Category: Health

Gene Editing of Embryos Promises to Cure Inherited Diseases

(p. A13) For the first time in the United States, scientists have edited the genes of human embryos, a controversial step toward someday helping babies avoid inherited diseases.
. . .
The Oregon scientists reportedly used a technique called CRISPR, which allows specific sections of DNA to be altered or replaced. It’s like using a molecular scissors to cut and paste DNA, and is much more precise than some types of gene therapy that cannot ensure that desired changes will take place exactly where and as intended. With gene editing, these so-called “germline” changes are permanent and would be passed down to any offspring.
The approach holds great potential to avoid many genetic diseases, . . .
. . .
One prominent genetics expert, Dr. Eric Topol, director of the Scripps Translational Science Institute in La Jolla, California, said gene editing of embryos is “an unstoppable, inevitable science, and this is more proof it can be done.”
Experiments are in the works now in the U.S. using gene-edited cells to try to treat people with various diseases, but “in order to really have a cure, you want to get this at the embryo stage,” he said.

For the full story, see:
THE ASSOCIATED PRESS. “U.S. Scientists Edit Genes in Human Embryo.” The New York Times (Fri., JULY 28, 2017): A13.
(Note: ellipses added.)
(Note: the online version of the story has the date JULY 27, 2017, and has the title “In U.S. First, Scientists Edit Genes of Human Embryos.”)

Artificial Technology Can Make Food Safer

(p. A11) . . . the wider food-handling community increasingly is calling for a “kill step” in handling raw vegetables and produce.
Cooking (properly) is a kill step that works for food that is cooked.
. . .
After the 2015 disaster, Chipotle hired Prof. James Marsden of Kansas State University’s renowned food safety program. By the details released so far, the company has indeed begun experimenting with kill steps. These include blanching–dipping produce in boiling water–or spritzing with “natural” pathogen-neutralizers like lemon juice. Certain tasks have also been shifted to a central, McDonald’s -style kitchen and away from the local restaurant, though the company says certain steps were reversed when customers complained about the taste or appearance of their meals.
. . . Many in the food-safety camp are already keen on more-energetic kill steps, such as irradiation, chemical treatment with ozone or chlorine compounds, or the use of high-barometric-pressure systems.
. . .
A 2007 KSU study put volunteers in a test kitchen to see if they could follow directions safely to prepare frozen, uncooked, breaded chicken products. Many couldn’t. Among the findings: 100% of adolescents (the kind that work in fast-food restaurants) claimed they washed their hands when video monitoring showed they hadn’t.

For the full commentary, see:
Holman W. Jenkins, Jr. “Chipotle Seeks a ‘Kill Step’; America’s growing taste for fresh greens is a challenge to food-handling practices.” The Wall Street Journal (Sat.., July 29, 2017): A11.
(Note: ellipses added.)
(Note: the online version of the commentary has the date July 28, 2017.)

War and Pandemics Are Greater Threats than Global Warming

(p. A17) To arrive at a wise policy response, we first need to consider how much economic damage climate change will do. Current models struggle to come up with economic costs commensurate with apocalyptic political rhetoric. Typical costs are well below 10% of gross domestic product in the year 2100 and beyond.
That’s a lot of money–but it’s a lot of years, too. Even 10% less GDP in 100 years corresponds to 0.1 percentage point less annual GDP growth. Climate change therefore does not justify policies that cost more than 0.1 percentage point of growth. If the goal is 10% more GDP in 100 years, pro-growth tax, regulatory and entitlement reforms would be far more effective.
. . .
Global warming is not the only risk our society faces. Even if science tells us that climate change is real and man-made, it does not tell us, as President Obama asserted, that climate change is the greatest threat to humanity. Really? Greater than nuclear explosions, a world war, global pandemics, crop failures and civil chaos?
No. Healthy societies do not fall apart over slow, widely predicted, relatively small economic adjustments of the sort painted by climate analysis. Societies do fall apart from war, disease or chaos. Climate policy must compete with other long-term threats for always-scarce resources.

For the full commentary, see:
David R. Henderson and John H. Cochrane. “Climate Change Isn’t the End of the World; Even if world temperatures rise, the appropriate policy response is still an open question.” The Wall Street Journal (Mon., July 31, 2017): A17.
(Note: ellipsis added.)
(Note: the online version of the commentary has the date July 30, 2017.)

Health Innovations Launch Where Regulations Are Few

(p. A15) One type of mobile device that is likely to appear first in the Far East and be widely adopted there is the digital stethoscope. This device is able to detect changes in pitch and soon will be able to detect asthma in children, pneumonia in the elderly, and, in conjunction with low-cost portable electrocardiographs, cardiopulmonary disease.
An additional advantage is that this part of the world–particularly India and Africa–has limited regulation, which makes it much easier to launch these kinds of health-care tools. In India and much of Africa, there are few government drug agencies or big insurance companies to throw up barriers.
Companies that make medical devices and their accompanying smartphone apps could establish themselves almost overnight. Then, once they have built a large, profitable base of users, they could consider jumping through the legal and regulatory hoops to bring the technology to developed countries.

For the full commentary, see:
Michael S. Malone. “Silicon Valley Trails in Medical Tech; With smartphones everywhere and little regulation, India and Africa are set to lead..” The Wall Street Journal (Mon., July 24, 2017): A15.
(Note: the online version of the commentary has the date July 23, 2017.)

U.S. Has 250,000 Less Jobs Due to Obamacare

(p. A15) Democrats loudly complain that people will lose health insurance if the Affordable Care Act is repealed. They never mention those who lose jobs because the ACA remains.
The ACA includes a penalty on employers that fail to provide “adequate” insurance for full-time workers. Thanks to the ACA, hiring the 50th full-time employee effectively costs another $70,000 a year on top of the normal salary and benefits.
. . .
In partnership with the Mercatus Center at George Mason University, in March 2017 I was able to commission Hanover Research to survey small businesses nationwide regarding their hiring and compensation practices. The result was a sample of 745 small businesses, representing every major industry and together employing almost 50,000 people.
. . .
Many businesses, when they do not offer coverage, keep their payrolls just below 50 full-time employees and thereby narrowly escape the ACA’s penalty. This pattern is not visible among businesses that offer coverage.
When we followed up, the businesses employing just fewer than 50 often said the ACA caused them to hire less and cut hours below the full-time threshold. The penalty caused payrolls to shrink or prevented them from growing.
Nationwide, we estimate the ACA-inspired practice of keeping payrolls below 50 has cost roughly 250,000 jobs. This does not count jobs lost when businesses close (we didn’t survey closed businesses) or shrink because of other ACA incentives.

For the full commentary, see:

Casey B. Mulligan. “How Many Jobs Does ObamaCare Kill? We surveyed managers at small businesses and put the count at 250,000.” The Wall Street Journal (Thurs., July 6, 2017): A15.
(Note: ellipses added.)
(Note: the online version of the commentary has the date July 5, 2017.)

“90 Is the New 65”

(p. A15) In this era full of baby boomers caring for frail parents, we’ve seen plenty of documentaries, plays and memoirs about dementia, infirmity, loss. But in the HBO documentary “If You’re Not in the Obit, Eat Breakfast,” Carl Reiner and friends take up another side of the phenomenon of longer life spans: the many people in their later years who are still sharp and vigorous and engaged.
The film, . . . , doesn’t pussyfoot around when setting its bar; no “life after 65” theme here. Mr. Reiner is interested in people 90 and above.
. . .
There is chagrin on occasion; no one likes the condescension that is often showered on people of this age.
“I think the culture stereotypes everything,” Norman Lear says. “Because I’m 93 I’m supposed to behave a certain way. The fact that I can touch my toes shouldn’t be so amazing to people.” (Mr. Lear is now 94.)
. . .
. . . there is plenty of life yet in the population born before the Great Depression. Now the broader culture needs to consider how to change its preconceptions if 90 is the new 65.

For the full review, see:
NEIL GENZLINGER. “Life Goes On (The 90-and-Up Crowd.” The New York Times (Fri., JUNE 5, 2017): C7.
(Note: ellipses added.)
(Note: the online version of the review has the date JUNE 4, 2017, and has the title “Review: ‘If You’re Not in the Obit, Eat Breakfast’ Finds Vigor After 90.”)

Britain’s Socialist National Health Service Failed to Update Old Software

(p. A4) LONDON — Martin Hardy was in his hospital gown, about to be wheeled into the operating room for knee surgery on Saturday morning [May 13, 2017] at Royal London Hospital in East London, when, he said, his operation was abruptly canceled.
Mr. Hardy, 52, a caregiver for his father, said his surgeon told him the operation could not be carried out because the hospital’s computer system was not working and his condition was not life-threatening.
“I was in my hospital robe literally about to go in,” he said, wincing as he stood on crutches outside the hospital, waiting for a taxi home. “How can anyone in their right mind do such a thing?” he added, referring to the people behind the devastating cyberattack that affected organizations in nearly 100 countries and sent tremors across Britain’s National Health Service.
A day after one of the largest “ransomware” attacks on record, which left thousands of computers at companies in Europe, universities in Asia and hospitals in Britain still crippled or shut down on Saturday, Amber Rudd, the British home secretary, told the BBC that the N.H.S. needed to learn from what had happened and upgrade its information technology system.
. . .
Ms. Rudd conceded that the N.H.S., where many computers had outdated software vulnerable to malware and ransomware, had been ill prepared, despite numerous warnings. “I would expect N.H.S. trusts to learn from this and to make sure that they do upgrade,” she said.
. . .
“You can’t blame the hospital, but surely the N.H.S. knew this could happen?” he said, his face reddening with anger. “And I don’t understand why their computers weren’t secure. We all pay into the N.H.S., and this is what we get. What on earth is going on in this country?”
. . .
Dr. Krishna Chinthapalli, a senior resident at the National Hospital for Neurology and Neurosurgery in London, who predicted a cyberattack on the N.H.S. in an article published in the British Medical Journal a few days before the attack, said it was disturbing.
“I had expected an attack,” he said in an interview. “But not on this scale.”
He had warned in the article that hospitals were especially vulnerable to ransomware attacks because they held vital data, and were probably more willing than others to pay a ransom to recover it. He said in the interview that many of the N.H.S. computers still ran Windows XP, an out-of-date software.

For the full story, see:
DAN BILEFSKY. “British Patients Suffer as Hospitals Race to Revive Computer Systems.” The New York Times, First Section (Sun., MAY 14, 2017): 11.
(Note: ellipses, and bracketed date, added.)
(Note: the online version of the story has the date MAY 13, 2017, and has the title “British Patients Reel as Hospitals Race to Revive Computer Systems.”)

Socialized Medicine Seeks to Ensure “No One Does Anything New or Interesting”

(p. A15) Heart surgeons are among the superstars of the medical profession, possessing finely tuned skills and a combination of detachment and sheer guts that enables them to carve open fellow human beings and hold the most vital human organ in their hands. In “Open Heart,” British cardiac surgeon Stephen Westaby shares often astonishing stories of his own operating-room experiences, illuminating the science and art of his specialty through the patients whose lives he has saved and, in some cases, lost.
. . .
One theme in “Open Heart” is Dr. Westaby’s frustration with Britain’s National Health Service, which, he says, values saving money over saving lives. He grows frustrated as he tries to get the reluctant government-run payer to cover the costs of advanced interventions. There are other problems too: Dire situations often get worse, he says, because of treatment delays and poor attention to best practices, like administering clot-busting drugs after a heart attack. Medical directors, he says, seem intent on ensuring that “no one does anything new or interesting.”

For the full review, see:
Laura Landro. “BOOKSHELF; Priming the Pump; One procedure involved implanting a turbine heart-pumping device and screwing a titanium plug, Frankenstein-like, into the skull.” The Wall Street Journal (Fri., July 14, 2017): A15.
(Note: ellipsis added.)
(Note: the online version of the review has the date July 13, 2017.)

The book under review, is:
Westaby, Stephen. Open Heart: A Cardiac Surgeon’s Stories of Life and Death on the Operating Table. New York: Basic Books, 2017.

In Spite of Anxiety about Fatal Mistakes, Starzl Persevered

(p. A10) As he completed his medical training in the late 1950s, Thomas Starzl searched for a way to make his name in the annals of medicine. In an interview late in his life, he recalled asking himself: “What’s out there that needs development but looks impossible?”
The choice seemed obvious to him: transplanting organs.
He became the first surgeon to transplant a human liver successfully in 1967 and went on to do hundreds more, in dicey operations that could last as long as 20 hours. Tall, lean and cerebral, he pioneered drug therapies to fight the body’s rejection of foreign tissue. Though less famous than Christiaan Barnard, who in 1967 was the first to transplant a heart, Dr. Starzl was often called the “father of transplantation.”
. . .
In Miami, crime furnished more than enough gunshot wounds to train a young surgeon. He learned the arts of replacing blood vessels. In his spare time, he experimented on dogs, devised a technique for removing livers and began thinking about how to “install” new ones.
As his surgical skills improved, his anxieties about making potentially fatal mistakes worsened. “With growing concern, I came to believe that I was not emotionally equipped to be a surgeon or to deal with its brutality,” he wrote. “I did not like doing the one thing for which I had become uniquely qualified.” He also felt it was too late to turn back.

For the full obituary, see:
James R. Hagerty. “‘Father of Transplantation’ Defeated His Own Doubts.” The Wall Street Journal (Sat., MARCH 18, 2017): A10.
(Note: ellipsis added.)
(Note: the online version of the obituary has the date MARCH 17, 2017, and has the title “‘Father of Transplantation’ Defeated His Own Doubts and Fears.”)

Retiring Later Improves Health in Old Age

(p. 3) Despite what may seem like obvious benefits, scholars can’t make definitive statements about the health effects of working longer. The research is inherently difficult: Just as retirement can influence health, so can health influence retirement.
“I would say, in my experience, the research is mixed,” said Dr. Maestas of Harvard Medical School. “The studies I have seen tend to show that there are health benefits to working longer.”
As the economists Axel Börsch-Supan and Morten Schuth of the Munich Center for the Economics of Aging of the Max Planck Institute for Social Law and Social Policy put it in an article for the National Bureau of Economic Research, “Even disliked colleagues and a bad boss, we argue, are better than social isolation because they provide cognitive challenges that keep the mind active and healthy.”
Other studies have examined the impact of work and employment on the richness of social networks and social connectedness. The economists Eleonora Patacchini of Cornell University and Gary Engelhardt of Syracuse University tapped into a database of some 1,300 people from ages 57 to 85 that asked about their social networks in 2005 and 2010. After controlling for marital status, age, health and income, they concluded that people who continued to work enjoyed an increase in the size of their networks of family and friends of 25 percent. The social networks of retired people, on the other hand, shrank during the five-year period. In the study, the gains were found to be largely limited to women and older people with postsecondary education.

For the full commentary, see:
CHRISTOPHER FARRELL. “Retiring; Their Jobs Keep Them Healthy.” The New York Times, SundayBusiness Section (Sun., MARCH 5, 2017): 3.
(Note: the online version of the commentary has the date MARCH 3, 2017, and has the title “Retiring; Working Longer May Benefit Your Health.”)

The article by Börsch-Supan and Schuth, is:
Börsch-Supan, Axel, and Morten Schuth. “Early Retirement, Mental Health, and Social Networks.” In Discoveries in the Economics of Aging, edited by David A. Wise. Chicago: University of Chicago Press, 2014, pp. 225-50.

Fearing FDA, Schools Stop Students from Using Sunscreen Lotions

(p. A11) The Sunbeatables curriculum, designed by specialists MD Anderson Cancer Center, features a cast of superheroes who teach children the basics of sun protection including the obvious: how and when to apply sunscreen.
There’s just one wrinkle. Many of the about 1,000 schools where the curriculum is taught are in states that don’t allow students to bring sunscreen to school or apply it without a note from a doctor or parent and trip to the nurse’s office.
Schools have restrictions because the U.S. Food and Drug Administration labels sunscreen as an over-the-counter medication.
. . .
Melanoma accounts for the majority of skin cancer-related deaths and is among the most common types of invasive cancers. One blistering sunburn in childhood or adolescence can double the risk of developing melanoma, says Dr. Tanzi. And sun damage is cumulative. The Skin Cancer Foundation notes that 23% of lifetime sun exposure occurs by age 18. Regular sunscreen application is a widespread recommendation among medical experts though some groups have raised concerns about the chemicals in certain sunscreens.
“Five or more sunburns increases your melanoma risk by 80% and your non-melanoma skin cancer risk by 68%,” Dr. Tanzi says.
Pediatric melanoma cases add up to a small but growing number. There are about 500 children diagnosed every year with the numbers increasing by about 2% each year, says Shelby Moneer, director of education for the Melanoma Research Foundation.

For the full story, see:
Sumathi Reddy. “YOUR HEALTH; It’s School, No Sunscreen Allowed.” The Wall Street Journal (Tues., May 16, 2017): A11.
(Note: ellipsis added.)
(Note: the online version of the story has the date May 15, 2017, and has the title “YOUR HEALTH; Where Kids Aren’t Allowed to Put on Sunscreen: in School.”)