Issue 22: Columbia, Anti-Addiction Vaccine, Tattoos, Epidiolex, and more

Columbia to be the First Debt-free Medical School in the Country
Image Credit: Columbia University P&S

Last December, Columbia received a generous gift of over $300 million from the Vagelos family and got a new name. That's right, you get to name a school if you pay up; its official name is Columbia University Vagelos College of Physicians and Surgeons. Columbia announced this week that about half those funds will be dedicated to covering what would have been student loans. Dr. Roy Vagelos, a graduate of P&S, was a CEO of Merck and had a successful career in building the pharmaceutical giant as well as doing humanitarian work. It was noted that he understood the pain of financial burden for medical students, and that he hoped that students can pursue their interests rather than choose a specialty to compensate for student debt (about $189k in average). Whoever you are, don't forget where you came from! 


Anti-Addiction Treatment in the Works
Scientists are working towards developing an experimental vaccine to help men and women who are addicted to opioids. If it works, this vaccine would block the binding of opioids to their receptors in the brain. Dr. Gary Matyas, an Immunologist at Walter Reed Army Institute of Research, has been working hard to develop this vaccine, which aims to create high levels of antibodies to the drugs it targets. For example, once administered, the antibodies may be designed to bind heroin, so once there is heroin in the system, it would all be bound to antibodies instead of crossing the blood brain barrier and exerting its effects on the central nervous system. As promising as this endeavor sounds, there is still a long way to go until it is used in practice to help recovering addicts. Currently, Dr. Matyas is hopeful for the future, as he has had success with lab mice and rats. It must still be tested on humans and later approved, so the process will likely be going on for some time. In the future, the hope is that this vaccine can be administered to patients suffering from addiction. Though it won’t end the opioid craving itself, it will block the patient from getting high, and hopefully reduce the risk of overdoses. If this endeavor is successful, it could be a great help to fight our current opioid crisis.

Using Diseased Kidneys to Save More Lives
Image Credit: yezry/Shutterstock.com

Imagine the relief and joy someone on the waitlist for a kidney transplant would feel upon hearing the following words: “Congratulations, we have a kidney for you!” And then the utmost confusion when those words are followed up by: “Errr, it’s actually diseased but no worries!” In the past year, 10 patients at Johns Hopkins University School of Medicine underwent transplant surgeries in which they received kidneys infected with hepatitis C. After surgery, patients remained in the hospital for a few days until the virus showed up in their blood. At that point, they were started on a 12-week dose of Zepatier to clear the infection. All 10 recipients of the diseased kidneys not only cleared the hepatitis infection, but remain disease-free even one year later. This may be groundbreaking news for the 90,000 people currently on the waitlist to receive kidney transplants. Hundreds of kidneys are thrown away each year due to hepatitis C infections, but perhaps now these can be salvaged in order to save more lives.

Tattoos that detect Cancer

Let's face it tattoos are cool, but apparently some can also save lives. A team of researchers in Switzerland are working on a biomedical skin tattoo that can detect some of the most common cancers including breast, colon, prostate, and lung. The idea is that in the presence of elevated calcium levels, which occurs in 30% of cancer patients the tattoo would change color. They are currently doing animal studies in mice which have shown promising results, however, the researchers are quick to point out that it could take a long time for the device to reach humans. For now at least we will have to stick with regrettable tramp stamps.

FDA is 4/20 friendly
In case if you forgot 4/20 was a few days ago and we've got good news. The FDA is becoming more pro-pot. Last week a 13 member panel of FDA experts voted unanimously to endorse a new cannabidiol based drug to treat severe childhood epilepsy. The drug, Epidiolex, is made by GW pharmaceuticals and doesn't actually contain any THC aka the ingredient that gets you baked AF. This is a huge deal since the FDA has yet to officially approve medical marijuana treatments for any illness. The FDA is expected to announce it's official decision in late June of this year. Of course there are some possible downsides including price, which Wall Street projects will cost $25k/year.  

Hospitals Sue Anthem 

So the second biggest insurance company and a bunch of hospitals in Virginia are duking out in the courtrooms regarding Emergency Room and imaging payments. The crux of the issue is that Anthem offered a lower reimbursement rate which was expected to lead to increased patient volume at the hospitals. What happened next was that Anthem started denying ER payments if the billed procedure or ER admission was later deemed not an emergency. They also denied in-patient imaging. So can an insurance company just deny payments or change its policy anytime? It gets complicated because we are in the middle of changing our payment system from fee-for-service to value-based-care. Hospitals make a lot of money from ER visits and relevant in-patient procedures such as imaging. The hospitals are arguing that Anthem violated some state statues and that it will limit the physician from making critical decisions, all the while limiting patient's autonomy. But at the same time, Anthem wants the hospitals to admit and image those who really need it. We do need an overhaul in our payment system but there sure will be more moments of trial and error such as this one.  


Using gene therapy to potentially cure patients with beta-thalassemia
Imagine needing regular blood transfusions in order to stay alive. For patients with beta thalassemia, this can be an unfortunate reality. Until now. Researchers from Northwestern and UCSF just published a preliminary study showing that 15 out of 22 patients with beta thalassemia who received gene therapy were able to completely stop or reduce the number of regular transfusions they received. This treatment, created by the company Bluebird Bio, takes stem cells from patients and then uses a virus to modify the cells so that a working copy of the gene that is defective in beta thalassemia is inserted. Patients received chemotherapy to remove the defective blood cells from the body, and the new and improved blood stem cells were infused. Some of the patients were monitored over a three-year period, and so far none have developed any serious adverse events. The researchers stress that more studies need to be conducted over longer periods of time before this therapy can be put into main stream use. For now, this is an exciting step for the 288,000 patients living with beta thalassemia worldwide. Imagine needing regular blood transfusions in order to stay alive. This study has the potential to keep that thought in your imagination. 




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