Ask a Patient® Health News: September 19, 2023
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- Today and tomorrow (September 19 and 20, 2023), the U.S. Food and Drug Administration Pediatric Advisory Committee is holding a meeting on "artificial womb technology." Technical, regulatory and ethical considerations will be presented related to "first in human (FIH)" clinical trials that use systems to mimic the womb for babies born extremely preterm. Two techniques have been developed, one of which involves placing the premature baby in a plastic "womb," and the other which doesn’t surround babies with fluid, but instead fills only their lungs though an endotracheal tube.
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Click image to view "live action" photo of actual lamb in artifical womb. This lamb was one of eight in a 2017 artificial-womb experiment carried out by researchers at the Children’s Hospital of Philadelphia (CHOP) in Pennsylvania. In the"live action" photo, the lamb, which is only about three-quarters of the way through its gestation period, seems to be dreaming. Article and image source:
https://www.nature.com/articles/d41586-023-02901-1
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Today (September 19), some panel members raised concerns about nutrition issues and the intrauterine environment using "sterile" amniotic fluid. They suggest more animal studies are needed and that more animals should be brought to term to find out what happens to the microbiome. Members also stressed the need to identify safety issues, goals for progress, define adverse effects and have a protocol for what happens in an emergency. On September 20, 2023, the meeting will be closed to permit discussion and review of trade secret and/or confidential commercial information
FDA meeting materials, the set of questions for the committee to consider, and links to presentations and the webcast: https://www.fda.gov/advisory-committees/pediatric-advisory-committee/2023-meeting-materials-pediatric-advisory-committee
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New Medical Charges: $ for Emails
- Spurred by the sharp rise in email messaging during the covid pandemic, a growing number of health systems have started charging patients when physicians and other clinicians send replies to their messages. One patient expressed her surprise at a $13 co-pay for a reply sent through the "MyChart" portal from her primary care doctor at University of Michigan Health.
Health systems that have adopted billing for some e-visits include a number of the nation’s premier medical institutions: Cleveland Clinic, Mayo Clinic, San Francisco-based UCSF Health, Vanderbilt Health, St. Louis-based BJC HealthCare, Chicago-based Northwestern Medicine, and the U.S. Department of Veterans Affairs. Billing for e-visits raises questions about the balance between fairly compensating providers for their time and enhancing patients’ access to care. At University of Michigan Health, patients receive an alert prior to sending a message that there may be a charge; they must click a box indicating they understand. https://kffhealthnews.org/news/article/email-doctor-visits-new-fees-copays/
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Blood Shortage
- The American Red Cross has declared a national blood shortage in the wake of a record catastrophic year for natural disasters across the country. The national blood supply has fallen nearly 25% since early August. Hurricane Idalia, which two weeks ago slammed through Florida, Georgia, and the Carolinas, caused more than 700 units of blood and platelets to go uncollected. The Red Cross says there is an emergency need for platelet donors and type O blood donors. https://www.redcross.org/about-us/news-and-events/press-release/2023/red-cross-announces-national-blood-shortage.html
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Research News
- Cedars Sinai Health researchers found that half of patients who suffer a sudden cardiac arrest experience symptoms in the hours, days, or weeks before their cardiac arrest, and that the prevalence of warning symptoms differ for women and men. Among women, dyspnea (or shortness of breath) was significantly associated with sudden cardiac arrest. Among men, chest pain, dyspnea, and diaphoresis (sweatiness) were all significantly associated with sudden cardiac arrest. People who call 911 before a collapse from sudden cardiac arrest are more than five times more likely to survive. The study was published in The Lancet Digital Health. https://medicine.yale.edu/swim/news-article/sex-specific-warning-symptoms-of-cardiac-arrest/
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- A study by researchers at University of Groningen found that people with consistently high levels of urinary albumin excretion (UAE) and serum creatinine in their urine are at higher risk of developing heart failure. The new finding supports the known connection between kidney failure and heart failure. Cardiologist Dr. Richard Wright, not involved in the study but interviewed by Medical News Today, suggests including a simple urine test measuring UAE and serum creatinine during checkups—a test he suspects few doctors prescribe. The study was published in European Journal of Heart Failure. https://www.medicalnewstoday.com/articles/could-a-urine-test-help-predict-the-risk-for-first-time-heart-failure
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Medical Mystery
In 2009, Avid runner and security consultant Randolph Pherson developed unexplainable episodes of shortness of breath. His heart was deemed healthy based on a nuclear stress test, so he was treated for asthma for several years. But the breathlessness continued. I turned out that his heart was not healthy – when he went to an ER after having difficulty walking, he found out that four coronary arteries were blocked and underwent quadruple bypass surgery. Health problems continued and in the following years he had unexplained episodes of fevers, chills, joint pain, and anemia.
It wasn’t until a September 2021 vacation in Iceland, during which he became seriously ill, that a rheumatologist in Reykjavik connected the dots that would lead to his diagnosis. While his condition is such a newly identified disease that it is considered rare at the moment, doctors think “this is a disease hiding in plain sight.” Read Sandra Boodman’s latest medical mystery. https://www.washingtonpost.com/wellness/2023/09/09/fevers-swelling-breathlessness-medical-mystery/?itid=sf_article_list
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Influenza Vaccines: Flu Season
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It's flu shot season! The vaccine choices are the same as last year, but the CDC has announced that even if you have an egg allergy, it is safe to take an egg-based vaccine. About 25% of the available vaccines will be egg-free. Vaccine manufacturers have projected that they will supply the United States with as many as 156.2 million to 170 million doses of influenza vaccines for the upcoming 2023-2024 season. The CDC recommends getting a flu shot by the end of October.
Check out past years' reviews of the various vaccines and add yours: https://www.askapatient.com/comparedrugs.asp?class=INFLUENZA+VACCINES
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Ask a Patient® Health Newsletter: September 19, 2023 Copyright, 2023
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