Issue 6: 17 Highlights of 2017

The holidays are finally here! Time to eat a bunch of food, talk to family members we haven't seen in forever, and receive presents we may or may not deserve. As we approach 2018 we want to take a moment to reflect on this past year. Below we got you covered with the 17 biggest stories in the medical field of 2017. Here’s to making New Year’s resolutions and watching that ball drop. Enjoy!

(1) Ketamine: Why Entering the K-hole May Treat Depression

Special K has a rep. Thrill seeking party animals use it as way to get high. Docs in the ER use it as a sedative for short procedures such as fracture reduction. Anesthesiologists and veterinary docs can use it to put patients/animals under before surgery. Recently scientists have discovered that it’s also really effective at treating treatment resistant depression in suicide prone patients. And it works within HOURS. Studies show that between 60-70% of treatment resistant depressive patients respond to "Special K". Psychiatrists are calling it one of the most promising discoveries in antidepressant therapy in decades since the advent of SSRIs, which can take weeks to produce effects and are frequently ineffective. Currently pharma giant Johnson and Johnson is working on stage III clinical trials for its ketamine derivative nasal spray, esketamine, which it projects to generate more than a billion dollars in sales annually.
 
(2) Iphone Addict: FOMO in the Age of NOMOphobia

The average American is estimated to check their smartphone 46 times a day. 9% of people even report checking their phones during sex. The Iphone celebrated its 10th birthday this year, but detractors say that the smartphone is the new crack cocaine. Scientific studies by the University of Missouri have recently revealed psychological impairment and impaired concentration when study participants were separated from their phones. Scientists have even created a NOMOphobia - NO MObile phone phobia - questionnaire that you can take HERE which shows how addicted you are to your phone.  
 
(3) Robot Sperm Could Treat Cancer



Nanotechnologists recently showed that they could effectively deliver doxorubicin via sperm to directly target gynecological cancers in vitro. The idea is that sperm are ideally suited to swim through the female reproductive tract and can better deliver chemotherapy than traditional agents. In the experiments, scientists used bovine sperm which delivered doxorubicin to a mass of cervical cancer cells grown in a petri dish. Over 3 days, the sperm doxo combo killed 87% of the cancer cells. A question you may have is wait...a woman could potentially get prego from this tho right? Scientists say it’s unlikely because the sperm will be outfitted to specifically target cancer cells and in the rare event they do fuse with an egg the sperm would inject anti-cancer drugs which would obvi not be good. To be clear scientists have never done this in real life yet so more exciting experiments to come 

(4) USC D-Bag Deans



In case you were under a (crack) rock for 2017 we got you with this one. The LA Times did some hardcore investigative reporting and brought to light the case of USC Dean, Dr. Pulifiato, who kicked it with a prostitute in his office, tried to cover up her OD in a seedy hotel room that the police intervened in, and smoked meth as well as a host of other hard drugs while dean. After he left USC to *ahem* pursue other career opportunities, he was replaced by a Dr. Rohit Varma who also was kicked out after it came to light that he previously pressured a young female researcher to have sex with him and blackmailed her after she refused.   

(5) Call Me Maybe: Telemedicine



Telemedicine has been slowly adopted across the country yet payments for them from insurance companies lingers far behind. In May, Texas became the final state to allow telemedicine visits without requiring an initial in person meeting between the doc and the patient. Now it is up to health care providers and payers (health insurance companies) to realize the economics of telemedicine. Believe it or not, but the VA (Veteran Affairs) offers more advanced telehealth services than any other healthcare organization in this country! 

(6) 20 Years Later and the VA Believes CPRS May be Outdated
While we are on the topic of the VA, Cerner (2nd largest electronic health record vendor in the US) was awarded a 10 billion dollar contract to create a new EHR to replace CPRS. Have you ever used CPRS? Feels like Microsoft notepad from Windows 1995. Makes sense as CPRS was released in 1997 and minimally modified since then.
(7) FDA Slow AF


Recently president and former reality TV star Donald Trump publicly harangued the FDA for being too slow and burdensome and promised to make changes to the way drugs are approved in the US. In addition to being criticized as being too slow on the approval front, USA TODAY and several major news organizations recently published absolutely damning exposes on how the FDA responds to food recall. According to the HHS office 80% of the US’s food recall can take up to 10 MONTHS to get off the shelves even when people are getting sick! CBS News points out that the FDA’s slowness has directly led to death and miscarriages in pregnant women. We give the FDA a giant F.  

(8) Does My Voice Make Me Sound Fat?

Several companies in the US and Israel are working on voice analysis to detect disease. It turns out that subtle changes in our voice and speech pattern can be used to predict the risk of heart disease and depression. The Mayo Clinic and Israeli Beyond Verbal teamed up to do a study on 150 patients and using Beyond Verbal’s machine learning and voice analysis tech discovered 13 vocal features associated with coronary artery disease. One specific voice characteristic related to frequency changes which can only be detected by the app’s technology and not the human ear discerned a 19x increase in the likelihood of CAD.
 

(9) Early Stage Cancer Blood Biopsies  
Oncology researchers at John Hopkins were able to successfully detect Stage I/II cancer in 86 out of 138 patients already diagnosed with breast, lung, ovarian, or colorectal cancer by scanning patient blood for tumor DNA. Equally impressive the researchers used the same test on 44 cancer-free patients and showed that the blood test did not detect any cancer related mutations. “Liquid Biopsies” already exist for late stage cancer detection, but this study represents one of the first for early stage cancers and could be useful in detecting cancers earlier to provide life-saving treatment.  
  
(10) New HTN guidelines

Earlier this year the American College of Cardiology and the American Heart Association dropped a bombshell by changing the definition of hypertension. Now if you're BP is greater than 130/80 you have HTN! A change from the previous definition as greater than 140/90. Per these new guidelines close to half of the US population will have HTN now. 

(11) CRISPR 2.0 No Superhumans Allowed  


For the past 5 years nerds in white lab coats everywhere have been obsessed with CRISPR/Cas 9, which long story short is a way to edit the genome using the enzymes CRISPR and Cas 9. (Note: this is an extremely simplified explanation. For more detail go HERE). Scientists this year made major waves by using the CRISPR technology on human embryos and for the first time ever on an adult human being. A medical team at SichuanUniversity in Chendu delivered modified cells using CRISPR into a patient withnon small cell lung cancer in a clinical trial that is still currently underway. Earlier in the year the US National Academies of Science, Engineering, and Medicine even released a 200+ page report saying that gene editing could be used to cure and treat disease in humans, BUT NOT to create SUPERHUMANS. Now we see why those white coated nerds are so dang excited. 

(12) The Price is Wrong

Secretary for Human and Health Services (aka the Health Dept), Tom Price, resigned after stories broke out that he was using a taxpayer funded government private jet for personal use and to have lunch with friends/family. Classic for someone who loves fiscal responsibility.

(13) Tax Reform
 
OG Founding father Ben Franklin once said, “...nothing can be certain except death and taxes”. Well times have changed Ben. The new tax bill made some serious changes. Here’s the summary how they relate to healthcare: individual mandate portion of ACA axed, medical expense tax deductions will remain at 7.5% of gross income but increase to 10% in 2019, and tax credits for companies testing rare orphan drugs will drop from 50% to 25%.

(14) Amazon Rumored to Take Over Everything 
 
When Amazon bought Whole Foods in June, many cheered under the impression that prices would suddenly drop across the store. If you’ve been to Whole Foods lately, you’d know that such change has not taken place and business as usual continues. When Amazon purchased Whole Foods, the financial markets crushed thestocks of traditional grocers such as Kroger, but also drug wholesalers took atumble as well. It’s been rumored all year that Amazon plans to enter the pharmaceutical industry and in typical Amazonian fashion ruthlessly crush the competition. Fun fact if you google www.relentless.com it will take you to Amazon. Hmmmm…

(15) Opiate Epidemic. Trump Wants a Wall
Earlier this year POTUS DT declared that the opiate epidemic was a national public health emergency. It's estimated that since 1999 the deaths from opiate OD have roughly increased by 4x and that last year more than 60k people died of opiate overdoses. During his speeches Trump emphasized more campaigns aimed at preventing young people from trying drugs and of course building a giant wall to prevents narcotics from entering the US. 

(16) Aetna and Humana Try to Make Out (like bandits) but Get Court Blocked

Insurance giants Aetna (3rd largest in US) and Humana (4th largest in US) merger was blocked by anti-trust U.S. District court in February. The two insurance conglomerates did not appeal the court decision and quickly gave up in May. Healthcare providers and patients’ collective sigh of relief can be heard from around the country as further horizontal consolidation between insurers would weaken negotiation powers for physicians, health systems, and people who buy insurance. Physician groups in the AMA and the Osteopathic Medical Association in Floridateamed up to fight or as we like to call it “Doc-block” the merger and the courts ultimately agreed that the merger would do more harm than good.

(17) The Year of Mergers

December marks the month of acquisitions and mergers - of particular importance were vertical mergers. This refers to the merging of industries that do not directly compete. Best examples include the CVS Aetna buyout and United Health and DaVita Medical buyout. The significance behind these mergers is explained by a new breed of system where providers (doctors, hospitals) and payers (insurance companies) are now under one roof with one purpose - reduce cost and maximize profit. How will this change the practice of medicine? Wait and see.