medicine

FDA Oks First-Ever DNA Alternative to Pap Smear

(WASHINGTON) — Federal health regulators have cleared a genetic test from Roche as the first U.S.-approved alternative to the pap smear, the decades-old mainstay of cervical cancer screening.

The Food and Drug Administration approved Roche’s cobas HPV test to detect the human papillomavirus, or HPV, in women 25 and older. HPV causes nearly all cases of cervical cancer. Such DNA-based tests have been used for several years to confirm results from the pap tests. But Thursday’s decision means Roche can now market the test as a stand-alone option for cervical cancer screening, without the pap test.

The decision comes despite pushback from a number of women’s health groups, who warned regulators that approving the DNA test as an alternative to pap testing could lead to confusion, higher costs and overtreatment.

Saudi Arabia

Saudi Arabia Reports 4 More MERS Deaths

Asian workers wear mouth and nose masks while on duty during a football match at the King Fahad stadium, on April 22, 2014 in Riyadh.
Asian workers wear mouth and nose masks while on duty during a football match at the King Fahad stadium, on April 22, 2014 in Riyadh. The health ministry reported more MERS cases in the city of Jeddah, prompting authorities to close the emergency department at the city's King Fahd Hospital. Fayez Nureldine—AFP/Getty Images

Nearly 300 people are infected in Saudi Arabia, and some worry that the virus could spread when millions of Muslims make the Hajj to Mecca later this year

Saudi Arabia has reported four new deaths and 36 more infections within the last day from the Middle East Respiratory Syndrome (MERS), the Associated Press reports.

Among the newly infected is a 65-year-old Turkish pilgrim in Mecca, one of two cities where millions of Muslims from across the world will gather later this year for the Hajj, an annual Islamic ritual. Some health experts are concerned the gatherings will exacerbate MERS’ rapid spread to other countries.

Saudi Arabia has seen a spike in MERS infections in recent weeks, with many health workers among the sick and the dead. The Saudi Health Ministry says there have now been 297 cases and 85 deaths related to the virus since it first appeared in the country two years ago.

MERS is in the same family of viruses as SARS (Severe Acute Respiratory Syndrome) and the common cold. MERS has no vaccine or treatment. It’s unclear how the virus is being transmitted, though some scientists theorize that the virus may have spread from camels. The virus does not spread as quickly as SARS. It’s possible MERS will die out on its own, though some are worried it could mutate into a more easily-spreadable disease.

[AP]

Health Care

Advocates React To Mississippi Ban On Abortions After 20 Weeks

The bill signed this week by Gov. Phil Bryant that bans abortions after the midpoint of a pregnancy, and which makes no exception to cases of rape or incest, has quickly provoked adverse reactions from the pro-choice and pro-life communities

A bill signed by Mississippi Gov. Phil Bryant on Wednesday that bans abortions after 20 weeks with no exception for cases of rape or incest has provoked typically split reactions from the pro-life and pro-choice communities.

“Today is an important day for protecting the unborn and the health and safety of women in Mississippi,” Bryant said after signing HB 1400, which is set to become a law July 1. The bill bans abortion starting at 20 weeks’ gestational age, or since the beginning of the woman’s last period of menstruation. Pregnancies typically last 40 weeks. While the bill doesn’t provide exceptions to women who have been the victim of rape or incest, it does allow women to abort if they face risks of death or permanent injury or “severe fetal abnormalities.”

Bryant’s remarks were echoed by supporters who believe the law is a crucial step for women’s health. “A woman seeking an abortion at 20 weeks is 35 times more likely to die from abortion than she was in the first trimester. At 21 weeks or more, she is 91 times more likely to die from abortion than she was in the first trimester,” Dr. Charmaine Yoest, CEO of Americans United for Life, said in a statement. “I commend the leadership in Mississippi who worked together to achieve commonsense limits on dangerous abortion procedures.”

Opponents, however, called the new restrictions “dangerous” and “unconstitutional.” The Center for Reproductive Rights said that instances of abortions after 20 weeks were “exceptionally rare,” claiming only two were performed in 2012.

According to the Guttmacher Institute, which deals with reproductive health, while 23 percent of American abortion providers offer abortions at 20 weeks, only 1.2 percent of abortions occur after that point. Still, there has been a recent trend of legislation to bar abortion at that period. Several states including Alabama, Arkansas, Louisiana, and Texas ban abortions from the mid-pregnancy point.

But Planned Parenthood claimed that while those bans begin at the point of fertilization — or two weeks after the first day of a woman’s last menstrual cycle — the Mississippi law would start counting the pregnancy at gestation, prohibiting abortions two weeks earlier than most other so-called 20-week bans. “Women who make the deeply personal and often complex decision to end a pregnancy [at its midpoint] should do so in consultation with their physician, not politicians,” Felicia Brown-Williams, director of public policy for Planned Parenthood Southeast, told The Clarion-Ledger.

But Diane Deriz, who owns Mississippi’s only abortion clinic, says that the bill would have little bearing on actual abortion practices in the state. “[The bill is] a totally irrelevant piece of legislation that I’m sure was aimed at the clinic,” Derzis, owner of the Jackson Women’s Health Organization, told the Jacksonville Free Press in March. “The clinic goes to 16 weeks, so what difference does that bill make?”

Addiction

5 Sketchy Things We Still Don’t Know About E-Cigarettes

The FDA has cracked down on e-cigs by asserting its regulatory power and proposing a ban on sales to minors

+ READ ARTICLE

On Thursday, the U.S. Food and Drug Administration (FDA) flexed its regulatory muscles and extended its authority over more tobacco products, including the highly debated electronic cigarettes, or e-cigarettes. In the announcement, the agency said it now has jurisdiction over items that meet the statutory definition of tobacco products—which includes e-cigarettes, pipe tobacco, and hookah tobacco, among others. The FDA says it also plans to crack down on e-cigarettes by proposing a ban of their sale to people under 18 and by requiring health warnings on packaging.

The UK already has stiff regulations on e-cigarettes and some cities in the U.S., like Los Angeles, have banned them in several public places. The trouble with e-cigarettes is that they are so new, and there’s not enough evidence to definitively determine either how effective they are at helping people quit smoking—or the health risks associated with inhaling vaporized nicotine. Here are five things we are still scratching our heads over.

1. Do e-cigarettes actually help people quit—or are they a gateway for new smokers?
Some e-cigarette brands claim that they can help people wean themselves off regular cigarettes by supplying would-be quitters with nicotine (but without the carcinogens in conventional cigarette smoke). However, recent research is questioning whether they really help people quit. A recent study published in the journal JAMA Internal Medicine looked at self-reports from 949 smokers–88 of whom used e-cigarettes at the start of the study–in order to determine if e-cigarettes were helping people kick or cut back on nicotine. Researchers found that e-cigarettes did not help people quit, concluding, for now at least, that the case for e-cigarettes as a cessation tool is flimsy at best. (The study size was small, signaling a need for more research.)

There’s also the worry that e-cigarettes are tempting people into trying the real thing. Another study published in March found that adolescents who use e-cigarettes are more likely to smoke other tobacco products and regular cigarettes, which suggests that e-cigarettes are not always the lesser of two evils, but instead, just another vector for nicotine exposure. According to data from the National Youth Tobacco Survey, the percentage of middle school and high school students who have tried e-cigarettes doubled from 3.3% in 2011 to 6.8% in 2012. Of course, there are still not enough studies to reach a firm conclusion that e-cigarettes make people more likely to smoke tobacco—and the FDA says this is not yet determined.

2. How dangerous is liquid nicotine?
The health risks associated with the liquid nicotine used in e-cigarettes are not fully understood. A recent New York Times article found that the liquid could be linked to poisonings; the number of poisonings linked to e-cigarette liquids rose to 1,351 in 2013, which is a 300% increase from 2012. The CDC also released a report earlier this month that showed what they called a “dramatic” rise in e-cigarette-related calls to U.S. poison centers. The spike went from one call a month in September 2010 to 215 calls a month in February 2014. Over half of the calls involved kids age five and under, and 42% involved people ages 20 and older. Known symptoms of liquid nicotine ingestion include vomiting, nausea, and eye irritation.

3. Are the vaporizers safe?
Though the numbers are small, there have been a few cases of e-cigarettes exploding and harming users and the people around them. E-cigs contain a small lithium battery that heats up the liquid inside. The liquid is made up of nicotine dissolved in a colorless liquid called propylene glycol, with added synthetic flavor and sometimes dyes. When an e-cigarette exploded in a Florida man’s face, Thomas Kiklas, co-founder of the Tobacco Vapor Electronic Cigarette Association, told the Associated Press that the industry does not know of issues with the cigarettes or batteries exploding.

4. Is propylene glycol dangerous?
Propylene glycol is a a clear, colorless liquid that becomes vapor when it’s heated. It can also be found in food, cosmetics, and pharmaceutical products, and the small amounts people are typically exposed to are largely believed to be benign. However, it’s uncertain whether inhaling propylene glycol could come with unique health risks. “As for long-term effects, we don’t know what happens when you breathe the vapor into the lungs regularly,” Thomas Glynn, the director of science and trends at the American Cancer Society told ABC News. “No one knows the answer to that.”

5. Can you get addicted to e-cigarettes?
As the FDA says, nicotine is “highly addictive.” The FDA says they still don’t know how much nicotine or other potentially harmful chemicals are being inhaled during e-cigarette use. Therefore, it’s hard to tell how much or little damage is being done.

 

TIME 100

TIME 100: The People in Health You Need to Know

The 2014 TIME 100 list–the annual determination of people who influenced the world in the past year for better or worse–is here, and we highlight the leaders making a difference in health.

This year, TIME recognizes innovators who tackled issues from hunger and maternal health to marijuana and aging.

  • Christy Turlington Burns, an ambassador for maternal health. Burns founded Every Mother Counts, which provides poor countries with health education, medicine and emergency care.

“When [mothers] are healthy, everyone thrives. Christy is helping make that happen.” –Melinda Gates, co-chair of the Bill & Melinda Gates Foundation

  • Ertharin Cousin, a Chicagoan who helps feed the world. As head of the U.N.’s World Food Program, Cousin is responsible for feeding over 100 million people each year.

“Her goal is nothing short of eradicating global hunger in our lifetimes, creating a world where no child or adult knows the feeling of an empty stomach” –Rahm Emanuel, mayor of Chicago, served in the Clinton and Obama administrations

  • Aliko Dangote, doing well and doing good for Africa. Dangote is one of the richest men in Africa who also dedicates his time to ridding countries of infectious diseases.

“This year, Nigeria is on pace for its lowest number of polio cases ever. Aliko is a big reason why” –Bill Gates, co-chair of the Bill & Melinda Gates Foundation

  • Robert Lanza, in the vanguard of stem-cell research. Dr. Lanza is the chief scientific officer at the biotech firm Advanced Cell Technology, and found a way to turn adult cells into stem cells that may soon be turned into new treatments, or cures, for diseases like diabetes and Alzheimer’s.

“The controversies may continue, but thanks to Lanza the science will too.” –Alice Park, health and medicine writer for TIME and author of The Stem Cell Hope

  • José Mujica, the revolutionary who legalized pot. As Uruguay’s president, José “Pepe” Mujica signed a law making the country the first to legalize the production and sale of marijuana.

“Uruguay has embarked on a bold and fascinating experiment that will be closely watched by supporters of legalization in other countries–including myself” –Meghan McCain, co-host of Pivot’s TakePart Live

  • Arunachalam Muruganantham, an unlikely health crusader. Muruganantham designed a simple machine to make sanitary napkins after seeing how hard it was for his wife to get access to affordable ones.

“The invention has sparked interest around the world. It’s a truism for a reason: Empathy is the most revolutionary emotion” –Ruchira Gupta, founder of Apne Aap, an Indian anti-sex-trafficking organization

  • David Sinclair, bringing us closer to reversing aging. Sinclair is a genetics professor at Harvard Medical School who discovered a compound that makes old cells act young again.

“Immortality is out of reach, but living more years with a body that’s robust enough to make the most of them is a real possibility” –Dr. David Agus, professor of medicine and author of A Short Guide to a Long Life

  • Alice Waters, pioneer of good food for all. As a respected chef, Waters promotes accessible produce for everyone, including for the youngest eaters, with the Edible Schoolyard Project.

“She proved the power of a chef, showing an entire generation that one passionate person can reshape the eating habits of a nation” --Ruth Reichl, a food writer whose first novel, Delicious!, will be published in May

relationships

Stop Obsessing Over Finding The Perfect Partner

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Tim Robberts—Getty Images

When it comes to relationships, we disagree over who makes the ideal mate

Evolution tells it straight: Some people make more desirable partners than others. Current theories on mate value go a little like this: People who have it all, including good looks and status, can land a partner who also has it all. The people who don’t, well, they’re going to have to settle. But new research published in the Journal of Personality and Social Psychology suggests what anyone who’s fallen for a pretty face knows: finding the ideal partner for you is much more complicated. In fact, the more we get to know someone, the more our opinion of their desirability changes.

To reach these findings, the researchers at the University of Texas at Austin conducted three studies in which they asked participants to rate a group of people for their perceived value. Some of the factors were basic, like how attractive they are, or how outgoing. Other factors went deeper, with participants ranking whether a person seemed likely to be a good, committed partner.

In the first study, participants rated people they’d never met; in the second study they rated people they’d known for a few months; and in the third study they rated people they had known for at least three years. When people ranked individuals they didn’t know, people tended to agree on who was a catch and who wasn’t—it came down to superficial markers like good looks and likability. But researchers also found that as people got to know each other, perceptions changed and people tended to disagree about who seemed like a good partner and who didn’t.

“[As we spend more time with someone] we stop agreeing on how desirable or undesirable they are,” says study author Dr. Paul W. Eastwick, an assistant professor in the department of human development and family sciences. “We start to have very idiosyncratic opinions of one another.” The findings show that who we ultimately determine to be an ideal mate is unique, and we can greatly differ in our opinions of who is attractive, intelligent, popular, and who would make a good relationship partner.

So when it comes down to it, sure: At “hello,” some people have a leg up on others. But once someone is a known quantity, their desirability isn’t so clear-cut: Attractiveness and social status give way to compatibility and how suitable someone is for an actual relationship. “These findings are a good thing if people don’t care about getting the [conventionally ideal] mate, but care about finding the mate that is good and compatible for them,” says Eastwick.

Infectious Disease

Ebola Virus Death Toll Rises to 142 in West Africa

Doctors Without Borders called the outbreak 'unprecedented', as reported deaths continue to rise in Guinea and Liberia. However, the number of new infections has slowed

A total of 142 people have now died from an Ebola outbreak in Guinea and Liberia, the World Health organization said on Wednesday. Doctors Without Borders said that the size of the outbreak is unprecedented.

The World Health Organization debunked rumors that the virus was spreading to other countries, however, in a statement on their website. They said nineteen suspected cases reported in Sierra Leone have tested negative.

Doctors in Guinea and Liberia don’t have any experience with the virus, as this is the first time it has emerged in western Africa. WHO said that Guinea has reported 208 cases, including 136 deaths. Liberia has reported 34 cases, including six deaths.

The Ebola virus kills up to 90 percent of those infected, shutting down the immune system and bringing on fever, headache, muscle pain and bleeding.

Environment

Lead Didn’t Bring Down Ancient Rome—But It’s Still a Modern Menace

Roman aqueducts led to lead contamination
Aqueducts like this one contaminated Roman tap water with lead Moment via Getty Images

Lead levels were high in ancient Rome's tap water—but not high enough to cause the collapse of its civilization

You could fill a book with theories on why the ancient Roman Empire declined and fell—which, in fact, is what the 18th British historian Edward Gibbon did in his magisterial Decline and Fall of the Roman Empire. But if you don’t have time to read the 3,000 or so pages in Gibbon’s full work, here’s one very simple theory: it was lead. Canadian scientist Jerome Nriagu published an influential 1983 paper arguing that high levels of the neurotoxin lead—which contaminated water and other beverages through lead aqueducts and lead cups—caused mental disabilities and erratic behavior among members of Roman high society. Nriagu even reviewed the personalities and habits of Roman emperors between 30 B.C. and 22o A.D.—a list that includes notorious nutjobs like Nero and Caligula—and concluded that two-thirds of them suffered from symptoms of chronic lead poisoning. It’s hard to keep an empire going when your living god of an emperor has been brain-poisoned.

An empire brought down by one of its signature innovations, the aqueduct — it’s a theory that has stuck with the public, although experts have long been skeptical of its merits. It turns out that the theory was half-right: In a new study in the Proceedings of the National Academy of Sciences (PNAS), a group of French and British researchers report that the tap water in ancient Rome was indeed contaminated with lead, with levels up to 100 times higher than those found in local spring water at the time. But while Roman tap water might not have passed modern-day standards, it’s almost certain that the contamination wasn’t extensive enough to be responsible for the collapse of Roman civilization.

As lead author Francis Albarede of Claude Bernard University in Lyon told the Guardian:

Can you really poison an entire civilization with lead? I think it would take more than lead piping in Rome to do that.

Still, any amount of lead can pose a danger to the human brain, especially those of young children, so Rome’s contaminated water couldn’t have helped. In fact, the more researchers learn about lead, the more dangerous it seems—and the more important it becomes to get lead out of the environment. There’s a fascinating body of research, summed up in this excellent piece by Mother Jones‘s Kevin Drumm, that links the drastic drop in violent crime in the U.S. over the past two decades to the phasing out of leaded gasoline in the early 1970s, which greatly reduced lead levels in the environment.

The theory is that children in the 1940s, 50s and 60s were exposed to high levels of lead in leaded gasoline and lead paint. High blood lead levels are directly correlated with a loss of IQ points. But more than that, lead seems to particularly damage the parts of the brain linked to aggression control and executive function. Lead seems to affect boys more—and men, of course, make up the vast majority of violent criminals. When those lead-exposed boys became young adults in the 1970s and 80s, it wasn’t surprising that so many of them fell into violent crime. But once they aged out by the 1990s, that cohort was replaced by a generation of children who largely hadn’t been exposed to high levels of lead, and violent crime dropped.

But while most—though not all—American children are no longer exposed to high levels of lead, it’s still a major problem in poorer countries around the world. NGOs like the Blacksmith Institute are working to clean up lead contamination, though far more needs to be done. Lead may not have brought down the Roman Empire—you’ll need to go back to Gibbon for that—but two thousand years later, it’s still a public health menace.

medicine

Michigan Man Among 1st in U.S. To Get ‘Bionic Eye’

Bionic Eye
In this April 16, 2014 image from video Dr. Naheed Khan, right, works with Roger Pontz, left, on an exercise to test how well he sees shapes on a computer screen at the University of Michigan Kellogg Eye Center, April 16, 2014, in Ann Arbor, Mich. Mike Householder—AP

(ANN ARBOR, Mich.) — A degenerative eye disease slowly robbed Roger Pontz of his vision.

Diagnosed with retinitis pigmentosa as a teenager, Pontz has been almost completely blind for years. Now, thanks to a high-tech procedure that involved the surgical implantation of a “bionic eye,” he’s regained enough of his eyesight to catch small glimpses of his wife, grandson and cat.

“It’s awesome. It’s exciting — seeing something new every day,” Pontz said during a recent appointment at the University of Michigan Kellogg Eye Center. The 55-year-old former competitive weightlifter and factory worker is one of four people in the U.S. to receive an artificial retina since the Food and Drug Administration signed off on its use last year.

The facility in Ann Arbor has been the site of all four such surgeries since FDA approval. A fifth is scheduled for next month.

Retinitis pigmentosa is an inherited disease that causes slow but progressive vision loss due to a gradual loss of the light-sensitive retinal cells called rods and cones. Patients experience loss of side vision and night vision, then central vision, which can result in near blindness.

Not all of the 100,000 or so people in the U.S. with retinitis pigmentosa can benefit from the bionic eye. An estimated 10,000 have vision low enough, said Dr. Brian Mech, an executive with Second Sight Medical Products Inc., the Sylmar, Calif.-based company that makes the device. Of those, about 7,500 are eligible for the surgery.

The artificial implant in Pontz’s left eye is part of a system developed by Second Sight that includes a small video camera and transmitter housed in a pair of glasses.

Images from the camera are converted into a series of electrical pulses that are transmitted wirelessly to an array of electrodes on the surface of the retina. The pulses stimulate the retina’s remaining healthy cells, causing them to relay the signal to the optic nerve.

The visual information then moves to the brain, where it is translated into patterns of light that can be recognized and interpreted, allowing the patient to regain some visual function.

When wearing the glasses, which Pontz refers to as his “eyes,” he can identify and grab his cat and figure out that a flash of light is his grandson hightailing it to the kitchen.

The visual improvement is sometimes startling for Pontz and his wife, Terri, who is just as amazed at her husband’s progress as he is.

“I said something I never thought I’d say: ‘Stop staring at me while I’m eating,’” Terri Pontz said.

She drives her husband the nearly 200 miles from tiny Reed City, Mich., to Ann Arbor for check-ups and visits with occupational therapist Ashley Howson, who helps Roger Pontz reawaken his visual memory and learn techniques needed to make the most of his new vision.

At the recent visit, Howson handed Pontz white and black plates, instructed him to move them back and forth in front of light and dark backgrounds and asked that he determine their color.

Back home, Terri Pontz helps her husband practice the techniques he learns in Ann Arbor.

For them, the long hours on the road and the homework assignments are a blessing.

“What’s it worth to see again? It’s worth everything,” Terri Pontz said.

The artificial retina procedure has been performed several-dozen times over the past few years in Europe, and the expectation is that it will find similar success in the U.S., where the University of Michigan is one of 12 centers accepting consultations for patients.

Candidates for the retinal prosthesis must be 25 or older with end-stage retinitis pigmentosa that has progressed to the point of having “bare light” or no light perception in both eyes.

Dr. Thiran Jayasundera, one of two physicians who performed the 4.5-hour surgery on Roger Pontz, is scheduled to discuss his experiences with the retinal prosthesis process during a meeting of the American Society of Cataract and Refractive Surgery on Friday in Boston. He calls it a “game-changer.”

Pontz agrees: “I can walk through the house with ease. If that’s all I get out of this, it’d be great.”

 

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