(The Wall Street Journal) – How much time people spend in hospitals or nursing homes in the final months of life, instead of at home, varies widely depending on where they live, new research shows. Across the Rockies and regions of the Gulf Coast, the dying spend more than two additional weeks hospitalized or in other facilities, on average, compared with those at the end of life in the Midwest and Montana, researchers reported Wednesday in the New England Journal of Medicine.
(Medscape) – There appear to be very few discussions about discontinuing potentially inappropriate medications at the end of life, concludes a Dutch study published in the Journal of the American Geriatrics Society. “In practice, reconsidering an individual’s medication use in the last phase of life seems to be rare,” say the authors, led by Eric C.T. Geijteman, MD, from the Department of Public Health, Erasmus University, Rotterdam, the Netherlands. “Therefore, people often take multiple medications that may not have beneficial effects in view of their limited life expectancy and changing organ function,” they note. These potentially inappropriate medications may cause side effects, and they also involve costs.
(New Scientist) – An injected male contraceptive has been shown to be almost 100 per cent effective in a trial involving 320 men. The hormone-based jab is designed to lower sperm counts by acting on the brain’s pituitary gland. Over a year-long trial, the injection was effective in nearly 96 per cent of couples. However, researchers said more work was needed to address the treatment’s reported side effects, which included depression and other mood disorders, muscle pain, acne and increased libido. The side effects caused 20 men to drop out of the trial.
(STAT News) – The warning signs of what would become a deadly opioid epidemic emerged in early 2001. That’s when officials of the state employee health plan in West Virginia noticed a surge in deaths attributed to oxycodone, the active ingredient in the painkiller OxyContin. They quickly decided to do something about it: OxyContin prescriptions would require prior authorization. It was a way to ensure that only people who genuinely needed the painkiller could get it and that people abusing opioids could not. But an investigation by STAT has found that Purdue Pharma, the manufacturer of OxyContin, thwarted the state’s plan by paying a middleman, known as a pharmacy benefits manager, to prevent insurers from limiting prescriptions of the drug.
(The Atlantic) – In the past few decades, as scientists have waged battles in academic journals and conferences over the definition of death, one phenomenon inextricably stark in its optics and simple in its mechanics has remained a clear marker of life’s end: decapitation. But even decapitation, it turns out, can be ambiguous. A philosophical dispute about the possibility of life despite decapitation is forcing researchers to grapple with the most fundamental questions about what it means to be alive.
We Must Recapture the Spirit of the Hospice Revolution to Provide End-of-Life Care to All Who Need It
(The Telegraph) – Next year will mark 50 years since the hospice movement pioneer Cicely Saunders established St Christopher’s Hospice in south London, spearheading a transformation in care across the country. Today, more than 200 hospices deliver the highest quality of care to people with terminal conditions – over 90 per cent rated as “good” or “outstanding” by the Care Quality Commission in England. This quiet revolution did not have its origins in the NHS, or in local government, but among communities who came together to respond to the distressing deficit in care for the dying by the NHS of the 1960s.
(Physorg) – A next-generation gene-editing system developed by Carnegie Mellon University and Yale University scientists has successfully cured a genetic blood disorder in living mice using a simple IV treatment. Unlike the popular CRISPR gene-editing technique, the new technology can be administered to living animals and it significantly decreases unwanted, off-target gene mutations. The findings, reported in Nature Communications, offer a new therapeutic approach to treat genetic diseases of the blood like beta thalassemia and sickle cell disease by targeting faulty genes in hematopoietic stem cells.
(JAMA) – As part of his 1984 doctoral thesis, Church developed and described the first direct DNA sequencing method that became the precursor to modern-day next-generation sequencing approaches. Church was involved in launching the Human Genome Project and received 1 of its first grants. In 2013, his laboratory was 1 of 2 that described human genome editing using CRISPR-Cas9. More recently, he’s been working on genome-scale engineering of Escherichia coli—proof-of-concept for HGP-write. As the project moves forward, Church said his laboratory will develop and test innovations like generating transplantable organs from altered stem cells.
(MIT Technology Review) – A recent analysis published in the journal Nature revealed that 81 percent of participants in these genome-wide association studies were of European descent. Together, individuals of African, Latin American, and native or indigenous ancestry represent less than 4 percent of all genomic samples analyzed. While the overall diversity in genome-wide association studies has increased since 2009, when 96 percent of data was from people of European descent, much of the rise in diversity is due to large gains in Asian data and only marginal increases from other population groups.
(Nature) – In a move lauded as a landmark for transparency in medical science, the London-based European Medicines Agency (EMA) has begun to publish details of the full clinical-trial data that it receives from pharmaceutical companies. On 20 October, the agency published some 100 clinical reports about two EMA-approved medicines (carfilzomib, a cancer drug, and lesinurad, a gout treatment) that together run to around 260,000 pages. The disclosures make the EMA the first major drug regulatory agency to publish the warts-and-all results of clinical investigations that drug developers submit when they apply for the agency’s approval to market medicines in the European Union.
(New Scientist) – IN THE 2009 Bruce Willis movie Surrogates, people live their lives by embodying themselves as robots. They meet people, go to work, even fall in love, all without leaving the comfort of their own home. Now, for the first time, three people with severe spinal injuries have taken the first steps towards that vision by controlling a robot thousands of kilometres away, using thought alone. The idea is that people with spinal injuries will be able to use robot bodies to interact with the world. It is part of the European Union-backed VERE project, which aims to dissolve the boundary between the human body and a surrogate, giving people the illusion that their surrogate is in fact their own body.
(UPI) – Using genetic analyses of 40-year-old blood samples, scientists have arrived at a clearer understanding of the introduction and spread in North America of the virus that causes AIDS. One myth already debunked by the research: That there was a “Patient Zero” who somehow caused the epidemic of human immunodeficiency virus (HIV) in the United States.
(Medical Xpress) – More than 15 years ago, 17 babies were born after an experimental infertility treatment that gave them DNA from three people: Mom, Dad and an egg donor. Now researchers have checked up on how the babies are doing as teenagers. The preliminary verdict: The kids are all right. With no sign of unusual health problems and excellent grades in school at ages 13 to 18, these children are “doing well,” said embryologist Jacques Cohen at Saint Barnabas Medical Center in Livingston, New Jersey, where the treatment was done.
(Vice) – Calcagno’s decision to seek treatment outside of the United States is not unique. An estimated 1.4 million Americans will make the same choice this year, and the Centers for Disease Control (CDC) believes “medical tourism” will show extreme growth over the next decade. Some, like Calcagno, will end up outside of the country due to general mistrust of American doctors (Calcagno feared treatments like chemotherapy were toxic). Others, failed by the traditional methods, will travel seeking experimental, alternative medical practices.
(Dallas Morning News) – Nurse Nina Pham settled her lawsuit Monday against Texas Health Resources, owner of the hospital where she contracted Ebola while caring for the first person in the United States diagnosed with the deadly disease. The deal was signed exactly two years after Pham was declared free of Ebola, although she still has health problems likely related to the disease and experimental treatments.
(Los Angeles Times) – The state’s early success using familial DNA searches to identify the so-called “Grim Sleeper” serial killer led Los Angeles Police Chief Charlie Beck to predict that the method would “change the way policing is done in the United States.” Civil liberty groups expressed alarm, saying the searches raised significant ethical and privacy concerns. Some questioned their legality. Since then, familial DNA has made more modest progress than Beck predicted but has also gained wider respect.
(The Wall Street Journal) – Many people are excited by the potential of the genetic tool Crispr-Cas9 to serve as a kind of molecular scissors to cut and repair malfunctioning DNA. The tool has generated hundreds of millions of dollars in investment, a tense patent battle and even a forthcoming Jennifer Lopez TV drama. But Cas9 isn’t the only possible application of Crispr. Dr. Barrangou, now a food scientist who runs a Crispr lab at North Carolina State, is among a growing number of researchers who think that other approaches may reach doctors and patients more quickly.
(Kaiser Health News) – On a recent Saturday morning, Maher stood before a dozen members of a North Philadelphia neighborhood association to walk them through the specifics of the Philadelphia Immediate Transport in Penetrating Trauma Trial. At the heart of the study is a simple but counterintuitive idea. For patients who are potentially bleeding to death, Maher and her colleagues say, basic, stabilizing care is better than more advanced care until they reach the hospital. To test this, patients in the study would get different medical attention based on the dispatch number city paramedics receive — what’s called a randomized study.
(The Guardian) – At times, the language in Fatal Experiments: the Downfall of a Supersurgeon is far from clinical. The documentary, which sparked controversy in Sweden earlier this year and which airs on the BBC this week, slices open the somewhat murky story of Paolo Macchiarini – a brilliant surgeon accused of falsifying scientific results and being investigated over potential charges akin to manslaughter, after attempts to implant plastic windpipes failed and patients died.
(Reuters) – The World Health Organization’s cancer agency – which is facing criticism over how it classifies carcinogens – advised academic experts on one of its review panels not to disclose documents they were asked to release under United States freedom of information laws. In a letter and an email seen by Reuters, officials from the International Agency for Research on Cancer (IARC) cautioned scientists who worked on a review in 2015 of the weedkiller glyphosate against releasing requested material.