Wednesday, May 24, 2017

FDA Clears First Cancer Drug Based on Genetics of Disease, Not Tumor Location - Scientific American

Merck & Co's immunotherapy Keytruda chalked up another approval on Tuesday as the U.S. Food and Drug Administration said the cancer medicine can be used to treat children and adults who carry a specific genetic feature regardless of where the disease originated.
It is the first time the agency has approved a cancer treatment based solely on a genetic biomarker.
"Until now, the FDA has approved cancer treatments based on where in the body the cancer started - for example, lung or breast cancers," said Richard Pazdur, head of oncology products for the FDA's Center for Drug Evaluation and Research. "We have now approved a drug based on a tumor's biomarker without regard to the tumor's original location."
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https://www.scientificamerican.com/article/fda-clears-first-cancer-drug-based-on-genetics-of-disease-not-tumor-location/?

Friday, May 19, 2017

It'll Take an Army to Kill the Emperor - Popular Mechanics

The men and women who are trying to bring down cancer are starting to join forces rather than work alone. Together, they are winning a few of the battles against the world's fiercest disease. For this unprecedented special report, we visited elite cancer research centers around the country to find out where we are in the war.

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http://www.popularmechanics.com/science/health/a26290/we-will-beat-cancer/?

Monday, May 15, 2017

The painful truth about teeth - The Washington Post

SALISBURY, Md. — Two hours before sunrise, Dee Matello joined the line outside the Wicomico Civic Center, where hundreds of people in hoodies, heavy coats and wool blankets braced against a bitter wind.

Inside, reclining dental chairs were arrayed in neat rows across the arena's vast floor. Days later, the venue would host Disney on Ice. On this Friday morning, dentists arriving from five states were getting ready to fix the teeth of the first 1,000 people in line.

Matello was No. 503. The small-business owner who supports President Trump had a cracked molar, no dental insurance and a nagging soreness that had forced her to chew on the right side of her mouth for years.

"It's always bothering me," she said. And although her toothache wasn't why she voted for Trump, it was a constant reminder of one reason she did: the feeling that she had been abandoned, left struggling to meet basic needs in a country full of fantastically rich people.

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http://www.washingtonpost.com/sf/national/2017/05/13/the-painful-truth-about-teeth/?

STAT - Reporting from the frontiers of health and medicine

STAT delivers fast, deep, and tough-minded journalism. We take you inside science labs and hospitals, biotech boardrooms, and political backrooms. We dissect crucial discoveries. We examine controversies and puncture hype. We hold individuals and institutions accountable. We introduce you to the power brokers and personalities who are driving a revolution in human health. These are the stories that matter to us all.

https://www.statnews.com/

Saturday, May 13, 2017

NFL players fight pain with medical marijuana: ‘Managing it with pills was slowly killing me’ - The Washington Post

BOULDER, Colo. — One by one, they entered a nondescript building on the eastern edge of town, 18,000 square feet with no signage out front. They came looking for relief. These nine former professional football players are part of the Denver Broncos Alumni Association. They played in nearly 700 NFL games combined and have enough aches and pains to keep an entire hospital staff busy.

"Every day, I wake up in pain, from my ankles to my neck," said Ebenezer Ekuban, 40, who played defensive end for nine NFL seasons. "It's part of the territory. I know what I signed up for."

Retirement is a daily exercise in managing pain, which is what brought the men to the unmarked CW Hemp offices on a recent Friday for a tour and a firsthand lesson on the potential benefits of the marijuana plant. As the country's discussion on the drug broadens, state laws change and public perception shifts, there's a movement in football circles to change the way marijuana is viewed and regulated within the NFL, which still includes cannabis on its list of banned substances.

For decades, football players have treated pain with postgame beers, over-the-counter anti-inflammatories and powerful prescription painkillers. The sport's overreliance on drugs for pain management is the subject of a federal lawsuit and has sparked an investigation by the Drug Enforcement Administration. Retired NFL players use opioids at four times the rate of the general population, according to one study, and marijuana advocates say there's a safer, healthier alternative available.

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https://www.washingtonpost.com/sports/redskins/nfl-players-fight-pain-with-medical-marijuana-managing-it-with-pills-was-slowly-killing-me/2017/05/02/676e4e62-2e80-11e7-9534-00e4656c22aa_story.html?

More than a million patients flock to this website. Drug companies are in hot pursuit. - The Washington Post

This isn't Brian Loew's first run at Internet success.

During the thick of the dot-com mania 20 years ago, Loew and some friends built an online publishing company called Worldweb.net. It had 150 employees and $15 million in revenue but, like many start-ups from the era, it never posted a profit.

Worldweb.net created website software in the Internet's early days for Elle, Car and Driver, the ill-fated George magazine and other publications.

"I was going to be rich beyond my wildest dreams," Loew said, recounting what his bankers had told him at the time.

Ten days away from the company's initial public offering, the go-go, dot-com age imploded and Loew's path to riches vaporized. The company, which bankers predicted could eventually be worth $1 billion, was sold off for a small fraction of that.

"Investors got their money back, but nobody got rich," Loew said.

The 46-year-old entrepreneur appears to be on to something with a better future this time around. His nine-year-old medical-website business, known as Inspire, has 1.1 million members, 33 employees and nearly $10 million in revenue, and it will turn its first profit this year.

Inspire essentially is a giant, online discussion community where people can use real or assumed names to share experiences, information and advice about their various medical conditions.

"Join many others who understand what you're going through and are making important decisions about their health," says the greeting on Inspire's website.

Loew and his company are attached to the surge of patient assertiveness, with more people questioning their health care and taking more of the responsibility out of the hands of professionals. 

"Patient centricity really matters," said Loew, who owns a big chunk of the company, along with investors and employees.

Membership is free and increasing by 1,000 per day. Seventy-eight percent of members are women.

"Women are the chief medical officers of the home," Loew said. "Many of our female members represent a member of the family — husbands, fathers, fathers-in-law, siblings, children. So sometimes a woman would join and say, 'I'm a parent of a 'preemie,' a child of someone with a medical condition, a sister of someone else.' "

The company has a team of community moderators to make sure members get along on chats.

Revenue comes from advertising and from companies looking for hard-to-find patients to participate in clinical drug trials or market research.

Many of the research contracts come from pharmaceutical giants to carry out drug trials or marketing studies on everything from psoriasis (one of the most common ailments among members) to cancer. The contracts can pay anywhere from $50,000 to $750,000, Loew said. It usually amounts to about $1,000 per patient for market research and up to $10,000 for clinical trials.

Inspire's clients include the top 10 pharmaceutical companies in the world, as well as most of the top 25.

"It matters to these companies what patients think and want and how they make decisions," Loew said.

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https://www.washingtonpost.com/business/economy/more-than-a-million-patients-flock-to-this-website-drug-companies-are-in-hot-pursuit/2017/04/27/7b533944-29ec-11e7-a616-d7c8a68c1a66_story.html?

Thursday, May 11, 2017

We’re Bad at Death. Can We Talk? - The New York Times

Her last conversation should not have been with me.

I'd just arrived for the night shift in the I.C.U. when her breathing quickened. I didn't know much about the patient, and the little I did know wasn't good: She had cancer. Her lungs were filled with fluid. As her breathing deteriorated and her oxygen levels plunged, I searched the chart for her wishes in an emergency. Nothing.

I explained to her how rapidly her condition had worsened and asked if she'd discussed intubation and mechanical ventilation. She shook her head; she didn't think it would get so bad so fast. Together we called her husband, who had just left for the evening, but there was no answer.

"If we do it, when will I…" she paused. "When will I wake up?"

I hesitated. It was as likely as not that she wouldn't. I explained that we never leave patients intubated longer than necessary, but when people were as sick as she was it was impossible to know when — or even if — they would be extubated.

"O.K.," she said. "Do it."

There are, no doubt, differing opinions on what constitutes a good death. But this, inarguably, was not one.

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https://www.nytimes.com/2017/05/10/upshot/were-bad-at-death-first-we-need-a-good-talk.html?

Tuesday, May 9, 2017

Cotton Swab Injuries Send 12,500 Kids To Hospital Each Year – Consumerist

We all know that we're not supposed to stick things in our ear, but we're also told that ear wax is icky and should be removed post-haste. This contradictory set of priorities might explain why thousands of kids show up at the hospital each year with swab-related ear injuries.

The National Children's Hospital study, published in the The Journal of Pediatrics, found that over a 21-year-period from 1990 to 2010, 263,000 children — ages 18 and younger — were treated in emergency rooms for cotton-tip related ear injuries. That works out to 12,500 annual visits, or 34 visits every day.

According to the report — compiled using data from the Consumer Product Safety Commission's National Electronic Injury Surveillance System — the majority of these injuries (about 73% ) occurred as a result of using cotton tip applicators to clean the ears.

Another 10% of injuries occurred when children were playing with the applicators, and 9% when they fell with he cotton tip applicator in their ears.

"The two biggest misconceptions I hear as an otolaryngologist are that the ear canals need to be cleaned in the home setting, and that cotton tip applicators should be used to clean them; both of those are incorrect," co-author of the study, Dr. Kris Jatana said in a statement, noting that ear canals are typically self-cleaning.

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https://consumerist.com/2017/05/08/cotton-swab-injuries-send-12500-kids-to-hospital-each-year/?

PowerPost - The Health 202 Newsletter - The Washington Post

Your daily guide to the health-care debate.

https://www.washingtonpost.com/news/powerpost/wp/category/the-health-202/?

A Public Overdose. An Antidote at Hand. Would Passers-By Use It? - The New York Times

Across the country, someone dies of an opioid overdose every 24 minutes. In Massachusetts, the death toll is five people a day.

In the face of this epidemic, Cambridge could become the first city to take a step that until recently might have seemed unthinkable: It might place lockboxes on street corners to give the public easy access to Narcan, the brand name for naloxone, a medication that can rapidly revive people who have overdosed.

The idea is in its earliest stages, and any concrete plan for the city, and residents, to consider seems at least a year away. But several days ago, the city police and area doctors who support the boxes conducted an experiment here, asking people who walked by if they would help a stranger who had overdosed.

The officials placed a dummy on the ground on a brick plaza along busy Massachusetts Avenue in Central Square, between two of this city's most drug-infested areas. Passers-by were asked to pretend they had just found an unconscious person. They were handed a cellphone, which was connected to someone acting as an emergency dispatcher.

The dispatcher directed them to a nearby lockbox, gave them a code to open it and then explained how to administer Narcan, a nasal spray. Doctors say Narcan is safe; if given to someone who has not overdosed, it does no harm. It is not addictive and cannot be abused.

"We want to see if regular people walking down the street would be willing to help someone who appeared to be overdosing," said Dr. Scott Goldberg, director of emergency services at Brigham and Women's Hospital, who oversaw the experiment. "And if they were willing to help, would they be able to help?"

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https://www.nytimes.com/2017/05/09/us/opioids-narcan-drug-overdose-heroin-fentanyl.html