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

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

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

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 – Express.co.uk

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

The New England Journal of Medicine: Research & Review Articles on …

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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

BMC Receives Largest Addiction Medicine Donation In Past Decade – Rhode Island Public Radio

Officials gathered at the Boston Medical Center to announce the largest private gift in the hospital’s history. The $25 million donation will be used to address the opioid addiction and overdose epidemic.

The gift from the Grayken family, of Massachusetts and London, will establish the BMC Grayken Center for Addiction Medicine. Its goal is to provide enhanced research into addiction, offer and track treatment and train doctors and others about substance use disorders. Senator Ed Markey told the Grayken family that the gift will save tens of thousands of lives:

“There’s never been an issue like this that is affected our state and our nation. Your leadership today is going to help turn the corner on this disease so children will have to look to the history books to find that there ever was such a scourge.”

BMC officials say it’s the largest donation for addiction medicine in the US in the past decade.

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BMC Receives Largest Addiction Medicine Donation In Past Decade – Rhode Island Public Radio

Crowdsourced Medicine Is Transforming the Diagnosis of Rare Disorders – NBCNews.com

CrowdMed detectives represent a broad spectrum of medical backgrounds from surgeons to acupuncturists to patients who have become experts on their own conditions. Cecilie Arcurs / Getty Images

Patients trust their doctors to diagnose them accurately and quickly. But when a patient has a rare condition or non-specific symptoms, getting that accurate diagnosis can become a costly process that takes months or even years.

Maybe crowdsourced medical diagnosis could do a better job. That’s the proposition of

Launched in 2013, the San Francisco-based company has helped more than 2,000 patients get closer to finding the right diagnosis. CrowdMed currently has pilot programs underway with four major insurance firms to explore whether crowdsourced medicine can be economically effective for patients and insurers.


“If you have a condition that doctors see often, say a heart condition or cancer or diabetes, it’s not hard to get a diagnosis and get on the right treatment path,” says CrowdMed founder and CEO Jared Heyman. If the condition is more unusual, he adds, “you often end up in this cycle where you just get referred from specialist to specialist searching for that needle-in-a-haystack person who might have familiarity with what you have.”

Heyman has seen that cycle first-hand. Back in 2003, his sister, Carly, began gaining weight and sleeping all day. It took three years, more than 20 doctors, and over $100,000 in medical bills to figure out she had a rare genetic mutation called fragile X-associated primary ovarian insufficiency (FXPOI). Carly was treated with a hormone patch and her symptoms vanished within a month.

“I saw how ill-equipped the traditional medical system is when it comes to helping people with difficult to diagnose or rare diseases,” Heyman says. “I wanted to apply everything I knew about crowdsourcing to healthcare to help people like my sister.”

Patients log on to the site, answer a series of questions about their symptoms and medical history, and then, if they choose to do so, upload their medical records to the site with identifying information removed. Then the site’s so-called “medical detectives” collaborate with the patient and each other to offer suggestions as to what they believe is going on, which patients can then discuss with their doctors.

CrowdMed has its critics, including those who question the efficacy of detectives who can’t see a patient in-person and those who believe the site doesn’t provide enough data on patient outcomes.

But it also has its fans like Madeleine Gerlach, a 24 year-old in Pacifica, California, who turned to CrowdMed in early 2013 after a series of doctors failed to identify the cause of the severe, intermittent pain she began experiencing the previous year.

Initially, doctors could find nothing wrong with Madeleine, and her pain subsided for a few months. When it returned, Madeleine’s doctors attributed the pain to spasms in her pelvic floor, the bundle of muscles, nerves, and connective tissues that support the rectum, bladder, and uterus. They referred her to a pelvic pain center and prescribed painkillers.

Nothing worked.

After learning about endometriosis, a uterine disorder that can cause severe abdominal pain and bleeding and whose nonspecific symptoms make it notoriously difficult to diagnose, Madeleine thought that’s what she might have. Her CrowdMed detectives also suggested it was the most likely culprit, but her in-person doctors didn’t agree. Madeleine had diagnostic surgery that May, but it didn’t reveal enough uterine lining growth for doctors to support endometriosis.

Bolstered by what CrowdMed detectives believed, Madeleine got a second opinion, paid $25,000 out of pocket to have a second diagnostic surgery, and in October it was determined she had stage two endometriosis, shaving years, potentially even a decade, off of the average time to diagnosis.

“Just having the diagnosis gave me everything,” Madeleine says. “I was over the moon when I woke up from surgery. I was like ‘I’m not crazy. There’s actually something wrong with me.'”

Getting a correct diagnosis, even if no medical treatment is available for the condition, is often a triumph for patients who need validation that something is truly wrong, says Ronald DeBellis, chief scientific officer for the National Organization for Rare Disorders, a nonprofit organization headquartered in Danbury, Connecticut.

But for patients with rare disorders illnesses that affect fewer than 200,000 people across the entire U.S. getting a proper diagnosis is especially tough. On average, it takes patients with rare disorders seven years to get an accurate diagnosis. In the meantime, as some patients ping-pong from doctor to doctor and undergo repeated batteries of tests, they can run out of money and hope.

“The mental anguish that goes along with this is unbelievable,” DeBellis says. “Every time you go to the doctor, you think someone’s going to find something” that can help.

CrowdMed seeks to reduce the timeline of a diagnosis by enlisting detectives representing a broad spectrum of medical backgrounds everyone from surgeons to acupuncturists to patients who have become experts on their own conditions. Detectives start with a ranking based on verifiable medical credentials and can move up the CrowdMed ladder by adding suggestions other detectives find valuable, and by becoming the medical detective the patient deems most effective as the case closes.

Moderators, all of whom are licensed physicians, monitor conversation to ensure conclusions are drawn based on peer-reviewed science. Well-supported suggestions from the case’s highest-ranked detectives float to the top of the answer pile, as do those that a CrowdMed algorithm determines as having the highest probability of being right. Patients receive a list of potential diagnoses, ranked from most to least probable based on algorithmic assessment and crowd opinion.

But it’s not cheap. Patients pay fees of up to $749 per month higher fees buy higher-ranked detectives working on the case and the site reserves a monetary reward of $200 to $1,000 that a patient can divide among the most helpful medical detectives on the case.


Providing a direct diagnosis isn’t CrowdMed’s goal. The site and its detectives sidestep liability issues by offering suggestions afflicted users can bring to their in-person doctors, rather than official medical advice. The true aim is to provide patients with new insights they can use along with their medical providers to get answers.

Patients like Madeleine sing CrowdMed’s praises, but some in the medical community have doubts.

Jordan Shlain, a primary care doctor in San Francisco, believes that the site offers patients access to experts they may not reach otherwise, but he’s concerned that CrowdMed detectives might not have the tools to recognize when a symptom is from a physical condition and when it’s a manifestation of a patient’s psychology.

On average, it takes patients with rare disorders seven years to get an accurate diagnosis. In the meantime, patients can run out of money and hope. Reza Estakhrian / Getty Images

Difficulty separating physical disorders from somatoform conditions wherein mental illness causes physical symptoms is “definitely a concern and a limitation of not being able to physically examine a patient,” says Kyle Walker, a CrowdMed moderator and general practice physician in Ohio.

Walker says that medical detectives, including those from neurology and psychology backgrounds, sometimes suggest somatoform disorders, but patients often aren’t open to that possibility.

“More often than not, patients just say, ‘Oh I didn’t get a diagnosis from CrowdMed’ and leave dissatisfied,” he says.

Some are also concerned about how patients fare after their CrowdMed case is closed. Hardeep Singh, a patient safety researcher at the Michael E. DeBakey VA Medical Center and Baylor College of Medicine in Houston, published


“Imagine the crowd makes a suggestion of this pathway and you get more tests and more tests and a procedure based on those tests and the procedure doesn’t go very well,” Singh says. “We actually don’t know the downstream outcomes of the suggestions coming out of the crowd, which is exactly why we need that evaluation component.”

CrowdMed patients are asked to complete a survey within 90 days after case closure to evaluate the site’s success Heyman says that “75 percent of the time, if a patient has a medically confirmed diagnosis, it came from us” but medical detectives and moderators generally don’t know how specific patients fare after their case is closed.

Crowdsourced medical help could be a boon for patients, and a game changer for insurance companies, since even a small reduction in time to a diagnosis can translate to thousands in saved medical costs. Joseph A. Ladapo, an assistant professor of medicine at the University of California, Los Angeles, published

Ladapo found that after CrowdMed detectives resolved a case, the number of patient healthcare visits by dropped by nearly 50 percent and their average medical costs went down by about $200 per month. The results are preliminary but “very exciting,” Ladapo says, adding that sites like CrowdMed could significantly broaden access to medical expertise.


“I have patients right now in the hospital that have symptoms I have never seen before that are stumping our entire team,” he says. “We’ve brought consultants in and we’re all stumped. It would almost certainly represent an improvement to have more people thinking about that patient.”

It won’t be clear whether CrowdMed will join forces with major insurance policies, and potentially become a larger part of healthcare in general, until the company’s pilot programs are over later this year. But online resources that allow patients to research their own symptoms, connect with experts who can offer medical feedback, and provide data and suggestions to in-person physicians are rapidly expanding. It’s forcing the medical community to consider how it will evolve to work within a landscape of more empowered patients, Hardeep Singh says.

“I think the physician community is not completely ready,” he says. “But I think it’s increasingly recognizing that we’re in a new era, we’re in a new world where we’re going to have to change the way we receive this online information. I think this is going to continue. CrowdMed is just the beginning.”

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Crowdsourced Medicine Is Transforming the Diagnosis of Rare Disorders – NBCNews.com

Folk ‘Medicine’ Hurts More than Humans – American Council on Science and Health

ACSH followers are clear about the problems associated with fake science from the promotion of supposed obesity “cures” by Dr. Oz to the nonsense of hydrogen-infused water, we’ve covered a myriad of pseudoscience. Some, such as supplements containing aristolochic acid, cause life-threatening effects, while others simply cause users to waste their money and avoid more effective treatments. One effect we’ve not really paid enough attention to, though, is the effect on fauna and flora all over the world. A recent article on Real Clear Science points to several species that are well on the way to extinction because of unfounded beliefs in their health effects.

For starters, take a look at this animal which most of us have never heard of the pangolin. Pangolins are anteaters (though they’ll extend their diets to termites too) that are denizens of Africa and Asia. They’re covered by protective scales, which give them rather a prehistoric look. While the scales may protect them from most predators, they are also the cause of their downfall since ground up scales are believed to be beneficial for lactating mothers and cure cancer and asthma.

Yet other folk beliefs center around sea horses. According to folk beliefs, ground up dried seahorses can benefit those afflicted with impotence, wheezing and bed wetting. They’re found in shallow tropical and temperate waters world wide. Although they don’t really look it, sea horses are indeed fish, renowned for their upright mode of swimming as well as the fact that it’s the male that incubates the eggs in a pouch on his abdomen. Over 150 million of these creatures are harvested each year mostly for use in traditional Chinese medicine, but also for the pet trade and for curios.

And then there are the bears not the usual black, grizzly or polar bears that we’re used to thinking of, but the already endangered Asian black bears and sun bears. They’re inhabitants of dense forests of Southeast Asia habitats that are disappearing rapidly. They are agile climbers and feast on honeycombs, honey and insects. These animals are valued for their bile supposedly a panacea in traditional Chinese medicine. But either the bears are killed to obtain their gall bladders, or they’re kept in captivity so the bile can be harvested via cannula not a humane practice.

These are but three of the less-known animals whose existence is threatened by beliefs that have no place in any modern pharmacopeia. And of course there are the more familiar ones most of us have heard about:

elephants poached for their tusks, rhinos for their horns, tigers for their bile and penises and many more.

So the next time you hear that “the Chinese have used X for 5,000 years” as a testament to the utility of some nostrum, think about more than the lack of any data supporting such beliefs, and consider what at least some of the effects may be on wildlife.

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Folk ‘Medicine’ Hurts More than Humans – American Council on Science and Health

The Medicine Shoppe will sponsor 34th annual Times Leader Spelling Bee – Wilkes Barre Times-Leader

WILKES-BARRE The marathon-long rounds of the Times Leaders annual regional spelling bee may have come to an abrupt end without the help of a few local business owners.

Owners of The Medicine Shoppe locations in Wilkes-Barre and Dallas banded together to help fund the event, which has been a Times Leader tradition for more than three decades.

This years bee, the 34th annual, will be held at 1 p.m. Sunday at The Woodlands Inn & Resort, Route 315, Plains Township. Twenty-one spellers from across Northeastern Pennsylvania will compete locally for a chance to spell on the national stage.

The first-place winner of the bee will receive a trip to Washington, D.C., during the week of Memorial Day, during which he or she will meet other top spellers from across the country, tour the capital and compete in the Scripps National Spelling Bee.

We learned last summer that we wouldnt be able to hold this years bee unless a benefactor stepped forward, and we are so very grateful to The Medicine Shoppe pharmacies in Wilkes-Barre and Dallas for their generous sponsorship, said Times Leader features writer Mary Therese Biebel, who is coordinating the 2017 regional bee with arts and entertainment editor Sarah Haase.

By sending a speller to Washington for the National Bee, the Medicine Shoppe is helping that young scholar have the experience of a lifetime, Biebel said.

Times Leader Media Group Publisher Mike Murray said he is grateful for The Medicine Shoppes support of the bee, which has had a major impact on some past participants lives.

Its a pleasure this year to welcome The Medicine Shoppe as a co-sponsor of the TL Spelling Bee, said Murray. Thanks to their generosity, we are able to continue to build upon a tradition that has been part of the area for over three decades and look forward to its continued success.

Biebel said this years contestants can be inspired by Sukanya Roy, a speller from Abington Heights Middle School who won the regional bee three times and, on her third trip to Washington in 2011, won the national bee.

That was phenomenal, Biebel said.

Gary Karwaski, owner of The Medicine Shoppe in Dallas, said he believes education is key to a successful future a notion that was instilled within him since he was young.

Personally, when I was a child, my parents didnt have a lot of money, he said. My dad went to eighth grade, and I think my mother did too. I always knew how they struggled their whole life, and they would say when I was young, Youre going to college, youre going to college. It was expected. I always instill that into my children. Education helps you, and it makes things a heck of a lot easier.

Karwaski said he was surprised to learn that the bee may not have continued if it hadnt found a sponsor.

I had no idea that was the case, he said. That makes me feel pretty good.

Peg Freeman, owner of The Medicine Shoppe in Wilkes-Barre, has always had trouble spelling, so shes excited to encourage youngsters to start learning the craft.

Im an adult whos 66 years old and has a tough time spelling every day, she said. With our phones, you dont need to spell. Everything is checked for you. (I think) its important to learn how to spell.

Last years winner, Peter Khoudary from Good Shepherd Academy in Kingston, will once again participate in the bee. Khoudary, of Dallas, was eliminated in the third round of the Scripps National Spelling Bee last year with the word niacin.


Jamison Bessoir, of Abington Heights Middle School, competes in the Times Leader Spelling Bee at The Woodlands Inn & Resort in Plains Township last March.

http://timesleader.com/wp-content/uploads/2017/03/web1_TTL030716SpellingBee3-1.jpgJamison Bessoir, of Abington Heights Middle School, competes in the Times Leader Spelling Bee at The Woodlands Inn & Resort in Plains Township last March. Sean McKeag File Photo | Times Leader

Peter Khoudary, of Good Shepherd Academy, wins the Times Leader Spelling Bee last March.

http://timesleader.com/wp-content/uploads/2017/03/web1_TTL030716SpellingBee4-1.jpgPeter Khoudary, of Good Shepherd Academy, wins the Times Leader Spelling Bee last March. Sean McKeag File Photo | Times Leader

Reach Sarah Hite Hando at 570-704-3945.

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The Medicine Shoppe will sponsor 34th annual Times Leader Spelling Bee – Wilkes Barre Times-Leader

Urban Animal showed me how to get strong with a medicine ball – austin360 (blog)

Laura Cisneros showed me how to strengthen my core with a medicine ball. PAM LeBLANC/American-Statesman

I met fitness trainer Laura Cisneros down at The Rock along the Butler Trail this morning, to find out how she gets those rock hard abs. She busted out a 6-pound Dynamax medicine ball and put me through a workout Im pretty sure Ill feel tomorrow. I crunched, I tossed, I engaged my abs and lats and tried to keep my knees from wobbling.

Cisneros, who runs a fitness program called Urban Animal, says medicine balls come in handy for athletes of all types looking for an all-over warm up or cool down. On their own, they can help increase power, strength and cardio fitness.

Im a swimmer, but my core is my weak link. I need this. Youre trying to train a whole range of motion and get your joints to work sequentially, she told me. Thats where the power comes from. First, a warning. You have to pay attention to what youre doing, or you might take a medicine ball to the gut.At least thats what I heard. You cant just go through the motions or youll eat vinyl. Youve got ball coming at you and youve got to deal with that, Cisneros says.

Cisneros heads a training program called Urban Animal. PAM LeBLANC/American-Statesman

And honestly, I never played ball sports. Glancing up to see a big ball flying at my face makes me want to duck . With Cisneros help, though, itll turn me into an animal. She ran me through a series of exercises, including one where I flopped on my belly (Superwoman style) and tossed a ball back and forth with her, and another that made me feel like I was flinging a bucket full of water at someone. Now Im going to show you how to put it all together and it will kill you, she said. Who can resist that? We combined five exercises she showed me in what she called a hub and wheel routine, where I did reps of each individual exercise, alternating with a basic ball toss. Cisneros heads up a training program called Urban Animal. The 45-minute high intensity training sessions take place at Sanchez Elementary School; session times are 6:15 a.m. Monday, Wednesday and Friday and 5:45 p.m. Monday and Friday. Cost is $100 a month for unlimited classes.


Things I saw on my bike thisweek

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Urban Animal showed me how to get strong with a medicine ball – austin360 (blog)

Precision Medicine Initiative | The White House

Precision Medicine is already saving lives. Read the stories of some of the people that have benefited from this new approach:

William Elder, Jr. was diagnosed with cystic fibrosis (CF) at the age of eight, when the life expectancy for CF patients was very low. Now at 27, Bill is alive thanks to Kalydeco, a treatment of a particular form for his cystic fibrosis and a remarkable drug that treats the underlying cause of his CF, rather than the symptoms.

At a congressional briefing in 2013, Bill told members of the U.S. Senate that just knowing that there were individuals who were researching his condition gave him hope and the strength to continue his treatments and work to be healthier every day. Bill described waking up in the middle of the night after taking his new treatment for the first time. I sat on the floor of my room for a while slowly breathing in and out through my nose, and then I realized that was it. I had never been able to easily breathe out of my nose before. This was something profound, he said. He recalls telling his parents, “For the first time in my life, I truly believe that I will live long enough to be a grandfather.

At age six, Emily Whitehead was the first pediatric patient to be treated with a new kind of cancer immunotherapy and was cancer free only 28 days later. If you didnt know what happened to her, and you saw her now, you would have no idea what she has been through, says Emily’s Mom.

Her parents decided to enroll her in a pioneering cancer immunotherapy trial at the Childrens Hospital of Philadelphia. Emilys T-cells were collected from her blood and re-engineered in the lab to recognize a protein found only on the surface of leukemia cells. Those T-cells were then infused back into Emilys blood, where they circulated throughout her body on a mission to seek and destroy her leukemia.Knowing how to turn these T-cells into what Emily called ninja warriors required big investments in basic biomedical research. In fact,Science Magazine named it a 2013 Breakthrough of the Year Emily’s family couldn’t agree more.

Melanie Nix’s family has a history of breast cancer a history that Melanie couldn’t escape when she tested positive for the BRCA gene mutations linked to breast cancer in 2008. After 16 rounds of chemotherapy and breast reconstruction surgery, she had to have both ovaries removed to further reduce risks of cancer in the future. But Melanie is now cancer free thanks to precision medicine.

Melanie’s positive test results for the BRCA gene mutations instantly concerned her medical team. BRCA gene mutations are linked to breast and ovarian cancers. Further tests confirmed that she had triple-negative breast cancer, a very aggressive form of breast cancer that disproportionately affects African-American women. Her best chance for cancer-free survival was to have a bilateral mastectomy. Melanie says that this type of tailored treatment gave her hope. “Precision medicine offers the hope that by the time my daughter is at an age when she considers genetic testing, new, targeted treatments will be available to give her additional choices for preserving her health,” she said.

Beatrice Rienhoff’s eyes were spaced wider than usual, her leg muscles were weak, and she couldn’t gain weight. Her father, a trained clinical geneticist, took notice and wanted to help. After six years, he and his team of scientific volunteers identified the cause of her condition.

Beatrice’s original medical team had thought her condition resembled Marfan syndrome, a genetic disorder that can cause tears in the human heart. It’s typically a fatal syndrome. However, the doctors couldn’t fully diagnose Beatrice with Marfan or any other known disease. Acting as “Super Dad,” Hugh lead his team to identifying a variant responsible for his daughter’s condition and this research gave rise to the description of a whole new syndrome. The team continues to use precision medicine to learn more about the new syndrome and further study genetic variation to help those like his daughter. Today, Beatrice is living a full life.

Six-time NBA Most Valuable Player, Kareem Abdul-Jabbar was diagnosed with a form of leukemia in 2008. Known to be lethal, leukemia is a cancer of the blood and bone marrow. It caused the basketball great to slow down, fall ill, and worry. A few years later, he credits precision medicine for helping him to be well today.

Learn More:

FACT SHEET: President Obamas Precision Medicine Initiative

The Precision Medicine Initiative: Data-Driven Treatments as Unique as Your Own Body

Precision Medicine Is Already Working to Cure Americans: These Are Their Stories

Next Steps in Developing the Precision Medicine Initiative

Precision Medicine: A One-Year Update

The Precision Medicine Initiative: Data-Driven Treatments as Unique as Your Own Body

President Obama on the Benefits of Precision Medicine

FACT SHEET: Obama Administration Announces Key Actions to Accelerate Precision Medicine Initiative

Remarks by the President in Precision Medicine Panel Discussion

The White House Hosts a Precision Medicine Initiative Summit

Precision Medicine: Health Care Tailored to You

Letter to President Obama

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Precision Medicine Initiative | The White House

How traditional medicine can play a key role in Latino health care – The Conversation US

Meticulously marked natural remedies at Latino American botnica, Fuente de Salud.

In the U.S., many undocumented individuals and other vulnerable groups in the Latino immigrant population, such as indigenous language speakers, are already marginalized from mainstream health services. Increased scrutiny and a growing atmosphere of tension and discrimination could deter even documented Latino immigrants from seeking proper care.

Traditional or indigenous medicine, commonly referred to as TM, can bridge some of these barriers to health care because their methods stem from the unique values, cultural systems and specific health needs of these populations.

The World Health Organization says that TM, of proven quality, safety, and efficacy, contributes to the goal of ensuring that all people have access to care. In its latest report on traditional medicine, WHO acknowledges TM as a mainstay of health and health care delivery. The report represents a novel strategy for integrating more traditional and community-based health care options into mainstream medicine.

The strategy centers on two overarching goals. The first is enabling member states to channel the potential of TM into people-centered universal health systems and coverage. The second involves promoting safe and evidence-based use of TM to guarantee safety and quality.

I am a doctoral candidate in health promotion and behavior, and my research is focused on TM services in Latino immigrant communities of the southeastern U.S. One question I seek to answer is how TM practitioners can work with mainstream health care providers in a cooperative spirit to better serve the health needs of Latino immigrant communities.

TM and allopathic (a technical term for biomedicine or Western) medicine are often presented as opposing schools of thought. Yet researchers have noted Latino individuals tend to move freely between [TM] and biomedicine based on what they can access, what they can relate to, and what they believe works.

In general terms, TM approaches tend to be more preventative and lifestyle-oriented than allopathic approaches. Patients may be advised to change personal behaviors and habits rather than just start taking a pill. Because TM providers offer health services based on indigenous, community traditions, they can also serve as initial access points for those facing cultural barriers to mainstream care.

Ideally, they could even function as bridges to allopathic care for marginalized Latino immigrant communities.

But this is contingent on the two sectors developing a higher standard of communication and collaboration. If achieved, TM practitioners might even opt for specialized training to help screen patients for more serious health problems and issue appropriate referrals.

The botnica is a TM-oriented health service venue which has reemerged in Latin American immigrant communities across the United States. Botnicas provide health services and products rooted in Mesoamerican and pre-Columbian indigenous cultures. Their offerings are generally aimed at treating the whole person. This includes targeting physical, psychological, emotional and spiritual health.

Preliminary interviews I conducted revealed Latino immigrants will often seek a botnica providers services before attempting to access mainstream care. Proprietors prescribe herbs and natural treatments for a wide range of conditions, often marketing specialties such as individualized herbal blends or healing salves for their regular customers. Many practitioners also offer spiritual counseling services and cleansing rituals, treating a range of mental health concerns and stressors.

As noted in an article highlighting a culture of medical pluralism among Mexican immigrants, the core health belief for most Mexican Americans is that good health is achieved by balancing the spiritual, natural, physical, emotional, moral and communal factors within ones life.

In his book Botnica: Sacred Spaces of Healing and Devotion in Urban America, Dr. Joseph M. Murphy claims botnicas have played an important role as a mediating institution in helping immigrants deal with psychological issues which arise while adapting to a new culture. Botnicas, says Murphy, help immigrants adjust to new environments and challenges. And further, they provide armor and an array of weapons in the fight to find a safe and sustaining place in the new world.

This mental health component of botnica services is vital. Immigrants face unique political and financial constraints when seeking mental health care. And undocumented immigrants may have little hope of accessing mainstream mental health treatment at all. The spiritual counseling services botnicas provide can soothe the complex and intersecting stress many immigrants face upon arrival in the U.S.

Researchers Gomez-Beloz and Chavez have concluded that Latino immigrants access the services of conventional health care providers in an interchangeable manner with botnica providers. Their findings helped establish the botnica as an important health care resource for the U.S. Latino population.

Viladrich, a researcher who studied botnicas and herb-healing practices in New York City, confirmed the botnica as a primary health service of choice for Latino immigrants.

In my own exploratory research, I surveyed Latino immigrants in the southeastern U.S. regarding their views on TM services. Feedback was consistent with research findings that Latino immigrants access botnica services in tandem with mainstream providers. This practice seemed to remain consistent regardless of immigration status or insurance coverage.

Dr. David Hayes-Bautista, professor of medicine and director of the Center for the Study of Latino Health and Culture at the School of Medicine at UCLA, has encouraged the medical communitys involvement with botnica networks. He echoes claims that Latin Americans generally prefer a more holistic and natural approach to medicine. Hayes-Bautista described one prototype for collaboration a University of New Mexico workshop where students meet with curanderos (healers trained in indigenous Mexican traditions) each summer.

Hayes-Bautista relayed that one important theme presented in the collaborative workshops is how Latino immigrants have probably already seen four or five curanderos to shop around first before seeking allopathic care. Students intending to work in health services are instructed to survey Latino immigrant patients regarding previous visits with TM healers, in order to discern and coordinate their own role in a patients ongoing care.

More research is needed on how botnicas and curanderos can fully realize their potential in alignment with WHO strategy toward resolving health disparities and gaps in access to care for vulnerable communities. Such potential may include integrating some of their more affordable services into mainstream care options. They may also provide accessible alternatives to cost-prohibitive services for uninsured patients.

The World Health Organization is not alone in promoting models integrating TM with allopathic medicine. The CDC recently concluded a Traditional Foods Project aimed at Type 2 Diabetes prevention, which was conducted in partnership with American Indian and Alaskan Native communities. Initial CDC analysis of this program published this month concluded that collaboration with traditional indigenous community knowledge keepers can increase the effectiveness and sustainability of health interventions conducted across agencies working on similar issues throughout the country.

As called for in the WHO strategy, ongoing research and development of research partnerships will be vital to addressing current gaps in scientific literature concerning the effectiveness and utility of traditional and indigenous medicine in the modern health care ecosystem.

More evidence-based data can help pave the way for local and national policies that safeguard the most vulnerable individuals and populations from looming and escalating health disparities. This will include increased scrutiny on TM methods, but also greater access to, and preservation of, natural resources used in treatments.

Millions of people in the United States remain in limbo waiting to see if they lose health care access under the Trump administration. Indeed, these same individuals may have only recently gained access under Obama. In such insecure times, the need to experiment with new (or old, as it may be) health service paradigms is more crucial than ever.

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How traditional medicine can play a key role in Latino health care – The Conversation US

Smoking pot as a medicine raises questions for doctors about side effects – CBC.ca

Not all medicinal marijuana is created equal. That’s what some experts are saying as they warn about the health risks and curtailed effectiveness associated with smoking medicine.

As medical pot becomes increasingly mainstream and Canada moves toward legalizing the substance, health experts are emphasizing the need for doctors and patients to consider the sometimes serious side effects linked to the various ways of consuming the drug.

Marc Emery holds a handful of marijuana at the opening of Cannabis Culture store in Montreal. (Paul Chiasson/Canadian Press)

Paul Farnan, an addictions specialist at the University of British Columbia, likened a recommendation to smoke medicinal marijuana to a doctor handing out a prescription to light up an opium pipe.

“We know there’s something in opium that helps pain, and we’re able to pharmaceutically develop morphine and other analgesics, but we wouldn’t say to people, ‘You have pain? Why don’t you smoke opium?'” he said.

“We’re kind of saying to people, ‘We think there’s some stuff that cannabinoids will be helpful for. Why don’t you just smoke cannabis?’ First of all, cannabis is actually a really dangerous thing for your lungs.”

Mikhail Kogan, medical director of the Center for Integrative Medicine at George Washington University in Washington, D.C., said he sees no reason for people to smoke marijuana medically anymore.

It’s difficult to absorb enough of the drug through the lungs, and gastric acids interfere when someone eats it, he said, adding that it’s more effective to take the drug by other means, such as under the tongue.

“Rectally is actually a lot more preferred because of the volume of absorption. You can put a lot more and it gets absorbed a lot better, but not everybody is open to this way of administration,” Kogan said.

Last year, Health Canada gave medicinal pot growers the green light to produce cannabis oil and other plant extracts. (CBC)

“We have so many other products now, so many modes of delivery, that smoking in my opinion is very archaic and has very little clinical applicability,” he added.

Health Canada officially recommends against smoking marijuana.

“Many of the chemicals found in tobacco smoke are also found in cannabis smoke,” reads its website.

The Canadian Medical Association has no formal position on the consumption of medicinal pot, but it officially opposes the inhalation of any burned plant material.

Association spokesman Jeff Blackmer added that many physicians are reluctant to prescribe medical marijuana because of the absence of peer-reviewed research into whether the drug is medically effective, its possible side effects, appropriate dosage and more.

A “strong majority” of doctors would prefer not to be involved as so-called gatekeepers, Blackmer added.

“Most of them hate it,” he said.

A woman smokes a large marijuana joint at the Vancouver Art Gallery during the annual 4/20 day. (Ben Nelms/Reuters)

“This is something that was imposed on us by the government and the majority of physicians do not want to have anything to do with it.”

Colette Rivet, head of the association that represents licensed cannabis producers in Canada, said that while the industry is against smoking medical marijuana, ultimately it can’t restrict what patients do.

“We know that there’s an issue with smoking. However, we can’t control it at the patient level,” Rivet said.

“We’re trying to develop new product forms so they would be more inclined to go away from that.”

Canadian company CannTrust has developed a pot pod for your single serve coffee maker. (CannTrust)

Each licensed producer has its own unique document that physicians fill out when prescribing medical marijuana, which includes a minimum amount of information required by Health Canada, Rivet said.

Beyond that, some companies ask whether a patient would prefer dried marijuana or oil, while others don’t, she added.

A Health Canada spokesman confirmed that patients are in charge of requesting the form of medical marijuana they prefer, whether dry leaf or oil, and they are not restricted in how they wish to consume it.

The sale of edibles is banned, but a June 2015 decision from the Supreme Court of Canada ruled medicinal marijuana patients have the right to prepare their medication however they want, including cooking it.

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Smoking pot as a medicine raises questions for doctors about side effects – CBC.ca