– Selection of events and findings from developments in health and medicine in 2019-/
Scientists discovered a new cure for tuberculosis
Researchers learned that tuberculosis had evolved a terrifying new strain in 2006 that is resistant to antibiotics typically used to fight the disease. Now, a clinical trial in South Africa is showing that a new regimen can cure most patients. In the US, the Food and Drug Administration has effectively endorsed the approach, giving scientists hope that other regulatory agencies will soon approve it worldwide.
Your own body’s fungi may play a significant role in your health
In mice and human patients with pancreatic cancer, fungi seem to proliferate 3,000-fold compared with healthy tissue. Scientists have found that one fungus that can cause skin irritation and dandruff is also linked to inflammatory bowel diseases. Another study found that it was also present in extremely high numbers in pancreatic cancer patients. Administering an antifungal drug got rid of the fungi in mice and kept tumors from developing further.
The re-invasion of measles
Scientists believe New York’s measles outbreak has its roots in Uman, Ukraine, the site of a Rosh Hoshana pilgrimage that attracts tens of thousands of Orthodox men each year. The overwhelming majority of American parents vaccinate their children. But there are ominous trends in vaccine resistance, a byproduct of internet rumors, mistrust of Big Pharma, infatuation with anti-immunization celebrities and the anti-science rhetoric from the Trump administration. As a result, measles returned with a vengeance this year. An outbreak centered in New York City forced Mayor Bill de Blasio to declare a public health emergency in April and order mandatory vaccination in parts of Brooklyn. Public health experts connected the outbreak to Jewish pilgrims who had not been vaccinated and went to Ukraine to visit the grave of a founder of a branch of Hasidism. From there, the measles virus spread to others who visited Israel, and eventually landed in Britain and the United States.
Vaping crisis and opioid-related lawsuits
Across
the country there were reports of healthy individuals who ended up in emergency
rooms after using a vaping device to inhale nicotine, THC or a combination of
the two. Since
mid-August, 2,506 lung injury cases and 54 deaths linked to vaping have been
reported. Most patients were otherwise healthy and in their late teens and 20s.
The likely culprit is an additive made
with vitamin E oil, researches say. Several states and cities have imposed
bans, mainly on flavored e-cigarettes as a precaution. The legal battle over opioids got underway. Two counties in Ohio with the second-highest rate of
opioid-related overdose deaths in the country in 2017 have sued five drug
industry defendants. As the number of opioid-related lawsuits against the
pharmaceutical industry grew to nearly 3,000, some breakthroughs began to
emerge. Oklahoma, the first state to go to trial, won a judgment against
Johnson & Johnson for $465 million; the first federal trial, for two Ohio
counties, settled just before opening arguments, for $20.4 million. More
litigation and negotiations are expected ahead. Purdue
Pharma, producer of OxyContin, and the Sackler family who control the company,
offered to settle all cases and sought bankruptcy protection to restructure. Two
dozen states oppose the deal, saying the family itself should pay more. Three
giant drug distributors and two manufacturers offered their own comprehensive
settlement. But many states and thousands of local governments have flatly
rejected it. In 2020 there will be more
bellwether trials around the country, including the first against the big
pharmacy chains.
Preventing
spread of H.I.V. virus still a challenge while cure is possible in rare cases
Nearly 12 years after the first person was cured
of H.I.V., the virus that causes AIDS, researchers reported that they had cured
a second patient. Their surprise success confirmed that a cure for H.I.V. is
possible. Both milestones resulted from bone-marrow transplants given to the
infected patients — to treat cancer, not H.I.V. While this is an unrealistic
treatment option for millions of people living with H.I.V., rearming the body’s
immune cells might work in the future. Only about one in three men who are at
high risk for H.I.V. infection is taking a drug to prevent transmission of the
virus, the Centers for Disease Control and Prevention says. One of the main
reasons has to do with cost. In May, the Trump administration reached a deal
with the makers of Truvada and Descovy to donate pre-exposure prophylaxis, or
PrEP, drugs to 200,000 patients annually for more than a decade. Experts
said the donation was a good start, but it filled only one-fifth of the need in
the United States.
Drug-resistant
germs will be one of the nastiest new health threats
Drug-resistant germs of all types thrive in hospital
settings and nursing homes: over the last five years, the fungus Candida auris
has hit a neonatal unit in Venezuela, forced a prestigious British Medical Center
to shut down its intensive care unit and infected nearly 800 people in the
United States, with half of patients dying within 90 days. Once C. auris takes
root, it is hard to eradicate from a facility. Some hospitals have had to bring
in special cleaning equipment and even rip out floor and ceiling tiles to get
rid of it.
Debt
relief as Medical School’s costs challenge aspiring doctors
The median medical education debt held by
graduates in 2018 was $200,000. That does not include credit card debt, which
can also pile up as students purchase stethoscopes and study-aid subscriptions,
register for licensing exams and travel for testing. These costs can be
especially prohibitive for some students, driving young doctors away from
lower-paying specialties, such as pediatrics and psychiatry, as well as jobs in
rural or less wealthy areas.
To address this problem, Cornell University and
Kaiser Permanente have started to waive tuition for medical students, following
in the footsteps of New York University last year. State repayment programs,
such as CalHealthCares, also promise to help young doctors with debt relief.
Future of
Obamacare uncertain
In December, a federal appeals court struck down
the individual mandate of the Affordable Care Act, which required Americans to
buy health insurance or pay a penalty. But the court did not throw out the rest
of the law, putting its fate in limbo even as access to health care has become
a central issue in the presidential race. There
is no consensus on health care among Democrats. The candidates are divided over
how to improve health care. Some want to eliminate private insurance and
replace it with a single-payer system, or Medicare for All. Others favor a
public option that would preserve private insurance, but give people a chance
to choose government insurance.
Work space impact on your brain
When carbon dioxide accumulates in small rooms,
it can decrease the amount of communication between brain regions. Researchers
have found that inhaling carbon dioxide at levels that are probably not
uncommon in crowded spaces like small conference rooms might affect
productivity and decision-making skills. This suggests that the recommended
minimum air flow for such rooms might not actually be optimal. Instead, it
might be worth cracking a door or a window, when possible.
Sperm
donation is a poorly regulated business
As genetic testing becomes more widespread,
parents, or sometimes their donor-conceived children, are discovering that the
wrong sperm was provided by a sperm bank or fertility clinic. Facilities often
use poor record keeping, writing sperm vial numbers in pen and ink rather than
digitizing the sample data. In a growing number of instances, doctors have
secretly used their own sperm for artificial insemination, only to be
discovered decades later. One
particularly egregious case, in which an Indianapolis doctor used his own sperm
to impregnate at least 46 women, has prompted legal changes, including a Texas
law that redefined such an act as sexual assault. In many states, the laws
applied to such cases remain unclear. Some
200 million girls and women in Africa, the Middle East and Asia have been
genitally cut. This traditional ritual, which ranges from nicks to extreme
damage to the female anatomy, can cause pain during sex and child birth, and
reduced sexual sensation. As some women move to the United States, demand is
growing for surgery that can repair the damage.
Powerful industry forces shape world food policy
In India and in other countries, an organization
funded by food and beverage companies quietly fights restrictions on sugary or
processed foods. The International Life Sciences Institute, an American
nonprofit, has been quietly infiltrating government health and nutrition bodies
around the world. The organization rejects allegations that it works to advance
the interests of the corporate members that provide its $17 million budget, but
it championed tobacco interests during the 1980s and 1990s in Europe and the
United States. The International Life Science Institute has recently expanded its
activities in Asia and Latin America. In
China, researchers have noted that the organization helped shape anti-obesity
education campaigns stressing physical activity over dietary changes, a
strategy long espoused by Coca-Cola.
Psychedelic
and personalized medicine offer innovations in treatment
Scientists developed a specialized treatment for
a child with Batten disease that involves rapid neuro-degeneration and is
fatal. It is believed to be the first custom treatment for a genetic disease
because it blocks a mutation unique to the child. Scientists are starting to test the power of
psychedelic drugs to treat a range of mental health problems. In September,
Johns Hopkins Medicine announced the opening of the Center for Psychedelic and
Consciousness Research to study compounds like psilocybin and LSD. One study at
the center has already found that psilocybin can be more effective at helping
people quit smoking compared with using a nicotine patch…
