It Not Just One Suspect Herpes Vaccine Trial: Most Experimental Drugs Are Tested Offshore–Raising Concerns about Data
(STAT News) – But in some respects, the herpes vaccine trial isn’t all that unusual. Nearly all drug makers seeking U.S. approval today rely in part on overseas locations and populations to test their drugs, the result of a decades-long push by industry to try to cut costs and speed recruitment of patients. In fact, a STAT analysis found that 90 percent of new drugs approved this year were tested at least in part outside the U.S. and Canada.
(STAT News) – It isn’t terribly reassuring to know that doctors who might need to make life or death decisions about your health could be doing so after having been awake for so long. Would they be on top of their game at hour 16? What about hour 22? In medicine, the devil can be in the details — what if the doctor was too tired to notice something small that might not actually be that small? But according to the organization that sets the rules on how long resident physicians like me are allowed to work, the Accreditation Council for Graduate Medical Education (ACGME), this is OK. And just so we are clear, as you read this, thousands of young resident physicians are working in hospitals for shifts lasting up to 28 hours every few days and providing care to thousands of Americans.
(Medical Xpress) – Why are so many teenagers taking their own life? One factor is what I call “toxic socialization” —a process of physical or emotional childhood and adolescent abuse. Those who grow up in toxic environments are up to 12 times more likely to experience addiction, depression and to try to commit suicide.
(Philadelphia Inquirer) – As more doctors choose to work past the traditional retirement age, health systems are navigating a complex set of issues that revolve around what may sometimes be competing interests: keeping valued “late-career” employees happy and keeping patients safe. Most older doctors do good work and many choose to do less challenging work as a concession to age, experts said. But systems are testing how best to screen for the few who are slipping and don’t know it. This region’s two largest health systems — Penn Medicine and Jefferson Health — are embarking on screening programs.
(Kaiser Health News) – As large hospital systems like Sutter Health, Stanford Medicine and UCSF Medical Center gobble up doctor practices, they gain market muscle that pushes costs upward. It’s a key reason why Northern California is now the most expensive place in the country to have a baby. A study published this week in Health Affairs found that large doctor practices, many owned by hospitals, exceed federal guidelines for market concentration in more than a fifth of the areas studied. But the mergers are typically far too small for federal antitrust authorities to notice.
(The Conversation) – Shakespeare’s Seven Ages of Man (from As You Like It) famously and effectively portrays humans in deep old age as returning to infancy. But in many societies, the approach to end of life care requires us to continue as active and responsible citizens for as long as our mental capacities allow – to make choices about what kind of care we want, and where. In anticipation of losing capacity, people are urged to act responsibly and make preferences known in advance while they are still able.
(Managed Care Magazine) – States have taken action on curbing drug costs before, but state-level laws and regulations have usually focused on Medicaid and prescription drug coverage for state employees. But now they are venturing into new territory with laws that require drug manufacturers and distributors to divulge what they charge. No fewer than 13 states have such laws pending. What’s new is the specific mention of price gouging in some of these laws.
(NPR) – Wealthy Chinese woman are hiring Americans to be surrogate moms. We explore how the relationship between a Chinese woman and her American surrogate changed during a particularly difficult pregnancy.
(ABC News) – A California judge ruled that a teen girl declared brain dead more than three years ago after a tonsillectomy may still be technically alive, allowing a malpractice lawsuit against the hospital to proceed. Alameda County Judge Stephen Pulido ruled Tuesday that it’s up to a jury to determine whether Jahi McMath is alive, which would increase the amount of damages if jurors decide in the family’s favor.
(ABC News) – New York’s ban on assisted suicide will stand after the state’s highest court on Thursday rejected arguments from terminally ill patients who say they should have the right to seek life-ending drugs from a doctor. The Court of Appeals ruled Thursday that state lawmakers had a rational reason for passing a ban on assisted suicide and that the ban doesn’t violate the state constitution.
(Scientific American) – Harvey is the first major storm since the federal government revised emergency preparedness standards for hospitals, in response to Katrina and 2012’s Superstorm Sandy. Now, health care providers that receive Medicare or Medicaid dollars must have disaster preparedness plans, including relocation strategies for at-risk patients and mechanisms to maintain basic power. Berggren shared her distinctive perspective last week, drawing on her knowledge of Texas, her memories from New Orleans and knowledge as one of the country’s leading bioethicists. The following transcript has been edited for length and clarity.
(Kaiser Health News) – Although hospices now serve more than 1.4 million people a year, this specialized type of care, meant for people with six months or less to live, continues to evoke resistance, fear and misunderstanding. “The biggest misperception about hospice is that it’s ‘brink-of-death care,’” said Patricia Mehnert, a longtime hospice nurse and interim chief executive officer of TRU Community Care, the first hospice in Colorado. In fact, hospice care often makes a considerable difference for those with months to live.
(Reuters) – The couple had known from the 24th week of the pregnancy that their child would be born with Arnold Chiari Type II syndrome – a structural defect in the brain. Since abortions in India are allowed only up to 20 weeks of pregnancy, the couple petitioned India’s Supreme Court to allow them a to terminate the pregnancy, which was by then 27 weeks. The court rejected their plea. The couple, who chose to remain anonymous in the much-publicised case, said in media interviews that they did not have the wherewithal – emotional and financial – to take care of the child, while doctors could not indicate the infant’s expected life span.
(TIME) – Two scientists who paved the way for widely used vaccines and another who discovered key players in cell growth have been awarded prestigious medical research awards. The Albert and Mary Lasker Foundation also announced Wednesday that it was giving its public service award to Planned Parenthood. Each award includes a $250,000 honorarium.
(Nature) – More than 11,000 people died when Ebola tore through West Africa between 2014 and 2016, and yet clinicians still lack data that would enable them to reliably identify the disease when a person first walks into a clinic. To fill that gap and others before the next outbreak hits, researchers are developing a platform to organize and share Ebola data that have so far been scattered beyond reach. The information system is coordinated by the Infectious Diseases Data Observatory (IDDO), an international research network based at the University of Oxford, UK, and is expected to launch by the end of the year. At a meeting to discuss Ebola on 7–9 September in Conakry, Guinea, the team heading the platform will seek input from West African scientists, health officials and advocacy groups.
(Medical Xpress) – A new national survey of more than 2,000 physicians across multiple specialties finds that physicians believe overtreatment is common and mostly perpetuated by fear of malpractice, as well as patient demand and some profit motives. A report on the findings, published Sept. 6 in PLOS ONE, highlights physicians’ perspectives on unnecessary health care practices and the potential causes and solutions. “Unnecessary medical care is a leading driver of the higher health insurance premiums affecting every American,” says Martin Makary, M.D., M.P.H., professor of surgery and health policy at the Johns Hopkins University School of Medicine and the paper’s senior author.
(Quartz) – Earlier this week, doctors at the Mayo Clinic and the Scripps Research Institute published a review article in the Journal of American Geriatrics calling and outlining designs for human clinical trials on the first class of drugs developed specifically to treat aging. The “geroscience hypothesis” is relatively new to the world of accepted science. It states that targeting the fundamental mechanisms of aging can help treat or delay the onset of age-related diseases like type 2 diabetes, osteoporosis, and various forms of cancers. The idea is to increase healthspan: the years in which people are viable, active members of society. The subtext though, is that these treatments also have the potential to delay aging itself.
(BBC) – A test that involves drawing a spiral on a sheet of paper could be used to diagnose early Parkinson’s disease. Australian researchers have trialled software that measures writing speed and pen pressure on the page. Both are useful for detecting the disease, which causes shaking and muscle rigidity. The Melbourne team said the test could be used by GPs to screen their patients after middle age and to monitor the effect of treatments.
(Reuters) – Kentucky’s “unapologetically pro-life” governor and the state’s last abortion clinic will square off on Wednesday in a federal courtroom in a case that could make it the first U.S. state without an abortion provider. In a three-day trial, the state will argue before a U.S. District judge in Louisville that EMW Women’s Surgical Center does not have proper state-required agreements with a hospital and an ambulance service in case of medical emergencies.