Orphan Drugs

 By Megan Lutz

This article is about pharmaceutical companies having to submit applications for their treatments
to be labeled as "orphan drugs" (a drug used to treat any disease with
less than 200,000 affected in the US). With this designation,
companies receive several incentives, including tax breaks and
marketing privileges, that help to offset the fact that they have a
very limited pool of people to which they can sell their product. My
mom works for one of the companies mentioned in this article, and she
has had the opportunity to work on a drug called Sabril, used to treat
a type of seizure affecting about 8,500 infants. I know that this drug
has been a huge endeavor for the company and there has been several
obstacles, including finding enough subjects to use for clinical
support of the drug's effectiveness. I think that this is interesting
to us as future physicians for several reasons and serves as a
reminder that there are many interactions involved in medicine in
addition to the one occurring between the doctor and the patient.

http://online.wsj.com/article/SB10001424052748704145904575111943356541152.html?KEYWORDS=orphan+drugs

Abstienence Only Sex Education

 By Christine Graves

Obama administration has begun to shift federal funding from abstinence-until-marriage sex education programs to reducing teen pregnancy "through science-based prevention approaches,"; however, a recent study has shown that abstinence-only sex education program was effective in delaying sexual activity among teenagers. But, there were some positive effects from a comprehensive sex education including reduction of number of students reporting multiple sexual partners. Read more below about the debate on what we should be teaching teenagers about sex. Become educated on the different sides of the debate, form your own well-informed opinion, and impress others with your knowledge!

Latest Abstinence Study Does Little To Quell Sex Education Debate
A recent study showing that an experimental abstinence-only sex education program was effective in delaying sexual activity among teenagers is far from the last word in the debate over sex education, the Boston Globe reports. According to the Globe, the study's results come at a "pivotal point" in the debate, as the latest data show that the U.S. teen pregnancy rate rose in 2006 for the first time in since the early 1990s. The sex education study, conducted by researchers from the University of Pennsylvania, found that sixth- and seventh-graders in Philadelphia who were enrolled in an abstinence-only program that did not include a moralistic message were less likely to become sexually active than students who completed a comprehensive program that included information about contraception.
The results of the new study have reopened the "tinderbox that is sex education" and shown that it is "as combustible as ever," the Globe reports. Bill Albert, chief program officer for the National Campaign To Prevent Teen and Unplanned Pregnancy, said the debate over sex education "is a mini culture war." He added, "The reason why this is so fraught with controversy and elicits such passion is because it touches on some primal issues that people care deeply about -- education of our children, when and under what circumstances to start a family, sex."

Abstinence-only advocates claim the recent study offers "proof they were right all along," the Globe reports (Smith, Boston Globe, 2/15). The advocacy group Abstinence Clearinghouse on its Web site proclaimed that the study proved "comprehensive sex ed a big flop." However, such claims are disputed by John Jemmott, the lead author of the study, who said that the program in the study would not have qualified for federal funding under the Bush administration because it did not emphasize abstinence until marriage and included information on contraception.

Jemmott added that the study also did not prove that a more comprehensive program failed, as that approach resulted in some positive outcomes, such as reducing the number of students who reported multiple sexual partners. "On the one hand are people who are concerned that the comprehensive intervention was not significant, and on the other are those who are happy that it wasn't significant," Jemmott said, adding, "Both reactions are wrong" (Flam, Philadelphia Inquirer, 2/16). 

 

Valerie Huber, executive director of the National Abstinence Education Association, said that although Jemmott's study was more rigorous than those in the past, opponents of abstinence-only education have been too critical of previous studies. "When opponents just repeat the same sound bites without a real understanding of what the broad abstinence field looks like, it can cast a much different view of what these programs really are," Huber said, adding, "That's another reason I'm actually happy the conversation has been reopened as a result of this study."

The results of the study come as the Obama administration has begun to shift federal funding from abstinence-until-marriage sex education programs to reducing teen pregnancy "through science-based prevention approaches," according to a federal official. According to Albert, the program created for Jemmott's study would meet the new standard for federal funding, although it is unknown how effective the program would be in a different community or among other adolescents. "I don't think we can let the perfect be the enemy of the good," Albert said, adding, "We now have a good program that's been well-evaluated and well-tested. Let's go try it elsewhere" (Boston Globe, 2/15). He also said, "We need to buck up and move beyond politics to invest in things that work. While adults are arguing about all this, teenagers are getting pregnant" (Philadelphia Inquirer, 2/16). 

From http://www.medicalnewstoday.com/articles/179349.php

MCAT vs Personality

Bryce Bond

      The biggest challenge of any pre-medicine student is matriculating into a medical program.  Regardless of one’s choice of D.O or M.D., one thing is clear…you must perform well on the MCAT.  A lesser G.P.A can be forgiven by excellent MCAT marks but a sub-28 composite and most students start looking at Master’s in Public Health programs.  An interesting article caught my attention in the New York Times a while ago.  The columnist sought to look into whether the importance of the MCAT is starting to be downplayed or even eliminated.  Here is the link to the story http://www.nytimes.com/2010/01/15/health/14chen.html.

I think the personality testing that is proposed in the article is a vital assessment medical schools should take either replacing the MCAT scores or supplementing an application.  As a junior who is taking the MCAT this summer, I am very weary of receiving a poor score on the test.  Although I believe that I will end up doing just fine on the exam, I would like to think that my value as a doctor is more than the amount of science I know.  From firsthand experience as a surgical patient this summer, character counts.  With that said, we all want the surgeon who wrote the textbook (and in my case I did in fact have that surgeon).  The point is clear and everyone should already know it:  We are more than the information we learn because of our character.  The columnist also added that the personality testing would be a means of showing that a hard working individual can, in fact, make-up his or her lower score one the MCAT.  Good work ethic makes doctors more aware and better at what they do.  Ultimately, each person brings something unique to the medical field and that needs to be evaluated and considered by schools.  Doctor-patient interactions are most crucial when hard decisions have to be made.  I know I trusted my doctor this summer to no end.  He was able to provide care when I was most vulnerable and did so with kindness and skill.  Someday, hopefully, I will be able to bring a similar experience to my patients.

Let's Move! Michelle Obama Launches Campaign Against Childhood Obesity

Michelle Obama has launched a project about childhood obesity.

 

It's a big campaign, but here are few highlights that caught our eye, via a White House press release:

• Next Generation Food Pyramid: To help people make healthier food and physical activity choices, the U.S. Department of Agriculture will revamp the famous food pyramid. MyPyramid.gov is one of the most popular websites in the federal government, and a 2.0 version of the Web site will offer consumers a host of tools to help them put the Dietary Guidelines into practice.
• Reauthorize the Child Nutrition Act: The Administration is requesting an historic investment of an additional $10 billion over ten years starting in 2011 to improve the quality of the National School Lunch and Breakfast program, increase the number of kids participating, and ensure schools have the resources they need to make program changes, including training for school food service workers, upgraded kitchen equipment, and additional funding for meal reimbursements. With this investment, additional fruits, vegetables, whole grains, and low-fat dairy products will be served in our school cafeterias and an additional one million students will be served in the next five years.
• Eliminate Food Deserts: As part of the President’s proposed FY 2011 budget, the Administration announced the new Healthy Food Financing Initiative - a partnership between the U.S. Departments of Treasury, Agriculture and Health and Human Services that will invest $400 million a year to help bring grocery stores to underserved areas and help places such as convenience stores and bodegas carry healthier food options. Through these initiatives and private sector engagement, the Administration will work to eliminate food deserts across the country within seven years.
• Increase Farmers Markets: The President’s 2011 Budget proposes an additional $5 million investment in the Farmers Market Promotion Program at the U.S. Department of Agriculture which provides grants to establish, and improve access to, farmers markets.

http://laist.com/2010/02/09/lets_move_michelle_obama_launches_c.php

Katie Nau

Robotic Surgery

"This article highlights a serious problem in modern medicine: the general acceptance of a new medical approach based on aggressive advertising citing uncertain studies. It becomes unimportant whether a surgeon feels that the robotic approach is unlikely to yield better or even equal results to a traditional method. The patient, as a consumer, has already been convinced. We thus see still more increased expense in spite of the uncertainty of the method’s usefulness and the sharp learning curve associated with it, even for experienced surgeons." - Henry
"It's become popular because of the media and patients have been asking for it more for minor surgeries, even though it is typically more expensive and is unproven whether it has better outcomes than traditional surgeries. One of the doctors interviewed for the article attributes this mostly to marketing." -Teresa

On one level, robot-assisted surgery makes sense. A robot’s slender arms can reach places human hands cannot, and robot-assisted surgery is spreading to other areas of medicine.
But robot-assisted prostate surgery costs more — about $1,500 to $2,000 more per patient. And it is not clear whether its outcomes are better, worse or the same.
One large national study, which compared outcomes among Medicare patients, indicated that surgery with a robot might lead to fewer in-hospital complications, but that it might also lead to more impotence and incontinence. But the study included conventional laparoscopy patients among the ones who had robot-assisted surgery, making it difficult to assess its conclusions.

 http://www.nytimes.com/2010/02/14/health/14robot.html?ref=health

Henry Dust and Teresa Vodopest

Obama Plans Bipartisan Summit on Health Care

President Obama renewed his promise for a televised bipartisan discussion about health care between Democrats and Republicans. After months of secret meetings behind closed doors and an endless game of he-said she-said both sides are expected to present new proposals and embrace other possibilities. Although the health care debate has seemed interminable and with little progress, Obama believes reform is still possible. The date is set for Thursday, February 25.

http://www.nytimes.com/2010/02/08/us/politics/08webobama.html?ref=health

Amy Johnson

Dems look at bypassing Senate health care vote

Interesting, and definitely worth a read.

By CHARLES BABINGTON

BOSTON (AP) - A panicky White House and Democratic allies scrambled Sunday for a plan to salvage their hard-fought health care package in case a Republican wins Tuesday's Senate race in Massachusetts, which would enable the GOP to block further Senate action.
The likeliest scenario would require persuading House Democrats to accept a bill the Senate passed last month, despite their objections to several parts.
Aides consulted Sunday amid fears that Republican Scott Brown will defeat Democrat Martha Coakley in the special election to fill the late Edward M. Kennedy's seat. A Brown win would give the GOP 41 Senate votes, enough to filibuster and block final passage of the House-Senate compromise on health care now being crafted.
House Democrats, especially liberals, viewed those compromises as vital because they view the Senate-passed version as doing too little to help working families. Under the Senate-passed bill, 94 percent of Americans would be covered, compared to 96 percent in the version passed last year by the House.
The House plan would increase taxes on millionaires while the Senate plan would tax so-called Cadillac, high-cost health insurance plans enjoyed by many corporate executives as well as some union members.
When the House passed its version, members assumed it would be reconciled with the Senate bill and then sent back to both chambers for final approval, even if by the narrowest of margins.
A GOP win in Massachusetts on Tuesday would likely kill that plan, because Republicans could block Senate action on the reconciled bill.
The newly discussed fallback would require House Democrats to swallow hard and approve the Senate-passed bill without changes. President Barack Obama could sign it into law without another Senate vote needed.
House leaders would insist that the Senate make some changes later under a complex plan called "budget reconciliation." It requires only a simple majority, but it's unclear whether that could happen.
The plan is highly problematic. House liberals already are bristling over changes the Senate forced upon them earlier, and some may conclude that no bill is better than the Senate bill. Meanwhile, some moderate Democrats may abandon the health bill altogether after seeing a Republican win Kennedy's seat in strongly Democratic Massachusetts.
Republican activists openly scoffed at the notion of Democrats passing the highly contentious health package after a GOP takeover of Kennedy's Senate seat. But some Democrats said failure to pass a health bill will cripple their ability to tell voters this November that they accomplished anything with their control of the House, Senate and White House.
"The simplest way is the House route," a White House aide said Sunday, speaking on condition of anonymity because Democrats have not conceded the race to Brown.
White House press secretary Robert Gibbs declined to discuss the option, telling reporters that the administration expects Coakley to win.
If she does win, final passage of a House-Senate compromise on overhauling health care is not guaranteed but seems likely.
But even as Obama campaigned for Coakley in Boston Sunday, top aides furiously weighed options if she loses. They include:
_Acting before Brown is sworn in. Congressional and White House negotiators could try to reconcile the House and Senate bills quickly and pass the new version before Brown takes office. A firestorm of criticism would follow, but some Democrats say it would be better than having no bill.
_Seeking a Republican to cast the crucial 60th Senate vote. Some Democrats hope Sen. Olympia Snowe, R-Maine, might do this, but others seriously doubt it.
_Start over and pass a new, scaled back health bill using budget reconciliation, which requires a simple majority of 51 Senate votes. Several Senate aides said this was unlikely.
Speaker Nancy Pelosi has repeatedly ruled out a House vote on the Senate's version, and privately, officials have raised concerns about asking the rank and file to vote on legislation containing provisions that might prove problematic in the midterm elections.
As an example, the Senate-passed measure exempts self-insured health plans from many of the steps Democrats say are essential to curb insurance industry abuses. By one estimate, as many as 100 million individuals are covered under such plans.
It was unclear how the negotiators at the White House in recent days have resolved that issue.
Additionally, House Democrats in last week's talks pushed for additional subsidies for lower-income individuals and families who would be required to buy insurance under the measure that cleared the Senate. Several Democrats familiar with the talks said Obama had agreed with this point of view, and changes had been made accordingly.
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Associated Press writers David Espo and Ricardo Alonso-Zaldivar contributed to this report.

http://apnews.myway.com/article/20100118/D9D9U7Q80.html