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"content": "\u003cp>It's been clear for many years that vitamin D helps keep bones strong, but studies have been inconclusive and conflicting about the vitamin's value in protecting against certain cancers, including \u003ca href=\"https://www.cancer.gov/types/colorectal\" target=\"_blank\" rel=\"noopener\">colorectal cancer\u003c/a>.[contextly_sidebar id=\"9k4uFVtwqiLPQYTYxUgc0nIsJORbVOWp\"]\u003c/p>\n\u003cp>Now a large international \u003ca href=\"https://academic.oup.com/jnci/article-lookup/doi/10.1093/jnci/djy087\" target=\"_blank\" rel=\"noopener\">study\u003c/a> provides the strongest evidence yet that vitamin D may indeed be protective against colorectal cancer and that a deficiency may increase the risk of this cancer. The findings appear Thursday in the \u003cem>Journal of the National Cancer Institute\u003c/em>.\u003c/p>\n\u003cp>\"For both men and women, deficient levels of vitamin D were associated with a 30 percent increased risk of colorectal cancer,\" says \u003ca href=\"https://www.cancer.org/research/acs-researchers/marjorie-mccullough-bio.html\" target=\"_blank\" rel=\"noopener\">Marji McCullough\u003c/a>, a nutritional epidemiologist with the American Cancer Society and study co-author. People who had higher circulating blood levels of vitamin D\u003cstrong>, \u003c/strong>above the range deemed \"sufficient,\" had a 22 percent lower risk, she says.\u003c/p>\n\u003cp>The study pooled findings from 17 previous studies that included 12,813 adults in the U.S., Europe and Asia. Those studies collectively looked at 5,706 people with colorectal cancer and 7,107 people of a similar age and race who didn't have cancer. Women's menopausal status was also taken into account.\u003c/p>\n\u003cp>To determine what role vitamin D might be playing, researchers looked at participants' blood samples collected in the years before their cancer diagnosis. They also considered the established risk factors for colorectal cancer, including smoking, low physical activity and high body mass index.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"Our findings suggest what's optimal for bone health may not be optimal for colorectal risk reduction,\" McCullough says, which could mean higher doses are needed to prevent cancer. Current recommendations for vitamin D supplementation are based solely on studies showing conclusively that it does preserve bone health.\u003c/p>\n\u003cp>A particularly provocative finding of the study, McCullough says, is the relatively strong correlation between higher blood levels of vitamin D and lower risk of colorectal cancer in women.\u003c/p>\n\u003cp>\"We don't know why,\" she says. One hypothesis is that there is some interaction between vitamin D and female hormones. Or it's possible vitamin D prevents cancer by reducing the proliferation of tumor cells or by stopping their growth and \"actually killing those cells,\" she says.\u003c/p>\n\u003cp>Studies like this do not prove cause and effect but rather show only that there may be a connection between the levels of vitamin D circulating through the body and cancer. Still, the authors of the paper write that the results \"substantially strengthen the evidence, previously considered inconclusive, for a causal relationship\" between low vitamin D levels and colorectal cancer.[contextly_sidebar id=\"MAqLylPcwu1QCC3r4WiQXhzaSDOZfRPb\"]\u003c/p>\n\u003cp>Another interesting observation in the study, McCullough says, was that beyond a certain level, increasingly higher amounts of vitamin D in the blood had no additional benefit. At the highest levels above what is considered \"adequate,\" there was no further reduction in risk. In other words, she says, \"more is not necessarily better.\"\u003c/p>\n\u003cp>Her take-home message: Don't race out and buy high doses of vitamin D \"just in case.\" Overdoing it can be toxic. Taking too much vitamin D can cause kidney stones and, in very rare cases, death.\u003c/p>\n\u003cp>The issue of whether vitamin D supplements should be used at all to prevent colorectal cancer is still up in the air. \"The key question now is whether intervening with people who have low levels of vitamin D can make a difference,\" says \u003ca href=\"http://www.dana-farber.org/find-a-doctor/jeffrey-a-meyerhardt/\" target=\"_blank\" rel=\"noopener\">Dr. Jeffrey Meyerhardt\u003c/a>, director of the Gastrointestinal Cancer Center at Dana-Farber Cancer Institute in Boston, who was not involved in the study.\u003c/p>\n\u003cp>The study didn't evaluate whether adding vitamin D through food, sunlight or supplements made a difference in cancer risk. It was limited to looking at the level of vitamin D in people's blood.\u003c/p>\n\u003cp>Currently, a large \u003ca href=\"https://www.vitalstudy.org/\" target=\"_blank\" rel=\"noopener\">study\u003c/a> involving more than 25,000 patients is underway at Brigham and Women's Hospital in Boston to find out whether taking vitamin D supplements might reduce the risk of numerous cancers as well as heart disease and stroke. Meyerhardt says answers may be available in the coming year.\u003c/p>\n\u003cp>In the meantime, he suggests people talk with their health care provider about having a blood test to measure vitamin D levels. If you're starting in the deficient range, he says, some doctors might prescribe high doses, to be taken each week for a month or two, and then prescribe lower, maintenance levels.[contextly_sidebar id=\"x4oXchtt2cZV7lIWDVrGT7XXeJne7cWq\"]\u003c/p>\n\u003cp>The cancer society's McCullough says it is generally \u003ca href=\"https://www.bones.nih.gov/health-info/bone/bone-health/nutrition/calcium-and-vitamin-d-important-every-age\" target=\"_blank\" rel=\"noopener\">recommended\u003c/a> that adults have a daily intake of 600 international units of vitamin D up to age 70. Men and women over age 70 should increase their uptake to 800 IUs daily, she says.\u003c/p>\n\u003cp>People should talk with their doctor because different individuals have different needs, she says.\u003c/p>\n\u003cp>\"It depends on where you live and what race you are, because darker skin tends to absorb less vitamin D.\" Sun, age, genetics and weight also play a role in how the body processes vitamin D.\u003c/p>\n\u003cp>Vitamin D can be obtained from vitamin D-rich foods such as egg yolks, salmon, trout, swordfish, tuna and sardines. Numerous foods are fortified with vitamin D including cow's milk, almond milk, soy milk, some cereals and some orange juices.\u003c/p>\n\u003cp>\"If you have a serving of salmon, that's about 500 IUs, and a cup of milk would give you 100 IUs,\" McCullough says, which adds up to the daily recommended dose of 600 IUs.\u003c/p>\n\u003cp>But Meyerhardt says most people don't eat enough fatty fish to reach the recommended vitamin D intake.\u003c/p>\n\u003cp>\"Most vitamin D doesn't really come from your diet\" in most cases, he says. And he says multivitamins contain relatively low levels of vitamin D. \"So you really have to take a supplement\" to meet recommended doses.\u003c/p>\n\u003cp>Vitamin D is often called the \"sunshine\" vitamin, because exposure to sunlight can stimulate production of the vitamin. But exposure to sun is generally not recommended as a way to boost vitamin D, McCullough says, since at excessive levels it can raise the risk of melanoma and other skin cancers.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>More than 20 medical centers and organizations participated in the study, including Harvard, the American Cancer Society and the National Cancer Institute.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Does+Vitamin+D+Really+Protect+Against+Colorectal+Cancer%3F&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"excerpt": "The jury's been out on whether low blood levels of vitamin D increase the risk of colorectal cancer. Researchers say a new review involving more than 12,000 people strongly suggests the answer is yes.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>It's been clear for many years that vitamin D helps keep bones strong, but studies have been inconclusive and conflicting about the vitamin's value in protecting against certain cancers, including \u003ca href=\"https://www.cancer.gov/types/colorectal\" target=\"_blank\" rel=\"noopener\">colorectal cancer\u003c/a>.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Now a large international \u003ca href=\"https://academic.oup.com/jnci/article-lookup/doi/10.1093/jnci/djy087\" target=\"_blank\" rel=\"noopener\">study\u003c/a> provides the strongest evidence yet that vitamin D may indeed be protective against colorectal cancer and that a deficiency may increase the risk of this cancer. The findings appear Thursday in the \u003cem>Journal of the National Cancer Institute\u003c/em>.\u003c/p>\n\u003cp>\"For both men and women, deficient levels of vitamin D were associated with a 30 percent increased risk of colorectal cancer,\" says \u003ca href=\"https://www.cancer.org/research/acs-researchers/marjorie-mccullough-bio.html\" target=\"_blank\" rel=\"noopener\">Marji McCullough\u003c/a>, a nutritional epidemiologist with the American Cancer Society and study co-author. People who had higher circulating blood levels of vitamin D\u003cstrong>, \u003c/strong>above the range deemed \"sufficient,\" had a 22 percent lower risk, she says.\u003c/p>\n\u003cp>The study pooled findings from 17 previous studies that included 12,813 adults in the U.S., Europe and Asia. Those studies collectively looked at 5,706 people with colorectal cancer and 7,107 people of a similar age and race who didn't have cancer. Women's menopausal status was also taken into account.\u003c/p>\n\u003cp>To determine what role vitamin D might be playing, researchers looked at participants' blood samples collected in the years before their cancer diagnosis. They also considered the established risk factors for colorectal cancer, including smoking, low physical activity and high body mass index.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"Our findings suggest what's optimal for bone health may not be optimal for colorectal risk reduction,\" McCullough says, which could mean higher doses are needed to prevent cancer. Current recommendations for vitamin D supplementation are based solely on studies showing conclusively that it does preserve bone health.\u003c/p>\n\u003cp>A particularly provocative finding of the study, McCullough says, is the relatively strong correlation between higher blood levels of vitamin D and lower risk of colorectal cancer in women.\u003c/p>\n\u003cp>\"We don't know why,\" she says. One hypothesis is that there is some interaction between vitamin D and female hormones. Or it's possible vitamin D prevents cancer by reducing the proliferation of tumor cells or by stopping their growth and \"actually killing those cells,\" she says.\u003c/p>\n\u003cp>Studies like this do not prove cause and effect but rather show only that there may be a connection between the levels of vitamin D circulating through the body and cancer. Still, the authors of the paper write that the results \"substantially strengthen the evidence, previously considered inconclusive, for a causal relationship\" between low vitamin D levels and colorectal cancer.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Another interesting observation in the study, McCullough says, was that beyond a certain level, increasingly higher amounts of vitamin D in the blood had no additional benefit. At the highest levels above what is considered \"adequate,\" there was no further reduction in risk. In other words, she says, \"more is not necessarily better.\"\u003c/p>\n\u003cp>Her take-home message: Don't race out and buy high doses of vitamin D \"just in case.\" Overdoing it can be toxic. Taking too much vitamin D can cause kidney stones and, in very rare cases, death.\u003c/p>\n\u003cp>The issue of whether vitamin D supplements should be used at all to prevent colorectal cancer is still up in the air. \"The key question now is whether intervening with people who have low levels of vitamin D can make a difference,\" says \u003ca href=\"http://www.dana-farber.org/find-a-doctor/jeffrey-a-meyerhardt/\" target=\"_blank\" rel=\"noopener\">Dr. Jeffrey Meyerhardt\u003c/a>, director of the Gastrointestinal Cancer Center at Dana-Farber Cancer Institute in Boston, who was not involved in the study.\u003c/p>\n\u003cp>The study didn't evaluate whether adding vitamin D through food, sunlight or supplements made a difference in cancer risk. It was limited to looking at the level of vitamin D in people's blood.\u003c/p>\n\u003cp>Currently, a large \u003ca href=\"https://www.vitalstudy.org/\" target=\"_blank\" rel=\"noopener\">study\u003c/a> involving more than 25,000 patients is underway at Brigham and Women's Hospital in Boston to find out whether taking vitamin D supplements might reduce the risk of numerous cancers as well as heart disease and stroke. Meyerhardt says answers may be available in the coming year.\u003c/p>\n\u003cp>In the meantime, he suggests people talk with their health care provider about having a blood test to measure vitamin D levels. If you're starting in the deficient range, he says, some doctors might prescribe high doses, to be taken each week for a month or two, and then prescribe lower, maintenance levels.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The cancer society's McCullough says it is generally \u003ca href=\"https://www.bones.nih.gov/health-info/bone/bone-health/nutrition/calcium-and-vitamin-d-important-every-age\" target=\"_blank\" rel=\"noopener\">recommended\u003c/a> that adults have a daily intake of 600 international units of vitamin D up to age 70. Men and women over age 70 should increase their uptake to 800 IUs daily, she says.\u003c/p>\n\u003cp>People should talk with their doctor because different individuals have different needs, she says.\u003c/p>\n\u003cp>\"It depends on where you live and what race you are, because darker skin tends to absorb less vitamin D.\" Sun, age, genetics and weight also play a role in how the body processes vitamin D.\u003c/p>\n\u003cp>Vitamin D can be obtained from vitamin D-rich foods such as egg yolks, salmon, trout, swordfish, tuna and sardines. Numerous foods are fortified with vitamin D including cow's milk, almond milk, soy milk, some cereals and some orange juices.\u003c/p>\n\u003cp>\"If you have a serving of salmon, that's about 500 IUs, and a cup of milk would give you 100 IUs,\" McCullough says, which adds up to the daily recommended dose of 600 IUs.\u003c/p>\n\u003cp>But Meyerhardt says most people don't eat enough fatty fish to reach the recommended vitamin D intake.\u003c/p>\n\u003cp>\"Most vitamin D doesn't really come from your diet\" in most cases, he says. And he says multivitamins contain relatively low levels of vitamin D. \"So you really have to take a supplement\" to meet recommended doses.\u003c/p>\n\u003cp>Vitamin D is often called the \"sunshine\" vitamin, because exposure to sunlight can stimulate production of the vitamin. But exposure to sun is generally not recommended as a way to boost vitamin D, McCullough says, since at excessive levels it can raise the risk of melanoma and other skin cancers.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>More than 20 medical centers and organizations participated in the study, including Harvard, the American Cancer Society and the National Cancer Institute.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Does+Vitamin+D+Really+Protect+Against+Colorectal+Cancer%3F&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Doctors Told Not To Order Electrocardiograms For Low-Risk Patients",
"title": "Doctors Told Not To Order Electrocardiograms For Low-Risk Patients",
"headTitle": "KQED Future of You | KQED Science",
"content": "\u003cp>Doctors shouldn't routinely perform electrocardiograms on patients at low risk for heart disease, an influential federal panel is recommending.[contextly_sidebar id=\"e1JGLWb5PPSqJTZMPu1oxhGludnQREkn\"]\u003c/p>\n\u003cp>While an ECG test of the heart's electrical activity is safe and inexpensive, the benefits for patients at low risk of heart disease are very low and the results can trigger possibly dangerous, unnecessary follow-up testing and treatment, according to the \u003ca href=\"https://www.uspreventiveservicestaskforce.org/\" target=\"_blank\" rel=\"noopener\">U.S. Preventive Services Task Force\u003c/a>.\u003c/p>\n\u003cp>\"In low-risk people, definitely don't do it,\" says \u003ca href=\"https://apps.medicine.uab.edu/facultydirectory/FacultyData.asp?Entity=SOM&FID=55574\" target=\"_blank\" rel=\"noopener\">Dr. Seth Landefeld\u003c/a>, chairman of the department of medicine at the University of Alabama at Birmingham. Landefeld is on the committee that developed the recommendations.\u003c/p>\n\u003cp>The \u003ca href=\"https://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.2018.6848\" target=\"_blank\" rel=\"noopener\">recommendation against routine ECGs in low-risk patients\u003c/a> was published Tuesday in \u003cem>JAMA,\u003c/em> the \u003cem>Journal of the American Medical Association\u003c/em>.\u003c/p>\n\u003cp>\"In people who are at low risk for cardiovascular disease, there is no evidence of benefits of doing ECG screening that would outweigh the possible harms,\" he says. \"And, in fact, the harms may well outweigh the benefits.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>For example, in rare cases, follow-up tests like \u003ca href=\"https://www.mayoclinic.org/tests-procedures/coronary-angiogram/about/pac-20384904\" target=\"_blank\" rel=\"noopener\">angiograms\u003c/a> can inadvertently damage the heart, Landefeld says.\u003c/p>\n\u003cp>Other doctors welcomed the new recommendations, noting they are consistent with those of many other medical groups. \"I think their recommendations are very reasonable,\" says \u003ca href=\"https://medicine.tulane.edu/departments/medicine-cardiology-clinical-radiology/faculty/robert-c-hendel-md\" target=\"_blank\" rel=\"noopener\">Robert Hendel\u003c/a>, chief of cardiology at Tulane University, speaking on behalf of the American College of Cardiology.[contextly_sidebar id=\"0v58FJHtga8wMvZaz5r88FbZKH9Smcv6\"]\u003c/p>\n\u003cp>ECGs use electrodes to measure the electrical activity of the heart and can identify irregular rhythms. Despite years of recommendations against routine ECGs, data collected by the National Center for Health Statistics \u003ca href=\"https://www.cdc.gov/nchs/data/ahcd/namcs_summary/2015_namcs_web_tables.pdf\" target=\"_blank\" rel=\"noopener\">indicate\u003c/a> the test is done as part of about 4 percent of routine exams. In 2015, the National Ambulatory Medical Care Survey \u003ca href=\"https://www.cdc.gov/nchs/data/ahcd/namcs_summary/2015_namcs_web_tables.pdf\" target=\"_blank\" rel=\"noopener\">found that about 40 million ECGs \u003c/a>were performed in doctors' offices.\u003c/p>\n\u003cp>Hendel and others hope the uniformity of the recommendations will finally persuade more doctors to stop using the test so commonly.\u003c/p>\n\u003cp>\"If there's really no benefit and it may open a can of worms, then why are we doing it?\" Hendel says.\u003c/p>\n\u003cp>Other routine tests that spot risk factors, such as high blood pressure and cholesterol, are much more useful in identifying people at elevated risk for heart attacks and strokes, the panel and others say. \u003ca href=\"https://www.cdc.gov/heartdisease/index.htm\" target=\"_blank\" rel=\"noopener\">Cardiovascular disease\u003c/a> is the leading cause of death in the United States.[contextly_sidebar id=\"aKFvcSrIqI0Llzq9ccxeP2ojnieKP0Vz\"]\u003c/p>\n\u003cp>\"What's happened is that the conventional risk factors have become so strong and so useful in preventing heart disease that the value of doing a routine ECG as part of an annual physical has faded,\" says \u003ca href=\"http://uhealthsystem.com/doctors/profile/1114\" target=\"_blank\" rel=\"noopener\">Dr. Robert Myerburg\u003c/a>, a professor of medicine at the University of Miami Miller School of Medicine, who wrote an editorial accompanying the recommendations.\u003c/p>\n\u003cp>But many doctors have continued to offer the test, often because patients want it, he says. An uncomplicated ECG on a patient at rest commonly costs about $50.\u003c/p>\n\u003cp>The panel concluded there was insufficient evidence to recommend for or against doing ECGs for people considered to be moderate or high risk because they have some other risk factors, such as high blood pressure or diabetes. So doctors should decide whether to order the test for those patients on an individual basis, the panel says.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Some patients might also consider getting one ECG to have as a baseline for comparison later in life, Tulane's Hendel says.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Doctors+Told+Not+To+Order+Electrocardiograms+For+Low-Risk+Patients&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"excerpt": "The U.S. Preventive Services Task Force says the benefits from routine electrocardiograms in people at low risk of heart disease don't outweigh the harms from unnecessary follow-up tests.",
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"description": "The U.S. Preventive Services Task Force says the benefits from routine electrocardiograms in people at low risk of heart disease don't outweigh the harms from unnecessary follow-up tests.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Doctors shouldn't routinely perform electrocardiograms on patients at low risk for heart disease, an influential federal panel is recommending.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>While an ECG test of the heart's electrical activity is safe and inexpensive, the benefits for patients at low risk of heart disease are very low and the results can trigger possibly dangerous, unnecessary follow-up testing and treatment, according to the \u003ca href=\"https://www.uspreventiveservicestaskforce.org/\" target=\"_blank\" rel=\"noopener\">U.S. Preventive Services Task Force\u003c/a>.\u003c/p>\n\u003cp>\"In low-risk people, definitely don't do it,\" says \u003ca href=\"https://apps.medicine.uab.edu/facultydirectory/FacultyData.asp?Entity=SOM&FID=55574\" target=\"_blank\" rel=\"noopener\">Dr. Seth Landefeld\u003c/a>, chairman of the department of medicine at the University of Alabama at Birmingham. Landefeld is on the committee that developed the recommendations.\u003c/p>\n\u003cp>The \u003ca href=\"https://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.2018.6848\" target=\"_blank\" rel=\"noopener\">recommendation against routine ECGs in low-risk patients\u003c/a> was published Tuesday in \u003cem>JAMA,\u003c/em> the \u003cem>Journal of the American Medical Association\u003c/em>.\u003c/p>\n\u003cp>\"In people who are at low risk for cardiovascular disease, there is no evidence of benefits of doing ECG screening that would outweigh the possible harms,\" he says. \"And, in fact, the harms may well outweigh the benefits.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>For example, in rare cases, follow-up tests like \u003ca href=\"https://www.mayoclinic.org/tests-procedures/coronary-angiogram/about/pac-20384904\" target=\"_blank\" rel=\"noopener\">angiograms\u003c/a> can inadvertently damage the heart, Landefeld says.\u003c/p>\n\u003cp>Other doctors welcomed the new recommendations, noting they are consistent with those of many other medical groups. \"I think their recommendations are very reasonable,\" says \u003ca href=\"https://medicine.tulane.edu/departments/medicine-cardiology-clinical-radiology/faculty/robert-c-hendel-md\" target=\"_blank\" rel=\"noopener\">Robert Hendel\u003c/a>, chief of cardiology at Tulane University, speaking on behalf of the American College of Cardiology.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>ECGs use electrodes to measure the electrical activity of the heart and can identify irregular rhythms. Despite years of recommendations against routine ECGs, data collected by the National Center for Health Statistics \u003ca href=\"https://www.cdc.gov/nchs/data/ahcd/namcs_summary/2015_namcs_web_tables.pdf\" target=\"_blank\" rel=\"noopener\">indicate\u003c/a> the test is done as part of about 4 percent of routine exams. In 2015, the National Ambulatory Medical Care Survey \u003ca href=\"https://www.cdc.gov/nchs/data/ahcd/namcs_summary/2015_namcs_web_tables.pdf\" target=\"_blank\" rel=\"noopener\">found that about 40 million ECGs \u003c/a>were performed in doctors' offices.\u003c/p>\n\u003cp>Hendel and others hope the uniformity of the recommendations will finally persuade more doctors to stop using the test so commonly.\u003c/p>\n\u003cp>\"If there's really no benefit and it may open a can of worms, then why are we doing it?\" Hendel says.\u003c/p>\n\u003cp>Other routine tests that spot risk factors, such as high blood pressure and cholesterol, are much more useful in identifying people at elevated risk for heart attacks and strokes, the panel and others say. \u003ca href=\"https://www.cdc.gov/heartdisease/index.htm\" target=\"_blank\" rel=\"noopener\">Cardiovascular disease\u003c/a> is the leading cause of death in the United States.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\"What's happened is that the conventional risk factors have become so strong and so useful in preventing heart disease that the value of doing a routine ECG as part of an annual physical has faded,\" says \u003ca href=\"http://uhealthsystem.com/doctors/profile/1114\" target=\"_blank\" rel=\"noopener\">Dr. Robert Myerburg\u003c/a>, a professor of medicine at the University of Miami Miller School of Medicine, who wrote an editorial accompanying the recommendations.\u003c/p>\n\u003cp>But many doctors have continued to offer the test, often because patients want it, he says. An uncomplicated ECG on a patient at rest commonly costs about $50.\u003c/p>\n\u003cp>The panel concluded there was insufficient evidence to recommend for or against doing ECGs for people considered to be moderate or high risk because they have some other risk factors, such as high blood pressure or diabetes. So doctors should decide whether to order the test for those patients on an individual basis, the panel says.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Some patients might also consider getting one ECG to have as a baseline for comparison later in life, Tulane's Hendel says.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Doctors+Told+Not+To+Order+Electrocardiograms+For+Low-Risk+Patients&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Simple Saliva Test Could Identify Men at Greatest Risk of Prostate Cancer",
"title": "Simple Saliva Test Could Identify Men at Greatest Risk of Prostate Cancer",
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"content": "\u003cp>A team of scientists at London's\u003ca href=\"https://www.icr.ac.uk/\" target=\"_blank\" rel=\"noopener\"> Institute of Cancer Research\u003c/a> have developed a \"spit test\" that can be used to identify men most likely to develop prostate cancer, the second leading cause of cancer death in U.S. men.[contextly_sidebar id=\"KO4wdzhP8pt1tRs02KEaCVL4V511U4Nk\"]\u003c/p>\n\u003cp>About 1 in 9 men are diagnosed with prostate cancer at some point, according to the \u003ca href=\"https://www.cancer.org/cancer/prostate-cancer/about/key-statistics.html\" target=\"_blank\" rel=\"noopener\">American Cancer Society. \u003c/a>\u003c/p>\n\u003cp>The study, \u003ca href=\"https://www.nature.com/articles/s41588-018-0142-8\" target=\"_blank\" rel=\"noopener\">published \u003c/a>Monday in the journal Nature Genetics, identified the 1 percent of men with the highest genetic risk for prostate cancer. This group is nearly six times more likely to develop prostate cancer than the general population, according to\u003ca href=\"https://www.eurekalert.org/pub_releases/2018-06/iocr-pcd060818.php\" target=\"_blank\" rel=\"noopener\"> the study.\u003c/a>\u003c/p>\n\u003cp>Researchers, funded in part by the National Institutes of Health, utilized a new DNA analysis method to study the genes of more than 70,000 people. They looked at 150 DNA markers and found that the top 10 percent of men at highest risk for prostate cancer were found to nearly three times the risk of developing the disease. From Gizmodo:\u003c/p>\n\u003cblockquote>\u003cp>Some 45,000 of the subjects had already developed prostate cancer, while 25,000 hadn’t. So the researchers compared the two groups, singling out any inherited genetic variations that might have contributed to their cancer risk.\u003c/p>\u003c/blockquote>\n\u003cp>Based on this data, the study said that researchers discovered 63 new variants that have previously not been associated with prostate cancer. Rosalind Eeles, a geneticist and co-author of the study, said those men found to be at greater genetic risk can receive proper screenings.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“The reason we are particularly excited by the test is that this can be offered in general practice as a spit test to really try and identify who is most at risk of prostate cancer so we can offer them targeted screening,” Eeles \u003ca href=\"https://www.theguardian.com/science/2018/jun/11/trials-begin-of-a-saliva-test-for-prostate-cancer\" target=\"_blank\" rel=\"noopener\">told T\u003c/a>\u003ca href=\"https://www.theguardian.com/science/2018/jun/11/trials-begin-of-a-saliva-test-for-prostate-cancer\" target=\"_blank\" rel=\"noopener\">he Guardian.\u003c/a>\u003c/p>\n\u003cp>Most men diagnosed with the disease do not die from it, according to the American Cancer Society. Risk factors include family history, advanced age, and those of African descent.[contextly_sidebar id=\"go4zed6vsFCKAoaAAycufIdrqinev6En\"]\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>About 6 in 10 cases of prostate cancer are diagnosed in men aged 65 or older. From Gizmodo:\u003c/p>\n\u003cblockquote>\u003cp>In the US, people over the age of 50 are \u003ca href=\"https://www.cancer.org/cancer/prostate-cancer/early-detection/acs-recommendations.html\" target=\"_blank\" rel=\"noopener\">generally screened\u003c/a> for prostate cancer via the prostate-specific antigen (PSA) blood test...But the saliva test could reveal especially high-risk people who need annual screening regardless of their PSA level.\u003c/p>\u003c/blockquote>\n\u003cdiv id=\"dfp-ad--inline2\" class=\"js-ad-slot ad-slot ad-slot--inline ad-slot--offset-right ad-slot--inline2 ad-slot--rendered\">\n\u003cdiv class=\"ad-slot__label\">\n\u003cp>Researchers\u003ca href=\"https://www.eurekalert.org/pub_releases/2018-06/iocr-pcd060818.php\" target=\"_blank\" rel=\"noopener\"> now plan a trial\u003c/a> run of the new test at a limited number of clinics to help devise treatments that could reduce cases of prostate cancer among this high-risk group.\u003c/p>\n\u003c/div>\n\u003cdiv>\"We are on the cusp of moving from theory to practice -- from explaining how genetics affect prostate cancer risk, to testing for genetic risk and attempting to prevent the disease,\" Paul Workman, chief executive at The Institute of Cancer Research, said in a \u003ca href=\"https://www.eurekalert.org/pub_releases/2018-06/iocr-pcd060818.php\" target=\"_blank\" rel=\"noopener\">statement\u003c/a>. \"This study also gives us important information about the causes of prostate cancer and the potential role of the immune system, which could ultimately be employed in the design of new treatments.\"\u003c/div>\n\u003c/div>\n\u003cdiv id=\"dfp-ad--inline2\" class=\"js-ad-slot ad-slot ad-slot--inline ad-slot--offset-right ad-slot--inline2 ad-slot--rendered\">\n\u003cdiv id=\"google_ads_iframe_/59666047/theguardian.com/science/article/ng_7__container__\" class=\"ad-slot__content\">\u003c/div>\n\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>A team of scientists at London's\u003ca href=\"https://www.icr.ac.uk/\" target=\"_blank\" rel=\"noopener\"> Institute of Cancer Research\u003c/a> have developed a \"spit test\" that can be used to identify men most likely to develop prostate cancer, the second leading cause of cancer death in U.S. men.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>About 1 in 9 men are diagnosed with prostate cancer at some point, according to the \u003ca href=\"https://www.cancer.org/cancer/prostate-cancer/about/key-statistics.html\" target=\"_blank\" rel=\"noopener\">American Cancer Society. \u003c/a>\u003c/p>\n\u003cp>The study, \u003ca href=\"https://www.nature.com/articles/s41588-018-0142-8\" target=\"_blank\" rel=\"noopener\">published \u003c/a>Monday in the journal Nature Genetics, identified the 1 percent of men with the highest genetic risk for prostate cancer. This group is nearly six times more likely to develop prostate cancer than the general population, according to\u003ca href=\"https://www.eurekalert.org/pub_releases/2018-06/iocr-pcd060818.php\" target=\"_blank\" rel=\"noopener\"> the study.\u003c/a>\u003c/p>\n\u003cp>Researchers, funded in part by the National Institutes of Health, utilized a new DNA analysis method to study the genes of more than 70,000 people. They looked at 150 DNA markers and found that the top 10 percent of men at highest risk for prostate cancer were found to nearly three times the risk of developing the disease. From Gizmodo:\u003c/p>\n\u003cblockquote>\u003cp>Some 45,000 of the subjects had already developed prostate cancer, while 25,000 hadn’t. So the researchers compared the two groups, singling out any inherited genetic variations that might have contributed to their cancer risk.\u003c/p>\u003c/blockquote>\n\u003cp>Based on this data, the study said that researchers discovered 63 new variants that have previously not been associated with prostate cancer. Rosalind Eeles, a geneticist and co-author of the study, said those men found to be at greater genetic risk can receive proper screenings.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“The reason we are particularly excited by the test is that this can be offered in general practice as a spit test to really try and identify who is most at risk of prostate cancer so we can offer them targeted screening,” Eeles \u003ca href=\"https://www.theguardian.com/science/2018/jun/11/trials-begin-of-a-saliva-test-for-prostate-cancer\" target=\"_blank\" rel=\"noopener\">told T\u003c/a>\u003ca href=\"https://www.theguardian.com/science/2018/jun/11/trials-begin-of-a-saliva-test-for-prostate-cancer\" target=\"_blank\" rel=\"noopener\">he Guardian.\u003c/a>\u003c/p>\n\u003cp>Most men diagnosed with the disease do not die from it, according to the American Cancer Society. Risk factors include family history, advanced age, and those of African descent.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>About 6 in 10 cases of prostate cancer are diagnosed in men aged 65 or older. From Gizmodo:\u003c/p>\n\u003cblockquote>\u003cp>In the US, people over the age of 50 are \u003ca href=\"https://www.cancer.org/cancer/prostate-cancer/early-detection/acs-recommendations.html\" target=\"_blank\" rel=\"noopener\">generally screened\u003c/a> for prostate cancer via the prostate-specific antigen (PSA) blood test...But the saliva test could reveal especially high-risk people who need annual screening regardless of their PSA level.\u003c/p>\u003c/blockquote>\n\u003cdiv id=\"dfp-ad--inline2\" class=\"js-ad-slot ad-slot ad-slot--inline ad-slot--offset-right ad-slot--inline2 ad-slot--rendered\">\n\u003cdiv class=\"ad-slot__label\">\n\u003cp>Researchers\u003ca href=\"https://www.eurekalert.org/pub_releases/2018-06/iocr-pcd060818.php\" target=\"_blank\" rel=\"noopener\"> now plan a trial\u003c/a> run of the new test at a limited number of clinics to help devise treatments that could reduce cases of prostate cancer among this high-risk group.\u003c/p>\n\u003c/div>\n\u003cdiv>\"We are on the cusp of moving from theory to practice -- from explaining how genetics affect prostate cancer risk, to testing for genetic risk and attempting to prevent the disease,\" Paul Workman, chief executive at The Institute of Cancer Research, said in a \u003ca href=\"https://www.eurekalert.org/pub_releases/2018-06/iocr-pcd060818.php\" target=\"_blank\" rel=\"noopener\">statement\u003c/a>. \"This study also gives us important information about the causes of prostate cancer and the potential role of the immune system, which could ultimately be employed in the design of new treatments.\"\u003c/div>\n\u003c/div>\n\u003cdiv id=\"dfp-ad--inline2\" class=\"js-ad-slot ad-slot ad-slot--inline ad-slot--offset-right ad-slot--inline2 ad-slot--rendered\">\n\u003cdiv id=\"google_ads_iframe_/59666047/theguardian.com/science/article/ng_7__container__\" class=\"ad-slot__content\">\u003c/div>\n\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "New Blood Tests Promise to Better Predict Early Labor",
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"content": "\u003cp>Two new blood tests promise pregnant women an easier, more affordable way of predicting their risk for an premature delivery. The blood tests, developed by\u003ca href=\"http://med.stanford.edu/\" target=\"_blank\" rel=\"noopener\"> Stanford University School of Medicine\u003c/a> and \u003ca href=\"https://www.ucsf.edu/\" target=\"_blank\" rel=\"noopener\">UC San Francisco\u003c/a>, look for specific biomarkers in the mother's bloodstream.[contextly_sidebar id=\"A9EcAExSSebnSiay0So2km8e4YnmN7OM\"]\u003c/p>\n\u003cp>Preterm delivery, which occurs when a baby is born before the 37th week of pregnancy, is the leading cause of death for children under 5 in the United States.\u003c/p>\n\u003cp>The \u003ca href=\"http://science.sciencemag.org/content/360/6393/1133\" target=\"_blank\" rel=\"noopener\">Stanford-led study\u003c/a>, predicts the risk of preterm birth using fetal RNA found in the mother's blood, while the \u003ca href=\"https://www.nature.com/articles/s41372-018-0112-0\" target=\"_blank\" rel=\"noopener\">UCSF study\u003c/a> focuses on inflammation markers.\u003c/p>\n\u003cp>There is currently one blood test on the market that screens for preterm risk, but it comes with serious limitations, according to \u003ca href=\"https://profiles.ucsf.edu/laura.jelliffe-pawlowski\" target=\"_blank\" rel=\"noopener\">Laura Jelliffe-Pawlowski\u003c/a>, co-author of the UCSF study and director of the \u003ca href=\"https://pretermbirth.ucsf.edu/\" target=\"_blank\" rel=\"noopener\">UCSF California Preterm Birth Initiative\u003c/a>. The costly test screens only for spontaneous preterm births. About three quarters of preterm births occur spontaneously while 25 percent are induced due to medical complications.\u003c/p>\n\u003caside class=\"pullquote alignright\">'We want to make sure that we're developing something that has the potential to help all women, including those most in need.’\u003ccite>Laura Jelliffe-Pawlowski, UCSF \u003c/cite>\u003c/aside>\n\u003cp>But for practitioners like \u003ca href=\"https://www.ucsfhealth.org/juan.gonzalez-velez\" target=\"_blank\" rel=\"noopener\">Dr. Juan Gonzalez\u003c/a>, a perinatologist at UCSF Medical Center, knowing whether a pregnancy is high-risk is not all that helpful without being able to adequately treat the problem.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"A patient can have a positive result but we need to know which intervention is the right intervention. This is a great finding but now we need those next steps, which are studies that focus on interventions. That's the part we don’t really know.\"\u003c/p>\n\u003cp>\u003ca href=\"https://www.mayoclinic.org/biographies/butler-tobah-yvonne-s-m-d/bio-20113896\" target=\"_blank\" rel=\"noopener\">Dr. Yvonne Butler Tobah\u003c/a>, a Mayo obstetrician, called the developments \"groundbreaking\" but warned that further research is required before it can be instituted clinically.\u003c/p>\n\u003cp>\u003cstrong>Causes of Preterm Birth\u003c/strong>\u003c/p>\n\u003cp>The causes of pre-term birth are not well understood, but doctors look for certain traits associated with the risk, according to\u003c/p>\n\u003cp>\"So we know things like hypertension and diabetes are associated with preterm birth,\" says Jelliffe-Pawlowski. \"And also the kinds of things that the test picks up, like inflammation, is associated with preterm birth.\"[contextly_sidebar id=\"CpQ3Oc4MfPMthrebKJEmSP9wVqLfobiI\"]\u003c/p>\n\u003cp>The UCSF study also looked at income and age of the pregnant women, two factors that exert an independent influence on bodily inflammation and placenta function, according to Jelliffe-Pawlowski. Mothers over the age of 34 are found to be at higher risk of inflammation levels.\u003c/p>\n\u003cp>An underlying infection, exposure to environmental toxins, stress, or chronic ailments like diabetes, can all trigger an inflammatory response in pregnant women, a condition that has potential to induce an early pregnancy.\u003c/p>\n\u003cp>A subset of women who test positive for preterm risk have a severe pregnancy complication called preeclampsia. The potentially fatal condition is characterized by high blood pressure and organ failure in the mother.\u003c/p>\n\u003cp>\u003cb>Treatments are Limited\u003c/b>\u003c/p>\n\u003cp>Current medical treatments are typically limited to cases of preeclampsia, and involve taking aspirin, which Jelliffe-Pawlowski says reduces the occurrence of preeclampsia by up to 30 percent.\u003c/p>\n\u003cp>For women with a prior history of preterm delivery, there is a progesterone supplement that is currently offered to decrease the risk, according to Tobah.\u003c/p>\n\u003cp>\"Prior preterm birth confers about a two fold increased risk,\" she said.\u003c/p>\n\u003cp>But outside of this limited category of high-risk pregnancies, there isn't much doctors can recommend in the way of decreasing preterm risk -- outside of bed rest, according to Gonzalez.\u003c/p>\n\u003cp>And preeclampsia comprises just 15 percent of all preterm births, making preventative care for the great majority of preterm cases all the more urgent, says Gonzalez.\u003c/p>\n\u003cp>\"Before doctors start running these tests, we really need to know what are we going to tell these women besides, 'You’re at risk,'\" he says.[contextly_sidebar id=\"FTcRs64SRm7xpizZAGK2uc0iQv1HNynr\"]\u003c/p>\n\u003cp>But for the researchers involved in both studies, affordability and accessibility played an important role in the tests' development.\u003c/p>\n\u003cp>\"While the current available treatments are not great, I do think they have some effect,\" says co-author \u003ca href=\"https://profiles.stanford.edu/mads-melbye\" target=\"_blank\" rel=\"noopener\">Mads Melbye\u003c/a>, a professor in medical epidemiology at the University of Copenhagen, Denmark. \"For instance, if you know a woman is likely to deliver a preterm baby, you would likely refer her to a specialized hospital. And certainly the knowledge alone is important.\"\u003c/p>\n\u003cp>For Jelliffe-Pawlowski, helping pregnant women in disadvantaged communities was a huge motivator for developing the test.\u003c/p>\n\u003cp>\"What we hear from women in the community, particularly black and Latina women, is what's really important to them, is knowing their risk,\" says Jelliffe-Pawlowski. \"It's not necessary that we fix it, but there's an opportunity to communicate risk with women so they can be taken care of appropriately.\"\u003c/p>\n\u003cp>And Melbye says accurate tests are important, since inaccurate estimates can lead to unnecessary treatments such as the induction of labor or Cesarean sections.\u003c/p>\n\u003cp>\u003cstrong>Measuring Risk Through RNA\u003c/strong>\u003c/p>\n\u003cp>The Stanford-led study, published last week in the journal Science, measured cell-free fetal RNA in the mothers' bloodstream to determine the due date and preterm risk.\u003c/p>\n\u003cp>The researchers compared the blood results of women who had healthy pregnancies with those found to be at high risk for preterm delivery. They accurately predicted six of eight preterm cases and wrongly classified only one of 26 full-term cases.\u003c/p>\n\u003cp>But the Stanford test is a pilot study based on a limited number of women.[contextly_sidebar id=\"RsEfYdBoZW1b667qNhE5ZxykfR7kWICL\"]\u003c/p>\n\u003cp>\"The next step will be to apply the findings to large clinical trials,\" says Melbye. \"The study is just the first in a series of studies that allows us to look at the different outcomes of pregnancy. The hope is that it will lead to healthier and safer pregnancies.\"\u003c/p>\n\u003cp>\u003cstrong>Measuring Risk Through Inflammation\u003c/strong>\u003c/p>\n\u003cp>The UCSF test focused on 63 biomarkers in the mother's bloodstream related to inflammation and placenta function. From there, researchers narrowed the test down to 25 biomarkers that together help to predict the chances of an early pregnancy.\u003c/p>\n\u003cp>The study, published in the May issue of \u003ca href=\"https://www.nature.com/articles/s41372-018-0112-0\">\u003ci>Journal of Perinatology\u003c/i>\u003c/a>, is more than 80 percent accurate in predicting preterm births in women who are between 15 and 20 weeks pregnant.\u003c/p>\n\u003cp>In cases of high risk pregnancies, the test was nearly 90 percent accurate.[contextly_sidebar id=\"7E5bGDPvRlmxjV4ypvKH5ngagVo4ise4\"]\u003c/p>\n\u003cp>The UCSF test, which took five years to develop, is based on ten years of research by Jelliffe-Pawlowski's team. Researchers took blood samples from 400 women during their second trimester.\u003c/p>\n\u003cp>Researchers hope their blood tests will lead to better preventative treatments for women found to be at high risk of preterm birth.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\"We want to make sure that we're developing something that has the potential to help all women, including those most in need,\" says Jelliffe-Pawlowski.\u003c/p>\n\n",
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"excerpt": "There is currently one blood test on the market that screens for preterm risk, but it comes with serious limitations. Now, two new tests hold the promise that pregnant women will have an easier, more affordable way.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>Two new blood tests promise pregnant women an easier, more affordable way of predicting their risk for an premature delivery. The blood tests, developed by\u003ca href=\"http://med.stanford.edu/\" target=\"_blank\" rel=\"noopener\"> Stanford University School of Medicine\u003c/a> and \u003ca href=\"https://www.ucsf.edu/\" target=\"_blank\" rel=\"noopener\">UC San Francisco\u003c/a>, look for specific biomarkers in the mother's bloodstream.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Preterm delivery, which occurs when a baby is born before the 37th week of pregnancy, is the leading cause of death for children under 5 in the United States.\u003c/p>\n\u003cp>The \u003ca href=\"http://science.sciencemag.org/content/360/6393/1133\" target=\"_blank\" rel=\"noopener\">Stanford-led study\u003c/a>, predicts the risk of preterm birth using fetal RNA found in the mother's blood, while the \u003ca href=\"https://www.nature.com/articles/s41372-018-0112-0\" target=\"_blank\" rel=\"noopener\">UCSF study\u003c/a> focuses on inflammation markers.\u003c/p>\n\u003cp>There is currently one blood test on the market that screens for preterm risk, but it comes with serious limitations, according to \u003ca href=\"https://profiles.ucsf.edu/laura.jelliffe-pawlowski\" target=\"_blank\" rel=\"noopener\">Laura Jelliffe-Pawlowski\u003c/a>, co-author of the UCSF study and director of the \u003ca href=\"https://pretermbirth.ucsf.edu/\" target=\"_blank\" rel=\"noopener\">UCSF California Preterm Birth Initiative\u003c/a>. The costly test screens only for spontaneous preterm births. About three quarters of preterm births occur spontaneously while 25 percent are induced due to medical complications.\u003c/p>\n\u003caside class=\"pullquote alignright\">'We want to make sure that we're developing something that has the potential to help all women, including those most in need.’\u003ccite>Laura Jelliffe-Pawlowski, UCSF \u003c/cite>\u003c/aside>\n\u003cp>But for practitioners like \u003ca href=\"https://www.ucsfhealth.org/juan.gonzalez-velez\" target=\"_blank\" rel=\"noopener\">Dr. Juan Gonzalez\u003c/a>, a perinatologist at UCSF Medical Center, knowing whether a pregnancy is high-risk is not all that helpful without being able to adequately treat the problem.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"A patient can have a positive result but we need to know which intervention is the right intervention. This is a great finding but now we need those next steps, which are studies that focus on interventions. That's the part we don’t really know.\"\u003c/p>\n\u003cp>\u003ca href=\"https://www.mayoclinic.org/biographies/butler-tobah-yvonne-s-m-d/bio-20113896\" target=\"_blank\" rel=\"noopener\">Dr. Yvonne Butler Tobah\u003c/a>, a Mayo obstetrician, called the developments \"groundbreaking\" but warned that further research is required before it can be instituted clinically.\u003c/p>\n\u003cp>\u003cstrong>Causes of Preterm Birth\u003c/strong>\u003c/p>\n\u003cp>The causes of pre-term birth are not well understood, but doctors look for certain traits associated with the risk, according to\u003c/p>\n\u003cp>\"So we know things like hypertension and diabetes are associated with preterm birth,\" says Jelliffe-Pawlowski. \"And also the kinds of things that the test picks up, like inflammation, is associated with preterm birth.\"\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The UCSF study also looked at income and age of the pregnant women, two factors that exert an independent influence on bodily inflammation and placenta function, according to Jelliffe-Pawlowski. Mothers over the age of 34 are found to be at higher risk of inflammation levels.\u003c/p>\n\u003cp>An underlying infection, exposure to environmental toxins, stress, or chronic ailments like diabetes, can all trigger an inflammatory response in pregnant women, a condition that has potential to induce an early pregnancy.\u003c/p>\n\u003cp>A subset of women who test positive for preterm risk have a severe pregnancy complication called preeclampsia. The potentially fatal condition is characterized by high blood pressure and organ failure in the mother.\u003c/p>\n\u003cp>\u003cb>Treatments are Limited\u003c/b>\u003c/p>\n\u003cp>Current medical treatments are typically limited to cases of preeclampsia, and involve taking aspirin, which Jelliffe-Pawlowski says reduces the occurrence of preeclampsia by up to 30 percent.\u003c/p>\n\u003cp>For women with a prior history of preterm delivery, there is a progesterone supplement that is currently offered to decrease the risk, according to Tobah.\u003c/p>\n\u003cp>\"Prior preterm birth confers about a two fold increased risk,\" she said.\u003c/p>\n\u003cp>But outside of this limited category of high-risk pregnancies, there isn't much doctors can recommend in the way of decreasing preterm risk -- outside of bed rest, according to Gonzalez.\u003c/p>\n\u003cp>And preeclampsia comprises just 15 percent of all preterm births, making preventative care for the great majority of preterm cases all the more urgent, says Gonzalez.\u003c/p>\n\u003cp>\"Before doctors start running these tests, we really need to know what are we going to tell these women besides, 'You’re at risk,'\" he says.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>But for the researchers involved in both studies, affordability and accessibility played an important role in the tests' development.\u003c/p>\n\u003cp>\"While the current available treatments are not great, I do think they have some effect,\" says co-author \u003ca href=\"https://profiles.stanford.edu/mads-melbye\" target=\"_blank\" rel=\"noopener\">Mads Melbye\u003c/a>, a professor in medical epidemiology at the University of Copenhagen, Denmark. \"For instance, if you know a woman is likely to deliver a preterm baby, you would likely refer her to a specialized hospital. And certainly the knowledge alone is important.\"\u003c/p>\n\u003cp>For Jelliffe-Pawlowski, helping pregnant women in disadvantaged communities was a huge motivator for developing the test.\u003c/p>\n\u003cp>\"What we hear from women in the community, particularly black and Latina women, is what's really important to them, is knowing their risk,\" says Jelliffe-Pawlowski. \"It's not necessary that we fix it, but there's an opportunity to communicate risk with women so they can be taken care of appropriately.\"\u003c/p>\n\u003cp>And Melbye says accurate tests are important, since inaccurate estimates can lead to unnecessary treatments such as the induction of labor or Cesarean sections.\u003c/p>\n\u003cp>\u003cstrong>Measuring Risk Through RNA\u003c/strong>\u003c/p>\n\u003cp>The Stanford-led study, published last week in the journal Science, measured cell-free fetal RNA in the mothers' bloodstream to determine the due date and preterm risk.\u003c/p>\n\u003cp>The researchers compared the blood results of women who had healthy pregnancies with those found to be at high risk for preterm delivery. They accurately predicted six of eight preterm cases and wrongly classified only one of 26 full-term cases.\u003c/p>\n\u003cp>But the Stanford test is a pilot study based on a limited number of women.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\"The next step will be to apply the findings to large clinical trials,\" says Melbye. \"The study is just the first in a series of studies that allows us to look at the different outcomes of pregnancy. The hope is that it will lead to healthier and safer pregnancies.\"\u003c/p>\n\u003cp>\u003cstrong>Measuring Risk Through Inflammation\u003c/strong>\u003c/p>\n\u003cp>The UCSF test focused on 63 biomarkers in the mother's bloodstream related to inflammation and placenta function. From there, researchers narrowed the test down to 25 biomarkers that together help to predict the chances of an early pregnancy.\u003c/p>\n\u003cp>The study, published in the May issue of \u003ca href=\"https://www.nature.com/articles/s41372-018-0112-0\">\u003ci>Journal of Perinatology\u003c/i>\u003c/a>, is more than 80 percent accurate in predicting preterm births in women who are between 15 and 20 weeks pregnant.\u003c/p>\n\u003cp>In cases of high risk pregnancies, the test was nearly 90 percent accurate.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The UCSF test, which took five years to develop, is based on ten years of research by Jelliffe-Pawlowski's team. Researchers took blood samples from 400 women during their second trimester.\u003c/p>\n\u003cp>Researchers hope their blood tests will lead to better preventative treatments for women found to be at high risk of preterm birth.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "A Science Writer Explores The 'Perversions And Potential' Of Genetic Tests",
"title": "A Science Writer Explores The 'Perversions And Potential' Of Genetic Tests",
"headTitle": "KQED Future of You | KQED Science",
"content": "\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe src=\"https://www.npr.org/player/embed/618870881/618969757\" width=\"100%\" height=\"290\" frameborder=\"0\" scrolling=\"no\" title=\"NPR embedded audio player\" class=\"iframe-class\">\u003c/iframe>\u003c/p>\n\u003cp>As a science columnist for\u003cem> The New York Times, \u003c/em>Carl Zimmer had reported extensively about genetics and the role gene mutations play in various ailments. After a while, he got to wondering about what secrets his own genetic code holds.[contextly_sidebar id=\"AyWMyOjcCCjd9Wr45bM9omzK5fGeueow\"]\u003c/p>\n\u003cp>\"I wanted to know if there was anything I needed to worry about,\" Zimmer says. \"We all think back to our relatives who got sick and then wonder, 'Is that in me?'\"\u003c/p>\n\u003cp>So Zimmer worked with a genetics counselor to get his entire genome sequenced — an experience he describes as \"very nerve-wracking.\" He worried that he would discover a mutation that would put him on the path for a particular disease.\u003c/p>\n\u003cp>As it turned out, the counselor told Zimmer he has a \"boring genome.\" Though Zimmer initially hoped for a more \"exciting and exotic\" assessment, the counselor reminded him \"A boring genome is a really good genome.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Zimmer writes about the broader implications of genetic research and testing in his new book, \u003cem>She Has Her Mother's Laugh: The Powers, Perversions and Potential of Heredity\u003c/em>.[contextly_sidebar id=\"YtqF4uhyPE2pCelB55bttG0XpqJfRSq3\"]\u003c/p>\n\u003chr>\n\u003cp>\u003cstrong>Interview Highlights\u003c/strong>\u003c/p>\n\u003cp>\u003cstrong>On how the new genetic editing technology known as \u003ca href=\"https://www.npr.org/tags/419142387/crispr\" target=\"_blank\" rel=\"noopener\">CRISPR\u003c/a> works\u003c/strong>\u003c/p>\n\u003cp>What happens with CRISPR is that scientists will design a molecule — think of it as a probe — and it will search around in the DNA in a cell until if finds a very specific short sequence. And it will grab onto it, and it brings on with it basically molecular scissors, which will then cut the DNA at that spot — kind of like cutting tape. And you can cut out a segment of DNA. And if you just do that, DNA will heal itself. Basically the two loose ends will stitch themselves together, and now that piece is just missing. Or you can add in a little piece of different DNA, and you can actually get the cell to put in that new piece of DNA where you just cut out the old one.\u003c/p>\n\u003cp>\u003cstrong>On whether CRISPR technology could be used to treat diseases in humans\u003c/strong>\u003c/p>\n\u003cp>We're just on the verge of human trials. They will be starting, hopefully very soon, for diseases like sickle-cell anemia. There's actually a lot of research on muscular dystrophy as well. There are a few key diseases where scientists think these would be the best places to start. To basically inject CRISPR molecules into people's bodies; these CRISPR molecules would then go to certain kinds of cells and repair one particular spot in their DNA. And that treats the disease.\u003c/p>\n\u003cp>We shouldn't look at this as a panacea. ... There have been earlier kinds of treatments known as gene therapy, where you basically try to add an extra gene into someone's cells. And that [seemed] like it was just a slam dunk, but then it turned out to not work very well for years and years. ... So CRISPR could be even more exciting and truly revolutionary. We just have to wait and see what this first generation of human clinical trials show us.\u003c/p>\n\u003cp>\u003cstrong>On his visit to an insectarium where a scientist is breeding genetically modified mosquitoes that are resistant to malaria\u003c/strong>\u003c/p>\n\u003cp>First of all, you have to gown up before you go in there. ... And then you go through an air lock, and then you're in this room where there are mosquitoes living in all their different life cycles.\u003c/p>\n\u003cp>So there's a dark room where the female mosquitoes are laying their eggs, because they like to do it in the dark. And then the scientists pull the eggs out from these rooms and they inject DNA into them and then they put them in water, because that's where mosquito larvae like to develop.\u003c/p>\n\u003cp>And so you go into this other room where there are these tubs of water, and these snake-like things are slithering around in there and then they develop into adults. And the females need to drink blood; so [researchers] found that the containers for movie popcorn work really well. What they do is, they basically clamp a warm container of calves' blood on top of them, and then the mosquitoes are underneath — on the underside of the plastic lid — basically poking through and drinking the blood and fattening themselves up. ...\u003c/p>\n\u003cp>You can tell that they've been genetically altered because they have red eyes, which is kind of spooky. But you look at that and you say, well, that means that these could be the cure for malaria. It really could happen. And hundreds of thousands of people die every year of malaria. We've thrown everything we can at it and this parasite is still knocking us down worldwide. So, maybe this could be it – so, that's actually quite exciting.\u003c/p>\n\u003cp>\u003cstrong>On how genetic testing was used in the Golden State Killer case\u003c/strong>\u003c/p>\n\u003cp>For the \u003ca href=\"https://www.npr.org/sections/thetwo-way/2018/04/27/606624218/in-hunt-for-golden-state-killer-investigators-uploaded-his-dna-to-genealogy-site\" target=\"_blank\" rel=\"noopener\">Golden State Killer case\u003c/a>, what somebody decided to do was take the DNA that they had from these crime scenes, and upload it to one of these open-access sites — not a commercial site — and then see if they could find any close matches. And they found that there were some people that looked like they were distant cousins of this person. And they went and did the genealogical research to figure out \"Well, how would they be related?\" And then said \"OK, who are the possible relatives that this person could be, and where do they live?\" And that actually helped narrow down their search until they made an arrest.\u003c/p>\n\u003cp>\u003cstrong>On whether genetic testing companies will protect user privacy\u003c/strong>\u003c/p>\n\u003cp>You can choose different levels of privacy with a lot of these services. So, for example, some people will say \"I want you to look at my DNA. I want you to tell me about my ancestry.\" ... For 23 and Me they'll give you a few bits of information about your medical conditions, and that's it. But they will try to get you to opt in to sharing your data for their own basic research. At 23 and Me, for example, there's a whole team of researchers who are studying all sorts of ... diseases, sleep patterns and so on. And then they will also go into partnerships with drug development companies who will take their data, looking at, say, 50,000 people with lupus and 50,000 people who don't have lupus, and try to look for the genetic differences. Those could point the way toward possible drugs.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>Phyllis Myers and Seth Kelley produced and edited the audio of this interview. Bridget Bentz and Seth Kelley adapted it for the Web.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 Fresh Air. To see more, visit \u003ca href=\"http://www.npr.org/programs/fresh-air/\">Fresh Air\u003c/a>.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=A+Science+Writer+Explores+The+%27Perversions+And+Potential%27+Of+Genetic+Tests&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"excerpt": "Carl Zimmer wondered what secrets lurked in his genetic code — so he decided to have his genome sequenced. He writes about the implications of the study of genetics in \u003cem>She Has Her Mother's Laugh.\u003c/em>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe src=\"https://www.npr.org/player/embed/618870881/618969757\" width=\"100%\" height=\"290\" frameborder=\"0\" scrolling=\"no\" title=\"NPR embedded audio player\" class=\"iframe-class\">\u003c/iframe>\u003c/p>\n\u003cp>As a science columnist for\u003cem> The New York Times, \u003c/em>Carl Zimmer had reported extensively about genetics and the role gene mutations play in various ailments. After a while, he got to wondering about what secrets his own genetic code holds.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\"I wanted to know if there was anything I needed to worry about,\" Zimmer says. \"We all think back to our relatives who got sick and then wonder, 'Is that in me?'\"\u003c/p>\n\u003cp>So Zimmer worked with a genetics counselor to get his entire genome sequenced — an experience he describes as \"very nerve-wracking.\" He worried that he would discover a mutation that would put him on the path for a particular disease.\u003c/p>\n\u003cp>As it turned out, the counselor told Zimmer he has a \"boring genome.\" Though Zimmer initially hoped for a more \"exciting and exotic\" assessment, the counselor reminded him \"A boring genome is a really good genome.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Zimmer writes about the broader implications of genetic research and testing in his new book, \u003cem>She Has Her Mother's Laugh: The Powers, Perversions and Potential of Heredity\u003c/em>.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003chr>\n\u003cp>\u003cstrong>Interview Highlights\u003c/strong>\u003c/p>\n\u003cp>\u003cstrong>On how the new genetic editing technology known as \u003ca href=\"https://www.npr.org/tags/419142387/crispr\" target=\"_blank\" rel=\"noopener\">CRISPR\u003c/a> works\u003c/strong>\u003c/p>\n\u003cp>What happens with CRISPR is that scientists will design a molecule — think of it as a probe — and it will search around in the DNA in a cell until if finds a very specific short sequence. And it will grab onto it, and it brings on with it basically molecular scissors, which will then cut the DNA at that spot — kind of like cutting tape. And you can cut out a segment of DNA. And if you just do that, DNA will heal itself. Basically the two loose ends will stitch themselves together, and now that piece is just missing. Or you can add in a little piece of different DNA, and you can actually get the cell to put in that new piece of DNA where you just cut out the old one.\u003c/p>\n\u003cp>\u003cstrong>On whether CRISPR technology could be used to treat diseases in humans\u003c/strong>\u003c/p>\n\u003cp>We're just on the verge of human trials. They will be starting, hopefully very soon, for diseases like sickle-cell anemia. There's actually a lot of research on muscular dystrophy as well. There are a few key diseases where scientists think these would be the best places to start. To basically inject CRISPR molecules into people's bodies; these CRISPR molecules would then go to certain kinds of cells and repair one particular spot in their DNA. And that treats the disease.\u003c/p>\n\u003cp>We shouldn't look at this as a panacea. ... There have been earlier kinds of treatments known as gene therapy, where you basically try to add an extra gene into someone's cells. And that [seemed] like it was just a slam dunk, but then it turned out to not work very well for years and years. ... So CRISPR could be even more exciting and truly revolutionary. We just have to wait and see what this first generation of human clinical trials show us.\u003c/p>\n\u003cp>\u003cstrong>On his visit to an insectarium where a scientist is breeding genetically modified mosquitoes that are resistant to malaria\u003c/strong>\u003c/p>\n\u003cp>First of all, you have to gown up before you go in there. ... And then you go through an air lock, and then you're in this room where there are mosquitoes living in all their different life cycles.\u003c/p>\n\u003cp>So there's a dark room where the female mosquitoes are laying their eggs, because they like to do it in the dark. And then the scientists pull the eggs out from these rooms and they inject DNA into them and then they put them in water, because that's where mosquito larvae like to develop.\u003c/p>\n\u003cp>And so you go into this other room where there are these tubs of water, and these snake-like things are slithering around in there and then they develop into adults. And the females need to drink blood; so [researchers] found that the containers for movie popcorn work really well. What they do is, they basically clamp a warm container of calves' blood on top of them, and then the mosquitoes are underneath — on the underside of the plastic lid — basically poking through and drinking the blood and fattening themselves up. ...\u003c/p>\n\u003cp>You can tell that they've been genetically altered because they have red eyes, which is kind of spooky. But you look at that and you say, well, that means that these could be the cure for malaria. It really could happen. And hundreds of thousands of people die every year of malaria. We've thrown everything we can at it and this parasite is still knocking us down worldwide. So, maybe this could be it – so, that's actually quite exciting.\u003c/p>\n\u003cp>\u003cstrong>On how genetic testing was used in the Golden State Killer case\u003c/strong>\u003c/p>\n\u003cp>For the \u003ca href=\"https://www.npr.org/sections/thetwo-way/2018/04/27/606624218/in-hunt-for-golden-state-killer-investigators-uploaded-his-dna-to-genealogy-site\" target=\"_blank\" rel=\"noopener\">Golden State Killer case\u003c/a>, what somebody decided to do was take the DNA that they had from these crime scenes, and upload it to one of these open-access sites — not a commercial site — and then see if they could find any close matches. And they found that there were some people that looked like they were distant cousins of this person. And they went and did the genealogical research to figure out \"Well, how would they be related?\" And then said \"OK, who are the possible relatives that this person could be, and where do they live?\" And that actually helped narrow down their search until they made an arrest.\u003c/p>\n\u003cp>\u003cstrong>On whether genetic testing companies will protect user privacy\u003c/strong>\u003c/p>\n\u003cp>You can choose different levels of privacy with a lot of these services. So, for example, some people will say \"I want you to look at my DNA. I want you to tell me about my ancestry.\" ... For 23 and Me they'll give you a few bits of information about your medical conditions, and that's it. But they will try to get you to opt in to sharing your data for their own basic research. At 23 and Me, for example, there's a whole team of researchers who are studying all sorts of ... diseases, sleep patterns and so on. And then they will also go into partnerships with drug development companies who will take their data, looking at, say, 50,000 people with lupus and 50,000 people who don't have lupus, and try to look for the genetic differences. Those could point the way toward possible drugs.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>Phyllis Myers and Seth Kelley produced and edited the audio of this interview. Bridget Bentz and Seth Kelley adapted it for the Web.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 Fresh Air. To see more, visit \u003ca href=\"http://www.npr.org/programs/fresh-air/\">Fresh Air\u003c/a>.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=A+Science+Writer+Explores+The+%27Perversions+And+Potential%27+Of+Genetic+Tests&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"content": "\u003cp>The deaths of celebrity chef Anthony Bourdain and fashion designer Kate Spade highlight a troubling trend — rising suicides among middle-aged Americans.[contextly_sidebar id=”VRyDwaewBsFbQgWstXuEk6sa8awOu2Ef”]\u003c/p>\n\u003cp>Mental health problems, often undiagnosed, are usually involved and experts say knowing warning signs and who is at risk can help stop a crisis from becoming a tragedy.\u003c/p>\n\u003cp>Bourdain, 61, and Spade, 55, died three days and a continent apart this week amid a new U.S. report showing an uptick in suicides rates in nearly every state since 1999. Middle-aged adults — ages 45 to 64 — had the largest rate increase, according to the \u003ca href=\"https://www.cdc.gov/media/releases/2018/p0607-suicide-prevention.html\" target=\"_blank\" rel=\"noopener\">report\u003c/a> from the Centers for Disease Control and Prevention.\u003c/p>\n\u003cdiv id=\"div-gpt-ad-1470255291270-0\" class=\"ad-placeholder\">\n\u003cp>Previous studies have suggested economic downturns and the nation’s opioid crisis contributed to the rise in middle-aged suicides.\u003c/p>\n\u003cp>Dr. Christine Moutier, a psychiatrist and chief medical officer for the American \u003ca href=\"https://afsp.org/\" target=\"_blank\" rel=\"noopener\">Foundation\u003c/a> for Suicide Prevention, said Friday it’s important for everyone to know the warning signs and to intervene when family members, friends or co-workers appear troubled. Asking if they’ve had suicidal thoughts is not harmful and lets them know you care, she said.\u003c/p>\n\u003cp>Behavior that may indicate someone is suicidal includes:\u003c/p>\n\u003cp>—Talking about feeling hopeless, trapped, a burden to others or wanting to die.\u003c/p>\n\u003cp>—Unusual mood swings or withdrawing from family, friends and usual activities.\u003c/p>\n\u003cp>—Giving away important possessions.\u003c/p>\n\u003cp>—Increased use of alcohol or drugs.\u003c/p>\n\u003cp>This week’s report found that many suicides were in people with no known mental illness. But Dr. Joshua Gordon, director of the National Institute of Mental Health, said that contradicts years of data, suggesting many have “gone undiagnosed and untreated. It’s very troubling.”\u003c/p>\n\u003cp>Gordon said doctors need to ask patients at every opportunity about their mental health and evaluate their risk for suicide.[contextly_sidebar id=”5yHVylMSzJGpyUIEUKvOwWpHBWw6aZNt”]\u003c/p>\n\u003cp>“When you ask everybody and not just people you might suspect, you double the number you detect,” he said.\u003c/p>\n\u003cp>Gordon noted that psychotherapy and certain psychiatric drugs have been shown to reduce suicidal tendencies.\u003c/p>\n\u003cp>Moutier of the American Foundation for Suicide Prevention, said that suicides can be “contagious” — hearing about one may make others who are already at risk turn to self-harm. She said celebrity suicides also typically prompt an increase in calls to suicide \u003ca href=\"https://suicidepreventionlifeline.org/\" target=\"_blank\" rel=\"noopener\">help lines.\u003c/a>\u003c/p>\n\u003cp>“People should know that suicide is preventable. Anyone contemplating suicide should know that help is available, and that there is no shame in seeking care for your mental health,” Dr. Altha Stewart of the American Psychiatric \u003ca href=\"https://www.psychiatry.org/patients-families/suicide-prevention\" target=\"_blank\" rel=\"noopener\">Association\u003c/a> said in a statement.\u003c/p>\n\u003c/div>\n\u003cp>[ad fullwidth]\u003c/p>\u003cp>\u003c/p>\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>The deaths of celebrity chef Anthony Bourdain and fashion designer Kate Spade highlight a troubling trend — rising suicides among middle-aged Americans.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Mental health problems, often undiagnosed, are usually involved and experts say knowing warning signs and who is at risk can help stop a crisis from becoming a tragedy.\u003c/p>\n\u003cp>Bourdain, 61, and Spade, 55, died three days and a continent apart this week amid a new U.S. report showing an uptick in suicides rates in nearly every state since 1999. Middle-aged adults — ages 45 to 64 — had the largest rate increase, according to the \u003ca href=\"https://www.cdc.gov/media/releases/2018/p0607-suicide-prevention.html\" target=\"_blank\" rel=\"noopener\">report\u003c/a> from the Centers for Disease Control and Prevention.\u003c/p>\n\u003cdiv id=\"div-gpt-ad-1470255291270-0\" class=\"ad-placeholder\">\n\u003cp>Previous studies have suggested economic downturns and the nation’s opioid crisis contributed to the rise in middle-aged suicides.\u003c/p>\n\u003cp>Dr. Christine Moutier, a psychiatrist and chief medical officer for the American \u003ca href=\"https://afsp.org/\" target=\"_blank\" rel=\"noopener\">Foundation\u003c/a> for Suicide Prevention, said Friday it’s important for everyone to know the warning signs and to intervene when family members, friends or co-workers appear troubled. Asking if they’ve had suicidal thoughts is not harmful and lets them know you care, she said.\u003c/p>\n\u003cp>Behavior that may indicate someone is suicidal includes:\u003c/p>\n\u003cp>—Talking about feeling hopeless, trapped, a burden to others or wanting to die.\u003c/p>\n\u003cp>—Unusual mood swings or withdrawing from family, friends and usual activities.\u003c/p>\n\u003cp>—Giving away important possessions.\u003c/p>\n\u003cp>—Increased use of alcohol or drugs.\u003c/p>\n\u003cp>This week’s report found that many suicides were in people with no known mental illness. But Dr. Joshua Gordon, director of the National Institute of Mental Health, said that contradicts years of data, suggesting many have “gone undiagnosed and untreated. It’s very troubling.”\u003c/p>\n\u003cp>Gordon said doctors need to ask patients at every opportunity about their mental health and evaluate their risk for suicide.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>“When you ask everybody and not just people you might suspect, you double the number you detect,” he said.\u003c/p>\n\u003cp>Gordon noted that psychotherapy and certain psychiatric drugs have been shown to reduce suicidal tendencies.\u003c/p>\n\u003cp>Moutier of the American Foundation for Suicide Prevention, said that suicides can be “contagious” — hearing about one may make others who are already at risk turn to self-harm. She said celebrity suicides also typically prompt an increase in calls to suicide \u003ca href=\"https://suicidepreventionlifeline.org/\" target=\"_blank\" rel=\"noopener\">help lines.\u003c/a>\u003c/p>\n\u003cp>“People should know that suicide is preventable. Anyone contemplating suicide should know that help is available, and that there is no shame in seeking care for your mental health,” Dr. Altha Stewart of the American Psychiatric \u003ca href=\"https://www.psychiatry.org/patients-families/suicide-prevention\" target=\"_blank\" rel=\"noopener\">Association\u003c/a> said in a statement.\u003c/p>\n\u003c/div>\n\u003cp>\u003c/p>\u003c/div>",
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"disqusTitle": "From Chaos To Calm: A Life Changed By Ketamine",
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"content": "\u003cp>For six years now, life has been really good for James. He has a great job as the creative director of an advertising firm in New York City. He enjoys spending time with his wife and kids.[contextly_sidebar id=\"s4NBmRFOwEaVfa4ea1pL5Kssair4SGBs\"]\u003c/p>\n\u003cp>And it has all been possible, he says, because for the past six years he has been taking a drug called\u003ca href=\"https://www.npr.org/sections/health-shots/2015/09/28/443203592/club-drug-ketamine-gains-traction-as-a-treatment-for-depression\" target=\"_blank\" rel=\"noopener\"> ketamine\u003c/a>.\u003c/p>\n\u003cp>Before ketamine, James was unable to work or focus his thoughts. His mind was filled with violent images. And his mood could go from ebullient to dark in a matter of minutes.\u003c/p>\n\u003cp>Ketamine \"helped me get my life back,\" says James, who asked that we not use his last name to protect his career.\u003c/p>\n\u003cp>Ketamine was developed as a human and animal anesthetic in the 1960s. And almost from the time it reached the market it has also been used as a mind-bending party drug.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>But ketamine's story took a surprising turn in 2006, when researchers at the National Institutes of Health \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/16894061\">showed\u003c/a> that an intravenous dose could relieve severe depression in a matter of hours. Since then, doctors have prescribed ketamine \"off label\" to \u003ca href=\"https://www.npr.org/sections/health-shots/2017/03/20/520169959/ketamine-for-severe-depression-how-do-you-not-offer-this-drug-to-people\" target=\"_blank\" rel=\"noopener\">thousands of depressed patients\u003c/a> who don't respond to other drugs.\u003c/p>\n\u003cp>And pharmaceutical companies are \u003ca href=\"https://www.npr.org/sections/health-shots/2015/05/28/409800015/ketamine-depression-treatments-inspired-by-club-drug-move-ahead-in-tests\" target=\"_blank\" rel=\"noopener\">testing\u003c/a> several new ketamine-related drugs to treat depression. Johnson & Johnson expects to seek approval for its nasal spray \u003ca href=\"https://www.jnj.com/media-center/press-releases/new-phase-3-data-show-esketamine-nasal-spray-demonstrated-rapid-improvements-in-depressive-symptoms-in-patients-with-treatment-resistant-depression\" target=\"_blank\" rel=\"noopener\">esketamine\u003c/a> later this year, though the approval would be limited to use in a clinical setting.[contextly_sidebar id=\"WxNsPZS18b7j3a9u3SqMCjwKimnR3LX8\"]\u003c/p>\n\u003cp>Meanwhile, doctors have begun trying ketamine on patients with a wide range of psychiatric disorders other than depression. And there is now growing evidence it can help people with anxiety, bipolar disorder, post-traumatic stress disorder, and perhaps even obsessive-compulsive disorder.\u003c/p>\n\u003cp>\"I think it's actually one of the biggest advances in psychiatry in a very long time,\" says Dr. \u003ca href=\"https://www.mcleanhospital.org/biography/martin-teicher\" target=\"_blank\" rel=\"noopener\">Martin Teicher\u003c/a>, an associate professor of psychiatry at Harvard Medical School and director of the Developmental Biopsychiatry Research Program at McLean Hospital.\u003c/p>\n\u003cp>Ketamine may also offer new hope for people like James who have symptoms of several different psychiatric disorders.\u003c/p>\n\u003cp>James had a happy childhood, he says. But his thoughts were out of control. \"I always felt like I was crossing a freeway and my thoughts were just racing past me,\" he says.\u003c/p>\n\u003cp>He spent much of his childhood terrified of \"an unknown, an ambiguous force out there.\" The fear was \"overwhelming,\" he says. \"I literally slept with the cover over my head with just room to breathe through my mouth until I went to college.\"\u003c/p>\n\u003cp>And there was something else about James: his body temperature.\u003c/p>\n\u003cp>\"I overheated constantly,\" he says. \"I would wear shorts all year long. In my 20s in my apartment I would sleep with the windows open in the middle of the winter.\"\u003c/p>\n\u003cp>In his late 20s, James saw a doctor who told him he had attention deficit hyperactivity disorder. So he started taking stimulants.[contextly_sidebar id=\"IjfTHMEjzV27TicYbrGolDFdASO5y6qG\"]\u003c/p>\n\u003cp>At first, the pills helped him focus. Then they didn't, no matter how many he took.\u003c/p>\n\u003cp>He'd done well as an idea guy in the advertising industry. But now James was trying to work at home, and it wasn't going well.\u003c/p>\n\u003cp>\"ADHD pills will make you interested in anything,\" he says. \"So I was putting the desk together and taking the desk apart. I was putting a laptop stand together and taking it apart. I was going in a massive downward spiral.\"\u003c/p>\n\u003cp>James had always suffered from mood swings. But now they were rapid and extreme. And he couldn't stop thinking about gruesome scenarios, like a murderer coming for his family.\u003c/p>\n\u003cp>\"My wife took a summer off to be with me because she was scared of what was going to happen to me,\" he says. \"She would go to work for a few hours, then rush home. There would be times I'd call her just screaming, 'Please come home. I can't get through another minute.' \"\u003c/p>\n\u003cp>Eventually, James found his way to Dr. \u003ca href=\"http://bipolarchild.com/about/authors/\" target=\"_blank\" rel=\"noopener\">Demitri Papolos\u003c/a>, an associate professor of clinical psychiatry at Albert Einstein College of Medicine.\u003c/p>\n\u003cp>\"He was like a whirling dervish when he came into my office,\" Papolos says. \"He was extremely fearful and scanning the environment all the time and he overheated at the drop of a hat.\"\u003c/p>\n\u003cp>Papolos diagnosed James with a variant of bipolar disorder he calls the \"fear of harm phenotype.\" It typically appears in childhood and often doesn't respond to traditional psychiatric drugs.[contextly_sidebar id=\"ONPRitNVz88O9pFNNVQ7htlsCs7xWv0w\"]\u003c/p>\n\u003cp>But Papolos has found that the condition does respond to ketamine. \"It's been transformational,\" he says.\u003c/p>\n\u003cp>In January, Papolos published a \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/28866299\">study\u003c/a> of 45 children with the problem. They inhaled a nasal mist containing ketamine about twice a week. Nearly all got dramatically better.\u003c/p>\n\u003cp>Scientists still aren't sure why ketamine works, but there's \u003ca href=\"https://www.npr.org/sections/health-shots/2012/10/04/162299564/ketamine-relieves-depression-by-restoring-brain-connections\" target=\"_blank\" rel=\"noopener\">evidence\u003c/a> that it encourages the brain to rewire, to alter the connections between cells. That process has been linked to recovery from depression. And it may also explain why ketamine helps people who have symptoms associated with several different psychiatric disorders.\u003c/p>\n\u003cp>\"I think it's having multiple effects, and that means it's probably useful for multiple different disorders,\" Teicher says.\u003c/p>\n\u003cp>One of those effects involves a part of the brain involved in temperature regulation. And that could explain why patients like James usually stop overheating once they are taking ketamine.\u003c/p>\n\u003cp>James started taking a ketamine nasal spray every other day. He says his response was dramatic.\u003c/p>\n\u003cp>\"One day I turn to my wife and I'm like, 'I feel calm today. I don't know if it's the sun coming in, I don't know if it's just the way we're sitting here, but I feel like I could go and sit at the computer and work.' \"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The next day, James did sit down at his computer. A month later, he was back at work.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=From+Chaos+To+Calm%3A+A+Life+Changed+By+Ketamine&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>For six years now, life has been really good for James. He has a great job as the creative director of an advertising firm in New York City. He enjoys spending time with his wife and kids.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>And it has all been possible, he says, because for the past six years he has been taking a drug called\u003ca href=\"https://www.npr.org/sections/health-shots/2015/09/28/443203592/club-drug-ketamine-gains-traction-as-a-treatment-for-depression\" target=\"_blank\" rel=\"noopener\"> ketamine\u003c/a>.\u003c/p>\n\u003cp>Before ketamine, James was unable to work or focus his thoughts. His mind was filled with violent images. And his mood could go from ebullient to dark in a matter of minutes.\u003c/p>\n\u003cp>Ketamine \"helped me get my life back,\" says James, who asked that we not use his last name to protect his career.\u003c/p>\n\u003cp>Ketamine was developed as a human and animal anesthetic in the 1960s. And almost from the time it reached the market it has also been used as a mind-bending party drug.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>But ketamine's story took a surprising turn in 2006, when researchers at the National Institutes of Health \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/16894061\">showed\u003c/a> that an intravenous dose could relieve severe depression in a matter of hours. Since then, doctors have prescribed ketamine \"off label\" to \u003ca href=\"https://www.npr.org/sections/health-shots/2017/03/20/520169959/ketamine-for-severe-depression-how-do-you-not-offer-this-drug-to-people\" target=\"_blank\" rel=\"noopener\">thousands of depressed patients\u003c/a> who don't respond to other drugs.\u003c/p>\n\u003cp>And pharmaceutical companies are \u003ca href=\"https://www.npr.org/sections/health-shots/2015/05/28/409800015/ketamine-depression-treatments-inspired-by-club-drug-move-ahead-in-tests\" target=\"_blank\" rel=\"noopener\">testing\u003c/a> several new ketamine-related drugs to treat depression. Johnson & Johnson expects to seek approval for its nasal spray \u003ca href=\"https://www.jnj.com/media-center/press-releases/new-phase-3-data-show-esketamine-nasal-spray-demonstrated-rapid-improvements-in-depressive-symptoms-in-patients-with-treatment-resistant-depression\" target=\"_blank\" rel=\"noopener\">esketamine\u003c/a> later this year, though the approval would be limited to use in a clinical setting.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Meanwhile, doctors have begun trying ketamine on patients with a wide range of psychiatric disorders other than depression. And there is now growing evidence it can help people with anxiety, bipolar disorder, post-traumatic stress disorder, and perhaps even obsessive-compulsive disorder.\u003c/p>\n\u003cp>\"I think it's actually one of the biggest advances in psychiatry in a very long time,\" says Dr. \u003ca href=\"https://www.mcleanhospital.org/biography/martin-teicher\" target=\"_blank\" rel=\"noopener\">Martin Teicher\u003c/a>, an associate professor of psychiatry at Harvard Medical School and director of the Developmental Biopsychiatry Research Program at McLean Hospital.\u003c/p>\n\u003cp>Ketamine may also offer new hope for people like James who have symptoms of several different psychiatric disorders.\u003c/p>\n\u003cp>James had a happy childhood, he says. But his thoughts were out of control. \"I always felt like I was crossing a freeway and my thoughts were just racing past me,\" he says.\u003c/p>\n\u003cp>He spent much of his childhood terrified of \"an unknown, an ambiguous force out there.\" The fear was \"overwhelming,\" he says. \"I literally slept with the cover over my head with just room to breathe through my mouth until I went to college.\"\u003c/p>\n\u003cp>And there was something else about James: his body temperature.\u003c/p>\n\u003cp>\"I overheated constantly,\" he says. \"I would wear shorts all year long. In my 20s in my apartment I would sleep with the windows open in the middle of the winter.\"\u003c/p>\n\u003cp>In his late 20s, James saw a doctor who told him he had attention deficit hyperactivity disorder. So he started taking stimulants.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>At first, the pills helped him focus. Then they didn't, no matter how many he took.\u003c/p>\n\u003cp>He'd done well as an idea guy in the advertising industry. But now James was trying to work at home, and it wasn't going well.\u003c/p>\n\u003cp>\"ADHD pills will make you interested in anything,\" he says. \"So I was putting the desk together and taking the desk apart. I was putting a laptop stand together and taking it apart. I was going in a massive downward spiral.\"\u003c/p>\n\u003cp>James had always suffered from mood swings. But now they were rapid and extreme. And he couldn't stop thinking about gruesome scenarios, like a murderer coming for his family.\u003c/p>\n\u003cp>\"My wife took a summer off to be with me because she was scared of what was going to happen to me,\" he says. \"She would go to work for a few hours, then rush home. There would be times I'd call her just screaming, 'Please come home. I can't get through another minute.' \"\u003c/p>\n\u003cp>Eventually, James found his way to Dr. \u003ca href=\"http://bipolarchild.com/about/authors/\" target=\"_blank\" rel=\"noopener\">Demitri Papolos\u003c/a>, an associate professor of clinical psychiatry at Albert Einstein College of Medicine.\u003c/p>\n\u003cp>\"He was like a whirling dervish when he came into my office,\" Papolos says. \"He was extremely fearful and scanning the environment all the time and he overheated at the drop of a hat.\"\u003c/p>\n\u003cp>Papolos diagnosed James with a variant of bipolar disorder he calls the \"fear of harm phenotype.\" It typically appears in childhood and often doesn't respond to traditional psychiatric drugs.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>But Papolos has found that the condition does respond to ketamine. \"It's been transformational,\" he says.\u003c/p>\n\u003cp>In January, Papolos published a \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/28866299\">study\u003c/a> of 45 children with the problem. They inhaled a nasal mist containing ketamine about twice a week. Nearly all got dramatically better.\u003c/p>\n\u003cp>Scientists still aren't sure why ketamine works, but there's \u003ca href=\"https://www.npr.org/sections/health-shots/2012/10/04/162299564/ketamine-relieves-depression-by-restoring-brain-connections\" target=\"_blank\" rel=\"noopener\">evidence\u003c/a> that it encourages the brain to rewire, to alter the connections between cells. That process has been linked to recovery from depression. And it may also explain why ketamine helps people who have symptoms associated with several different psychiatric disorders.\u003c/p>\n\u003cp>\"I think it's having multiple effects, and that means it's probably useful for multiple different disorders,\" Teicher says.\u003c/p>\n\u003cp>One of those effects involves a part of the brain involved in temperature regulation. And that could explain why patients like James usually stop overheating once they are taking ketamine.\u003c/p>\n\u003cp>James started taking a ketamine nasal spray every other day. He says his response was dramatic.\u003c/p>\n\u003cp>\"One day I turn to my wife and I'm like, 'I feel calm today. I don't know if it's the sun coming in, I don't know if it's just the way we're sitting here, but I feel like I could go and sit at the computer and work.' \"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The next day, James did sit down at his computer. A month later, he was back at work.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=From+Chaos+To+Calm%3A+A+Life+Changed+By+Ketamine&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Superbug Infections Rising Among Injection Drug Users",
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"content": "\u003cp>One type of superbug bacteria is increasingly spreading among people who inject drugs, according to a new government report.[contextly_sidebar id=\"TXMleCivt4faTqfnHbYmWo399CSQC3BJ\"]\u003c/p>\n\u003cp>Users of heroin and other injection drugs were 16 times more likely than other people to develop severe illnesses from MRSA, said the report published Thursday.\u003c/p>\n\u003cp>“Drug use has crept up and now accounts for a substantial proportion of these very serious infections,” said Dr. William Schaffner of Vanderbilt University, one of the study’s authors.\u003c/p>\n\u003cp>The U.S. is in the midst of its deadliest drug epidemic ever. While overdose deaths have been the main concern, some studies have noted HIV and hepatitis C infections are spreading among drug users. The authors say the new report is one of the first — and the largest — to highlight how superbug bacterial infections are spreading, too.\u003c/p>\n\u003cp>MRSA, or methicillin-resistant Staphylococcus aureus bacteria, often live on the skin without causing symptoms. But they can become more dangerous if they enter the bloodstream, destroying heart valves or causing other damage. Health officials have tied MRSA to as many as 11,000 U.S. deaths a year.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Public health efforts have focused on MRSA’s spread in hospitals and nursing homes, and infection-control campaigns have been credited for recent drops in MRSA infections at health care facilities.\u003c/p>\n\u003cp>But as that success story has unfolded, MRSA infections tied to illicit drug use have risen.[contextly_sidebar id=\"oC0RKWTYVM9cf8f2VjlDuZZ78N8xiI1P\"]\u003c/p>\n\u003cp>The opioid epidemic began with abuse of prescription pain pills, but in recent years has shifted to heroin and other injectable drugs.\u003c/p>\n\u003cp>MRSA “is on the skin, and as the needle goes into the skin it brings the bacteria with it,” explained Dr. Isaac See of the Centers for Disease Control and Prevention, another of the study’s authors.\u003c/p>\n\u003cp>The proportion of invasive, bloodstream-infecting MRSA cases that occurred among injection drug users more than doubled in five years, the study found. In 2011, 4 percent of those MRSA cases involved injection drug users; in 2016, the proportion was 9 percent.\u003c/p>\n\u003cp>The report is based on infections diagnosed at hospitals across Connecticut and in parts of California, Georgia, Minnesota, New York and Tennessee. Data were collected from 2005 through 2016.\u003c/p>\n\u003cp>About 39,000 invasive MRSA cases were reported, including about 2,100 among people who inject drugs.\u003c/p>\n\u003cp>___\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The Associated Press Health & Science Department receives \u003ca href=\"https://www.ap.org/press-releases/2018/ap-hhmi-expand-collaboration-to-bolster-health-science-coverage\" target=\"_blank\" rel=\"noopener\">support\u003c/a> from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>One type of superbug bacteria is increasingly spreading among people who inject drugs, according to a new government report.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Users of heroin and other injection drugs were 16 times more likely than other people to develop severe illnesses from MRSA, said the report published Thursday.\u003c/p>\n\u003cp>“Drug use has crept up and now accounts for a substantial proportion of these very serious infections,” said Dr. William Schaffner of Vanderbilt University, one of the study’s authors.\u003c/p>\n\u003cp>The U.S. is in the midst of its deadliest drug epidemic ever. While overdose deaths have been the main concern, some studies have noted HIV and hepatitis C infections are spreading among drug users. The authors say the new report is one of the first — and the largest — to highlight how superbug bacterial infections are spreading, too.\u003c/p>\n\u003cp>MRSA, or methicillin-resistant Staphylococcus aureus bacteria, often live on the skin without causing symptoms. But they can become more dangerous if they enter the bloodstream, destroying heart valves or causing other damage. Health officials have tied MRSA to as many as 11,000 U.S. deaths a year.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Public health efforts have focused on MRSA’s spread in hospitals and nursing homes, and infection-control campaigns have been credited for recent drops in MRSA infections at health care facilities.\u003c/p>\n\u003cp>But as that success story has unfolded, MRSA infections tied to illicit drug use have risen.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The opioid epidemic began with abuse of prescription pain pills, but in recent years has shifted to heroin and other injectable drugs.\u003c/p>\n\u003cp>MRSA “is on the skin, and as the needle goes into the skin it brings the bacteria with it,” explained Dr. Isaac See of the Centers for Disease Control and Prevention, another of the study’s authors.\u003c/p>\n\u003cp>The proportion of invasive, bloodstream-infecting MRSA cases that occurred among injection drug users more than doubled in five years, the study found. In 2011, 4 percent of those MRSA cases involved injection drug users; in 2016, the proportion was 9 percent.\u003c/p>\n\u003cp>The report is based on infections diagnosed at hospitals across Connecticut and in parts of California, Georgia, Minnesota, New York and Tennessee. Data were collected from 2005 through 2016.\u003c/p>\n\u003cp>About 39,000 invasive MRSA cases were reported, including about 2,100 among people who inject drugs.\u003c/p>\n\u003cp>___\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The Associated Press Health & Science Department receives \u003ca href=\"https://www.ap.org/press-releases/2018/ap-hhmi-expand-collaboration-to-bolster-health-science-coverage\" target=\"_blank\" rel=\"noopener\">support\u003c/a> from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "California Sues Two Makers of Baby Formula For Lead Contamination",
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"content": "\u003cp>The state of California is suing two companies, Nutraceutical Corp. and Graceleigh Inc., whose toddler formulas contain dangerous levels of lead that exceed both state and federal standards.[contextly_sidebar id=\"dDFZfxJC6DngGGIurpGHrevnbYYzKMAg\"]\u003c/p>\n\u003cp>State \u003ca href=\"https://www.oag.ca.gov/news/press-releases/attorney-general-becerra-issues-cease-and-desist-letters-and-files-suit-over\" target=\"_blank\" rel=\"noopener\">testing\u003c/a> revealed that the two products -- Peaceful Planet Toddler Supreme and Sammy’s Milk Free-Range Goat Milk Toddler Formula – contained between 13 and 15 times the maximum allowable dose level under California law.\u003c/p>\n\u003cp>California Attorney General Xavier Becerra told reporters on Thursday that after the state Department of Justice issued cease-and-desist orders, the companies voluntarily agreed to stop selling the contaminated baby formulas in California.[contextly_sidebar id=\"A1OKE7foNBL4C7EMCs4DtnAcdEd76Tw8\"]\u003c/p>\n\u003cp>\"Parents across America, and certainly in California, on a daily basis rely on the representations made by companies,\" said Becerra during the press conference, \"to make sure that what our children are eating is not only good for them, but is safe as well.\"\u003c/p>\n\u003cp>In\u003ca href=\"https://www.oag.ca.gov/news/press-releases/attorney-general-becerra-issues-cease-and-desist-letters-and-files-suit-over\" target=\"_blank\" rel=\"noopener\"> a statement\u003c/a> accompanying the announcement, the department called the findings a “parent’s worst nightmare\" and said the lawsuit is intended to put all manufacturers on notice.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"The California Department of Justice will hold you accountable for gambling with our children’s health,\" the agency warned.\u003c/p>\n\u003cp>The lawsuit, which seeks monetary penalties, alleges that the companies violated California’s Unfair Competition Law, False Advertising Law, and Proposition 65, which requires companies to adequately warn consumers that their products expose them to toxic chemicals.\u003c/p>\n\u003cp>\"Parents across America, and certainly in California, on a daily basis rely on the representations made by companies,\" said Becerra during today's presser, \"to make sure that what our children are eating is not only good for them, but is safe as well.\"\u003c/p>\n\u003cp>And when it comes to lead consumption, there really isn't a tolerable level for children, according to Dr. Timur Durrani, a toxicologist at UCSF.[contextly_sidebar id=\"2INd1f7DezHFZVXzQK6VbkQZUIqMUhE2\"]\u003c/p>\n\u003cp>\"One message I would put to you is that there really is no safe level of lead, particularly for children,\" he told reporters at the announcement.\u003c/p>\n\u003cp>According to the Mayo Clinic, \u003ca href=\"https://www.mayoclinic.org/diseases-conditions/lead-poisoning/symptoms-causes/syc-20354717\" target=\"_blank\" rel=\"noopener\">even small amounts\u003c/a> of lead can cause serious health problems in children, affecting their mental and physical development. Chronic lead exposure can seriously impair brain development and lead to learning and behavioral problems.\u003c/p>\n\u003cp>The presence of lead in baby formula is especially concerning, said Becerra, since toddlers consume it daily.\u003c/p>\n\u003cp>Lead, a naturally occurring chemical, is found in the environment in small amounts. The majority of human exposure to it is through activities such as ceramics, or products such as cosmetics, paint and toys, according to the \u003ca href=\"https://www.epa.gov/lead/learn-about-lead\" target=\"_blank\" rel=\"noopener\">Environmental Protection Agency.\u003c/a>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Becerra has urged parents of toddlers who consumed the contaminated formulas to get them tested for lead exposure.\u003c/p>\n\n",
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"excerpt": "Products contained 13 to 15 times allowable levels -- but physicians warn there is no \"safe\" level for children.",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>The state of California is suing two companies, Nutraceutical Corp. and Graceleigh Inc., whose toddler formulas contain dangerous levels of lead that exceed both state and federal standards.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>State \u003ca href=\"https://www.oag.ca.gov/news/press-releases/attorney-general-becerra-issues-cease-and-desist-letters-and-files-suit-over\" target=\"_blank\" rel=\"noopener\">testing\u003c/a> revealed that the two products -- Peaceful Planet Toddler Supreme and Sammy’s Milk Free-Range Goat Milk Toddler Formula – contained between 13 and 15 times the maximum allowable dose level under California law.\u003c/p>\n\u003cp>California Attorney General Xavier Becerra told reporters on Thursday that after the state Department of Justice issued cease-and-desist orders, the companies voluntarily agreed to stop selling the contaminated baby formulas in California.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\"Parents across America, and certainly in California, on a daily basis rely on the representations made by companies,\" said Becerra during the press conference, \"to make sure that what our children are eating is not only good for them, but is safe as well.\"\u003c/p>\n\u003cp>In\u003ca href=\"https://www.oag.ca.gov/news/press-releases/attorney-general-becerra-issues-cease-and-desist-letters-and-files-suit-over\" target=\"_blank\" rel=\"noopener\"> a statement\u003c/a> accompanying the announcement, the department called the findings a “parent’s worst nightmare\" and said the lawsuit is intended to put all manufacturers on notice.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"The California Department of Justice will hold you accountable for gambling with our children’s health,\" the agency warned.\u003c/p>\n\u003cp>The lawsuit, which seeks monetary penalties, alleges that the companies violated California’s Unfair Competition Law, False Advertising Law, and Proposition 65, which requires companies to adequately warn consumers that their products expose them to toxic chemicals.\u003c/p>\n\u003cp>\"Parents across America, and certainly in California, on a daily basis rely on the representations made by companies,\" said Becerra during today's presser, \"to make sure that what our children are eating is not only good for them, but is safe as well.\"\u003c/p>\n\u003cp>And when it comes to lead consumption, there really isn't a tolerable level for children, according to Dr. Timur Durrani, a toxicologist at UCSF.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\"One message I would put to you is that there really is no safe level of lead, particularly for children,\" he told reporters at the announcement.\u003c/p>\n\u003cp>According to the Mayo Clinic, \u003ca href=\"https://www.mayoclinic.org/diseases-conditions/lead-poisoning/symptoms-causes/syc-20354717\" target=\"_blank\" rel=\"noopener\">even small amounts\u003c/a> of lead can cause serious health problems in children, affecting their mental and physical development. Chronic lead exposure can seriously impair brain development and lead to learning and behavioral problems.\u003c/p>\n\u003cp>The presence of lead in baby formula is especially concerning, said Becerra, since toddlers consume it daily.\u003c/p>\n\u003cp>Lead, a naturally occurring chemical, is found in the environment in small amounts. The majority of human exposure to it is through activities such as ceramics, or products such as cosmetics, paint and toys, according to the \u003ca href=\"https://www.epa.gov/lead/learn-about-lead\" target=\"_blank\" rel=\"noopener\">Environmental Protection Agency.\u003c/a>\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Becerra has urged parents of toddlers who consumed the contaminated formulas to get them tested for lead exposure.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Clinic Claims Success In Making Babies With 3 Parents' DNA",
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"content": "\u003cp>In a clinic on a side street in Kiev, the capital of Ukraine, doctors are doing something that, as far as is publicly known, is being done nowhere else in the world: using DNA from three different people to create babies for women who are infertile.[contextly_sidebar id=\"hJp3PK3nX6Xp23jBK7povAqNM584M314\"]\u003c/p>\n\u003cp>\"If you can help these families to achieve their own babies, why it must be forbidden?\" \u003ca href=\"http://nadiyaclinic.com/about-the-clinic/our-team/valery-zukin/\" target=\"_blank\" rel=\"noopener\">Valery Zukin\u003c/a>, director of the \u003ca href=\"http://nadiyaclinic.com/\" target=\"_blank\" rel=\"noopener\">Nadiya Clinic\u003c/a>, asks as he peers over his glasses. \"It is a dream to want to have a genetic connection with a baby.\"\u003c/p>\n\u003cp>I traveled to Ukraine because Zukin promised unusual access to his private fertility clinic, including the first demonstration for a U.S. journalist of how scientists create \"three-parent\" babies — a procedure prohibited by the U.S. Food and Drug Administration.\u003c/p>\n\u003cp>Zukin also arranged the first-ever interview with a mother of a 15-month-old boy who is one of the four children he says he has produced this way.\u003c/p>\n\u003cp>Three more of his patients are pregnant, Zukin says, including a woman from Sweden. Women from several other countries including Britain, Brazil and Israel are going through the process, he says.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Leading ethicists and genetics researchers criticize the clinic for rushing ahead to use this method for infertility. No one knows whether children produced this way will be healthy, they say. And some worry the procedure may open the door to \"designer babies.\"\u003c/p>\n\u003cp>\"This is pretty troubling,\" says \u003ca href=\"https://www.geneticsandsociety.org/user/25\" target=\"_blank\" rel=\"noopener\">Marcy Darnovsky\u003c/a>, who heads the Center for Genetics and Society, a U.S.-based watchdog group.\u003c/p>\n\u003cp>But Zukin dismisses those criticisms.\u003c/p>\n\u003cp>\"As a doctor I understand only one thing: We have parents who couldn't have children and now they have their own biological child. That's all,\" Zukin says.[contextly_sidebar id=\"e9qixdqsJYlqHyn9aCm0jBm9SiC8DfaI\"]\u003c/p>\n\u003cp>Zukin has helped form a \u003ca href=\"http://www.dl-nadiya.com/\" target=\"_blank\" rel=\"noopener\">company\u003c/a>, Darwin Life-Nadiya, with a \u003ca href=\"https://www.newhopefertility.com/\" target=\"_blank\" rel=\"noopener\">New York clinic\u003c/a> to market the service to U.S. women willing to travel to Ukraine. Ukrainian women pay about $8,000 for the procedure; for foreigners, it's about $15,000.\u003c/p>\n\u003cp>\u003cstrong>Transferring DNA From Egg to Egg\u003c/strong>\u003c/p>\n\u003cp>To show how the procedure works, Zukin sends me upstairs to the embryo lab. After putting on a sterile blue gown and booties, I meet Pavlo Mazur, a clinic embryo scientist.\u003c/p>\n\u003cp>\"We will begin,\" Mazur says, as he takes a clear plastic dish out of an incubator.\u003c/p>\n\u003cp>The dish contains a 1-day-old embryo. It was created by fertilizing the egg of a woman with sperm from her male partner.\u003c/p>\n\u003cp>The dish also holds a second embryo. This was made using the same man's sperm to fertilize an egg from another woman, who was paid to donate eggs.\u003c/p>\n\u003cp>After sliding the embryos under a large microscope, Mazur starts a timer. He has only 15 minutes to complete the delicate procedure without risking damage to the embryos.\u003c/p>\n\u003cp>A monitor nearby displays what Mazur sees through the microscope. A round structure comes into focus on the screen. It's one of the embryos.[contextly_sidebar id=\"lH4aHr8bWw920dNDT3zPx9BxxYAHoA23\"]\u003c/p>\n\u003cp>\"You see?\" Mazur says, pointing to two smaller round structures inside. They contain the DNA of the man and woman trying to have a baby.\u003c/p>\n\u003cp>\"One is from sperm. It's paternal,\" Mazur says. \"And the second one is maternal.\"\u003c/p>\n\u003cp>Mazur slowly inserts a tiny, hollow glass needle into the fertilized egg. Even though Mazur is under pressure to work fast, he can't move too quickly.\u003c/p>\n\u003cp>\"Very steady and slow,\" Mazur says. \"We don't want to damage it, right? We want it to survive.\"\u003c/p>\n\u003cp>He uses the needle to extract the would-be parents' DNA. Mazur does the same thing with the second fertilized egg, removing all the DNA — except for 37 genes known as \u003ca href=\"https://ghr.nlm.nih.gov/mitochondrial-dna\" target=\"_blank\" rel=\"noopener\">mitochondrial DNA\u003c/a>.\u003c/p>\n\u003cp>Mitochondria provide energy for eggs. A defect in the patient's mitochondrial DNA might be what's preventing her from getting pregnant. So using the donor's mitochondrial DNA may be what enables the patient to produce healthy embryos and babies.\u003c/p>\n\u003cp>\"It's like an universal currency for a cell,\" Mazur says. \"It helps for all processes within the cell.\"\u003c/p>\n\u003cp>The next step is to transfer the DNA of the woman and man trying to have a child into the donor's mostly gutted embryo — empty except for the other woman's mitochondrial DNA.\u003c/p>\n\u003cp>\"And now we will just try to put the genetic material of our patient inside,\" Mazur says as he gently inserts the needle holding the couple's DNA and injects the genes.\u003c/p>\n\u003cp>\"That's it,\" he says, glancing at his timer to see there are still two minutes left.\u003c/p>\n\u003cp>\"So, you see? It's inside,\" Mazur says, pointing to the couple's DNA. \"It will develop into embryo.\"\u003c/p>\n\u003cp>The Nadiya clinic is transferring embryos reconstructed this way into the wombs of women trying to become pregnant.\u003c/p>\n\u003cp>So far, the clinic has tried the procedure on 21 women. Fourteen attempts failed, probably because the women were older, the clinic staffers say.\u003c/p>\n\u003cp>But the other women either had babies or are pregnant. They were younger, but could never produce viable embryos on their own.\u003c/p>\n\u003cp>\"I adore that such technology exists. I adore that it can help some people,\" says Mazur.\u003c/p>\n\u003cp>These babies end up with DNA from three different people: the woman trying to have a baby; her male partner; and the egg donor who has provided 37 mitochondrial genes. That's why they're called three-parent babies.\u003c/p>\n\u003cp>But Mazur says that label is wrong.\u003c/p>\n\u003cp>\"These babies — they have DNA from mother and from father. So they are genetically related to their parents,\" Mazur says.[contextly_sidebar id=\"epZCsHoOtfaC0xfJUpdgovxcZOsKlTBF\"]\u003c/p>\n\u003cp>The overwhelming majority of the baby's DNA comes from the nucleus of the cell. And those are the genes responsible for the traits that most people consider their genetic inheritance, such as their eye and hair color, height, weight and personality.\u003c/p>\n\u003cp>The bit of mitochondrial DNA is \"incomparable,\" Mazur says. \"These children are more like their parents — not donor.\"\u003c/p>\n\u003cp>Mazur will present the clinic's latest results at the \u003ca href=\"https://www.eshre.eu/\" target=\"_blank\" rel=\"noopener\">European Society of Human Reproduction and Embryology\u003c/a>'s annual meeting in Barcelona in July.\u003c/p>\n\u003cp>\u003cstrong>Moving too fast?\u003c/strong>\u003c/p>\n\u003cp>Some scientists are welcoming this as a potentially exciting new option for some women.\u003c/p>\n\u003cp>\"It is pioneering work,\" says \u003ca href=\"http://cumc.p.cumcweb.org/mdphd/profile/degli\" target=\"_blank\" rel=\"noopener\">Dietrich Egli\u003c/a>, an assistant professor of developmental biology at Columbia University Medical Center in New York. The procedure is technically known as \"pronuclear transfer.\"\u003c/p>\n\u003cp>\"What we can learn from their work is that pronuclear transfer may be useful for some cases of infertility,\" says Egli.\u003c/p>\n\u003cp>But critics say it's far too soon to be attempting this procedure to create children.\u003c/p>\n\u003cp>\"This is really an irresponsible kind of human experimentation,\" Darnovsky of the Center for Genetics and Society says.\u003c/p>\n\u003cp>Not nearly enough laboratory and animal research has been done to know if the procedure is safe, Darnovsky and others say.\u003c/p>\n\u003cp>\"We just don't know what's going to happen to these children,\" Darnovsky says.\u003c/p>\n\u003cp>In the 1990s, a doctor in New Jersey injected fluid from healthy eggs into the eggs of infertile women, and some babies were born with mitochondrial DNA from three people. But that was discontinued after the FDA intervened.\u003c/p>\n\u003cp>Only one other baby is known to have been produced using a technique similar to the one being used by Zukin. \u003ca href=\"https://www.newhopefertility.com/about-us/fertility-doctor/john-zhang/\" target=\"_blank\" rel=\"noopener\">John Zhang\u003c/a> of the \u003ca href=\"https://www.newhopefertility.com/\" target=\"_blank\" rel=\"noopener\">New Hope Fertility Center\u003c/a> in New York performed a related procedure for a Jordanian couple to try to prevent their child from having \u003ca href=\"https://ghr.nlm.nih.gov/condition/leigh-syndrome\" target=\"_blank\" rel=\"noopener\">Leigh syndrome\u003c/a>, a disorder caused by defects in mitochondrial DNA.\u003c/p>\n\u003cp>That's why the procedure was developed — to help women carrying \u003ca href=\"https://medlineplus.gov/mitochondrialdiseases.html\" target=\"_blank\" rel=\"noopener\">mitochondrial disorders\u003c/a> have healthy children. In severe cases, these disorders can be fatal.\u003c/p>\n\u003cp>A U.S. National Academy of Sciences panel \u003ca href=\"https://www.npr.org/sections/health-shots/2016/02/03/465319186/babies-with-genes-from-three-people-could-be-ethical-panel-says\" target=\"_blank\" rel=\"noopener\">concluded\u003c/a> it could be ethical to attempt the procedure for this purpose. But because the FDA \u003ca href=\"https://www.fda.gov/BiologicsBloodVaccines/CellularGeneTherapyProducts/ucm570185.htm\">won't allow\u003c/a> it at all in the United States, the baby of the Jordanian couple whom \u003ca href=\"https://www.npr.org/sections/thetwo-way/2016/09/27/495668299/new-york-fertility-doctor-says-he-created-baby-with-3-genetic-parents\" target=\"_blank\" rel=\"noopener\">Zhang helped was born in Mexico in 2016.\u003c/a>\u003c/p>\n\u003cp>Doctors in the United Kingdom have started trying the technique to prevent mitochondrial disorders. But the British doctors are being \u003ca href=\"https://www.npr.org/2015/02/03/383578221/u-k-lawmakers-allow-scientists-to-attempt-dna-transplants\">allowed\u003c/a> to try to make only one baby at a time as part of a tightly regulated \u003ca href=\"https://www.npr.org/sections/health-shots/2014/11/10/360342623/combining-the-dna-of-three-people-raises-ethical-questions\" target=\"_blank\" rel=\"noopener\">research program\u003c/a>.[contextly_sidebar id=\"2QVJm0WQxeuB5lotTMLysQyqrPHpvncJ\"]\u003c/p>\n\u003cp>Zukin says he received approval for a five-year research program from the Ukrainian Postgraduate Medical Academy, which is under the auspices of the Ukrainian Ministry of Public Health. But Zukin concedes the procedure is far less regulated in his country. Nevertheless, he makes sure all the women understand they are undergoing an experimental procedure.\u003c/p>\n\u003cp>\"We explain everything to the families. And not all families give permission for providing this experimental procedure,\" he says.\u003c/p>\n\u003cp>Because mitochondrial DNA can be inherited, Darnovsky worries the procedure is crossing a line that long has been considered taboo: making changes in human DNA that can be passed down to future generations. One fear is that a mistake could create a new disease that could be inherited.\u003c/p>\n\u003cp>Mitochondrial DNA is inherited from the mother. Zukin already has used the procedure to produce one baby girl — a girl who could one day pass the mitochondrial DNA to her own children.\u003c/p>\n\u003cp>Darnovsky worries the procedure could also open the door to creating babies who are genetically modified for other reasons.\u003c/p>\n\u003cp>\"What we're seeing is a fast slide down a very slippery slope toward designer babies,\" Darnovsky says. \"We could see parents feeling eager to give their children traits like greater strength, needs less sleep. Some people are saying that, 'Yes, there are genes for IQ and we could have smarter babies.' \"\u003c/p>\n\u003cp>Zukin dismisses speculation about designer babies. He says he's interested only in helping women who are infertile have genetically related children or prevent mitochondrial diseases. And so far, all the babies he has created appear to be perfectly healthy, he says.\u003c/p>\n\u003cp>The only way to know whether the procedure works and is safe is to try it, he argues. He hopes to figure out how to make the procedure work for women suffering from age-related infertility as well, which would help far more women.\u003c/p>\n\u003cp>\"If you would like to swim,\" he says, \"then, first of all, you must jump in the water.\"\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>A second story on Wednesday afternoon features an exclusive interview with a mother and her three-parent son.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Clinic+Claims+Success+In+Making+Babies+With+3+Parents%27+DNA+&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>In a clinic on a side street in Kiev, the capital of Ukraine, doctors are doing something that, as far as is publicly known, is being done nowhere else in the world: using DNA from three different people to create babies for women who are infertile.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\"If you can help these families to achieve their own babies, why it must be forbidden?\" \u003ca href=\"http://nadiyaclinic.com/about-the-clinic/our-team/valery-zukin/\" target=\"_blank\" rel=\"noopener\">Valery Zukin\u003c/a>, director of the \u003ca href=\"http://nadiyaclinic.com/\" target=\"_blank\" rel=\"noopener\">Nadiya Clinic\u003c/a>, asks as he peers over his glasses. \"It is a dream to want to have a genetic connection with a baby.\"\u003c/p>\n\u003cp>I traveled to Ukraine because Zukin promised unusual access to his private fertility clinic, including the first demonstration for a U.S. journalist of how scientists create \"three-parent\" babies — a procedure prohibited by the U.S. Food and Drug Administration.\u003c/p>\n\u003cp>Zukin also arranged the first-ever interview with a mother of a 15-month-old boy who is one of the four children he says he has produced this way.\u003c/p>\n\u003cp>Three more of his patients are pregnant, Zukin says, including a woman from Sweden. Women from several other countries including Britain, Brazil and Israel are going through the process, he says.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Leading ethicists and genetics researchers criticize the clinic for rushing ahead to use this method for infertility. No one knows whether children produced this way will be healthy, they say. And some worry the procedure may open the door to \"designer babies.\"\u003c/p>\n\u003cp>\"This is pretty troubling,\" says \u003ca href=\"https://www.geneticsandsociety.org/user/25\" target=\"_blank\" rel=\"noopener\">Marcy Darnovsky\u003c/a>, who heads the Center for Genetics and Society, a U.S.-based watchdog group.\u003c/p>\n\u003cp>But Zukin dismisses those criticisms.\u003c/p>\n\u003cp>\"As a doctor I understand only one thing: We have parents who couldn't have children and now they have their own biological child. That's all,\" Zukin says.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Zukin has helped form a \u003ca href=\"http://www.dl-nadiya.com/\" target=\"_blank\" rel=\"noopener\">company\u003c/a>, Darwin Life-Nadiya, with a \u003ca href=\"https://www.newhopefertility.com/\" target=\"_blank\" rel=\"noopener\">New York clinic\u003c/a> to market the service to U.S. women willing to travel to Ukraine. Ukrainian women pay about $8,000 for the procedure; for foreigners, it's about $15,000.\u003c/p>\n\u003cp>\u003cstrong>Transferring DNA From Egg to Egg\u003c/strong>\u003c/p>\n\u003cp>To show how the procedure works, Zukin sends me upstairs to the embryo lab. After putting on a sterile blue gown and booties, I meet Pavlo Mazur, a clinic embryo scientist.\u003c/p>\n\u003cp>\"We will begin,\" Mazur says, as he takes a clear plastic dish out of an incubator.\u003c/p>\n\u003cp>The dish contains a 1-day-old embryo. It was created by fertilizing the egg of a woman with sperm from her male partner.\u003c/p>\n\u003cp>The dish also holds a second embryo. This was made using the same man's sperm to fertilize an egg from another woman, who was paid to donate eggs.\u003c/p>\n\u003cp>After sliding the embryos under a large microscope, Mazur starts a timer. He has only 15 minutes to complete the delicate procedure without risking damage to the embryos.\u003c/p>\n\u003cp>A monitor nearby displays what Mazur sees through the microscope. A round structure comes into focus on the screen. It's one of the embryos.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\"You see?\" Mazur says, pointing to two smaller round structures inside. They contain the DNA of the man and woman trying to have a baby.\u003c/p>\n\u003cp>\"One is from sperm. It's paternal,\" Mazur says. \"And the second one is maternal.\"\u003c/p>\n\u003cp>Mazur slowly inserts a tiny, hollow glass needle into the fertilized egg. Even though Mazur is under pressure to work fast, he can't move too quickly.\u003c/p>\n\u003cp>\"Very steady and slow,\" Mazur says. \"We don't want to damage it, right? We want it to survive.\"\u003c/p>\n\u003cp>He uses the needle to extract the would-be parents' DNA. Mazur does the same thing with the second fertilized egg, removing all the DNA — except for 37 genes known as \u003ca href=\"https://ghr.nlm.nih.gov/mitochondrial-dna\" target=\"_blank\" rel=\"noopener\">mitochondrial DNA\u003c/a>.\u003c/p>\n\u003cp>Mitochondria provide energy for eggs. A defect in the patient's mitochondrial DNA might be what's preventing her from getting pregnant. So using the donor's mitochondrial DNA may be what enables the patient to produce healthy embryos and babies.\u003c/p>\n\u003cp>\"It's like an universal currency for a cell,\" Mazur says. \"It helps for all processes within the cell.\"\u003c/p>\n\u003cp>The next step is to transfer the DNA of the woman and man trying to have a child into the donor's mostly gutted embryo — empty except for the other woman's mitochondrial DNA.\u003c/p>\n\u003cp>\"And now we will just try to put the genetic material of our patient inside,\" Mazur says as he gently inserts the needle holding the couple's DNA and injects the genes.\u003c/p>\n\u003cp>\"That's it,\" he says, glancing at his timer to see there are still two minutes left.\u003c/p>\n\u003cp>\"So, you see? It's inside,\" Mazur says, pointing to the couple's DNA. \"It will develop into embryo.\"\u003c/p>\n\u003cp>The Nadiya clinic is transferring embryos reconstructed this way into the wombs of women trying to become pregnant.\u003c/p>\n\u003cp>So far, the clinic has tried the procedure on 21 women. Fourteen attempts failed, probably because the women were older, the clinic staffers say.\u003c/p>\n\u003cp>But the other women either had babies or are pregnant. They were younger, but could never produce viable embryos on their own.\u003c/p>\n\u003cp>\"I adore that such technology exists. I adore that it can help some people,\" says Mazur.\u003c/p>\n\u003cp>These babies end up with DNA from three different people: the woman trying to have a baby; her male partner; and the egg donor who has provided 37 mitochondrial genes. That's why they're called three-parent babies.\u003c/p>\n\u003cp>But Mazur says that label is wrong.\u003c/p>\n\u003cp>\"These babies — they have DNA from mother and from father. So they are genetically related to their parents,\" Mazur says.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The overwhelming majority of the baby's DNA comes from the nucleus of the cell. And those are the genes responsible for the traits that most people consider their genetic inheritance, such as their eye and hair color, height, weight and personality.\u003c/p>\n\u003cp>The bit of mitochondrial DNA is \"incomparable,\" Mazur says. \"These children are more like their parents — not donor.\"\u003c/p>\n\u003cp>Mazur will present the clinic's latest results at the \u003ca href=\"https://www.eshre.eu/\" target=\"_blank\" rel=\"noopener\">European Society of Human Reproduction and Embryology\u003c/a>'s annual meeting in Barcelona in July.\u003c/p>\n\u003cp>\u003cstrong>Moving too fast?\u003c/strong>\u003c/p>\n\u003cp>Some scientists are welcoming this as a potentially exciting new option for some women.\u003c/p>\n\u003cp>\"It is pioneering work,\" says \u003ca href=\"http://cumc.p.cumcweb.org/mdphd/profile/degli\" target=\"_blank\" rel=\"noopener\">Dietrich Egli\u003c/a>, an assistant professor of developmental biology at Columbia University Medical Center in New York. The procedure is technically known as \"pronuclear transfer.\"\u003c/p>\n\u003cp>\"What we can learn from their work is that pronuclear transfer may be useful for some cases of infertility,\" says Egli.\u003c/p>\n\u003cp>But critics say it's far too soon to be attempting this procedure to create children.\u003c/p>\n\u003cp>\"This is really an irresponsible kind of human experimentation,\" Darnovsky of the Center for Genetics and Society says.\u003c/p>\n\u003cp>Not nearly enough laboratory and animal research has been done to know if the procedure is safe, Darnovsky and others say.\u003c/p>\n\u003cp>\"We just don't know what's going to happen to these children,\" Darnovsky says.\u003c/p>\n\u003cp>In the 1990s, a doctor in New Jersey injected fluid from healthy eggs into the eggs of infertile women, and some babies were born with mitochondrial DNA from three people. But that was discontinued after the FDA intervened.\u003c/p>\n\u003cp>Only one other baby is known to have been produced using a technique similar to the one being used by Zukin. \u003ca href=\"https://www.newhopefertility.com/about-us/fertility-doctor/john-zhang/\" target=\"_blank\" rel=\"noopener\">John Zhang\u003c/a> of the \u003ca href=\"https://www.newhopefertility.com/\" target=\"_blank\" rel=\"noopener\">New Hope Fertility Center\u003c/a> in New York performed a related procedure for a Jordanian couple to try to prevent their child from having \u003ca href=\"https://ghr.nlm.nih.gov/condition/leigh-syndrome\" target=\"_blank\" rel=\"noopener\">Leigh syndrome\u003c/a>, a disorder caused by defects in mitochondrial DNA.\u003c/p>\n\u003cp>That's why the procedure was developed — to help women carrying \u003ca href=\"https://medlineplus.gov/mitochondrialdiseases.html\" target=\"_blank\" rel=\"noopener\">mitochondrial disorders\u003c/a> have healthy children. In severe cases, these disorders can be fatal.\u003c/p>\n\u003cp>A U.S. National Academy of Sciences panel \u003ca href=\"https://www.npr.org/sections/health-shots/2016/02/03/465319186/babies-with-genes-from-three-people-could-be-ethical-panel-says\" target=\"_blank\" rel=\"noopener\">concluded\u003c/a> it could be ethical to attempt the procedure for this purpose. But because the FDA \u003ca href=\"https://www.fda.gov/BiologicsBloodVaccines/CellularGeneTherapyProducts/ucm570185.htm\">won't allow\u003c/a> it at all in the United States, the baby of the Jordanian couple whom \u003ca href=\"https://www.npr.org/sections/thetwo-way/2016/09/27/495668299/new-york-fertility-doctor-says-he-created-baby-with-3-genetic-parents\" target=\"_blank\" rel=\"noopener\">Zhang helped was born in Mexico in 2016.\u003c/a>\u003c/p>\n\u003cp>Doctors in the United Kingdom have started trying the technique to prevent mitochondrial disorders. But the British doctors are being \u003ca href=\"https://www.npr.org/2015/02/03/383578221/u-k-lawmakers-allow-scientists-to-attempt-dna-transplants\">allowed\u003c/a> to try to make only one baby at a time as part of a tightly regulated \u003ca href=\"https://www.npr.org/sections/health-shots/2014/11/10/360342623/combining-the-dna-of-three-people-raises-ethical-questions\" target=\"_blank\" rel=\"noopener\">research program\u003c/a>.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Zukin says he received approval for a five-year research program from the Ukrainian Postgraduate Medical Academy, which is under the auspices of the Ukrainian Ministry of Public Health. But Zukin concedes the procedure is far less regulated in his country. Nevertheless, he makes sure all the women understand they are undergoing an experimental procedure.\u003c/p>\n\u003cp>\"We explain everything to the families. And not all families give permission for providing this experimental procedure,\" he says.\u003c/p>\n\u003cp>Because mitochondrial DNA can be inherited, Darnovsky worries the procedure is crossing a line that long has been considered taboo: making changes in human DNA that can be passed down to future generations. One fear is that a mistake could create a new disease that could be inherited.\u003c/p>\n\u003cp>Mitochondrial DNA is inherited from the mother. Zukin already has used the procedure to produce one baby girl — a girl who could one day pass the mitochondrial DNA to her own children.\u003c/p>\n\u003cp>Darnovsky worries the procedure could also open the door to creating babies who are genetically modified for other reasons.\u003c/p>\n\u003cp>\"What we're seeing is a fast slide down a very slippery slope toward designer babies,\" Darnovsky says. \"We could see parents feeling eager to give their children traits like greater strength, needs less sleep. Some people are saying that, 'Yes, there are genes for IQ and we could have smarter babies.' \"\u003c/p>\n\u003cp>Zukin dismisses speculation about designer babies. He says he's interested only in helping women who are infertile have genetically related children or prevent mitochondrial diseases. And so far, all the babies he has created appear to be perfectly healthy, he says.\u003c/p>\n\u003cp>The only way to know whether the procedure works and is safe is to try it, he argues. He hopes to figure out how to make the procedure work for women suffering from age-related infertility as well, which would help far more women.\u003c/p>\n\u003cp>\"If you would like to swim,\" he says, \"then, first of all, you must jump in the water.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>A second story on Wednesday afternoon features an exclusive interview with a mother and her three-parent son.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Clinic+Claims+Success+In+Making+Babies+With+3+Parents%27+DNA+&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>",
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"disqusTitle": "Millions May Have Been Prescribed the Wrong Heart Meds, Study Says",
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"content": "\u003cp>More than 11 million Americans may have received incorrect prescriptions for aspirin, statins and blood pressure medications to prevent a heart attack or stroke, according to a study by the \u003ca href=\"http://med.stanford.edu/\">Stanford University School of Medicine\u003c/a>.[contextly_sidebar id=\"umDTpLmik9hK8eNRjnsW7rpmcRPF19ZX\"]\u003c/p>\n\u003cp>That's because the tool used to estimate a patient's risk of heart attack or stroke is based on outdated data, apparently off by as much as 20 percent, according to the \u003ca href=\"http://annals.org/aim/article-abstract/2683613/clinical-implications-revised-pooled-cohort-equations-estimating-atherosclerotic-cardiovascular-disease\" target=\"_blank\" rel=\"noopener\">study\u003c/a>, published Monday in \u003cem>Annals of Internal Medicine.\u003c/em>\u003c/p>\n\u003cp>\"A lot has changed in terms of diets, environments and medical treatment since the 1940s,” senior author Dr. Sanjay Basu said in the \u003ca href=\"http://med.stanford.edu/news/all-news/2018/06/millions-could-have-incorrect-statin-aspirin-blood-pressure-prescriptions.html\" target=\"_blank\" rel=\"noopener\">press release \u003c/a>that accompanied the study. “So, relying on our grandparents’ data to make our treatment choices is probably not the best idea.”\u003c/p>\n\u003cp>The problem was discovered when some doctors, including Basu, kept noticing that the current tool was failing to accurately predict risk in their patients, particularly if they were African American.\u003c/p>\n\u003cp>Because the calculator was built on older studies that lacked a sufficient sample of African-Americans, doctors may have in fact been underestimating the risks of heart attacks or strokes in those patients.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“So while many Americans were being recommended aggressive treatments that they may not have needed according to current guidelines, some Americans — particularly African-Americans — may have been given false reassurance and probably need to start treatment given our findings,” Basu said in the press release.[contextly_sidebar id=\"IVz9AhjwqJ3N1XCCqSO9xlwYfN9Xm5GQ\"]\u003c/p>\n\u003cp>The study says that in many cases medications were over prescribed.\u003c/p>\n\u003cp>A CBS \u003ca href=\"https://www.cbsnews.com/news/millions-of-americans-could-be-getting-wrong-heart-meds-study-finds/\" target=\"_blank\" rel=\"noopener\">report\u003c/a> describes the calculator's importance in developing preventive treatments:\u003c/p>\n\u003cblockquote>\u003cp>Risk estimate tools predict the likelihood of a future heart attack or stroke in the next 10 years. Doctors use these tools to help them decide what treatment a patient needs, if any at all.\u003c/p>\u003c/blockquote>\n\u003cp>In response to the troubling findings, the team of researchers developed a new calculator, incorporating an updated list of risk factors. From a \u003ca href=\"https://www.statnews.com/2018/06/04/new-risk-calculator-could-change-the-aspirin-statins-and-blood-pressure-medications-some-people-take/\" target=\"_blank\" rel=\"noopener\">STAT \u003c/a>news story:\u003c/p>\n\u003cblockquote>\u003cp>To test their methods, the researchers created two models. In the first one, they updated the cohorts they used. The populations were more diverse racially and ethnically, and they also reflected factors that can’t necessarily be captured by blood tests. Nutrition, physical activity, or even secondhand smoke — which wasn’t recognized in the 1940s — can affect a person’s baseline risk for disease. That’s why risk calculators don’t stay accurate forever.\u003c/p>\u003c/blockquote>\n\u003cp>Some doctors, however, still question whether the updated calculator can accurately assess risks in communities of color.\u003c/p>\n\u003cp>Dr. Andrew DeFilippis and Patrick Trainor of the University of Louisville, Kentucky say the new calculator falls short in accounting for racial differences in risk factors.\u003c/p>\n\u003cp>“This question is timely because a growing Hispanic population and 40 percent increase in Asian-Americans account for more than half of the U. S. population growth between 2000 and 2019,” they said in an \u003ca href=\"http://annals.org/aim/article/doi/10.7326/M18-1175\" target=\"_blank\" rel=\"noopener\">editorial\u003c/a> published with the Stanford study. “We clearly need an accurate risk assessment tool for these growing American populations.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The Stanford researchers say the newer tool will need to be updated with changing times.\u003c/p>\n\n",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003cp>More than 11 million Americans may have received incorrect prescriptions for aspirin, statins and blood pressure medications to prevent a heart attack or stroke, according to a study by the \u003ca href=\"http://med.stanford.edu/\">Stanford University School of Medicine\u003c/a>.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>That's because the tool used to estimate a patient's risk of heart attack or stroke is based on outdated data, apparently off by as much as 20 percent, according to the \u003ca href=\"http://annals.org/aim/article-abstract/2683613/clinical-implications-revised-pooled-cohort-equations-estimating-atherosclerotic-cardiovascular-disease\" target=\"_blank\" rel=\"noopener\">study\u003c/a>, published Monday in \u003cem>Annals of Internal Medicine.\u003c/em>\u003c/p>\n\u003cp>\"A lot has changed in terms of diets, environments and medical treatment since the 1940s,” senior author Dr. Sanjay Basu said in the \u003ca href=\"http://med.stanford.edu/news/all-news/2018/06/millions-could-have-incorrect-statin-aspirin-blood-pressure-prescriptions.html\" target=\"_blank\" rel=\"noopener\">press release \u003c/a>that accompanied the study. “So, relying on our grandparents’ data to make our treatment choices is probably not the best idea.”\u003c/p>\n\u003cp>The problem was discovered when some doctors, including Basu, kept noticing that the current tool was failing to accurately predict risk in their patients, particularly if they were African American.\u003c/p>\n\u003cp>Because the calculator was built on older studies that lacked a sufficient sample of African-Americans, doctors may have in fact been underestimating the risks of heart attacks or strokes in those patients.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>",
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"content": "\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“So while many Americans were being recommended aggressive treatments that they may not have needed according to current guidelines, some Americans — particularly African-Americans — may have been given false reassurance and probably need to start treatment given our findings,” Basu said in the press release.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The study says that in many cases medications were over prescribed.\u003c/p>\n\u003cp>A CBS \u003ca href=\"https://www.cbsnews.com/news/millions-of-americans-could-be-getting-wrong-heart-meds-study-finds/\" target=\"_blank\" rel=\"noopener\">report\u003c/a> describes the calculator's importance in developing preventive treatments:\u003c/p>\n\u003cblockquote>\u003cp>Risk estimate tools predict the likelihood of a future heart attack or stroke in the next 10 years. Doctors use these tools to help them decide what treatment a patient needs, if any at all.\u003c/p>\u003c/blockquote>\n\u003cp>In response to the troubling findings, the team of researchers developed a new calculator, incorporating an updated list of risk factors. From a \u003ca href=\"https://www.statnews.com/2018/06/04/new-risk-calculator-could-change-the-aspirin-statins-and-blood-pressure-medications-some-people-take/\" target=\"_blank\" rel=\"noopener\">STAT \u003c/a>news story:\u003c/p>\n\u003cblockquote>\u003cp>To test their methods, the researchers created two models. In the first one, they updated the cohorts they used. The populations were more diverse racially and ethnically, and they also reflected factors that can’t necessarily be captured by blood tests. Nutrition, physical activity, or even secondhand smoke — which wasn’t recognized in the 1940s — can affect a person’s baseline risk for disease. That’s why risk calculators don’t stay accurate forever.\u003c/p>\u003c/blockquote>\n\u003cp>Some doctors, however, still question whether the updated calculator can accurately assess risks in communities of color.\u003c/p>\n\u003cp>Dr. Andrew DeFilippis and Patrick Trainor of the University of Louisville, Kentucky say the new calculator falls short in accounting for racial differences in risk factors.\u003c/p>\n\u003cp>“This question is timely because a growing Hispanic population and 40 percent increase in Asian-Americans account for more than half of the U. S. population growth between 2000 and 2019,” they said in an \u003ca href=\"http://annals.org/aim/article/doi/10.7326/M18-1175\" target=\"_blank\" rel=\"noopener\">editorial\u003c/a> published with the Stanford study. “We clearly need an accurate risk assessment tool for these growing American populations.”\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>The Stanford researchers say the newer tool will need to be updated with changing times.\u003c/p>\n\n\u003c/div>\u003c/p>",
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"info": "Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? How can we get there? Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.",
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"soldout": {
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