Category Archives: Biotechnology

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.)
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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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Gene’s effect on brain connections may play role in schizophrenia, study

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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.

“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,”

The site in Chromosome 6 harboring the gene C4 towers far above other risk-associated areas on schizophrenia’s genomic “skyline,” marking its strongest known genetic influence. The new study is the first to explain how specific gene versions work biologically to confer schizophrenia risk. — Psychiatric Genomics Consortium

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.”

“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,” said Thomas Lehner, Ph.D., director of the Office of Genomics Research Coordination of the NIH’s National Institute of Mental Health (NIMH). “It could help explain schizophrenia’s delayed age-of-onset of symptoms in late adolescence/early adulthood and shrinkage of the brain’s working tissue. Interventions that put the brakes on this pruning process-gone-awry could prove transformative.” Continue reading

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State prisons turn to telemedicine to improve health and save money

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Video CameraBy Michael Ollove
Stateline

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.

Needless to say, he’s a big fan of telemedicine.

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

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Does your favorite supplement contain an illegal drug? Search this database to find out.

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supplementsThe 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.

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Heavy use of CT scans raises concerns about patients’ exposure to radiation

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(Illustration by Kai Ti Hsu for The Washington Post)

(Illustration by Kai Ti Hsu for The Washington Post)

By Sandra G. Boodman
KHN/Washington Post

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.

Hanvik said she wanted to follow that approach again but avoid a scan, which contains about 10 millisieverts (mSv) of radiation, the rough equivalent of 200 chest X-rays or 1,500 dental X-rays.

Like X-rays and PET scans, CT scans use ionizing radiation, which can damage DNA and cause cancer.

“I don’t think she appreciated my uncharacteristic behavior,” said Hanvik, adding that her primary care doctor reluctantly agreed, but made her promise to return within 48 hours if she did not improve. Hanvik got better, as she had previously.

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

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