Saturday, October 17, 2015

A comprehensive guide to Theranos’s troubles and what it means for you - The Washington Post

A deeply reported story by the Wall Street Journal has pulled the curtain back on Theranos, the hot and intensely secretive Palo Alto, Calif., company that aims to revolutionize how we get our blood tested. The newspaper's investigation raises questions about the accuracy and also the novelty of what the company is doing. Here's a guide to the growing questions about this company, the industry, and why it matters.

Hot Startup Theranos Has Struggled With Its Blood-Test Technology - WSJ

On Theranos Inc.'s website, company founder Elizabeth Holmesholds up a tiny vial to show how the startup's "breakthrough advancements have made it possible to quickly process the full range of laboratory tests from a few drops of blood."

The company offers more than 240 tests, ranging from cholesterol to cancer. It claims its technology can work with just a finger prick. Investors have poured more than $400 million into Theranos, valuing it at $9 billion and her majority stake at more than half that. The 31-year-old Ms. Holmes's bold talk and black turtlenecks draw comparisons to Apple Inc. cofounder Steve Jobs.

But Theranos has struggled behind the scenes to turn the excitement over its technology into reality. At the end of 2014, the lab instrument developed as the linchpin of its strategy handled just a small fraction of the tests then sold to consumers, according to four former employees.

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Thursday, October 15, 2015

Dietary Supplements Lead to 20,000 E.R. Visits Yearly, Study Finds - The New York Times

A large new study by the federal government found that injuries caused by dietary supplements lead to more than 20,000 emergency room visits a year, many involving young adults with cardiovascular problems after taking supplements marketed for weight loss and energy enhancement.

The study is the first to document the extent of severe injuries and hospitalizations tied to dietary supplements, a rapidly growing $32 billion a year industry that has attracted increased scrutiny in the past year and prompted calls for tougher regulation of herbal products.

Critics of the industry said that the findings provided further evidence that the relatively low level of regulation in the United States put many consumers at risk. But industry representatives said that the products were used by roughly half of all Americans and that the data showed only a tiny fraction sustained major injuries.

The new study was published Wednesday in The New England Journal of Medicine and led by health authorities at the Food and Drug Administration and the Centers for Disease Control and Prevention. The researchers tracked emergency room visits at a large network of hospitals around the country over a 10-year period and then analyzed those in which a dietary supplement was implicated.

Among the injuries cited were severe allergic reactions, heart trouble, nausea and vomiting, which were tied to a broad variety of supplements including herbal pills, amino acids, vitamins and minerals. Roughly 10 percent, or about 2,150 cases yearly, were serious enough to require hospitalization, the researchers found.

In comparison, prescription drugs are responsible for 30 times as many trips to the emergency room each year.

One finding was that emergency room visits caused by supplements occurred predominantly among young people, whereas those for pharmaceutical products occurred in large part among older adults, said Dr. Andrew Geller, a medical officer at the division of health care quality promotion at the C.D.C. and the lead author of the study. "The contrast is striking," he said.

More than a quarter of the emergency room visits occurred among people ages 20 to 34, and half of these cases were caused by a supplement that was marketed for weight loss or energy enhancement, commonly producing symptoms like chest pain, heart palpitations and irregular heart rhythms.

These products typically contain a variety of herbs and extracts and are widely advertised online, in magazines and on television with names like Hydroxycut, Xenadrine, Raspberry Ketones and Black Jack Energy, the researchers said.

It was unclear how many, if any, of these cases are fatal because the study tracked hospital visits, not deaths. Weight loss supplements and energy boosters have been implicated in serious problems, including one outbreak in 2013 that sickened 97 people and caused at least one death and three liver transplants.

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Tuesday, October 13, 2015

Will doctors be more empathetic in the future? -

A doctor's training hasn't historically focused on sensitivity. And too often, while juggling heavy workloads and high stress, they can be viewed as brusque, condescending or inconsiderate. 

2011 study, for instance, found barely more than half of recently hospitalized patients said they experienced compassion when getting health care, despite widespread agreement among doctors and patients that kindness is valuable and important. 

    But payment initiatives and increasing patient expectations are slowly forcing changes, encouraging doctors to be better listeners and more sensitive to patients' needs. 

    "We train people to ask the question, 'What's the matter?' We train toward diagnosis," said Martha Hayward, who leads public and patient engagement efforts at the Institute for Healthcare Improvement, a Massachusetts-based nonprofit. "We don't train toward lifestyle understanding."

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    Monday, October 12, 2015

    NYTimes: Should We Bank Our Own Stool?

    BY last August, my 1-year-old son had taken five courses of antibiotics for recurrent ear infections. That was alarming. By age 10, the average American child has had about 10 courses, and some microbiologists argue that even one course a year is too many — that it might damage our native microbial ecosystem, with far-reaching consequences.

    My son was off to a worrisome start. Why, I wondered, didn't doctors work harder to prevent this collateral damage, not with store-bought probiotics, but with "microbial restoration"? Why didn't we reinfuse patients with their own microbes after antibiotics?

    The scientific term for this is "autologous fecal transplant." In theory, it could work like a system reboot disk works for your computer. You'd freeze your feces, which are roughly half microbes, and when your microbiome became corrupted or was depleted with antimicrobials, you could "reinstall" it from a backup copy.

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    NYTimes: Are Fats Unhealthy? The Battle Over Dietary Guidelines

    People are passionate about food. People can also become pretty passionate about nutrition.

    We got a taste of that this month over early efforts to influence the dietary guidelines that the United States Department of Agriculture establishes every five years. We got even more last week, when a congressional hearing on the scope and reliability of the science behind recommendations became heated.

    It started when Nina Teicholz wrote an article in a respected medical journal, BMJ, arguing that the Dietary Guidelines Advisory Committee that advises the agriculture department isn't using good research to make its decisions. Ms. Teicholz, a journalist, is the author of "The Big Fat Surprise: Why Butter, Meat and Cheese Belong in a Healthy Diet." Her biggest concern is how fats are treated.

    Much of what we know about nutrition is based on small, sometimes flawed, short-term studies. Doing more than that is often very difficult and very expensive. But every once in a while, good research does occur that can truly inform our thoughts and decisions on nutrition policy.

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    The Hurdles to Getting Hearing Aids - The New York Times

    At a chamber music concert in Woodstock, N.Y., I noticed the hearing aids discreetly tucked behind the ears of the man sitting in front of me. Intrigued, I asked about them, knowing that, with tinnitus and diminished hearing in one ear, the day would come when I will need such a device.

    He gently removed one to show me the tiny receiver that fits in his ear, attached by a very slender tube to the small, flesh-colored behind-the-ear case that housed a miniature microphone, amplifier and battery. Manipulating the tiny aids requires some dexterity, he said, "but they're a lot more comfortable than the first aids I had, which felt like peanuts stuck in my ears."

    His name was Mark Hammel and, as a practicing psychologist with what he calls a "biopsychosocial approach to health," he told me he has far too often treated people whose lives could be much improved by hearing aids but who don't wear them. The reasons are many, including the "unfortunate fact that audiologists using hearing test cutoffs sometimes tell people they don't need a hearing aid yet, even though functionally they do," he said.

    Hearing loss is usually gradual, and people often fail to recognize when it becomes severe enough to warrant hearing aids. Some deny that they have a problem, and instead accuse others of mumbling when they know people are talking but can't understand what is being said. Still others regard hearing aids as unattractive devices that make them feel and look old in a society that prizes youthfulness.

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