The New England Journal of Medicine (vol. 377, no. 19, 2017) is available online by subscription only.
- “The View from Puerto Rico — Hurricane Maria and Its Aftermath” by C.D. Zorrilla
- “Preparing for the Next Harvey, Irma, or Maria — Addressing Research Gaps” by J.M. Shultz and S. Galea
- “Creating Healthy Communities after Disasters” by R.V. Tuckson, V.J. Dzau, and N. Lurie
JAMA (vol. 318, no. 14, 2017) is available online by subscription only.
- “Flawed Theories to Explain Child Physical Abuse: What Are the Medical-Legal Consequences?” by John M. Leventhal and George A. Edwards
- “Cybersecurity—A Serious Patient Care Concern” by Mark P. Jarrett
- “Advancing the Research Mission in a Time of Mergers and Acquisitions” by Paul J. Hauptman, Richard J. Bookman, and Stephen Heinig
- “Global Health: What’s in It for Us?” by Satish Gopal
(The Atlantic) – For the first time since the early 1960s, life expectancy in the United States has declined for the second year in a row, according to a CDC report released Thursday. American men can now expect to live 76.1 years, a decrease of two-tenths of a year from 2015. American women’s life expectancy remained at 81.1 years. The change was driven largely by a rising death rate among younger Americans. The death rate of people between the ages of 25 and 34 increased by 10 percent between 2015 and 2016, while the death rate continued to decrease for people over the age of 65.
(Reuters) – Yemen’s cholera epidemic has reached one million suspected cases, the International Committee of the Red Cross said on Thursday, with war leaving more than 80 percent of the population short of food, fuel, clean water and access to healthcare. Yemen, one of the Arab world’s poorest countries, is embroiled in a proxy war between the Houthi armed movement, allied with Iran, and a U.S.-backed military coalition headed by Saudi Arabia.
(MIT Technology Review) – The clinical trial, which begins in April and will run for about four years, will be the largest effort in the U.S. to test a hormonal form of birth control for men. Currently, men’s only options for birth control are condoms or a vasectomy. In the last major study of a hormonal male contraceptive, which took place in Europe from 2008 to 2012, participants received injections of hormones every two months. The shots suppressed sperm production and prevented the men’s female partners from getting pregnant, but they also gave men severe mood swings and other serious side effects.
(CNN) – Rainy seasons in Nigeria bring out venomous snakes, which emerge from their shelters to hunt and breed. This is always a hazardous time, particularly for agricultural workers tending their fields, and this autumn proved especially cruel. Around 250 people were reportedly killed over a three-week period in the central states of Gombe and Plateau, in a crisis that overwhelmed local doctors and prompted a national outcry. The case was extreme, but not unique. Nigeria is among the countries worst affected by what some public health experts are calling an epidemic.
(Nature) – Open Phil, based in San Francisco, California, acknowledges the high odds of failure of the basic research it funds and, for a private funder, publishes brutally honest assessments of its projects. These range from developing lab-made meat alternatives to a controversial genetic-engineering technology called gene drive. For its latest funding round, it asked scientists whose grant applications had been rejected by an NIH competition for risky research to dust off their proposals. Some 120 researchers resubmitted their requests, and the project awarded $10.8 million to four teams.
(PhysOrg) – A new study in Nature Genetics identifies a specific population of pluripotent embryonic stem cells that can reprogram to totipotent-like cells in culture. Moreover, the scientists of Helmholtz Zentrum München and Ludwig-Maximilians-Universität München (LMU) have identified bottlenecks and drivers of this reprogramming.
(Kaiser Health News) – Complaints about allegedly improper evictions and discharges from nursing homes are on the rise in California, Illinois and other states, according to government data. These concerns are echoed in lawsuits and by ombudsmen and consumer advocates. In California alone, such complaints have jumped 70 percent in five years, reaching 1,504 last year, said Joseph Rodrigues, the state-employed Long-Term Care Ombudsman, who for 15 years has overseen local ombudsman programs, which are responsible for resolving consumer complaints.
(The Atlantic) – Now, a new National Bureau of Economic Research paper explores how Americans also perceive and report pain differently from people in other countries. In other words, not only are our doctors more trigger-happy when it comes to treating pain; we seem to find ourselves covered in Bengay and sitting on the exam table more than most. The paper, which is fittingly titled “Unhappiness and Pain in Modern America,” featured a question from a 2011 survey that asked people across 30 countries the following: During the past four weeks, how often have you had bodily aches or pains? Never; seldom; sometimes; often; or very often?
(Scientific American) – Facing bipartisan hostility over high drug prices in an election year, the pharma industry’s biggest trade group boosted revenue by nearly a fourth last year and spread the millions collected among hundreds of lobbyists, politicians and patient groups, new filings show. It was the biggest surge for the Pharmaceutical Research and Manufacturers of America, known as PhRMA, since the group took battle stations to advance its interests in 2009 during the run-up to the Affordable Care Act.
(Nature) – Most people who enter a clinical trial for a cancer immunotherapy have advanced disease. They hope that the treatment, which aims to activate their T cells against cancer, will boost their life expectancy from months to years. In rare cases, however, the pendulum swings the other way and the treatment results in a fatal reaction. Deaths in recent trials for three cancer immunotherapy drugs have put participants, researchers and drug companies on edge, largely because the causes of the deaths are not well understood.
(Nature) – Embarking on checkpoint-inhibitor immunotherapy for cancer is a bit like taking a single pull on the lever of a slot machine. For a relatively small risk — such drugs are generally safer than other types used to treat cancer — recipients can win a massive reward: years of disease-free survival. “My longest responder is from 2001, and she continues to do well long term,” says Antoni Ribas, an oncologist at the University of California, Los Angeles. However, only a small proportion of people who are eligible for treatment with the drugs reap that reward — less than 40% for melanoma, for example, the type of cancer for which treatment has been most successful.
(New York Times) – Among people in their 70s and 80s, cancer screenings often detect slow-growing tumors that are unlikely to cause problems in patients’ lifetimes. These patients often die of something else — from dementia to heart disease to pneumonia — long before their cancers would ever have become a threat, said Dr. Deborah Korenstein, chief of general internal medicine at Memorial Sloan Kettering Cancer Center in New York. Prostate cancers, in particular, are often harmless.
(CNN) – The longest known frozen human embryo to result in a successful birth was born last month in Tennessee. Emma Wren Gibson, delivered November 25 by Dr. Jeffrey Keenan, medical director of the National Embryo Donation Center, is the result of an embryo originally frozen on October 14, 1992.
The New England Journal of Medicine (vol. 377, no. 21, 2017) is available online by subscription only.
- “Cholera in Yemen — An Old Foe Rearing Its Ugly Head” by F. Qadri, T. Islam, and J.D. Clemens
- “Optimizing GME by Measuring Its Outcomes” by D.F. Weinstein
- “The Promise, Growth, and Reality of Mobile Health — Another Data-free Zone” by A. Roess
- “Firearm-Related Injury and Death — A U.S. Health Care Crisis in Need of Health Care Professionals” by D.B. Taichman, H. Bauchner, J.M. Drazen, C. Laine, and L. Peiperl
(STAT News) – Called gain-of-function experiments, the studies aim to understand genetic changes that can make viruses such as bird flu, SARS (severe acute respiratory syndrome), and MERS (Middle East respiratory syndrome) more transmissible from person to person. But if they escaped from the lab, perhaps through human error, the modified viruses could in theory spread quickly or be extremely virulent, increasing the toll of an outbreak. The moratorium was imposed a few months after two mishaps at government labs, one handling anthrax and one handling avian flu, which together suggested that biosafety and biosecurity at even the most respected labs fell well short of what is needed to protect the public.
(Milwaukee Journal Sentinel) – Last July, an international commission optimistically concluded that one-third of dementia may be preventable. With an aging population headed into the period of prime risk for developing Alzheimer’s and related forms of dementia, that seemed like good news. But a comprehensive set of papers published Monday in the Annals of Internal Medicine reached a seemingly opposite conclusion: There is no proven intervention for preventing late-life dementia. The difference can be found in the way scientists view various kinds of evidence.
(STAT News) – In the real world, the benefits of a treatment are often less than what they were in a clinical trial, and that might be the case here, too. This company-sponsored study enrolled only patients who were well enough to start chemo after surgery and radiation, said Stupp: “We could not include the absolutely worst patients.” Even for these participants, the electric fields were not a cure. Only 16 of the original 466 patients were alive by the end of the study.
(ABC News) – U.S. health officials on Tuesday approved the nation’s first gene therapy for an inherited disease, a treatment that improves the sight of patients with a rare form of blindness. It marks another major advance for the emerging field of genetic medicine. The approval for Spark Therapeutics offers a life-changing intervention for a small group of patients with a vision-destroying genetic mutation and hope for many more people with other inherited diseases. The drugmaker said it will not disclose the price until next month, delaying debate about the affordability of a treatment that analysts predict will be priced around $1 million.