Family inHome Caregiving Blog
President-elect Donald Trump is in the process of setting up his cabinet, but one of his choices is now under fire for foreclosing on a 90-year old woman’s home during the last recession over just 27 cents. Hedge fund manager Steven Mnuchin, who Trump has chosen for Treasury Secretary, founded a bank called OneWest with a number of partners and the bank benefitted greatly from the recession. In addition to the 90-year old who lost her home, New York Governor Andrew Cuomo singled out the lender for squeezing Superstorm Sandy victims. “We’re just coming out of a foreclosure crisis and a serious economic downturn. It’s not the time to appoint someone who sided with corporate America over real people,” Alys Cohen, an attorney with the National Consumer Center,” told a reporter.
The House of Representatives passed a bill 392-26 last week which will significantly increase federal funding for biomedical research as well as speed up the approval process at the Food & Drug Administration (FDA) for approving new drugs and medical devices. This is a big win for both pharmaceutical companies and consumers. The Senate is expected to take up the legislation this week and it looks likely to pass. President Barack Obama has said that he strongly supports passage of the bill.
Surgical robots are gaining in popularity, particularly with laparoscopic surgery which requires incisions of just 5 to 10 millimeters. It’s also being rolled out with needlescopic surgery, in which the incisions are less than 3 millimeters. Researchers at Vanderbilt University are using a robot that uses an ultraminiature mechanical wrist instrument to make incisions so small they need only a Band-Aid. Doctors are also using robots for tests such as cancer tests. Lung tumors, for example, can be difficult to spot early on without expensive imaging scans which typically aren’t recommended for low-risk patients. Robots can make a small incision and take a sample tissue, which is safe and fairly inexpensive.
Caregivers For Rheumatoid Arthritis and Crohn’s disease victims may soon see some patient improvement. SetPoint Medical is working on a device that uses electrical stimulation to treat inflammatory diseases. The technology was developed by neurosurgeon Kevin Tracy who found that the body’s vagus nerve can help reduce inflammation. By implanting a small electrical stimulator near the vagus nerve in the neck, SetPoint’s device is designed to jump-start the nerve’s activity. The first human studies of the device would start early next year, so keep your fingers crossed. SetPoint CEO Anthony Arnold told the Wall Street Journal the technology was essentially “a pacemaker for the immune system.”
There are some amazing breakthroughs in medical technology, including growing human tissue in labs and then implanting them safely in the body. One example of this is to make blood vessels which are designed for patients which are undergoing dialysis for kidney disease. The company which does this, Humancyte, uses donor cells to grow the human tissues needed to make the blood vessels so that your own immune system won’t reject them. They have done two human trials, the results of which were published in the journal Lancet, and the company is hoping to bring them to market in 2019. Laura iklason, an anesthesiologist and scientist at Yale University, told The Wall Street Journal, “It’s still a far cry from engineered whole organs—that’s still 20 years away. But in the 1990s, there was a log of hype and I think that it’s now finally starting to get here,”
Personal genome sequencing is becoming increasingly common and lower in cost. However, the question remains, would you want to know if you were extremely at risk for getting a disease for which there is no cure? There are a growing number of projects called predispositional personal genome sequencing, or PPGS, which can identify risks for heart disease, cancer and many other serious illnesses. The Journal of Personalized Medicine covers many studies on PPGS. Dr. Debra Leonard, chair of pathology and laboratory medicine at the University of Vermont College of Medicine and UVM Medical Center, recently joined the PeopleSeq project as part of a plan to begin clinical genome sequencing for the university’s patient population over the next two to five years. They will focus first on cardiovascular and neurological diseases and undiagnosed genetic diseases. By 2023, “we will be sequencing every patient,” she told The Wall Street Journal. About 15% of those participating in the trial got information causing them to seek medical attention, and another 5% plan to. Clearly there are benefits to knowing some information, but some people may be wary of participating in these types of test for fear of getting bad news about a potential fatal disease with no cure.
It’s no secret that physicians and others in the medical community are being forced by the government to go electronic. How successful the program is, however, remains to be seen. “Doctors are ingenious in circumventing anything in a computer, and if it makes their job harder they are just going to work around it,” Doctor Jeffrey Linder, director of the Primary Care Practice Based Research at Brigham and Women’s Hospital, told the Wall Street Journal. However, he did say that he found in his research that doctors do respond to certain feedback when it involves comparing them to how they stack up to their peers. For instance, there are clear guidelines that antibiotics are only to be prescribed for bacterial infections. Despite, this, many doctors continue to prescribe them for viruses like the flu. A recent report from the Pew Charitable Trusts reported that there are 47 million excess prescriptions per year in this category, which is resulting in antibiotic resistant strains developing. In a study published in the journal JAMA, peer comparison—essentially pointing out that doctors were overprescribing antibiotics—helped reduce unwarranted prescriptions from 20% to 4% over an 18-month period.
Telemedicine is transforming the health care industry, with doctors hooking up with their patients by phone, secure email and even webcams. They are also consulting with other physicians electronically, often times to make split-second decisions on heart attacks and strokes. They can also use the technology to monitor heart rates, blood pressure and other vital times. Mercy health system even has what they call a Virtual Care Center or a “hospital without beds” where physicians and nurses work around the clock to provide remote support for intensive care units and emergency rooms in 38 small hospitals. In the past year, ICUs monitored by Mercy specialists have seen a 35% decrease in patients’ average length of stay and 30% fewer deaths than anticipated. “That translates to 1,000 people who were expected to die who got to go home instead,” Randy Moore, president of Mercy Virtual, told The Wall Street Journal.
A new breakthrough in genetic research has occurred called CRISPR-Cas9. Just four years old, scientists have high hopes that this technology will have far reaching effects on many diseases by being able to reprogram our DNA. For instance, the National Institutes of Health (NIH) recently issued recommendations on the first bid to test a CRISPR-based medical treatment on people with myeloma. It takes out their blood cells and boosts their cancer fighting genes with CRISPR and then returns these edited disease-free cells to the body. And at New York’s Memorial Sloan Kettering Cancer Center, cancer biologist Scott Lowe is developing therapies that turn on and off genes in tumor cells to make them easier for the immune system to destroy. This treatment has a broad range of potential uses with debilitating diseases like Alzheimer’s and Parkinson’s. It’s not without its pundits, however. The Director of National Intelligence included gene-editing methods like CRISPR on a list of mass-destruction threats earlier this year. He fears the gene-altering technology could end up in the hands of terrorists and rogue states which could actually use it as a weapon. At this point, however, the cat is out of the bag and myriad scientists are working on ways to use it to stave off serious diseases.
Getting a cancer diagnosis can be a shock to the system, something which will last through the long process of chemotherapy treatments, which can be extremely draining. Researchers and physicians are currently working on ways to make it more tolerable and there are some new cancer drugs which have hit the market which have improved care, although they haven’t completely replaced chemo. Newer drugs can be more targeted in their attack, sparing healthy cells from being destroyed. One new technology being toyed with is using a tiny implantable sponge which soaks up excess chemo after it hits the tumor but before it can enter the bloodstream. Some physicians are experimenting with spacing out chemo infusion, giving lower doses or treating side effects which can make the chemo less toxic for patients. Developed by a startup called ChemoFilter Inc. in conjunction with the Department of Energy’s Lawrence Berkeley National Laboratory, physicians deliver the chemo directly to the targeted site via catheter and the sponge soaks up the excess drugs. The device has been tested in animals and human trials are scheduled to start within the next few years.