Curing the Precision Deficit Disorder in Cancer Medicine – Medscape – Medscape

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Curing the Precision Deficit Disorder in Cancer Medicine – Medscape – Medscape

How Using Social Media Could Minimize Adverse Effects From Medicine – Forbes

How Using Social Media Could Minimize Adverse Effects From Medicine
Adverse Drug Reactions (ADR) are the 4th leading cause of death in America. More people die from adverse effects from medicine than from pulmonary disease, diabetes, AIDS, pneumonia, accidents, and automobile deaths. People get sick or die because …

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How Using Social Media Could Minimize Adverse Effects From Medicine – Forbes

Proposal urges stronger focus on social and environmental factors in precision medicine – Science Daily

Proposal urges stronger focus on social and environmental factors in precision medicine
Science Daily
The authors suggest a naming system that expands the "-omes" discussed in precision medicine, such as the "genome" or "proteome," which describe the factors within an individual's body that impact disease or wellness. They call these internal domains

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Proposal urges stronger focus on social and environmental factors in precision medicine – Science Daily

Obituary: McGill’s Ted Percy was a sports medicine pioneer – Montreal Gazette

A McGill University graduate, Edward “Ted” Percy joined classmate Dr. Hugh Brodie as the team physician for the Redmen and later worked with the Alouettes, the Expos and the Canadiens. Ross Outerbridge / Outerbridge Photography

Ted Percy, one of the pioneers in Canadian sports medicine, has died in Victoria after a decade-long battle with cancer. He was 92.

A McGill University graduate, Percy joined classmate Dr. Hugh Brodie as the team physician for the Redmen and later worked with the Alouettes, the Expos and the Canadiens.

He was involved with the Alouettes, but when BobBrodrick, who was with the Expos, or Doug Kinnear, who was with the Canadiens, needed a surgeon, they called on Ted, Brodie said.

Percys most famous patient mighthave been Canadiens defenceman Serge Savard, who broke his leg in five places in 1970 and then broke the same leg a year later.

Ted screwed his leg back together and he was able to play in the Canada-Russia series in 1972, Brodie recalled. Team Canada gave all the players a watch to commemorate the series and when Serge returned from Russia, he gave his watch to Ted and he wore it all the time.

Dr. Robert (Bobby) Berke, who was one of the stars of the 1969 McGill football team thatwent to the national final, recalled Percys work as the team physician and as a mentor in his medical studies.

He also remarked on Percys wit.

Berke had a patient who recounted an unfortunate incident in which he walked into an open manhole in Westmount. The man was able to avoid falling completely in the opening, but he suffered severe shoulder damage.

When the man presented himself to Percy, the doctor asked: Did you see Ed Norton down there.

Readers of certain age will understand the reference to the sewer worker portrayed by Art Carney in the classic comedy series The Honeymooners starring Jackie Gleason.

Percy was born in Montreal on Oct. 15, 1924, the youngest of four children of Irish immigrant parents. He attended Westmount High School and enrolled at McGill in theearly 1940s. His undergraduate education was interrupted by the Second World War and he served overseas as a pilot with the RCAF.

He returned to McGill and graduated with honours from the Faculty of Medicine in 1951. His residency and fellowship in orthopaedic surgery culminated in his appointment to the orthopaedic staff of six hospitals, including the Montreal General and the Montreal Childrens Hospital.

Percy played a pioneering role in the field of sports medicine. In addition to his work with McGill and professional teams, he set up the first medical team for international Canadian athletes in 1970, was chief medical officer with the Canadian Olympic, Canadian Commonwealth, and Canadian Pan American Games teams, was a member of the International Association of Medical Officers, and was elected vice-president of the Canadian Olympic Association.

Percy was also a co-founder and the first president of the Canadian Academy of Sports Medicine.

In 1978, Percy moved to Tucson, where he was recruited by the University of Arizonas Faculty of Medicine to establish their sports medicine program. He remained an active member of both the medical and academic team there until his retirement in 1991.

With his children settling in British Columbia, Percy and his wife, Myrne, spent many summers in Kelowna before moving to Victoria in 2011. He is survived by his wife of 67 years, four children, 10 grandchildren and two great-grandchildren.

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Obituary: McGill’s Ted Percy was a sports medicine pioneer – Montreal Gazette

Major Hospitals are Offering Alternative Therapies. Is This Medicine … – Big Think

You check in at the hospital for chronic back pain. The doctor asks you to follow her past the MRI machines and operating room to a recently converted yoga studio. An unrolled mat awaits. En route you peek your head into an adjacent treatment room to watch an acupuncturist needling a patient. Rows of IV drips and homeopathic remedies line the shelves.

This not uncommon scene plays out in many small centers across the nation. Yet as Stat News reports, some of the countrys top hospitals and institutions are offering the same modalities, to mixed reviews. Staff and administrators claim to be listening to patient desires. Critics state this is not good medicine.

Part of the problem is that the numerous therapeutic modalities existing outside of the purview of Western medicine are lumped together into the ambiguous alternative therapies.’ Yoga and meditation, for example, have been clinically studied over the last few decades, showing promising results for pain relief, anxiety, and cognitive functioning. Homeopathy and energy healing, however, have at best been shown to be no better than the placebo response.

When dealing with the common cold, using an ineffective or unproven therapy such as a homeopathic proving is largely benignthe placebo response might prove helpful in such circumstances. But this trend is more insidious, Stat reports. The spa-like wellness centers are branding their own forms of mysticism, offering questionable treatments for cancer, heart disease, and chronic pain.

Duke even markets a pediatric program that suggests on its website that alternative medicine, including detoxification programs and botanical medicines, can help children with conditions ranging from autism to asthma to ADHD.

Separating wheat from chaff is challenging in the modern medical environment. Our emotions and perceptions really do play a role in healing, a major criticism of the cold mechanisms of Western medicine. One 1984 study found that the view from your hospital room influences healing time; more recent research suggests that hospital gardens are effective in speeding recovery. This makes sense as our environment always affects our nervous and immune systems. Being in a calm, peaceful space or gazing at a mountain lifts our mood, which aids healing.

The trend toward offering mineral and vitamin IV drips, by contrast, appears to be a money grab. Excess vitamins have detrimental effects. The notion that more is better is provably false. One IV drip purporting to attack and shorten illness features high doses of Vitamin C, zinc, and lysine, all of which create GI problems at high doses. It costs $175 an hour. For ten dollars less you can get a fat burner containing L-carnitine. Side effects of this amino acid include diarrhea, seizures, and vomiting, as well as causing your breath, sweat, and urine to have a fishy odor.

Not everyone experiences such side effects, nor are elevated doses of vitamins and minerals for short durations necessary harmful. Theyre even therapeutic under certain circumstances. Ordering a boost without credible supervision because you read a wellness blog claiming it helps shed visceral fat, though, does not honor the Hippocratic oath. It merely drains your wallet while putting you at risk of potential side effects.

Acupuncture is another common menu item. The system is based on unproven meridian channels and roughly four hundred points along the body. Research on its efficacy is mixed, with many studies finding it no more effective than placebo. But as interest grows, more research is being conducted. A recent study published in Brain found traditional points effective in treating long-term pain associated with carpal tunnel syndrome.

Some research states that adenosine might be the therapeutic mechanism behind acupuncture. Studies investigating electroacupuncutre, like the one published in Brain, are different from the style originating in Traditional Chinese Medicine, as an electric current is passed between pairs of needles. Add to this the time spent relaxing on a table listening to ambient music and its challenging to know what exact mechanisms are at play. That said, if a technique is shown to work, hospitals and clinics have a duty to offer it to patients. It should not be discredited if there is positive evidence in certain situations.

Perhaps the biggest challenge in this whole movement is egos. Doctors, nurses, researchers, and clinicians stand their ground. With insurance in disarray even major institutions are struggling to find revenue streams. One clinician at UCLA, also a licensed acupuncturist that formerly worked in integrative medicine at Cedars, told me,

The world of Western medicine is extremely territorial. Physicians, nursing, all positions in the paradigm fight vigorously to hold their ground and protect scope of practice. It’s very difficult to generate revenue for an IMG [integrative medical group] in the hospital setting, which is why a lot of them fail. Billing proves problematic.

Hopefully one day our notion of medicine will expand beyond invasive surgical techniques and pharmaceuticals and embrace modalities that are less expensive with fewer side effects. We should welcome major institutions integrating such therapies into their programs.

Yet when this movement is fueled by popular demand and not credible science we run into the same problems patients encounter when enduring pharmaceutical cocktails, overpriced treatments, and rushed doctors. Since before the days of Hippocrates medicine has been as much a work of art as science. Trendy vitamin drips and energy healing might bring in revenue but do not honor the oath each professional is bound to. Throw down a meditation cushion to help forge a mind-body connection, but leave homeopathic bee venom behind.

Derek’s next book,Whole Motion: Training Your Brain and Body For Optimal Health, will be published on 7/4/17 by Carrel/Skyhorse Publishing. He is based in Los Angeles. Stay in touch onFacebookandTwitter.

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Major Hospitals are Offering Alternative Therapies. Is This Medicine … – Big Think

Women turning to Chinese medicine: study – SBS

Many Australian women are turning to Chinese medicine to treat chronic medical conditions, and doctors are concerned.

The younger the woman is the more likely they are to bypass the local GP and turn to ‘complimentary’ medicine, new research has found.

A longitudinal study of 17 thousand participants found in just one year acupuncture was used by around 1 in 10 women aged 34-39 years and around 1 in 16 women aged 62-67 years.

Women with arthritis, chronic fatigue syndrome and endometriosis were more likely to use Chinese medicine and acupuncture, according to the University of Technology, Sydney study.

It also found the older women who consulted an acupuncturist were more likely to have low iron levels, anxiety disorder and depression, while those who were married or in a de facto relationship were less likely to use Chinese medicine compared to their single counterparts.

Those with private health insurance were 1.65 times more likely to use the treatment compared to those without.

“This research is important in providing a first examination of the prevalence and predictors of acupuncture and Chinese medicine use amongst women in Australia,” co-author Professor Jon Adams said.

Dr Tony Bartone, Vice President of the Australian Medical Association, says the study findings are concerning because it confirms anecdotal information that large numbers of Australians are choosing Chinese medicine for “hard-to-treat” medical conditions.

“It is more concerning that younger people and those with private health insurance are more likely to seek these treatments without the advice of their family doctor,” Dr Bartone told AAP.

Chinese herbal medicine has a long history of use, dating back thousands of years and it continues to be used in many countries as the first and primary treatment of choice.

It traditionally involves the use of raw herbs boiled in water for a period of time, which is then consumed as a liquid tea.

There are also a range of other options for taking herbal medicine are also available.

Dr Bartone says patients should always consult their GP first because there is little evidence supporting the efficacy of Chinese medicine.

He agrees with the authors of the UTS study that much more significant research is needed on the use of alternative medicines and to find out why they are becoming so popular.

“Acupuncture has been shown that it may have a role in a narrow range of conditions,” Dr Bartone acknowledged.

“However, the credible scientific studies throughout the world have failed to demonstrate robust reliable evidence that these modalities have a role to play, if any, in the management of the conditions highlighted in the study.

Dr Bartone also proposed that private health insurers only fund benefits for evidence-based treatments.

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Gunk from Neanderthals’ teeth tells us they used medicine – The Verge – The Verge

How much can you learn from Neanderthal plaque? A lot, scientists have discovered: DNA from the plaque provides an amazingly detailed view into the life of our extinct human relatives, including what they ate, how they took medicinal plants to combat disease, and what their mouth bacteria was like. The discovery gives scientists a window into the precious microbial world inside our closest relatives; this information could be used to better understand how bacteria that live inside our own bodies, called microbiome, evolved and how these microbes affect our health.

The study, published today in Nature, shows the exact foods consumed by five Neanderthal specimens in Europe: woolly rhinoceros, moss, pine nuts, and wild sheep. One individual suffered from a tooth abscess and a stomach bug, and appears to have treated himself using plants that have the same pain-killing component as aspirin, as well as a natural antibiotic. Finally, the scientists analyzed the different bacteria found in the Neanderthals mouths, including one thats 48,000 years old and is still found in our mouths today.

We basically have a new window on the past for us.

We can now track [the human microbiome] in time and space, and understand the evolutionary process, study co-author Keith Dobney, the head of department and chair of human paleoecology at the University of Liverpool, tells The Verge. We basically have a new window on the past for us, but we also have a way to use that to understand the present.

Neanderthals lived between about 400,000 to 40,000 years ago in Europe and parts of Asia, where they were eventually replaced by Homo sapiens. Since they were discovered in the 1800s, hundreds of studies have come out about their diet and lifestyles. One study found that Neanderthals ate lots of meat, such as reindeer, woolly mammoth, and woolly rhinoceros. Other studies showed that they were pretty intelligent they made glue as far back as 200,000 years ago, and built complex structures about 176,000 years ago, way before modern humans were around.

Todays study adds to our understanding of Neanderthals, and gives direct evidence of what they ate and how they lived. The researchers sequenced DNA from the calcified plaque of five specimens in Europe dated from 42,000 to 50,000 years ago: two from Spain, two from Belgium, and one from Italy. Plaque the disgusting film coating our teeth is made of bacteria and bits of food. Analyzing it shows scientists what we eat and what diseases we have. The researchers found that the Neanderthals living in Belgium ate mostly meat, including woolly rhinoceros and wild sheep. The individuals in Spain, however, were on a veggie diet: they ate mushrooms, pine nuts, and moss. (The Italian Neanderthal failed to produce results.)

One specimen in Spain was also found to suffer from a tooth abscess, a painful bacterial infection, as well as a chronic stomach bug that today causes severe diarrhea in people, says Dobney. The plaque on his teeth also contained the DNA of a Penicillin-like fungus (a natural antibiotic), as well as poplar, a plant that has the same pain-killing component of aspirin. That suggests that Neanderthals in Spain were taking medicine when they were sick a pretty advanced behavior. The general public view of Neanderthals is a pretty kind of basic, stereotype cartoon version of simplistic knuckle-dragging cavemen, Dobney says. But thats changing now. These were sophisticated relatives of ours.

The Spanish specimen also preserved the DNA of a 48,000-year-old bacterium that is still found in our mouths today in a slight different form. The Neanderthals must have passed that bacterium to modern humans when the two interbred, Doney says. They were obviously passing pathogens and microbiome to each other, he says.

The researchers did the near-complete sequence of this ancient form of Methanobrevibacter oralis; by comparing this ancient bacterium, as well as the other Neanderthal bacteria, with todays, scientists can better understand how the human microbiome evolved. This opens a new chapter in understanding the evolution of the commensal bacteria we carry in our [mouths,] Johannes Krause, the director of the Max Planck Institute for the Science of Human History, who did not take part in the study, writes in an email to The Verge.

These were sophisticated relatives of ours.

The study has some limitations. The DNA analyzed by the researchers is extremely old, and may have been contaminated by the soil in the caves were the specimens were found, Krause says. Its possible, for instance, that Spanish Neanderthals werent actually eating moss, but ancient moss was in the surrounding environment. Anything from the cave environment could have contaminated the samples, Krause says. (Dobney says thats very unlikely, because the DNA of animals, plants, and fungi degrades quickly unless its enclosed in some protective environment, like the calcified plaque.) We also dont have a database of the complete genome of all plants, animals, and bacteria in the world, so the researchers may be mistakenly matching an ancient DNA fragment with a modern organism, while instead it belonged to another organism thats not in the database yet, Krause says.

The most interesting part of the study is the analysis of the Neanderthals mouth microbiome, says Christina Warinner, the co-founder of the Laboratories of Molecular Anthropology and Microbiome Research at the University of Oklahoma. In recent years, scientists have started studying the collection of bacteria and viruses that inhabit our bodies with renewed interest, and we have only begun to understand the role these tiny creatures play in our health and disease. Learning what body bacteria our human ancestors had, and how those bacteria evolved, will help us better understand our bodies today. The study is an important reminder of how we’ve really just scratched the surface of the human microbiome, and how much work there is to do to understand the evolution and ecology of this fundamental part of our human biology, Warinner writes in an email to The Verge.

Its just the coolest science on the planet at the moment.

Dobney agrees. Its fantastically relevant to how we understand health and diet today because we can track it in time and space, he says. Dobney began looking at calcified plaques in the 1980s, when he was in his 20s. But the technology at the time didnt allow him and his colleagues to really analyze ancient DNA. I knew this could be really cool, he says. But we just couldnt do it. Nobody believed it could be done and the technology wasnt really there. It was tantalizingly close.

That has all changed in the past few years, Dobney says, and the technology has finally caught up with his dreams. Its just the coolest science on the planet at the moment, its amazing, he says. The moral there is, never give up on a good idea.

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ACA Repeal-Replace Bill Troubles Organized Medicine – Medscape – Medscape

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Drug Industry Bets Big On Precision Medicine: Five Trends Shaping Care Delivery – Forbes

Drug Industry Bets Big On Precision Medicine: Five Trends Shaping Care Delivery
The Death Of "One Size Fits Many" Care Models. Precision medicine promises a paradigm shift in care delivery, one that removes the need for guesswork, variable diagnoses and treatment strategies based on generalized demographics. Precision medicine …

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Drug Industry Bets Big On Precision Medicine: Five Trends Shaping Care Delivery – Forbes

Incredible Medicine: Real-life superhero SMELLS Parkinson’s disease before it’s diagnosed –

The future of Parkinsons disease diagnosis could be completely changing and its all thanks to one extraordinary woman.

In this episode of the BBC Two programme Incredible Medicine: Dr Westons Casebook, Dr Weston investigated cases of people with phenomenal brains all over the world.

In one of the most amazing stories, one woman, Joy Milne, shares her unique ability to smell things others cant.

As a nurse I found I could smell a lot of things, like blood, she said. I didnt realise not everyone could smell them.

This didnt affect her life too much until she stumbled across what has become known as her sensory superpower.


It’s a heavy, musky smell

Joy Milne

When her husband Les hit his mid-thirties, Joy started to notice his smell had changed. She said: I started to nag him that he needed to shower a bit more and brush his teeth better.

But Les insisted he was washing just as frequently as before.

Soon after, he was diagnosed with Parkinsons disease, a progressive neurological condition for which there is no cure. The main symptoms are tremors, rigidity and slowness of movement.

Its not easy to diagnose, and there are currently no laboratory tests to confirm it but this could all change thanks to Joys ability.

As her and her husband encountered other Parkinsons patients, she discovered why Les had smelled so different to her.

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Tremor – One of the most noticeable signs of Parkinson’s is a tremor that often starts in the hands or fingers when they are relaxed

After the first group we went to I said, they smell the same as you Les. These people smell like you.

She described the Parkinsons scent as a Heavy, musky smell.

In 2012 Joy attended a talk by Tilo Kunath, a Parkinsons specialist. At the end she stood up and asked a question: Why arent we using the smell of Parkinsons?

A bemused Tilo contacted her after the talk and was shocked to hear how she had noticed Less scent difference even before he was diagnosed.

Tilo recruited 12 volunteers, six with Parkinsons and six without, and Joy was given their t-shirts to smell.

She identified all six of the Parkinsons sufferers but said one of the non-Parkinsons volunteers had the condition too. However, six months later that person was also diagnosed with the disease.

Tests show that Joy really can smell Parkinsons and can detect it before patients have any symptoms and this is good news for scientists.

The scent was strongest for Joy on the backs of the t-shirts, meaning it was coming from the volunteers sebum, an oily or waxy matter thats secreted to lubricate and waterproof our skin and hair.

Chemists tested this and found 9,000 molecules made up this sebum. If they could isolate the ones that differ between Parkinsons sufferers and non-sufferers, they could potentially create an accurate diagnostic test to detect Parkinsons much earlier.

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Incredible Medicine: Real-life superhero SMELLS Parkinson’s disease before it’s diagnosed –

Sodium azide may have caused illness at Yale School of Medicine in New Haven, officials say – New Haven Register

NEW HAVEN >> Sodium azide, a substance commonly found in laboratories and used as a preservative, may have been the cause of four people falling ill at the Yale School of Medicine in February, officials said.

Four members of the Yale School of Medicine community became ill after drinking from a single-service, pod-style coffee machine Feb. 28 at the 333 Cedar St. facility.

They were monitored at Yale New Haven Hospital, but all four have since returned to work, Yale spokeswoman Karen Peart said Tuesday.

Yale Police, the New Haven Fire Department, the state Department of Energy and Environmental Protection and the Yale Environmental Health and Safety team responded and initiated an investigation.


On Tuesday, officials learned that an independent laboratory test on items removed from the area indicated the presence of sodium azide, Peart said. The potentially deadly chemical is commonly found in air bags, farming and hospital laboratories, according to the Centers for Disease Control and Prevention in Atlanta. It is odorless as a solid, but when mixed with water or an acid, sodium azide changes rapidly to a toxic gas, according to the CDC.

The single-serve coffee machine was not connected to a water source and the area was evaluated and declared to be safe by Yale Environmental Health and Safety, Peart said Tuesday. The Yale Police Department is continuing its investigation in collaboration with local, state and federal law enforcement.

At the same time, staff are reviewing security and safety procedures with its public safety team, Peart said.

Out of an abundance of caution, we have let the Yale School of Medicine community know that the symptoms of exposure to sodium azide are dizziness, headache, nausea and vomiting, rapid breathing and rapid heart rate, she said. Weve let the School of Medicine community know that if they experience these symptoms, they should contact Yale Health Acute Care. Weve also asked that anyone with any information regarding this incident to please contact Yale Police.

Robert J. Alpern, M.D., dean of the School of Medicine, has shared this update with those who were affected, as well as members of the School of Medicine community, Peart said.

Gathering complete information will take some time, she said. As always, the safety and security of the Yale community is our utmost priority.

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Sodium azide may have caused illness at Yale School of Medicine in New Haven, officials say – New Haven Register

Medicine Has a Problem with Racism – in-Training

With the future of the Affordable Care Act uncertain under President Trump, many Americans are left worrying how they will manage without health care. The Americans who must shoulder this burden are disproportionately people of color. It should come as no surprise to those familiar with the history of health care in this country that once again, our system, purportedly built to protect and promote health, is systematically ignoring the right to health care for communities of color.

The very structure of modern medicine in this country is rooted in the supremacyof white physicians. This is unsurprising, given the larger context of the institutional racism that pervades our society as a legacy of slavery. The 1910 Flexner report, which many credit for the legitimization of the medical profession in the United States, closed all but two African-American medical colleges. While encouraging the integration of men and women students, the report accepted racial segregation in medical education and further suggested that physicians of color should be trained differently; namely, to humbly serve their people as sanitarians. Today, the majority white voice in medicine and medical education persists; the 2015 American Association of Medical Colleges diversity report demonstrates that only 3 percent of full-time medical school faculty identify as black or African-American.

The structural racism that pervades the medical profession extends beyond physicians to the people they serve. Patients of color, and African-American patients in particular, have been subjected to racism in their care for as long as physicians have served them. Takethe case of segregation of hospital admissions: when patients of color were relegated to separate and unequal hospital wards where they suffered from demonstrably worse outcomes than did their white peers.

In 1931, Ms. Juliette Derricotte, the Dean of Women at Fisk University, was critically injured in amotor vehicle accident. The closest hospital, nearby Hamilton Memorial Hospital in Dalton, Georgia, did not admit patients of color. After six hours of searching for a hospital that would accept her as a patient, a Chattanooga facility located 35 miles away agreed to care for Ms. Derricotte. She died in transport.

The injustice of racism in health care is further underscored when one acknowledges how physicians have systematically exploited patients of color for medical experimentation. White physician Thomas Hamiltonleft African-American slaves in burning-hot pits as he sought a cure for sunstroke. White researchers studied syphilis in black men in the Tuskegee Study, watching them die until 1972 27 years after penicillin was proven to bethe life-saving treatment of choice for the disease.A young black Henrietta Lacks cervical cancer cells were harvested by white physicians without her informed consent and became the first immortal cell line, used across the globe for scientific pursuit. And yet, the scientific gains from these and scores of other unethical studies remain less accessible to patients of color than to their white peers.

Since the 1930s, our nation has taken several steps toward the creation of a more equitable health care system. One of the boldest and most successful steps towards health equity on a federalscale waswhen Lyndon B. Johnson signed Medicaid and Medicare into law in 1965. These programs expanded health care access for the elderly and the poor, regardless of race. It also condemned hospital segregation and required hospitals to comply with Title VI of the Civil Rights Act in order to be certified. Before Medicare and Medicaid, wealthy patients received twice as much care as the poor. By 1977, poor patients received 14 percent more care than the wealthy. The reversalwas and remains much needed, as poor patients continue to suffer worse health outcomes at disproportionately higher rates.

The 2010 Affordable Care Act (ACA) represents another important, though insufficient, step toward health equity in the United States. Among its successes was the provision of coverage to many Americans of color. Of those gaining coverage from 2010 to 2015, 57 percent were patients of color. These patientsare disproportionately likely to live in poverty and qualify for Medicaid coverage, and systemic discrimination and marginalization maintain this status quo.

Should the ACA be repealed, 30 million people will become newly uninsured. This includes not only the 19.2 million individuals who gained coverage under the ACA, but an additional 11.8 million served by the individual insurance market, which would collapse after repeal.

The ACA largely accomplished this coverage growth through the expansion of Medicaid to all those earning less than 138 percent of the federal poverty level ($27,821 for a family of three in 2016). However, while expansion was intended to be nationwide, 19 states most of them Republican-led Southern states with histories of racial segregationhave opted out and Medicaid coverage in those states remains limited. The median income qualification for parents in many of the states not participating in expansion is just 44 percent of the poverty level, or $8,870 for a family of three. Childless adults remain unqualified.

Despite somesignificant achievements, the U.S. health care system remains unfair on multiple levels. First, people of color continue to experience inequitiesin health outcomes. Minority and low-income patients with breast and colorectal cancer are less likely to receive recommended treatments as compared to white patients. Black males have a life expectancy almost five years shorter than that of white males. Second, low-income communities including poor white people continue to bear a disproportionately high burden of the cost of their care under the ACA, facing skyrocketing deductibles ($3,064 in silver plans, and $5,764 in bronze plans) and unaffordablecopays. When one considers that half of Americans cannot afford an unplanned $400 expense, we must acknowledge that health care reform in this country has not gone far enough in erasing its clear history of racism and inequity.

Any health care system in our country will, to a certain extent, be burdened by institutional racism as a result of the legacy of slavery in the United States. Even so, research suggests that a single-payer system could radically reduce health inequity, even if biases persist. Single payer national health insurance would be a system in which a single public agency, rather than private insurance companies, provides health care financing whilethe provision of care remains largely with private institutions. The evidence to suggest how single-payer would help lessen racial inequity in health care comes in part from the Veterans Administration (VA), a quasi-single-payer system here in the United States, in which black patients actually fare better than white patients in multiple measures of health. In the same measures, black Americans outside of the VA system fare much worse.

While it may be comforting to simply defendour current health care system in this time of immense change under a Trump administration, it is important to remember its limits. We cannot ignore that the health inequitygap continued to rise under President Obama and that poor Americans and Americans of color have never been adequately protected by our system. Let us struggle not only against the policies that promise to take us back to greater and less equal American health system but also for a change that would promise true equity in health care for all Americans. If we want to improve health equity in our nation and fight for racial justice, the answer is a system that provides universal, equal health care for all.

Contributing Writer

Boston University School of Medicine

Armide Storey is medical student at Boston University School of Medicine. She is particularly interested in understanding health as it intersects with class, race, ability, sexuality, and gender.

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Medicine Has a Problem with Racism – in-Training

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Lewis Katz School of Medicine at Temple University

Introducing the newly invested Lewis Katz Dean, Dr. Larry R. Kaiser

Dr. Larry R. Kaiser, now in his fifth year as dean, was recognized with Temple Universitys first-ever named endowed deans chair, Lewis Katz Dean at the School of Medicine.

Temple University Hospital will commemorate its historic 125th Anniversary with the community at large throughout the first six months of 2017.

Temples newest medical students earn their rites of passage.

Your gift by March 31 will be matched to celebrate Match Day.

Fox Chase Cancer Center was selected by the U.S. Department of Health and Human Services to host the official Cancer Moonshot Summit for Region 3.

Using gene editing technology, Temple researchers have, for the first time, successfully excised a segment of HIV-1 DNA the virus responsible for AIDS from the genomes of living animals.

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Lewis Katz School of Medicine at Temple University

Organized Medicine Blasts ACA Replacement Proposal – MedPage Today

Organized medicine cited multiple concerns about two Republican bills set to repeal and replace the Affordable Care Act (ACA), from a potential loss of coverage for millions of Americans to a lack of a strategy to bend the healthcare cost curve.

Some also criticized the authors of the American Health Care Act (AHCA) for not completing an estimate of costs tied to the new legislation, and for potentially not holding a hearing on the bills, instead sending them straight to full committees for markups.

Wanda Filer, MD, chair of the board at the American Academy of Family Physicians, wrote in a letter to the Energy & Commerce Committee that the measures “will result in millions of currently insured individuals losing their healthcare coverage.”

“The AAFP is uneasy that the focus of the AHCA appears to be on ‘taking away’ coverage and benefits,” Filer wrote. “Over the past two decades our nation, in a bipartisan manner, has made significant and measurable improvements to improve our healthcare system. As a result of these efforts, our nation’s uninsured rate is presently at a historic low.”

The letter, along with statements and letters from other groups, praised some of the provisions that were retained from the ACA, including coverage for those with pre-existing conditions and non-discrimination of insurance underwriting based on age, gender, race, or health history.

But many were quick to subsequently air their grievances.

“While we are initially encouraged by an acknowledgement in the draft of the importance of preserving critical, important patient protections including pre-existing conditions, the policy priority for the AHA remains the overall preservation of coverage for those Americans insured under Medicaid and the Affordable Care Act,” Nancy Brown, CEO of the American Heart Association, said in a statement. “We are not convinced, based on our initial analysis, that this goal will be accomplished by the proposed legislation. According to estimates attributed to the Brookings Institution, as many as 15 million fewer Americans would be covered under the proposal.”

Many medical groups said those who have the most trouble paying for healthcare are likely to feel the greatest impact.

American College of Physicians President Nitin Damle, MD, said replacing subsidies with tax credits “will make coverage far more expensive for poorer, sicker, and older persons and those in high healthcare spending areas,” adding that de-funding Medicaid expansion, set to begin in 2020, will “force states to restrict eligibility and curtail benefits.”

“Early indications are the replacement plan under consideration will mean less coverage and more costs for lower- and middle-income families,” the American Thoracic Society said in a statement. “And that means less access to care. The ATS is concerned that Americans, including our patient population of people with respiratory illnesses such as COPD and asthma, are not well served by the process or the policy that Congress is considering.”

The Trouble with Tax Credits

Chris Hansen, president of the American Cancer Society’s Cancer Action Network, said converting an income-based subsidy to a flat tax credit, “combined with reducing the standards for quality insurance, could return cancer patients to a world where many are unable to afford meaningful insurance or are left to buy coverage that doesn’t meet their health needs.”

“Moreover, reduced federal funding combined with state-specific eligibility and enrollment restrictions will likely result in fewer cancer patients accessing needed healthcare,” Hansen said in a statement. “For low-income individuals, these changes could be the difference between an early diagnosis when outcomes are better and costs are less or a late diagnosis where costs are higher and survival less likely.”

A statement from the drug rehabilitation institute Cliffside Malibu in California expressed concerns that patients with mental illness and addiction are also at risk, criticizing a potential switch to the block grants system as translating to “fewer dollars [being] available for healthcare for the nation’s poorest Americans,” and a switch to tax credits shifting away from those with the fewest resources.

“Both of these actions will limit access to mental health and addiction treatment resources for those who need it most,” the statement said.

Also weighing in was the HIV Medicine Association, which declared that the legislation “will likely shut the door on coverage in the individual insurance market for most of the 1.2 million Americans living with HIV.” The group argued that the penalties for discontinuous coverage and the “insufficient” tax credits for low-income people would disproportionately hurt HIV patients.

Women’s Health

Groups were also worried about the impact on healthcare services for women, especially low-income women. Sean Tipton, chief advocacy and policy officer for the American Society for Reproductive Medicine, said his organization’s biggest concern is the “malicious and counterproductive attempt to deny Planned Parenthood payment for services. There is already a ban on federal funding for abortion, this denies payment for things like Pap smears and contraception.”

In addition to access to healthcare, medical organizations charged that the new versions of healthcare reform do little to address a major deficiency in the ACA, which is controlling healthcare costs.

“Taking a step back, we are concerned the legislation does not include any changes needed to bend the cost curve, which is a more fundamental cause of our current difficulties in ensuring access to affordable, high-quality care to all Americans,” according to a statement from the American Osteopathic Association.

Jean Ross, RN, president of National Nurses United, said that because of the lack of controls on the “notorious price gouging by insurance companies, hospitals, pharmaceutical corporations, and other corporate interests in healthcare, more and more people will simply opt out of buying private insurance rather than endure the skyrocketing premiums, deductibles, co-pays, and other fees that are endemic to a wholly market based healthcare system.”

The American Nurses Association said committee leaders are “bucking the rules” by not holding hearings on the bill.

“If Congress truly cares about improving healthcare for all Americans, they need to give this bill fair and open hearings, and they need to hear from nurses before moving forward,” an ANA statement said.

Tom Price, MD, secretary of the U.S. Department of Health and Human Services, stated in a letter to Congressional leaders that the changes were a “necessary first step” and praised efforts to provide tax credits, put Medicare on a “sustainable path,” and expand the use of health savings accounts.

But achieving “all of the President’s goals to reform healthcare will require more than what is possible in a budget reconciliation bill, as procedural rules on this type of legislation prevent inclusion of key policies such as selling insurance across state lines, lowering drug costs for patients, providing additional flexibility in Medicaid for states to manage their programs in a way that best serves their most vulnerable citizens, or medical legal reforms,” Price said.

The American Medical Association said it was working on a statement for release later in the week.



Organized Medicine Blasts ACA Replacement Proposal – MedPage Today

War ushered in dawn of modern medicine – Virginia Gazette

This year is the centennial anniversary of the United States’ entry into World War I. It also marks the initiation of the transformation of American medicine to the modern era. Twenty-first century healthcare something that Americans take for granted today had its origins 100 years ago on Europe’s blood-soaked battlefields.

The United States formally entered the conflict on April 6, 1917, but officials began to prepare the medical aspects a full two years earlier. Necessity became the mother of invention and laid the foundation for future change.

America’s involvement in the war required the government to utilize both curative and preventative medicine to the fullest. The variety of health professionals mustered included the usual doctors, nurses and pharmacists. In addition, unlike in previous wars, sanitary engineers, lab techs and doctor specialists of every stripe were added to the medical teams.

Testimony of their collective value came after the war when the statistical record revealed that for the first time in American history, there had been fewer deaths from disease than from battle wounds.

This remarkable accomplishment before the era of antibiotics was achieved by innovations in a number of areas. These included more thorough examination of recruits, education and prophylaxis against venereal disease, and improved enforcement of sanitation and hygiene.

The wounded soldiers were taken to the hospitals from the battlefields in a better system of triage and evacuation. The treatment of the enormous number of causalities employed science-based therapies. In the military hospitals surgeons undertook a far greater variety of complex operations than had their predecessors in previous wars. Doctors used newly developed antiseptic solutions to irrigate injuries and refined a fundamental surgical principal: the removal of all devitalized tissue prior to suturing.

In addition, blood transfusions, which had been used sporadically prior to the conflict, became a reality. A U.S. Army Medical officer showed that blood could be donated in advance and stored using sodium citrate as an anticoagulant. He also developed the first blood bank.

The war saw the debut of the portable x-ray machine. Radium discoverer and Nobel prize winner Marie Curie organized a campaign to turn cars into x-ray vans to radiograph wounds on the front line. This allowed doctors to save lives and prevent disability by detecting broken bones, shrapnel and bullets buried in the flesh.

While many of these medical advances during the conflict dealt with healing the body, there was also treatment of psychological wounds that left many soldiers with the uncontrollable tremors, commonly called “shell shock.” This was known as “soldier’s heart” during the Civil War and “combat fatigue” in WW II. Shell shock was the forerunner of today’s post-traumatic stress disorder.

The war catapulted clinical practice forward. In the half-century between Appomattox and the Treaty of Versailles, the nation’s doctors had slowly assimilated the bedrock medical concepts of anesthesia, germ theory, antisepsis, microbiology and pathology. These were the roots of modern medical science.

American medicine immediately after WWI was on the cusp of a transformational leap forward. New higher standards of care were set. The cadre of talented doctors that came back after the fighting stopped would help American practitioners ascend into a position of leadership in the years ahead from which all citizens benefit today.

Stolz is a retired physician with a longtime interest in the history of medicine. He is a regular instructor at William & Mary’s Christopher Wren Association.

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War ushered in dawn of modern medicine – Virginia Gazette

With $25 Million Gift, Boston Medical Center Creates Hub For Addiction Medicine – WBUR

wbur Billionaire investor and South Shore native John Grayken and his wife, Eilene, donated $25 million to create the Grayken Center for Addiction Medicine at Boston Medical Center. It’s the largest private donation in the hospital’s history. (Jesse Costa/WBUR File Photo)

State, local and federal officials gathered at Boston Medical Center Monday for the formal announcement of the largest private donation in the hospital’s history: $25 million to help combat addiction.

The money, donated bybillionaire investor and South Shore native John Grayken and his wife, Eilene, will be used to establishthe Grayken Center for Addiction Medicine at the hospital.

“Addiction is happening to all of us,” Kate Walsh, the hospital’s president and CEO, said during a press conference Monday. “This is the most pressing public health issue of our time.”

Walsh says the money is the largest gift in the U.S. in the last decade for addiction medicine, and it will be used to coordinate research, training and treatment. She says the center will be a hub of innovation in addiction treatment and a national model.

“Our goal is to be a leader in care and prevention strategies,” Walsh said. “Our aim is to end this crisis.”

The Graykens were introduced to the hospital by Susan Donahue, a former board member who co-chairs its capital campaign. The couple says they prefer to donate anonymously, but are going public with hopes of destigmatizing addiction and encouraging others to do the same.

“I have personal experience with this disease and I know what it does to people,” Eilene Grayken said. “It can affect anybody. It’s important to me that this becomes destigmatized so people can get the proper help they need.”

Gov. Charlie Baker called the Grayken’s gift a “beautiful opportunity for us to do fabulous work.” And Boston Mayor Marty Walsh, who is in recovery from alcoholism, says the gift will help turn around the opioid addiction crisis in the region, and do research on treatment that may help stem the tide of opioid overdose deaths.

Latest estimates suggest 2,000 people died due to an opioid overdose in Massachusetts last year.

“This gift is going to raise awareness, bring hope and save lives,” Mayor Walsh said. “This will help Boston and its world-class brain power be able to have more groundbreaking research.”

Boston Medical Center is at the center of an area of Boston dubbed “Methadone Mile,” but Mayor Walshprefers to call it “Recovery Road.” Walsh has taken several steps to address problems in the area such as people openly using and selling drugs. The mayor says the $25 million gift will help that effort.

“It just so happens we have a lot of addicts using drugs and alcohol here, but it’s really ‘Recovery Road’ because they’re here for a reason,” Mayor Walsh said Monday. “They’re not here to get drugs, because they could get drugs anywhere in the city of Boston. But they’re here because they’re in and out of programs. This gift is going to turn ‘Recovery Road’ into ‘Recovery Nation.’ ”

Among those at Monday’s announcement was Sherri Harrison, a patient at Boston Medical Center who has been drug-free for eight years.

“Addiction is a disease not a moral failing, not a character flaw,” Harrison said. “It really touches me that people are beginning to understand this and there is so much more that can be done. I agree that BMC is the place to do it.”

Boston Medical Center says it will begin looking for an executive director to lead the new center and coordinate the hospital’s existing services, as well as add some of the research and training components.

Deborah Becker Host/Reporter Deborah Becker is a senior correspondent and host at WBUR. Her reporting focuses on mental health, criminal justice and education.


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With $25 Million Gift, Boston Medical Center Creates Hub For Addiction Medicine – WBUR

Yale School Of Medicine Members Likely Sickened By Chemical, University Says – Hartford Courant

Four members of the Yale School of Medicine who became ill at a campus building last month had likely ingested sodium azide, a substance commonly found in laboratories and used as a preservative, according to the university.

Sodium azide can cause dizziness, headache, nausea and vomiting, rapid breathing and rapid heart rate, the university said in a news release Tuesday.

Four people became sick at 333 Cedar St. on Feb. 28 after drinking from a single-serve, pod-style coffee machine, the release said. That prompted the involvement of the State Department of Energy & Environmental Protection, which handles hazardous materials.

While independent testing of items removed from the area indicated the presence of sodium azide, Yale Police Department is continuing its investigation in collaboration with local, state and federal law enforcement.

The School of Medicine members were monitored at Yale-New Haven Hospital and have all returned to work, the university said.

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Yale School Of Medicine Members Likely Sickened By Chemical, University Says – Hartford Courant

Janney Upgrades Foundation Medicine to Neutral – GenomeWeb

NEW YORK (GenomeWeb) Investment bank Janney upgraded Foundational Medicine to Neutral from Sell today, citing a recent rebound in the company’s shares which analyst Paul Knight attributed to an expected easy sequential earnings comparison for the company in the first quarter, among other reasons.

Earlier this month, Foundation Medicine announced that it had received the first payment from Palmetto GBA its Medicare Administrative Contractor in North Carolina for the Foundation One genomic profiling assay for Stage IIIB/IV non-small cell lung cancer.

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Janney Upgrades Foundation Medicine to Neutral – GenomeWeb

Alternative medicine becomes a lucrative business for US top hospitals – FierceHealthcare

Chinese herbal therapies, acupuncture, homeopathy and reiki are just a few of the offerings that some prestigious medical centers now provide, despite the fact that in many cases there is no evidence the therapies work.

The rise of alternative medicine has created friction within some of these hospitals as many physicians believe it undermines the credibility of the organizations, according to an in-depth investigation of 15 academic research centers by STAT.

The issue came to the forefront earlier this year when the Cleveland Clinic decided to rethink its alternative medicine offerings and how they align with evidence-based practices after the director of the organizations wellness program went on an anti-vaccine rant in a blog post that sparked an immediate backlash.

The clinic said the wellness center would stop selling some of the products, like homeopathy kits, on its website and focus instead on items that improve diet and lifestyle.

But the STAT investigation noted that the Cleveland Clinic is just one of many that has a hand in the $37-billion-a-year business. Other organizations include Duke University, Johns Hopkins, Yale and the University of California, San Francisco. Some hospitals open spa-like wellness centers, while others, like Duke, refer to them as integrative medicine centers.

Several of the hospitals highlighted in the STAT report declined to talk to the publication about why they have embraced unproven therapies, but critics were quick to point out that patients are being snookered and physicians who promote these therapies forfeit claims that they belong to a science-based profession.

Weve become witch doctors, Steven Novella, M.D., a professor of neurology at the Yale School of Medicine and a longtime critic of alternative medicine, told STAT.

Others, however, say that alternative therapies have helped patients and modern medicine doesnt offer a cure for everyone. Linda Lee, M.D., who runs the Johns Hopkins Integrative Medicine and Digestive Center, said the therapies offered are meant to complement, not supplement, conventional treatment.

But Novella worries that when these unconventional treatments are offered by prestigious institutions, patients will think they are legitimate. The problem only worsens when patients find the treatments being sold online by the institution. Thomas Jefferson University Hospital, for instance, sells homeopathic bee venom to relieve symptoms of arthritis.

Daniel Monti, M.D., who directs the integrative health center at the organization, admits the evidence behind some of these treatments is largely anecdotal but said the hospital only offers the treatment when there are few other options.

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Alternative medicine becomes a lucrative business for US top hospitals – FierceHealthcare