Medicine/Science

The latest cool stuff out of some of the nation's best labs; news on medical research and what it may mean for patients.

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Report Finds Stark Gaps In Mass. Addiction Care

The math is simple and starkly clear.

There are 868 detox beds in Massachusetts, where patients go to break the cycle of addiction. They stay on average one week. Coming out, they hit one of the many hurdles explained in a report out this week from the Center for Health Information and Analysis on access to substance abuse treatment in the state.

There are only 297 beds in facilities where patients can have two weeks to become stable. There are 331 beds in four-week programs.

As the table below shows, there are almost four times as many men and women coming out of detox, with its one-week average, as there are from a two- or four-week program.

From the CHIA report on Access to Substance Use Disorder Treatment in Massachusetts

From the CHIA report on Access to Substance Use Disorder Treatment in Massachusetts

Patients who can’t get into a residential program right away describe a spin cycle, where they detox and relapse, detox and relapse. Some seek programs in other states with shorter wait times.

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Massachusetts Court Upholds $63M Judgment In Motrin Lawsuit

The highest court in Massachusetts has upheld a $63 million judgment against the manufacturer of Children’s Motrin awarded to a family whose daughter developed a life-threatening disease after taking the over-the-counter medicine.

A Superior Court jury ruled in 2013 that Johnson & Johnson failed to provide sufficient warnings about the potential side effects of Motrin.

Samantha Reckis was 7 in 2003 when she was given the ibuprofen product to reduce a fever. She suffered a rare skin disease known as toxic epidermal necrolysis and was blinded.

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Visionaries: MIT Scientist Helps Blind Indian Children See, And Then Learns From Them

MIT neuroscience professor Pawan Sinha (Robin Lubbock/WBUR)

MIT neuroscience professor Pawan Sinha (Robin Lubbock/WBUR)

MIT neuroscience professor Pawan Sinha still gets goosebumps when he thinks about it, he says: “Things just happened so perfectly, so well-timed.”

Back in 2002, Sinha was grappling with a deep scientific question: How do we learn to recognize the objects we see? How do our brains know, “That’s a face”? Or “That’s a table”?

A fateful taxi ride set his research — and his life — onto a new road.

He was back visiting New Delhi, where he grew up on the elite campus of the Indian Institute of Technology before coming to America for graduate school. He was on his way to see a friend one evening, when the taxi he was riding in stopped at a traffic light.

“I noticed, by the side of the road was this little family, a mother and her two children,” he says. “And it felt really terrible to see these two children, who were barely wearing any clothes, very young children on this cold winter day. So I called over the mother to give her a little bit of change.”

When she approached, Sinha noticed that both of the children holding on to her sari had cataracts clouding their eyes.

It was the first time that he had seen children with cataracts. When he looked into childhood blindness in India, he learned that it is a widespread problem, often caused by rubella during the mother’s pregnancy. Blind children in the developing world suffer so much abuse and neglect that more than half don’t survive to age 5, he says.

Sinha wanted to help, but he figured that what he could contribute on his academic salary would be just a drop in the ocean.

“And that’s when the realization struck me that in providing treatment to those children, I would have exactly the approach that I had been looking for in my scientific work,” he says.

“If you have a child, say, a 10-year-old child who has not seen from birth, has only seen light and dark, and in a matter of half an hour you’re able to initiate sight in this child, then from the very next day, when the bandages are removed, you have a ringside seat into the process of visual development.”

Sinha applied for a federal grant to pay for cataract operations, which are relatively simple, and for studying the children who got them. Usually, American research money stays in America, “but I took a chance because I completely, honestly believed, and believe, that in providing that surgery, we are benefiting science that belongs to all of mankind, it’s not just specifically India.”

That grant eventually came though and to continue the work, Sinha founded a nonprofit based in New Delhi. He named it Project Prakash; Prakash means “light” in Sanskrit. Since 2005, he says, nearly 500 Indian children have gained sight through the project.

Now, at 48, Sinha is planning a major expansion of Project Prakash, to create a center that includes a hospital, a school and a research facility. The goal is to serve many more children than the current 40 to 50 a year. Continue reading

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Mass. Revamps ‘Confusing’ Medical Marijuana Dispensary Licensing Process

The Massachusetts Department of Public Health is “aggressively” revamping its process for licensing medical marijuana dispensaries in the state, a system the head of the department says has been “confusing and overly lengthy.”

Dispensaries will now be licensed in a process similar to that used for pharmacies, DPH Commissioner Monica Bharel announced at a Public Health Council meeting Wednesday morning.

The current process has “delayed appropriate patients from getting access” to medical marijuana, Bharel said.

Massachusetts voters approved a medical marijuana ballot initiative in November 2012. But the licensing process became bogged down after it came to light that the applicants were not thoroughly vetted before the first round of provisional approvals. Some of those applicants were then eliminated for having misrepresented claims of community support or for other problems with their applications. To date, no dispensaries have opened in the state.

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State Doctors’ Group To Meet On Addiction Crisis

The state’s growing heroin and prescription drug abuse crisis is getting the attention of the Massachusetts Medical Society.

The group representing more than 24,000 physicians will devote its annual Public Health Leadership forum to the opioid epidemic. The meeting will be held in Waltham on Wednesday with topics expected to include overdose prevention and the safe prescription of pain medication.

Michael Botticelli, director of the White House Office of National Drug Control Policy, is among scheduled speakers.

State police reported 217 suspected heroin overdose deaths in the first three months of this year. Those figures did not include the state’s three largest cities: Boston, Worcester and Springfield.

An opioid abuse task force created by Gov. Charlie Baker met at the Statehouse last week and is expected to make recommendations later this year.

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Harvard Study: Better Police Reports On Bike Crashes Could Save Lives

A "ghost bike" is placed in memory of Marcia Deihl, who was killed in a crash in Cambridge, Massachusetts, on March 11. (Rachel Zimmerman/WBUR)

A “ghost bike” is placed in memory of Marcia Deihl, who was killed in a crash in Cambridge, Massachusetts, on March 11. (Rachel Zimmerman/WBUR)

Last month, Marcia Deihl, a songwriter and community activist out for a bike ride on the first warm day after a brutal winter, was struck and killed by a dump truck outside a Whole Foods in Cambridge, Massachusetts. A white “ghost bike” now memorializes her death.

Aspiring photojournalist Christopher Weigl, just 23, was also killed in a bike accident: Wearing a helmet, and traveling in the bike lane near Boston University, Weigl collided with a 16-wheel tractor trailer when the truck made a wide right turn in the winter of 2012.

And less than a year before that, MIT graduate student Phyo N. Kyaw sustained fatal injuries when his bike collided with a truck in a busy Cambridge intersection.

These deaths happened close to home: where I work, shop, ride with my kids. And they underscore two truths: There are more cyclists on the road, and more of them are getting hurt in accidents, some fatal. The number of commuters who bike to and from work rose about 62 percent nationwide from 2000 to 2013, one report found. With those numbers comes added risk: 726 bicyclists were killed and 49,000 bicyclists injured in 2012, according to the National Highway Traffic Safety Administration.

As a driver, you don’t need a research study to tell you that bikes are everywhere, whether you’re in Boston, New York or Seattle. But you do need research, and data, to help fix the problem — that is, reduce the number of accidents and deaths.

(Source: National Highway Traffic Safety Administration)

(Source: National Highway Traffic Safety Administration)

Cities, towns, planners and private businesses can’t move forward building safer cars and safer bike environments until they learn more precisely how bike accidents happen. Is a truck’s wide turn to blame? A taxi door opening at the wrong time? These seemingly small details of crashes are critical, says Anne Lusk, a research scientist in the Department of Nutrition at the Harvard School of Public Health.

That’s why Lusk and her colleagues have issued a blueprint of sorts for improving bike-vehicle crash reports produced by the police; their findings are published this week in the journal Injury Prevention.

After studying hundreds of hopelessly low-tech police reports used to record bike accidents, Lusk and her colleagues are making a nationwide plea: They’re calling on police in all states to step into the modern era and improve reports on crashes involving vehicles and bicycles. Currently, Lusk said in an interview, the details on crashes are handwritten and drawn by police on paper, with few bicycle-specific codes or diagrams.

Lusk offered one example: Currently, a crash report from Massachusetts shows “two vehicles” drawn. One of the “vehicles” is then coded as a “pedal cyclist” but there is no drawing on the template of a bicycle to show which side of the bike was hit.

Police have been recording bike crashes since the introduction of the bicycle in 1890, researchers note.

Now it’s time for a major upgrade. Lusk says police should “use electronic tablets with dropdown menus that have specific vehicle/bicycle codes, for instance, whether the bicyclist was riding inside a painted bike lane when hit, or whether the cyclist crashed into a driver’s open car door. The dropdown menu would also include other specific data like a coded vehicle picture and a coded bicycle picture. This information could then be automatically loaded onto spreadsheets for later analysis, Lusk said. Continue reading

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Gov. Baker Adds Voice To Hundreds At Opioid Hearing

Hundreds turned out for the final public hearing before Gov. Charlie Baker’s opioid abuse task force to share their stories of addiction and recovery as the administration plots a course forward to combat what Baker has called a “crisis” in Massachusetts.

Baker joined Health and Human Services Secretary Marylou Sudders and Attorney General Maura Healey, both leaders of the task force, for the fourth and final public listening session on Thursday as the task force prepares to issues recommendations to the governor in May.

“There are plenty of opportunities for us to do everything that we need to do to make sure people have the access that they need and they deserve to pain medication, but we need to be open and honest with ourselves about the way we all, as a society, think about pain meds with respect to all sides of those issues,” Baker told the audience, which had crowded into the State House’s Gardner Auditorium.

The Massachusetts State Police this week reported that there had been 217 fatal opioid overdoses in the first three months of 2015, not including data from the state’s three largest cities of Boston, Worcester and Springfield.

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217 Suspected Massachusetts Heroin Overdose Deaths This Year

Massachusetts state police are reporting more than 200 suspected heroin overdose deaths during the first three months of this year, a figure that doesn’t even include the state’s three largest cities.

According to the statistics provided by the state police, there were 72 suspected heroin overdose deaths in March. The totals for the first two months of the year were similar: 72 deaths in February and 73 in January.

Among the March deaths, 54 were men and 18 women. The average age of those who died was 36.

The 217 fatalities were recorded in every region of Massachusetts, but state police noted they don’t keep the records of suspected heroin deaths in Boston, Worcester and Springfield, so the statewide total was almost certainly higher.

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House Passes Bill To Fix Medicare's Doctor Payments. What's In It?

House Speaker John Boehner speaks to members of the media during his weekly news conference on Capitol Hill Thursday. (Andrew Harnik/AP)

House Speaker John Boehner speaks to members of the media during his weekly news conference on Capitol Hill Thursday. (Andrew Harnik/AP)

The troubled payment formula for Medicare physicians is one step closer to repeal.

The House Thursday overwhelmingly passed legislation to scrap Medicare’s troubled physician payment formula, just days before a March 31 deadline when doctors who treat Medicare patients will see a 21 percent payment cut. Senate action could come this week as well, but probably not until the chamber completes a lengthy series of votes on the GOP’s fiscal 2016 budget package.

According to a summary of the bill, unveiled by Republican and Democratic committee leaders earlier this week, the current system would be scrapped and replaced with payment increases for doctors for the next five years as Medicare transitions to a new system focused “on quality, value and accountability.”

Hundreds of state and national physician groups are urging Senate passage.

“It will relieve many years of frustration and uncertainty for all physicians by eliminating that sword of Damocles, that’s been hanging over our heads with regards to cuts and replacing it with a predictable albeit small increase in fees over the next four to five years,” said the Massachusetts Medical Society’s president-elect, Dr. Dennis Dimitri.

There’s enough in the wide-ranging deal for both sides to love or hate.

Senate Democrats have pressed to add to the proposal four years of funding for an unrelated program, the Children’s Health Insurance Program, or CHIP. The House package extends CHIP for two years. In a statement Saturday, Senate Finance Democrats said they were “united by the necessity of extending CHIP funding for another four years” but others have suggested they may support the package.

Some Democratic allies said the CHIP disagreement should not undermine the proposal. After the House approved the package by a vote of 392-37, Ron Pollack, executive director of the consumers group Families USA, urged the Senate to “adopt a CHIP funding bill as soon as possible. Families USA believes that a four-year extension is preferable to two years. We also know that time is of the essence, and it is crucial that the Senate act quickly.”

Some senators have also raised concerns about asking Medicare beneficiaries to pay for more of their medical care, the impact of the package on women’s health services and cuts to Medicare providers.

In a letter to House members before Thursday’s vote, the seniors group AARP said the legislation places “unfair burdens on beneficiaries. AARP and other consumer and aging organizations remain concerned that beneficiaries account for the largest portion of budget offsets (roughly $35 billion) through greater out-of-pocket expenses” on top of higher Part B premiums that beneficiaries will pay to prevent the scheduled cut in Medicare physician payments.

Hospitals, nursing homes and rehabilitation centers would see lower rates of increase, but are largely backing the legislation.

“Although nothing’s perfect, at a time when it’s so difficult to reach accord on really complicated issues, broad support for this solution is really impressive,” said Tim Gens, executive vice president at the Massachusetts Hospital Association. “And if it fails, we go back to these temporary patches that only solve the problem in a very expensive way for months at a time.”

Some GOP conservatives and Democrats are unhappy that the package isn’t fully paid for, with policy changes governing Medicare beneficiaries and providers paying for only about $70 billion of the approximately $200 billion package. The Congressional Budget Office Wednesday said the bill would add $141 billion to the federal deficit.

For doctors, the package offers an end to a familiar but frustrating rite. Lawmakers have invariably deferred the cuts prescribed by a 1997 reimbursement formula, which everyone agrees is broken beyond repair. But the deferrals have always been temporary because Congress has not agreed to offsetting cuts to pay for a permanent fix. In 2010, Congress delayed scheduled cuts five times. In a statement Sunday, the American Medical Association urged Congress “to seize the moment” to enact the changes.

Here are some answers to frequently asked questions about the proposal and the congressional ritual known as the doc fix. Continue reading

Suicide Prevention Campaign Approaches Men ‘On Their Own Terms’

Franklin Cook, project manager of the MassMen campaign, and Candice Porter, executive director of Screening for Mental Health, using the MassMen website. (Lynn Jolicoeur/WBUR)

Franklin Cook, project manager of the MassMen campaign, and Candice Porter, executive director of Screening for Mental Health, using the MassMen website. (Lynn Jolicoeur/WBUR)

Franklin Cook of Watertown knows the issue of suicide among men all too well. In 1978, when Cook was 24, his father killed himself.

After that Cook struggled with addiction and found recovery, suffered from depression but got treatment, and built a career in suicide prevention and suicide grief support.

He knows many men struggle to seek help for mental illness.

More men than women die by suicide, and across the country middle-aged white men have the highest suicide rate of any age group.

“But the care-giving world also doesn’t market or doesn’t design programs specifically around our species, if you will,” Cook says. “[Some men] might not want to sit down face-to-face and talk to somebody for 55 minutes about their feelings. I’ve done that hundreds of times with a counselor, and it works for me, but it doesn’t work for all men.”

Now Cook is helping lead a Massachusetts suicide prevention campaign centered around a new website called MassMen.org. It was created by the Wellesley-based organization Screening for Mental Health, with funding from the state Department of Public Health.

On the site, people can complete an anonymous mental health screening in about two minutes to find out whether their feelings and behaviors are consistent with depression or another mental health disorder. They get results immediately and after the screening a “video doctor” does an interactive assessment.

“I’m concerned about your symptoms. I want to be sure you’re aware of the impact this can have on your health and well-being,” the video doctor, portrayed by an actor, says in one portion of the segment. “To help me understand how you feel about taking steps to feel less depressed, I have a question for you. On a scale of one to nine, how ready would you say you are to take steps to feel better?”

Candice Porter is executive director of Screening for Mental Health and a clinical social worker. She points out that while middle-aged men have the highest suicide rate, many of them may not be “moping around,” appearing overtly sad or depressed.

“They might mask their symptoms in a lot of ways that we’re not recognizing, and they’re not seeking the help,” Porter says. But she adds that even though the men might not seek counseling or treatment, many people who die by suicide visit their doctor for some physical ailment in the months leading up to their death.

“We do know that the primary care physicians are not asking the question, ‘How are you feeling? Are you depressed? Have you had thoughts of wanting to end your life?'” Porter explains. “So part of what we’re also trying to do is just increase awareness that these questions should be asked.”

The MassMen site also directs users to resources including mental health services in their communities.

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