TIME medicine

Bring the Doctor with You

The logical next step in managing chronic disease is technology that tracks our vitals and guides us to better health

Chronic disease affects 2 out of 3 adults in the U.S., and it is estimated that 8% of the American population suffers from diabetes. Sixty-nine percent of Americans say they would like direct access to their health records. People want to keep track of their health–and we’d be better off as a society if people had an easy way to do so.

As luck would have it, mobile technology is bringing us closer to the day when we’ll be able to essentially wear our doctors. So when TIME asked me to propose an idea for how design can improve the world, my thoughts quickly turned to medicine. I call my concept–and for now, it is only that–LifeTiles: a wearable kit of sensors for monitoring individual health.

The sensors–designed to be aesthetically pleasing–would noninvasively monitor the user’s physical activity, environment and bloodstream. The information would be sent automatically to the cloud, where specialized algorithms could be used to monitor it and notify the individual with personalized feedback.

A user could also volunteer to donate his or her data, which would be made anonymous and shared with medical experts. Researchers could use the data to look for patterns, understand how disease works and find ways to prevent and cure it. Our doctors would always be with us–and everyone would benefit.

Béhar is the founder of Fuseproject and leads design and brand at Jawbone

TIME

Running Out the Clock

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In our ongoing 'Doctor-in-Training' series, time is of the essence in more ways than one for a medical student conducting a routine physical on an elderly patient

I’m running out of time. It was right there on the vital signs monitor clock: 30 minutes left to finish the patient’s history and do her physical. And here she was, a real talker, expounding on the pros and cons of Obamacare. I pressed ahead with my questions about her health, not rushing her, but taking advantage of her pauses to steer the conversation in the direction of the information I needed to present in less than an hour to my supervising doctor.

A classmate and I had been assigned to this patient–I’ll call her Mrs. G.–as part of our course on the physical exam. She lay in her bed on the inpatient cardiac ward, frail under gown and blanket, an IV dribbling into her arm. We worked systematically, with lots of ground to cover. At this stage of our medical education, year two, nothing we do is for the patient’s benefit. Not the barrage of questions, not the poking and prodding for findings we’re only just beginning to understand. It’s all for our training. We find our patients catch-as-catch can. Sometimes one of our physician teachers will ask a patient to let us perform an examination. Other times the nurses tell us which of their charges that day are the nicest, and we ask those patients to put up with us. Invariably, they do. Though sicker than sick, they generously act as guinea pigs so we can learn the skills to help our future patients.

Mrs. G. was hoarse but still chatty as she answered our questions about her heart problems. “Have you experienced any palpitations?” I asked. “Only twice. Right before I came to the hospital, and the first time I saw my husband,” she deadpanned. They’d been married, she said, 63 years. As my classmate and I prepared to move from taking the history to doing the physical exam, it struck me that Mrs. G. was doing me a favor—allowing me to learn by practicing my budding physical exam skills on her frail form. And she was even entertaining. But I couldn’t repay her with the open-ended listening she was clearly hoping for. It’s starting, I found myself thinking. This is why everyone says doctors are always in a rush.

She was still talking. “They say I may go down in days,” she said. “I’m just hoping to get to Christmas with my grandkids.”

It was a mental slap on the wrist. I’m running out of time? I thought. My cheeks warm, I contemplated how few hours she could have left on this earth. A few hundred, probably. If she was lucky. And yet, here she was, spending one of those hours helping me grow into a doctor.

TIME tobacco

E-Cigarettes Don’t Discourage Smoking Among Teens

E-Cigarettes Become Increasingly Popular Amongst Smokers
Consumers smoke electronic cigarettes at a mall on June 30, 2013 in Manila, Philippines. Dondi Tawatao—Getty Images

Adolescents who use e-cigarettes are more likely to smoke other tobacco products and regular cigarettes, a new study finds, suggesting that e-cigarettes may not be the lesser of two evils that some had hoped

Are e-cigarettes the lesser of two evils, or just another method of nicotine exposure?

It’s a question public health experts are debating. Some question the benefits of steering smokers towards less harmful products on the nicotine product spectrum. And a new study published in JAMA Pediatrics suggests what medical experts dread: that people who use e-cigarettes are also likely to be regular cigarette users.

Adolescents who use e-cigarettes are more likely to smoke other tobacco products and regular cigarettes. The researchers surveyed 17,353 middle and high school students in 2011, and 22,529 young people in 2012 as part of the National Youth Tobacco Survey.

Youth who reported ever using e-cigarettes or currently using them had a greater likelihood of experimenting with regular cigarettes, smoking on a regular basis, or being a current cigarette smoker. Among young people who had used tobacco cigarettes, trying an e-cigarette was linked to being an established smoker. The researchers also found that teens who used e-cigarettes were more likely to want to quit smoking the next year, but they were also less likely to abstain from cigarettes all together.

The study didn’t look at whether young people are initiating smoking with regular cigarettes and then switching to e-cigarettes, or the other way around. However, e-cigarettes aren’t “discouraging use of conventional cigarettes,” the researchers say.

In September, numbers from the CDC showed that 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.

“While much remains to be learned about the public health benefits and /or consequences of [electronic nicotine delivery systems] use, their exponential growth in recent years, including their rapid uptake among youths, makes it clear that policy makers need to act quickly,” Frank J. Chaloupka of the University of Illinois at Chicago wrote in a corresponding editorial.

Most recently, Los Angeles extended its city-wide smoking ban to include e-cigarettes.

TIME Aids

Doctors Believe a Second Baby Is Cured of HIV

Dr. Deborah Persaud of Johns Hopkins' Children's Center in Baltimore.
Dr. Deborah Persaud of Johns Hopkins' Children's Center in Baltimore. Johns Hopkins Medicine—AP

A baby born infected with human immunodeficiency virus in Los Angeles who received treatment shortly after birth is still showing no signs of the disease a year later, doctors say. The child's mother was not taking her HIV medication while she was pregnant

A baby infected with HIV at birth has been cured of the disease, doctors believe.

The baby, who was born in Los Angeles, received treatment within a few hours after birth, and is still virus-free a year later, doctors announced Wednesday at the Conference on Retroviruses and Opportunistic Infections in Boston. The mother had not been taking her HIV medication while pregnant, doctors say.

Although it’s too early to know for certain whether the child is just in remission, doctors say the baby’s vitals are displaying differently compared with patients with suppressed HIV. The baby is currently in foster care.

This is the second baby doctors believe to be cured of the disease with very early treatment. Another child from Mississippi received similar treatment when her mother was discovered to be HIV-positive during labor. The child is now 3 1/2 years old and appears to be cured, even though her mother was not administering the baby her HIV medication at follow-up.

[AP]

TIME medicine

Experimental HIV Injection Drug Shows Promise

Monkeys who received an experimental injection-based HIV treatment didn't contract the disease when later exposed to it, raising hopes the current once-a-day pill system of treatment could soon be replaced for those battling the illness

New research shows that an experimental drug given once every few months could replace daily pills to prevent HIV infection.

In two different trials on a total of 28 monkeys, the Associated Press reports, researchers gave one group shots of an experimental HIV-preventative drug, while the others received placebo shots. They then exposed the monkeys to HIV at a few different times during the trials. The monkeys who were given the drug remained healthy, while the monkeys without the drug were infected. The drug had a protective window of about 10 weeks.

The results are very promising because they provide a potential alternative to Truvada, a daily pill that treats people with HIV. Truvada is also being used to help prevent infection in people who do not have the virus. Studies have shown it can significantly cut risk depending on how consistently people take the daily pills. If people at risk for contracting HIV could take a shot every one to three months instead, the injection method could help prevent even more infections.

The research was presented at the Conference on Retroviruses and Opportunistic Infections in Boston. Given the small sample size, and that the drug has not been tested in humans, the results are still preliminary.

[AP]

TIME medicine

9 Old-Time Cures Doctors Swear By (and 3 to Skip)

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Florea Marius Catalin—Getty Images/Vetta

Classic treatments we grew up with are making a comeback, thanks to fresh research confirming their powers. Here's why you should reach (again) for the Pepto, prunes, and other throwback cures

Medical offices might have gone high-tech, but some of the advice you’ll hear there these days rings more nostalgic: Complain of constipation or congestion and you may get an Rx for dried plums (née prunes) or a saltwater gargle. “The more that old remedies pan out in studies, the more likely physicians are to suggest them,” says Philip Hagen, MD, vice chair of the division of preventive medicine at Mayo Clinic. “Part of the drive is the cost of health care—trying these at home could save you a trip to the doctor.” Consider these golden oldies the next time you’re feeling under the weather.
Health.com: Scary Symptoms You Can Relax About
Ginger

For thousands of years, this spice was used to knock out nausea. But unless you went to an Eastern medicine doctor, you weren’t going to hear about it from your MD. Then, along with the 21st century came a string of studies pointing to ginger’s potential to combat nausea related to motion sickness, chemotherapy and pregnancy. “Once the science was there, more doctors were willing to ‘prescribe’ it,” says Patricia Raymond, MD, assistant professor of clinical internal medicine at Eastern Virginia Medical School in Norfolk, Va. Try candied ginger, ginger tea or even ginger cookies the next time that you’re feeling queasy.

BenGay

This pain-easing ointment was always a favorite with athletes but not so much with the average exerciser, mostly because of the medicinal scent. “When I smell menthol, I’m like, ‘Ugh,'” says Renee Acosta, clinical associate professor of health outcomes and pharmacy practice at the University of Texas, Austin. “You don’t want to smell like that at work.” Today, though, medical pros are touting BenGay even to weekend warriors, especially now that it comes in scentless and patch versions. “People are trying to stay active longer, and we want to give them all their options,” Acosta says.

Health.com: 27 Mistakes Healthy People Make
Prunes

Back in the day, the answer to irregularity was prunes, possibly administered from your grandmother’s stash and definitely embarrassing. That changed when, in 2000, the decidedly unsexy-sounding fruit was rebranded as “dried plums.” “They became an easier sell,” Dr. Raymond says, partly due to a growing interest in digestive health and food cures. Recent science has confirmed prunes’ benefits: A 2011 study found that eating 12 a day relieves constipation better than the trendier psyllium supplements.

Pepto-Bismol

Pepto was originally invented to treat infants before it became the ultimate upset-stomach cure for adults. In recent years, however, studies have shown that it works particularly well to treat traveler’s diarrhea—and even to prevent it if taken before a trip.

Salt-water gargle

This headache pill was elbowed out by nonsteroidal anti-inflammatory drugs (NSAIDs), such as Advil. Then the Food and Drug Administration approved Excedrin as the first over-the-counter medicine for migraine symptoms, and it was newly marketed as Excedrin Migraine. “That swayed doctors and pharmacists to look at it again,” Acosta says.

Petroleum jelly

Back in the 1800s, Vaseline was a popular remedy for skin complaints. Though it fell out of vogue in favor of newfangled creams, doctors have a surprising modern-day use for it: applying it to wounds after surgery. “Some patients have allergic reactions to antibiotic ointments, and petroleum jelly works just as well in the absence of infection,” says Stephen Stone, MD, professor of dermatology at Southern Illinois University School of Medicine in Springfield, Ill. You can use it on minor cuts, too.

Adhesive bandages

Speaking of cuts, the pretty recent common wisdom was that they’d heal better if you exposed them to air. “Turns out, we were right decades ago when we said to use adhesive bandages,” Dr. Stone says. They help maintain a moist environment for faster healing.

Health.com: 19 Signs Your Thyroid Isn’t Working Right
Ice

Ice packs are a classic headache-killer. Newer pain relievers may be more effective, but a recent study shows that migraine sufferers get great relief from ice packs—especially when placed for 15 minutes on the front of their neck, over the carotid arteries, rather than on their head. (For best results, try a bag of ice mixed with salt water.) Cool, indeed.

You shouldn’t try: Raw steak on a black eye

A slab of cold beef may feel soothing, but the bacteria on uncooked meat can lead to infection. Better idea: Apply an ice pack for 15 to 20 minutes every hour.

Health.com: The Truth About Internet Food Rumors
You shouldn’t try: Singeing a tick off with a match

“Ticks can be as small as poppy seeds, so you can easily burn your skin,” says Thomas Mather, PhD, director of the University of Rhode Island’s TickEncounter Resource Center in Kingston. It’s far safer to use pointy tweezers to pull the suckers off.

You shouldn’t try: Swigging whiskey for toothaches

“The alcohol was thought to kill bacteria and numb the area, but it doesn’t do either very well,” says Matthew Messina, DDS, a Cleveland dentist and ADA Consumer Advisory spokesperson. “If your tooth pain is bad enough to try this technique, you need to see a dentist in case you have an infection requiring antibiotics or surgery.”

This article originally appeared on Health.com.

TIME Aging

Oscar Winners Live Longer Than Nominees, Study Says

82nd Annual Academy Awards - "Meet The Oscars" New York
Bennett Raglin—WireImage/Getty Images

Actors who take home the statuette get about four extra years, while those who win multiple times get six

This Sunday, a handful of stars will go home empty handed from the 2014 Academy Awards show. Not only will they be left with the bitter sting of defeat, but such loss may also lead to shorter lifespans than the winners.

Seriously. Social status has long been recognized as a predictor for poor health. Typically, research has focused on disparities between the rich and the poor. But science tells us that the effect may extend to quite literally the top of social ladder. In fact, Oscar winners may also have the perk of longevity.

The finding was first noticed in 2001. Researchers from the University of Toronto studied 1,649 Oscar-nominated actors and actresses. When they accounted for factors that could influence death rates, they found that among the participants, Oscar winners had a survival advantage of about four extra years of life, and actors who won multiple Oscars had an advantage of six years. Nominees who didn’t win had the same survival rates as their non-nominated peers.

Success could possibly account for the survival advantage, the researchers say. They speculate that since stars are subjected to intense personal scrutiny, they pay special attention to their looks and behaviors. Consequently, they may avoid risky behavior and focus more intensively on eating and exercise. Not to mention, many have the means to hire nannies, trainers, and managers, which could mean they are under less stress than the general population.

Of course, there are the exceptions, like Oscar winner Philip Seymour Hoffman who died recently after an overdose. Another study published in the Annals of Internal Medicine questioned the methods of the 2001 study. The original study was criticized for counting the years an actor was alive, instead of comparing years after a win. They also declared winners and losers at the onset, and didn’t factor in whether actors in the study won an award later on. When the new researchers re-calculated, they didn’t find the numbers significant.

If the findings do hold true, it could mean that there are other factors that impact survival, like a jump in social status. Looks like we will have to wait and see.

TIME trends

Here Are the Most Popular Plastic Surgery Procedures In Three Charts

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2013 was a good year for butt augmentation and neck lifts

The American Society of Plastic Surgeons released their annual results on plastic surgery procedures in the U.S., reporting 15.1 million cosmetic procedures in 2013, a 3% increase from 2012.
Some of the findings were expected. For instance, breast implants remain the top cosmetic surgical procedure and Botox remained the top minimally invasive procedure. Interestingly, the procedures that are gaining popularity are buttock augmentation and neck lifts. Below are some of the most popular procedures Americans are going under the knife for.
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American Society of Plastic Surgeons
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American Society of Plastic Surgeons
TIME flu

Scientists Can Now Predict the Flu

Girl in bed with thermometer in mouth
Girl in bed with thermometer in mouth Getty Images

A mathematical model could make future seasons' vaccines more accurate

Researchers have figured out a formula that can predict the evolution of the seasonal flu for the next year.

In a study published in the journal Nature, researchers from Columbia University and the University of Cologne looked at the way the common H3N2 flu virus mutated and changed throughout the years since 1968. Based off that data, they created a mathematical model that accurately predicts how the virus will change in the future.

The seasonal H3N2 influenza accounts for about half a million deaths every year. To determine what flu strains should be included in the vaccine each year, health experts study the virus, how it changes, and its frequency. The prediction model that researchers have now come up with is significant because it could make the shot you get every season even more accurate, and thus flu-resistant.

To create their model, the researchers looked at the viruses circulating in a given season and its genomes, as well as how many people those viruses infected. Some of the viruses’ adaptive mutations, which occur in what is called the haemagglutinin protein of a virus, were shown to increase the virus’ life and growth, whereas others crippled it.

By examining every strain of the virus through the decades, the study’s authors formulated an equation. More weight was given to mutations that were likely to boost the virus, and the strain’s strength was determined by factoring in its growth rate. When researchers went back and compared their estimates to various years, they found their formula to be highly accurate.

The results of the study have to be replicated before they can begin to be applied to our real-world seasonal vaccines, but the study’s authors say they hope that a more precise prediction method could lead to a highly protective vaccine. And, likely, so does anyone crippled by the flu this season.

TIME medicine

Small Science, Big Diseases

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DNA helices Lawrence Lawry—Getty Images/Science Photo Library

Big pharma is slow and risk averse. Smaller companies are the future of medical innovation.

There is grandeur in the small science emerging from a select group of the world’s laboratories. This small science is about to change how we tackle our most troublesome diseases.

Gene therapy. Immunotherapy. Nanomedicine. This is what the next few decades of medicine will look like. But it isn’t coming from big pharma. It’s coming from the little guys. Small pharmaceutical and biotechnology companies, once overlooked for both their risky science and questionable market share, are revolutionizing how the industry pursues new therapies. This shift in science comes as big pharma is falling stagnant. Last year, the bulk of profits made by big pharma came from drugs approved prior to 2001. If we look at the percent of big pharma’s profits from drugs created within the last five years, the picture is grim. On average, new therapies make up only 8.3% of their profits. The patents are running out and big pharma’s science is sluggish. Now the underdogs of the industry, small pharma and biotech, are poised to take on what were once considered incurable diseases. Why are little companies succeeding while big ones are sliding? It comes down to risk.

This risk starts with the pursuit of great science. Edward Lanphier couldn’t get anyone at his company interested in a new technology capable of precisely cutting DNA so he decided to form his own. Ingmar Hoerr was a graduate student when he discovered a little known secret about our body’s genetic material. Omid Farokhzad, a researcher at Harvard Medical School, dreamed of a way of combining nanotechnology with medicine. All three of them put everything they had into one, promising piece of science. There was no room for failure.

Big pharma, on the other hand, is risk-adverse. They have good reasons for this. Bringing a new drug into the marketplace is incredibly expensive. By some estimates, it costs $350 million from the first rough experiments to final clinical trials. If you’re going to make this kind of investment you want to be reasonably sure it’s not going to fail somewhere in the middle. Even more important, you don’t want to have all your eggs in one basket. Better to spread the risk over many therapies that have both the proven technology to work and, perhaps most importantly, the right market of people who can pay for it. While this conservative mindset undoubtedly serves many industries well, for drug development it’s flawed. This is because great science is inherently risky.

In order to solve our biggest health struggles, we need daring solutions. The small science of gene therapy is a prime example of this. Gene therapy goes to the heart of how our bodies fight disease: our genes. But if we’re going to change something as essential as our genetics it needs to be done safely. This is where zinc finger nucleases have proved useful. These proteins are small, DNA cutting machines inspired by the African clawed frog. They are capable of manipulating our genes at a precise molecular level. They can free an immune system of a disease-causing mutation or, alternatively, create one that is capable of fighting back. The results have been striking. Sangamo Biosciences and their collaborators are currently testing them in clinical trials for three diseases: brain cancer, HIV, and Alzheimer’s.

Instead of cutting DNA, CureVac has found a new way to manipulate it. They target the messages genes send to control the body. The therapy acts like a double agent; substituting messages to direct the body to rout the disease. This results in an immune system that creates its own medicine. The results have been impressive, resulting in clinical trials for patients with prostate and lung cancer. They’re also evaluating the technique for rabies and the flu.

Nanomedicine is the epitome of thinking small. A company called Bind therapeutics has created nanoparticles so tiny that they surround a drug. These nanoparticles deliver the drug exactly where it needs to go in the body and keeps it there. This approach has been successful in shrinking prostate and lung cancers in clinical trials. In light of this success, Bind therapeutics decided to partner with the heavy-hitters, big pharma. These partnerships allow Bind to combine their clever delivery technology with effective drugs owned by larger companies.

Three different companies, three very different approaches, but they’re each taking on the big diseases. And these are just a few examples of the revolution happening in the drug development industry. Not all new ventures will survive; small companies, just like early experiments, are full of failure. But where these companies shine is in their pursuit of radical therapies rooted in the basic science of how our bodies fight disease. It could not be more different than the cautious, conservative approach favored by big pharma. If big pharma wants to be more than just partners in the pursuit of cures they’re going to have to get in on the game. The answers to some of the biggest medical challenges we face, cancer and infectious disease, are coming from small science. And it’s just the beginning.

Nathalia Holt is the author of Cured: How the Berlin Patients Defeated HIV and Forever Changed Medical Science.

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