers than he would have otherwise.

He added that the robots are really just carting things from one point to another, something most humans would not find particularly rewarding. “The Tug has a job to do, and it’s sort of a thankless job. So, I think, better to have a robot doing it, perhaps, than a human.”

But not everyone in the hospital is such a big fan of the Tugs. Continue reading

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A states obligated to provide expensive hepatitis C drugs?

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By Michael Ollove
Stateline

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

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NIH scientists discover genetic cause of rare allergy to vibration

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3d ChromosomeFrom 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.

The study was led by researchers at the National Institute of Allergy and Infectious Diseases (NIAID) and the National Human Genome Research Institute (NHGRI), both part of NIH. Continue reading

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