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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State Launches Opioid Addiction Awareness Campaign Aimed At Parents

A screenshot from a new state public service announcement about addiction. (YouTube)

A screenshot from a new public service announcement, created by the state, about opioid addiction. (YouTube)

Calling education an “essential part of the cure for this epidemic,” Gov. Charlie Baker on Wednesday announced the launch of an opioid addiction awareness campaign aimed at parents.

The “Stop Addiction In Its Tracks” campaign is a recommendation of Gov. Baker’s opioid abuse task force, which was charged with developing a statewide strategy for combating addiction. The group is set to announce its full slate of recommendations next week.

The campaign includes TV and digital ads that will run through the end of July, pointing people to a new state website — mass.gov/StopAddiction. The website offers information on warning signs of opioid addiction; a list of commonly misused prescription medications; a guide for how guardians can talk to kids of different ages about the dangers of opioid misuse; information on Narcan, a medication that can reverse the effects of an overdose; as well as how to get help.

“With this messaging, we are impressing on parents that the road to heroin could start with what is left in our own homes and medicine cabinets,” Health and Human Services Secretary Marylou Sudders said in a statement. Continue reading

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I Bought Narcan, And Here’s What I Learned

Evzio's "Trainer" (Jesse Costa/WBUR)

Evzio’s “Trainer” (Jesse Costa/WBUR)

I walked into a CVS across the street from WBUR this week to get some naloxone, which you might know by the brand name, Narcan. It temporarily reverses the effects of an opioid overdose and restores breathing.

For me, the purchase is not urgent. But I saw a woman in a cafe restroom recently who was in rough shape, I have a cousin who’s managing his addiction to heroin, I’m reporting on this issue, and I have three teenagers. I decided I wanted to be ready to help.

I asked the pharmacist for Evzio. It’s a newish option, an injectable form of naloxone, kind of like an EpiPen. Mark Herzog, a VP at Kaleo, the company that makes Evzio, handed me the “trainer” (pictured above) at a conference. It comes in a kit along with two injection canisters. Continue reading

Mass. Adopts Final ICU Nurse Staffing Rules

The 2014 nurse staffing law will apply to burn units and intensive care for newborns along with intensive care units for adults, under final regulations adopted by the Health Policy Commission on Wednesday.

Passed by the Legislature in part to avoid a ballot referendum, the law required each ICU nurse be assigned only up to two patients, and only one patient if that is what is required.

An acuity tool would be used to determine the nursing needs of patients, under the regulations approved on a voice vote Wednesday.

The final regulations designate March 31, 2016, as the acuity tool deadline for academic hospital ICUs, and push back the deadline at community hospitals and in neonatal ICUs to Jan. 31, 2017.

“All of us are committed to really high quality patient care, and I would really prefer to not see this have to be rigidly written in law and regulation, but that’s where we are,” Health and Human Services Secretary Marylou Sudders, who is on the commission, said after the vote.

The regulations drew a mixed response from nurses and a warning from a health care workers against cutting hospital jobs. Continue reading

Too Restrictive? Marijuana Labs Raise Concerns About Mass. Lead Regulations

The state’s first medical marijuana dispensary is expected to open in Salem later this month. But it may not have any actual dried marijuana for sale.

The main problem: lead.

“To date, every sample of cannabis that we have tested for heavy metals, particularly lead, would fail the existing regulations  TWEET ,” said Chris Hudalla, the chief scientific officer at ProVerde Laboratories, one of two marijuana testing facilities in Massachusetts.

Hudalla says there is no question that elevated lead levels would be dangerous for patients. But he claims the state standard is too restrictive and unrealistic. It is based on the assumption that patients will ingest 1 ounce a day — much more than most patients would reasonably use.

The amount of lead allowed in Massachusetts (212 parts per billion) is nearly 14 times lower than Connecticut and almost 50 times lower than what’s permitted by Colorado. Continue reading

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Your Doctor, Always Available, For A Monthly Fee

For 10 years, Jeff Gold showed up to a job he wanted to love: being a family doctor.

“I was busy as a bee,” says Gold, 39, with up to 2,500 patients, seeing 20 or so a day.

Dr. Jeff Gold runs a direct primary care office in Marblehead. (Martha Bebinger/WBUR)

Dr. Jeff Gold runs a direct primary care office in Marblehead. (Martha Bebinger/WBUR)

Rushing from one patient to the next, calling insurers who wouldn’t approve prescriptions, filling out paperwork that didn’t seem relevant to his patients, Gold kept asking himself, is this what I signed up for?

“I thought I was gonna help everybody and spend time with everybody and it’s impossible to do,” Gold says.

So Gold quit, wrote a business plan to be a doctor who does not take insurance, hired one staff member (a nurse), and borrowed almost $400,000 to outfit a two-exam-room office next to a candy shop and café in Marblehead.

Gold may be the first physician in Massachusetts practicing under a model called direct primary care. For a flat monthly fee, Gold offers patients one-hour same-day appointments, no wait. The doctor is available 24/7 in person, at the office, at the patient’s home, via text, email or Skype. Continue reading

Financial Relief Finally On Its Way For Meningitis Outbreak Victims

A vial of injectable steroids from the New England Compounding Center is displayed in the Tennessee Department of Health back in 2012. (Kristin M. Hall/AP)

A vial of injectable steroids from the New England Compounding Center is displayed in the Tennessee Department of Health back in 2012. (Kristin M. Hall/AP)

Lyn Laperriere, a retired automobile industry worker living in Michigan, was having back pain in the fall of 2012 when he received a dose of steroids produced at the former New England Compounding Center in Framingham.

Lapperiere was a drag racer and was looking forward to the winter bowling season. But a week after receiving the shot he checked into a hospital. Forty-two days later, his wife Penny Laperriere agreed to take him off life support. He was 61.

“We did everything together,” Penny Laperriere recalled. “So when he passed away, life for me came to a screeching halt too.”

Lyn Laperriere was one of 64 people who died after receiving a dose of steroids produced at the former New England Compounding Center in Framingham. (Courtesy Penny Laperriere)

Lyn Laperriere was one of 64 people who died after receiving a dose of steroids produced at the former New England Compounding Center in Framingham. (Courtesy Penny Laperriere)

More than two and a half years after NECC recalled all of its products after steroids the compounding pharmacy produced were linked to a nationwide meningitis outbreak, some financial relief may finally be on its way for the relatives of the 64 who died and the 750 who were sickened as a result of receiving injections of the tainted drugs.

A federal bankruptcy judge on Tuesday indicated he would approve a $200 million settlement to compensate NECC’s creditors, including victims of the outbreak.

‘There’s Been No Financial Help’

Penny Laperriere, who’s now 58, couldn’t afford to keep the house she’d shared with her husband. She had an auction to sell off the couple’s things and moved close to her sister. She’s received lots of bills, but no money to help with what became the deadliest case of contaminated medicine in the country’s history.

“That’s the hard part, there’s been no financial help for me or any of the patients who are still living with this,” she said.

Laperriere started a support group for victims of fungal meningitis who’ve had to cash in retirement funds, file bankruptcy and still face mounting medical bills. Patients and those who lost loved ones will file claims for a share of the $200 million settlement beginning next month.

Laperriere has no idea what to expect. “Anything I get will be a gift,” she said. “I’m not expecting much because there are so many hands in the pot.” Continue reading

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Cancer Haves And Have-Nots: Care And Treatment In 2 Different Worlds

By Michael J. Misialek, M.D.
Guest Contributor

Imagine feeling a lump on your body, visiting a doctor, and then waiting seven months (if you’re lucky) to find out whether it is cancer.

This has been the reality for the vast majority of patients in two of the world’s most impoverished nations, Rwanda and Haiti — both emerging from different but unthinkably grim histories of structural violence.

But since 2012, more patients are getting the care that everyone deserves, no matter what country they live in. A medical partnership between several Boston-based hospitals has radically reduced turnaround time for cancer diagnosis, and shrunk the number of people who fall through the cracks.

It is difficult to quantify the exact numbers here, since record keeping in the past has been poor. One data point: In Rwanda, where these interventions are in place, far fewer patients are lost to follow-up after they’ve been treated compared to patients in other poor countries, according to Dr. Larry Shulman, senior vice president for medical affairs at Dana-Farber Cancer Institute, and leader of the medical partnership.

As a pathologist at of one of these partner institutions — Newton-Wellesley Hospital — I can’t help but think about the patient behind the slides under the microscope. Here’s one: Tushime, an 11-year-old Rwandan girl, who had a large tumor protruding from her jaw.

The tissue sample from Tushime’s tumor arrived in Boston in a suitcase carried by an employee of Partners in Health, the global nonprofit. Like all other specimens, hers was processed into a slide by the pathology department of Brigham and Women’s Hospital and read by Harvard faculty.

Tushime’s tumor turned out to be a rhabdomyosarcoma, a common childhood sarcoma. After 48 weeks of chemotherapy and surgery in Rwanda, she is now healthy and free of disease. Doctors there used standard chemotherapy for a cost of about $300 (which was covered by Partners in Health, Dana Farber and the Rwandan government). They relied on age-old, tried and true chemotherapy drugs; in comparison, the newer chemotherapy agents in the U.S. often cost several thousands of dollars.

Even though access to care has improved dramatically in the developing world there is so much work to be done. There are patients who still present with tumors at an advanced stage, many being neglected for months or even years because of barriers to care. There’s often a lack of access to facilities for both diagnosis and treatment, and funding for cancer care is limited. As a result, ordinary diagnoses become extraordinary.

This is an image of a less aggressive (low grade) breast cancer, something that is fairly common among patients in the U.S. You can see the well formed tubules and glands of cancer, but fewer tumor cells growing in a more organized fashion -- only about 30 percent of the image is tumor. (Courtesy of Michael J. Misialek)

This is an image of a less aggressive (low grade) breast cancer, something that is fairly common among patients in the U.S. You can see the well formed tubules and glands of cancer, but fewer tumor cells growing in a more organized fashion — only about 30 percent of the image is tumor. (Courtesy of Michael J. Misialek)

This is an image of an aggressive (high grade) breast cancer not uncommonly diagnosed among patients in countries where access to medical care is limited, such as Haiti. You can see a solid mass of cancer -- the photo is 100 percent tumor. (Courtesy of Michael J. Misialek)

This is an image of an aggressive (high grade) breast cancer not uncommonly diagnosed among patients in countries where access to medical care is limited, such as Haiti. You can see a solid mass of cancer — the photo is 100 percent tumor. (Courtesy of Michael J. Misialek)

Under my microscope, I’ve seen some of the most aggressive appearing tumors from patients in these countries. What are typically rare cancers here in the U.S., such as sarcomas or unusual variants of breast cancers, are all too common in developing nations. Continue reading

Boston Medical Center And Tufts Medical Center End Merger Talks

(Kalman Zabarsky/BU)

(Kalman Zabarsky/BU)

Boston Medical Center and Tufts Medical Center announced Wednesday that they are ending merger talks.

The two nonprofit hospitals, which had been in talks since last year, said in a statement that both sides “determined that at this time it is best for our medical centers to remain separate.”

Here’s the full statement from BMC President Kate Walsh and Tufts President Michael Wagner:

Over the last several months, Tufts Medical Center and Boston Medical Center have carefully considered how we might combine our two organizations. We have had thoughtful conversations and considered different options for tackling the complex task of integrating two vital, but different, academic medical centers. After much consideration, we have determined that at this time it is best for our medical centers to remain separate. We conclude these discussions with great respect for each organization’s mission and remain open to future opportunities for collaboration as neighboring institutions.

Continue reading

A Life Filled With Promise Is Overpowered By A Complex Web Of Pain And Trauma

Jamie Neal's family -- her father Bob, mother Debbie and brother Abe -- at their church in Duxbury (Jesse Costa/WBUR)

Jamie Neal’s family — her father Bob, mother Debbie and brother Abe — at their church in Duxbury (Jesse Costa/WBUR)

When Jamie Neal was home on medical leave from Williams College in early 2010, her parents were going to great lengths to try to protect her.

“I knew she was suicidal,” says Jamie’s mother, Debbie Neal. “My husband and I decided we would do everything to keep her alive.”

Several months earlier, in August 2009, the Duxbury resident had made a suicide attempt that left her in a coma for several days.

“The last few months before she died, I had her sleep in my bed next to me,” Debbie Neal explains. “And every single day, I asked her on a [scale of] 1 to 10 how she felt and was she suicidal. And she would tell me that she was a 5 and that she wasn’t suicidal.”

In March of 2010, the 21-year-old killed herself in the family’s home. Suicide had become her desperate attempt to escape a complex web of pain and trauma: not only mental illness, but sexual assault and drug addiction — a dark journey in a life filled with so much promise.

CAPTION

Jamie Neal was a member of three varsity sports teams beginning her freshman year at Duxbury High School. She was recruited to play basketball at Williams College. (Courtesy the Neal family)

Like many other survivors of suicide, the Neals recall a loved one who was outwardly happy — even, in Jamie’s case, “outrageously fun.” She had a ready smile.

“Jamie was always, always smiling,” Debbie Neal says. “It kind of defined who she was. She loved other people who were struggling. And she was very kind, and she had a beautiful heart.”

There were some signs early on that Jamie might have mental health issues. A nursery school teacher noticed the normally cheerful, outgoing girl would sometimes withdraw into a sad state. And the straight-A student was a perfectionist in everything she did.

“That perfectionism drove her and motivated her,” says Jamie’s brother, Abe Neal. “On the other hand, I don’t want to say it necessarily did her in. But it was very difficult for her. You would find her at four in the morning editing some minor paper for an English class. And she was also very hard on herself as things started going downhill with herself.” Continue reading

After Cluster Of Suicides, MIT Works To Relieve Student Pressure, Raise Awareness

Student climb the steps of the Rogers building at MIT. (Robin Lubbock/WBUR)

Students climb the steps of the Rogers building at MIT. (Robin Lubbock/WBUR)

On a recent sunny spring day, MIT students were lined up at a table grabbing ice cream sundaes, milk and cookies, and, if they were interested, an embrace.

“Yes, giving away ice cream and now hugs,” explained MIT parent Sonal Patel, of Cambridge, as she embraced Miguel Mendez, a native of Mexico who is doing post-doctoral research at MIT.

“It’s always good to know that people around the campus actually care about you as a person,” Mendez said. “This being an institution that expects a lot from you, it can really pass a toll on you sometimes.”

The event was billed as “Stress Less Day,” a chance for people at the university that churns out many of the world’s top engineers and scientists to take a break from problem sets, exams and research.

The snack break was sponsored by the student group Active Minds, which promotes mental health awareness. Volunteers handed out flyers with facts on depression and anxiety, as well mental health resources at MIT.

Active Minds raised awareness about their group during MIT's campus preview weekend for incoming freshman. (Robin Lubbock/WBUR)

Active Minds raised awareness about their group during MIT’s campus preview weekend for incoming freshman last month. (Robin Lubbock/WBUR)

Following six student suicides since March 2014, Active Minds and other student groups have seen increased interest in their events designed to reduce stress, promote a sense of community and reduce stigma.

MIT is not the only higher education institution to struggle with suicide clusters. But the school and its students, widely considered among the world’s most elite, are taking some very open steps to confront the problem. Continue reading

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