Health Care at the High Court: 5 Ways This Time Is …

The never-ending political fight over health care hit the Supreme Court Wednesday, and insurance coverage for millions of Americans is on the line.

Didn't we do this already?

Yes, but foes of President Barack Obama's signature law hope this time the justices will gut "Obamacare." The law's defenders say it's a trumped-up attack.

Still sound familiar? Actually, a lot has changed since the Supreme Court's big health care decision of 2012.

Five ways this time is different:

PEOPLE ALREADY ARE USING THE HEALTH CARE PLANS

The first case came as major parts of the law were being phased in. The promised subsidies to help low- and middle-income families afford insurance were not available.

Now the law is in its second year of providing coverage to people who are not insured through their jobs. More than 11 million people are enrolled; nearly 9 out of 10 receive tax subsidies to help cover the cost.

If the Supreme Court rules against the government, many would be unable to afford their premiums.

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Health Care at the High Court: 5 Ways This Time Is ...

Health care maze: Retired teacher tells how dispute has affected her medical care

Published: Thursday, March 5, 2015 at 05:19 PM.

Ann Lancaster of Boiling Springs doesnt understand the disagreement between United HealthCare and Carolinas HealthCare System.

But 83-year-old Lancaster, a retired schoolteacher, does know that since she switched to United HealthCare she has paid more up front costs, and if she gets sick and has to go to Carolinas HealthCare System Cleveland, her insurance wouldnt be accepted.

That would bother me if I couldnt get care at Cleveland, Lancaster said.

Helping her navigate the insurance and health care maze is her cousin and power of attorney, Kitty Hoyle.

Cant find a doctor

Since Lancaster fell last fall and spent time in the hospital and a nursing home, Hoyle has tried to find her a primary care doctor who has hospital privileges.

I cant find a doctor, Hoyle said. No doctor will call back, and when they find out what kind of insurance she has, they dont want to take it.

Lancaster is back home now under the care of the nursing home doctor, but Hoyle also worries what would happen if she had to go back to the hospital.

She needs a doctor who has privileges at the hospital who has continuity of care they know me and know her, Hoyle said. It is shameful that this retired teacher cant find a primary care doctor in the county she served for 42 years.

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Health care maze: Retired teacher tells how dispute has affected her medical care

Chemical Exposure Linked to Billions in Health Care Costs

Exposure to hormone-disrupting chemicals is likely leading to an increased risk of serious health problems costing at least $175 billion (U.S.) per year in Europe alone, according to a study published Thursday.

Chemicals that can mimic or block estrogen or other hormones are commonly found in thousands of products around the world, including plastics, pesticides, furniture, and cosmetics.

The new research estimated health care costs in Europe, where policymakers are debating whether to enact the world's first regulations targeting endocrine disruptors. The European Union's controversial strategy, if approved, would have a profound effect on industries and consumer products worldwide.

Linda Birnbaum, the leading environmental health official in the U.S. government, called the new findings, which include four published papers, "a wake-up call" for policymakers and health experts.

"If you applied these [health care] numbers to the U.S., they would be applicable, and in some cases higher," says Birnbaum, director of the U.S. National Institute of Environmental Health Sciences.

The researchers detailed the costs related to three types of conditions: neurological effects, such as attention deficit disorders; obesity and diabetes; and male reproductive disorders, including infertility.

Some hormone-altering chemicals in consumer products have been linked to increased risk of diabetes.

Photograph by Mario Anzuoni, Reuters/Corbis

The biggest estimated costs, by far, were associated with chemicals' reported effects on children's developing brains. Numerous studies have linked widely used pesticides and flame retardants to neurological disorders and altered thyroid hormones, which are essential for proper prenatal brain development.

The researchers concluded that there is a greater than 99 percent chance that endocrine-disrupting chemicals are contributing to the diseases, according to the studies published in the Journal of Clinical Endocrinology and Metabolism.

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Chemical Exposure Linked to Billions in Health Care Costs

Sun damage causes genetic changes that predispose children and adolescents to melanoma

The St. Jude Children's Research Hospital -- Washington University Pediatric Cancer Genome Project found that melanoma in some adolescent and adult patients involves many of the same genetic alterations and would likely respond to the same therapy. The research appears in the March issue of the Journal of Investigational Dermatology.

The similarities involved adolescents with conventional melanoma tumors and included the first genetic evidence that sun damage contributes to melanoma in children and adolescents as well as adults. The findings stem from the most comprehensive analysis yet of the genetic alterations responsible for pediatric melanoma, which is the most common skin cancer in children and adolescents.

"This study shows that unlike many cancers, conventional melanoma is essentially the same disease in children and adults. That means we need to make it easier for adolescents to access promising therapeutic agents being tried in adults," said co-corresponding author Alberto Pappo, M.D., a member of the St. Jude Department of Oncology. "These results also underscore the importance of starting sun protection early and making it a habit for life."

Researchers also identified distinct genetic alterations associated with other pediatric melanoma subtypes, including those associated with large congenital nevi (CNM) and spitzoid tumors. The alterations include a mutation that might help identify spitzoid patients who would benefit from aggressive therapy as well as those who could be cured with less intensive treatment.

"Until now the genetic basis of pediatric melanoma has been a bit of a mystery," said co-corresponding author Armita Bahrami, M.D., an assistant member of the St. Jude Department of Pathology. "With this study, we have established the molecular signatures of the three subtypes of this cancer, signatures that have implications for diagnosis and treatment."

The National Cancer Institute (NCI) estimates that melanoma is diagnosed in 425 U.S. residents age 19 and younger each year. While the cancer remains rare in young people, the incidence has risen about 2 percent annually in recent decades, primarily in those ages 15 to 19. That age group makes up the majority of current pediatric melanoma patients. For the 75 percent of pediatric patients whose disease has not spread, long-term survival rates now exceed 90 percent.

"We were surprised to see that so many of the pediatric melanomas had genetic changes linked to UV damage," said co-author Richard K. Wilson, Ph.D., director of The Genome Institute at Washington University School of Medicine in St. Louis. "This in-depth look at the genomics of pediatric melanoma is extraordinarily important for diagnosis and for selecting treatments that give young patients the best chances of a cure."

This study included 23 melanoma patients ranging in age from 9 months to 19 years old. Researchers used whole genome sequencing and other techniques to compare the normal and tumor genomes of patients with three different types of melanoma for clues about the genetic alterations that underlie their disease. The genome is the blueprint for life that is encoded in the DNA found in almost every cell.

The group included 15 patients with conventional melanoma. Unlike many pediatric cancers, their tumors included numerous genetic alterations, more than any of the childhood cancers studied so far by the Pediatric Cancer Genome Project. More than 90 percent of the tumors had genetic changes consistent with damage caused by ultraviolet light. More than 60 percent of the tumors had mutations in the BRAF oncogene, the PTEN tumor suppressor gene or the promoter region of a gene called TERT. The same alterations are found in melanoma in adults and promoted the unchecked cell division and other changes that are hallmarks of cancer.

In contrast to conventional melanoma, the three patients with the CNM subtype had mutations in the NRAS oncogene and no defects in PTEN. The patients all died of their disease.

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Sun damage causes genetic changes that predispose children and adolescents to melanoma

Let’s Play The Repopulation – Episode 6 – More Genetic Engineering – Video


Let #39;s Play The Repopulation - Episode 6 - More Genetic Engineering
I (Tigwyk) actually manage to clone two different animals and demo the process of crafting "Man #39;s Best Friend". Stay tuned for more gameplay videos! This vid...

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Let's Play The Repopulation - Episode 6 - More Genetic Engineering - Video

Engineering the Perfect Baby

If anyone had devised a way to create a genetically engineered baby, I figured George Church would know about it.

At his labyrinthine laboratory on the Harvard Medical School campus, you can find researchers giving E. Coli a novel genetic code never seen in nature. Around another bend, others are carrying out a plan to use DNA engineering to resurrect the woolly mammoth. His lab, Church likes to say, is the center of a new technological genesisone in which man rebuilds creation to suit himself.

When I visited the lab last June, Church proposed that I speak to a young postdoctoral scientist named Luhan Yang, a Harvard recruit from Beijing whod been a key player in developing a new, powerful technology for editing DNA called CRISPR-Cas9. With Church, Yang had founded a company called eGenesis to engineer the genomes of pigs and cattle, sliding in beneficial genes and editing away bad ones.

As I listened to Yang, I waited for a chance to ask my real questions: Can any of this be done to human beings? Can we improve the human gene pool? The position of much of mainstream science has been that such meddling would be unsafe, irresponsible, and even impossible. But Yang didnt hesitate. Yes, of course, she said. In fact, the laboratory had a project to determine how it could be achieved. She flipped open her laptop to a PowerPoint slide titled Germline Editing Meeting.

Here it was: a technical proposal to alter human heredity.

Germ line is biologists jargon for the egg and sperm, which combine to form an embryo. By editing the DNA of these cells or the embryo itself, it could be possible to eliminate disease genes and to pass those genetic fixes on to future generations. Such a technology could be used to rid families of scourges like cystic fibrosis. It might also be possible to install genes that offer lifelong protection against infection, Alzheimers, and, Yang told me, maybe the effects of aging. These would be history-making medical advances that could be as important to this century as vaccines were to the last.

The fear is that germ line engineering is a path toward a dystopia of super people and designer babies for those who can afford it.

Thats the promise. The fear is that germ line engineering is a path toward a dystopia of super people and designer babies for those who can afford it. Want a child with blue eyes and blond hair? Why not design a highly intelligent group of people who could be tomorrows leaders and scientists?

CRISPR was discovered only three years ago but is already widely used by biologists as a kind of search-and-replace tool to alter DNA, even down to the level of a single letter. Its so precise that its widely expected to turn into a promising new approach for gene therapy treatment in people with devastating illnesses. The idea is that physicians could directly correct a faulty gene, say, in the blood cells of a patient with sickle-cell anemia (see Genome Surgery). But that kind of gene therapy wouldnt affect germ cells, and the changes in the DNA wouldnt get passed to future generations.

In contrast, the genetic changes created by germ line engineering would be passed on, and thats what has always made the idea seem so objectionable. So far, caution and ethical concerns have had the upper hand. A dozen countries, not including the United States, have banned germ line engineering, and scientific societies have unanimously concluded that it would be too risky to do. The European Unions convention on human rights and biomedicine says tampering with the gene pool would be a crime against human dignity and human rights.

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Engineering the Perfect Baby

Activating genes on demand: Possible?

When it comes to gene expression -- the process by which our DNA provides the recipe used to direct the synthesis of proteins and other molecules that we need for development and survival -- scientists have so far studied one single gene at a time. A new approach developed by Harvard geneticist George Church, Ph.D., can help uncover how tandem gene circuits dictate life processes, such as the healthy development of tissue or the triggering of a particular disease, and can also be used for directing precision stem cell differentiation for regenerative medicine and growing organ transplants.

The findings, reported by Church and his team of researchers at the Wyss Institute for Biologically Inspired Engineering at Harvard University and Harvard Medical School in Nature Methods, show promise that precision gene therapies could be developed to prevent and treat disease on a highly customizable, personalized level, which is crucial given the fact that diseases develop among diverse pathways among genetically-varied individuals. Wyss Core Faculty member Jim Collins, Ph.D., was also a co-author on the paper. Collins is also the Henri Termeer Professor of Medical Engineering & Science and Professor in the Department of Biological Engineering at the Massachusetts Institute of Technology.

The approach leverages the Cas9 protein, which has already been employed as a Swiss Army knife for genome engineering, in a novel way. The Cas9 protein can be programmed to bind and cleave any desired section of DNA -- but now Church's new approach activates the genes Cas9 binds to rather than cleaving them, triggering them to activate transcription to express or repress desired genetic traits. And by engineering the Cas9 to be fused to a triple-pronged transcription factor, Church and his team can robustly manipulate single or multiple genes to control gene expression.

"In terms of genetic engineering, the more knobs you can twist to exert control over the expression of genetic traits, the better," said Church, a Wyss Core Faculty member who is also Professor of Genetics at Harvard Medical School and Professor of Health Sciences and Technology at Harvard and MIT. "This new work represents a major, entirely new class of knobs that we could use to control multiple genes and therefore influence whether or not specific genetics traits are expressed and to what extent -- we could essentially dial gene expression up or down with great precision."

Such a capability could lead to gene therapies that would mitigate age-related degeneration and the onset of disease; in the study, Church and his team demonstrated the ability to manipulate gene expression in yeast, flies, mouse and human cell cultures.

"We envision using this approach to investigate and create comprehensive libraries that document which gene circuits control a wide range of gene expression," said one of the study's lead authors Alejandro Chavez, Ph.D., Postdoctoral Fellow at the Wyss Institute. Jonathan Schieman, Ph.D, of the Wyss Institute and Harvard Medical School, and Suhani Vora, of the Wyss Institute, Massachusetts Institute of Technology, and Harvard Medical School, are also lead co-authors on the study.

The new Cas9 approach could also potentially target and activate sections of the genome made up of genes that are not directly responsible for transcription, and which previously were poorly understood. These sections, which comprise up to 90% of the genome in humans, have previously been considered to be useless DNA "dark matter" by geneticists. In contrast to translated DNA, which contains recipes of genetic information used to express traits, this DNA dark matter contains transcribed genes which act in mysterious ways, with several of these genes often having influence in tandem.

But now, that DNA dark matter could be accessed using Cas9, allowing scientists to document which non-translated genes can be activated in tandem to influence gene expression. Furthermore, these non-translated genes could also be turned into a docking station of sorts. By using Cas9 to target and bind gene circuits to these sections, scientists could introduce synthetic loops of genes to a genome, therefore triggering entirely new or altered gene expressions.

The ability to manipulate multiple genes in tandem so precisely also has big implications for advancing stem cell engineering for development of transplant organs and regenerative therapies.

"In order to grow organs from stem cells, our understanding of developmental biology needs to increase rapidly," said Church. "This multivariate approach allows us to quickly churn through and analyze large numbers of gene combinations to identify developmental pathways much faster than has been previously capable."

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Activating genes on demand: Possible?

Vaccination is crucial to preventing cervical cancer

The number of people dying of cervical cancer in the world is now more than ever before, and health agencies should advise adolescent boys and girls to go in for proper vaccination to prevent them from contracting the disease, said Nobel Laureate Harald zur Hausen.

While delivering a lecture on prevention of cancers linked to infections at the Indian Genetics Congress organised by the department of genetic engineering at SRM University, Kattankulathur, on Wednesday, he said, in cervical cancer, prevention had caused a significant decrease in the number of infections.

In his address, M.S. Swaminathan, founder of M.S. Swaminathan Research Foundation, said there are three major dimensions of hunger calorie deprivation, protein deficiency and micronutrient deficiency.

One way to overcome protein hunger is through a pulses revolution, he said.

P. Sathyanarayanan, president of SRM University, called on the Centre to enhance funding for research and development in genetic engineering.

Trilochan Mohapatra, director, Central Rice Research Institute, Bhubaneswar, received the Lifetime Achievement Award, and Swarup K. Parida and Amit Mitra of the National Institute of Plant Genome Research, New Delhi, received the young genetics researchers award.

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Vaccination is crucial to preventing cervical cancer

The Gene Therapy Plan: Taking Control of Your Genetic Destiny with Diet and Lifestyle – Video


The Gene Therapy Plan: Taking Control of Your Genetic Destiny with Diet and Lifestyle
By Mitchell L. Gaynor MD (Author), Mehmet C. Oz M.D. (Foreword) http://genechanger.com/gene-therapy-plan-taking-control-genetic-destiny-diet-lifestyle/ From ...

By: Mitchell Gaynor M.D.

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The Gene Therapy Plan: Taking Control of Your Genetic Destiny with Diet and Lifestyle - Video

Cancer set to become treatable: expert

Advances in gene therapy and the deepening understanding of cancer will see the oft-fatal disease becoming treatable in two decades, said cancer researcher Inder M. Verma.

Cancer mutations are being exposed cancer is in retreat through a combination of surgery, radiation, chemotherapy, molecular and genetic therapy, cancer will become a chronic disease rather than a terminal one, said Dr. Verma, a professor in Laboratory of Genetics at the Salk Institute for Biological Studies, at the Infosys Science Foundation Lecture at the National Centre for Biological Sciences here on Wednesday.

His optimism was elaborated through an intriguing cat-and-mouse game that played out for over five years of research into the Glioblastomas multiforme (GBM), a lethal form of brain cancer that kills the patient within 14 months.

Understanding GBM was critical as relapse, even after surgery or treatment, was certainty, said Dr. Verma.

The researchers at the Salk Institute developed a novel genetic technique to switch on genes in around five cells of a mouse brain to make them into cancer cells. The cells grew to all parts of the brain, but more importantly, they started to exhibit stem cell characteristics, said Dr. Verma.

Unlike the normal cell, a stem cell can divide into specialised cells a phenomenon that explains the resurgent ability of the GBM cancer. Even if you surgically remove the tumour, one cell is enough to recreate the cancer again, he explained.

Using gene therapy, the team of scientists attempted to block this ability as well as use drugs to block blood supply to the cancer cell. While the tumour did become smaller, it became even more invasive. Though the treatment did not work, the cancer cell did reveal the genes responsible for its invasiveness.

We began to genetically cut out the cancers invasiveness, and for the first time, experiments showed GBM cancer could be controlled This is an exciting area that can be possibly used to treat other forms of cancer, said Dr. Verma.

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Cancer set to become treatable: expert

Neuropathy: Relief for diabetics with painful condition

Walking barefoot on sand "felt like walking on glass" for Keith Wenckowski, who has lived with type-one diabetes for more than two decades.

One of the participants in a new Northwestern Medicine study who suffered from painful diabetic neuropathy (PDN), Wenckowski finally found relief from the constant foot pain that required him to wear shoes at all times, even to the beach.

The study found that those with PDN who received two low dose rounds of a non-viral gene therapy called VM202 had significant improvement of their pain that lasted for months.

"I can now go to a beach and walk on the sand without feeling like I am walking on glass," Wenckowski said.

The results of this phase two, double-blind, placebo-controlled study will be published March 5 in the journal Annals of Clinical and Translation Neurology.

Right now there is no treatment for this disease of the peripheral nerves that affects 20 to 25 percent of diabetics. Patients with the most extreme form of the disease feel intense pain with a slight graze or touch. The pain can interfere with daily activities, sleep, mood and can diminish quality of life.

"Those who received the therapy reported more than a 50 percent reduction in their symptoms and virtually no side effects," said Dr. Jack Kessler, lead author of the study. "Not only did it improve their pain, it also improved their ability to perceive a very, very light touch."

Kessler is the Ken and Ruth Davee Professor of Stem Cell Biology in the department of neurology and a professor in the department of pharmacology at Northwestern University Feinberg School of Medicine. He also is an attending physician at Northwestern Memorial Hospital.

VM202 contains human hepatocyte growth factor (HGF) gene. Growth factor is a naturally occurring protein in the body that acts on cells -- in this case nerve cells -- to keep them alive, healthy and functioning. Future study is needed to investigate if the therapy can actually regenerate damaged nerves, reversing the neuropathy.

Wenckowski had continuous numbness, but now, more than a year since he received the therapy, his symptoms have not returned. "I am hoping the effects I am feeling do not cease," he said.

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Neuropathy: Relief for diabetics with painful condition