December 21, 2024

Pharmacogenomic Testing & Health Care Costs

Pharmacogenomic Testing: Could it Reduce Health Care Cost?

A relatively new type of drug testing could reduce health care costs. This type of testing is known as pharmacogenomic testing. It looks at how the genes a person inherits affects how medications works in his or her body.

Many things can affect how drugs work in the body. Someone’s size can be a factor, for example, as a large person needs more of a drug than does a small person. A person’s diet can also affect how well his or her body absorbs and uses medications.

Genes can also affect how a person’s body responds to drugs. Differences in genetic makeup between people influences what their bodies do to a drug and what a drug does to their bodies. A person’s genetic makeup may cause slow metabolism of medications, for example, and this can cause the drugs to accumulate to toxic levels in the body. Other people metabolize drugs so quickly that drug levels never get high enough to provide a therapeutic effect.

About Pharmacogenomics

In pharmacogenomics, scientists study the genetic differences that affect the response to drugs. The word “pharmacogenomics” is a combination of the word’s pharmacology and genomics; pharmacology is the study of the uses and effects of medications, while genomics is the study of genes and their functions. The aim of pharmacogenomics is to develop safe, effective medications and doses tailored to an individual’s genetic makeup.

Pharmacogenomic testing helps researchers get a better understanding of the relationship between genetics and drug response. This understanding ultimately leads to treatments that work better and cost less.

Most of the medications currently available are “one size fits all,” but these drugs do not work the same way for everybody due to genetic differences. These inherited differences can make it difficult to predict who will benefit from a drug, who will not respond at all, and who will suffer negative side effects. Incorrect predictions can lead to prescribing drugs that do not work, work poorly, or worst of all, cause adverse side effects.

The Food and Drug Administration (FDA) tracks adverse drug reactions and issues “black box warnings” for medications that have the potential for severe side effects associated with genetic predispositions and other causes. These warnings, which apply to more than 200 drugs, help doctors choose the right medications. In some cases, the black box warnings contain genomic information that alerts doctors to the potential risk of adverse reactions and provides dosing instructions according to pharmacogenomic testing results.

Pharmacogenomic testing can reduce health care costs by helping doctors prescribe medications that those patients who are genetically predisposed to benefiting from the drug. This testing can also reduces the risk of adverse events in patients with a certain genetic predisposition.

Negative side effects, also known as adverse drug reactions or adverse drug events, are a significant cause of hospitalizations and death. Adverse drug reactions lead to approximately 1.3 million emergency department (ED) visits and 350,000 hospitalizations every year, according to the Centers for Disease Control and Prevention (CDC). The FDA says that adverse drug events may be the fourth leading cause of death in the United States, causing more than 106,000 deaths annually.

Adverse drug reactions are dangerous, but they are also costly. Adverse drug events cost the nation about $3.5 billion in excess medical costs every year. These drug reactions affect about 2 million hospitalizations each year and prolong these hospital stays by 1.7 to 4.6 days, which significantly adds to the cost of hospital care. Outside the hospital, adverse drug reactions result in more than 3.5 million visits to doctor offices, approximately a million emergency department visits and around 125,000 admissions to the hospital. More than 40 percent of the costs related to adverse drug reactions occurring outside the hospital may be preventable.

About Pharmacogenomic Testing and its Benefits

Researchers are using information from the Human Genome Project to investigate how genetics affects the body’s response to medications. The results help researchers to predict whether a drug will work effectively for a particular person, and to help prevent adverse drug events.

The test requires a small blood or saliva sample. Laboratory technicians perform tests that look for changes or variants in one or more genes, which can affect your body’s response to certain medications.

Pharmacogenomic testing evaluates the genetic factors that affect how your body metabolizes medications. The information gained from the test helps your doctor determine if a particular medication is right for you, calculate the correct dosage to adjust for your metabolism, and to help predict whether you could experience serious side effects from the drug. It can also save money.

Medical and finance expert Frank Magliochetti explains;


Healthcare spending in the United States reached $3.5 trillion in 2017, rising by 3.9% year-on-year and accounting for 17.9% of gross domestic product (GDP), according to data from the Centers for Medicare and Medicaid Services (CMS). Independent federal actuaries estimate that the amount climbed to $3.65 trillion in 2018, and the Organization for Economic Co-Operation and Development (OECD) ranks the United States as the country with the highest health expenditure per capita. According to CMS projections, US spending will continue to grow at an average rate of 5.5% annually through 2026, when it is expected to reach $5.7 trillion and account for 19.7% of GDP. These massive and steadily rising costs are a source of concern for the government, which is constantly exploring means of reining in healthcare expenses, including through preventive measures and investment in research projects. Among the most promising new developments is pharmacogenomic testing, which involves studying the impact of people’s genetic makeup on their response to drugs so that effective and efficient treatment regimens can be devised

Frank Magliochetti owes his professional success to his expertise in two areas: medicine and finance. After obtaining a BS in pharmacy from Northeastern University, he stayed on to enroll in the Masters of Toxicology program. He later specialized in corporate finance, receiving an MBA from The Sawyer School of Business at Suffolk University. His educational background includes completion of the Advanced Management Program at Harvard Business School and the General Management Program at Stanford Business School. Frank Magliochetti has held senior positions at Baxter International, Kontron Instruments, Haemonetics Corporation, and Sandoz. Since 2000, he has been a managing partner at Parcae Capital, where he focuses on financial restructuring and interim management services for companies in the healthcare, media, and alternative energy industries. Earlier this year, he was appointed chairman of the board at Grace Health Technology, a company providing an enterprise solution for the laboratory environment.

Mr. Frank Magliochetti MBA
Managing Partner
Parcae Capital

www.parcaecapitalcorp.com
www.frankmagliochetti.com

3D Bioprinter Produces Skin for Tranplants

3D Bioprinter Prints Functional Human Skin Adequate for Transplant

3dprintedskin-frankmagliochetti-healthcareinnovationA team of researchers in Spain reports the development of a new three-dimensional (3D) printer capable of printing human skin suitable for transplant into patients. The printed skin is also suitable for testing drugs and cosmetics.

The team included several groups of researchers, including a group from the Universidad Carlos III de Madrid (UC3M) in Spain. The researchers describe their breakthrough in the scientific journal, Biofabrication.

3D Printing and Skin Production

3D printing has been around since the 1980s, when Charles (Chuck) Hull introduced the first stereolithography apparatus (SLA), but the 3D printing industry is now experience rapid growth with applications in many fields. In medicine, 3D printing holds great promise in someday giving clinicians the ability to produce personalized, complex human tissues and organs on demand. One woman has already received a 3D printed ear from one company, for example, while another frankmagliochettireport-3d-bioprintercompany provides 3D printed implants that the recipient’s body converts to bone.

Three-dimensional printing of human body parts is challenging in a number of ways. Replicating the complexity of anatomical structures is difficult. Ensuring the printed tissue survive transplantation in a living body is another problem.

The scientists in Spain have already engineered plasma-based, two-layered skin used successfully in the treatment of burns and other wounds in a large number of patients. The primary drawback to this method is that it takes 3 weeks to produce enough skin to cover an extensive burn or large wound. Another disadvantage is that the scientists must perform much of the process manually.

3D printing is similar to a desktop computer printer except that the nozzle on the 3D printer exudes biological components rather than ink. These biological components, or bio-inks, are essential to successful 3D printing of human organs and tissues.

To aid in the process, a computer controls the nozzles and flow of biological components so that the nozzles deposit the bio-inks on precise locations on the print bed.

Prints large area of skin in 35 minutes

The authors of the study describe how their 3D printing method generated a 100 x 100 centimeter area of skin in just under 35 minutes.

Like the scientists’ existing plasma-based manual method of producing skin, the 3D printing technology generates two layers of skin – the epidermis and the dermis. The printer starts by producing the epidermis, including the protective outermost layer of keratinized cells, known as the stratum corneum. Next, it prints the thicker, deeper dermis, complete with collagen-producing frank-magliochetti_bioprinter-skinfibroblasts.

The new 3D printing method is faster, but still complex. One of the authors of the report, Juan Francisco del Cañizo of the Hospital General Universitario Gregorio Marañón and Universidad Complutense de Madrid, notes:

“Knowing how to mix the biological components, in what conditions to work with them so that the cells don’t deteriorate, and how to correctly deposit the product is critical to the system.”

The research team tested the printed skin in test tubes and in immunodeficient mice. Transplantation of the printed skin into the mice helped the scientists test the long-term effects in a living animal. In both tests, the 3D printed skin was very similar to human skin and indistinguishable from the manually produced bi-layered skin from plasma.

There are two main potential uses for this 3D skin – to produce skin for research and laboratory testing of drugs and cosmetics, and to produce person-specific skin from the patient’s own cells to treat burns and other wounds. The research team is also investigating ways to use the technology to print other human tissues.

Source

http://iopscience.iop.org/article/10.1088/1758-5090/9/1/015006/meta

Frank Magliochetti is Managing Partner for Parcae Capital

  • North Andover, Massachusetts

This column of posts is directed at the Healthcare Industry.  Frank plans to release new sites dedicated to the industry. Frank currently assists companies who are building, restructuring, transforming and resurrecting there business’s. An example of his client base are, Xenetic Biosciences , IPC Medical Corp, Just Fellowship Corp, Environmental Services Inc., Parsons Post House LLC, ClickStream Corporation as well as having a business talk radio show; The Business Architect on the URBN network.

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Telemedicince Vs Bedside Assessment

Telemedicine for Assessing Levels of Consciousness in Comatose Patients: How Does it Compare to Bedside Assessment?

Effective care for comatose patients in intensive care units (ICUs) depends on proper intervention based on reliable assessment. Researchers recently conducted a study at Mayo Clinic Hospital in Arizona to compare the effectiveness of using telemedicine to assess levels of consciousness in comatose patients with standard bedside assessment.

Proper intervention relies on the ability to recognize changes in a comatose patient’s clinical status quickly. This had usually meant that, in order to complete an assessment, the practitioner needed to be in the same room. Advanced medical technology is changing all that and robotic medicine now allows clinicians to assess patients from across the hospital or from across the world.frankmagliochetti_Telemedice_HealthcareTrends-Innovations

Telemedicine has been around since the 1960s, when NASA built telemedicine technology into astronauts’ suits. Prior to this technology, astronauts had to rely on crewmates for an accurate diagnosis. Monitors in the suits sent biometric information about the wearer back to earth for assessment.

Computers have revolutionized telemedicine and the internet helps doctors assess patients living in remote places. This is especially helpful for patients living in underserved areas.

Despite major advances, many still worry about the effectiveness in using this technology for the most critically ill patients. A new study published in Telemedicine and e-Health should help to dispel this fear, with researchers showing that robotic telemedicine can be used successfully to complete assessments in comatose ICU patients.

Testing the Reliability of Telemedicine in the Assessment of Levels of Consciousness

Researchers enrolled 100 patients from Mayo Clinic Hospital in Arizona into the study, which occurred over a 15-month timeframe. Mean age of patient participants was 70.8 years. On average, each examination took just over 5 minutes.

Sixteen medical doctors also participated by using two scoring systems, the Glasgow Coma Scale (GCS) and the Full Outline of UnResponsiveness (FOUR) score, to assess patients’ levels of consciousness. The researchers randomly assigned two practitioners to each patient; one doctor used real-time audio and a visual robotic telemedicine system to perform the assessment and the other clinician conducted an assessment at the patient’s bedside. Each used GCS and FOUR scales.

The researchers used paired t-test and Pearson correlation coefficient (PCC) to compare the GCS and FOUR scores between bedside and Telemedicine_FrankMAgliochetti-HealthcareReportremote physician.

Differences in GCS and FOUR scores between remote and beside assessment were small. The mean Glasgow Coma Scale score at bedside was 7.5 while the mean GCS score for the remote examination was 7.23. Scores were comparable in the FOUR total scores too, with a mean bedside score of 9.63 and a mean remote score of 9.21.

The researchers also asked the clinicians about their overall satisfaction and ease of use. Ninety-five percent of remote providers rated GCS and 89% rated FOUR score as good (4/5).

Conclusions

The study is the first to evaluate the effectiveness of telemedicine in assessing patients with depressed levels of consciousness. The results suggest that doctors can reliably assess levels of consciousness in comatose patients using existing robotic telemedicine technology. Healthcare providers could adopt telemedicine to help evaluate critically ill patients in neurologically underserved areas.

“This is good news in many ways,” states lead author of the study, Amelia Adcock, M.D, in a press release issued by Mayo Clinic. “We use telemedicine frequently when evaluating acute stroke patients. This study suggests yet another way telemedicine can enhance patient care. There is a shortage of intensive care unit providers and facilities with round-the-clock patient coverage. Telemedicine can provide a way to ameliorate this shortage and improve early evaluation of critically ill patients.”

Source

http://online.liebertpub.com/doi/10.1089/tmj.2016.0225

Frank Magliochetti is Managing Partner for Parcae Capital

  • North Andover, Massachusetts

This column of posts is directed at the Healthcare Industry.  Frank plans to release new sites dedicated to the industry. Frank currently assists companies who are building, restructuring, transforming and resurrecting there business’s. An example of his client base are, Xenetic Biosciences , IPC Medical Corp, Just Fellowship Corp, Environmental Services Inc., Parsons Post House LLC, ClickStream Corporation as well as having a business talk radio show; The Business Architect on the URBN network.

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Color Compounds in Foods Lowering Risk of Lung Cancer?

Color Compound in Some Fruits and Vegetables Could Lower Lung Cancer Risk in Smokers

A pigment in oranges, sweet red peppers, and other fruits and vegetables may lower the risk of lung cancer in smokers, according to a new study.

Nicotine is the primary addictive component of tobacco and some e-cigarette liquids. Medical scientists believe nicotine contributes to cancer promotion and progression by activating nicotinic acetylcholine receptors. The study results suggest that the color compound, known as beta-frankimagliochetti-healthcare-reportcryptoxanthin (BCX), reduces the number of these receptors. This means eating fruits and vegetables high in BCX might reduce the risk of lung cancer resulting from smoking.

Doctors diagnose about 222,500 new cases of lung cancer in the United States each year, according to the American Cancer Society, and more than 155,000 Americans will die from the disease each year. The American Lung Association notes that male smokers are 23 times more likely to develop lung cancer than are men who do not smoke, and female smokers are at 13 times greater risk of developing lung cancer than are non-smoking women.

Causing approximately 7,330 deaths among nonsmokers each year, exposure to secondhand smoke is also a risk factor for lung cancer.

Nicotine and the Growth of Lung Tumors

Tobacco smoke contains more than 7,000 compounds and many of these substances, upon inhalation, act as carcinogens to damage the cells lining the lungs. While nicotine does not cause lung cancer directly, the addictive compound can promote lung tumor growth.

Study co-author Xiang-Dong Wang, of the Jean Mayer United States Department of Agriculture Human Nutrition Research Center on Aging at Tufts University in Boston, MA, and colleagues provide more insight into how nicotine promotes lung cancer.

frankmagliochetti-helathcare-ReportWhen inhaled, nicotine binds to nicotinic acetylcholine receptor α7 (α7-nAChR), which is a nicotine receptor lying on the surface of the lungs. The binding action prompts a signaling cascade that results in the proliferation of cells and the formation of new blood vessels. Cell proliferation and blood vessel formation are processes involved in the growth of cancer.

Nicotine also increases the production of nicotinic receptors, actually creating more α7-nAChR on which to bind. Providing more nicotinic receptors strengthens the signaling cascade, further encouraging the growth of lung cancer cells. In other words, the more a person smokes or suffers secondhand exposure to smoke, the more receptors he or she develops, the stronger the process encouraging the growth cancer.

Wang and colleagues think that consuming BCX could effectively reduce the number of α7-nAChR receptors on the lungs, thereby decreasing the potential growth of lung cancer cells.

BCX reduced lung tumor growth in laboratory mice

BCX is a carotenoid that gives yellow, orange and red fruits and vegetables their color. Oranges, tangerines, butternut squash, and sweet red peppers contain beta-cryptoxanthin.

In an earlier study, Wang and a team of researchers observed an association between eating foods rich in BCX and a lower risk of lung cancer in humans. In this study, the team focused on pinpointing the mechanisms underlying the link between a BCX-rich diet and lowered risk of lung cancer in smokers.

The scientists administered a daily injection of a carcinogen derived from nicotine to two groups of mice. The test group of mice also received a daily dose of BCX before and after the nicotine injection. The researchers found that, compared with the mice that did not receive the carotenoid, the test group experienced a 52-63 percent reduction in lung tumor growth.frank magliochetti-healthcare-report

The researchers determined 870 micrograms, which is the equivalent to one sweet pepper or two tangerines per day for humans, as the most effective daily dose of BCX for reducing lung tumor growth.

The team then tests BCX on human lung cancer cells, both with and without α7-nAChR. They discovered that lung cancer cells with α7-nAChR receptors were less likely to spread after exposure to the color compound, as compared with lung cancer cells without those receptors.

Further research could provide a better understanding of how consuming foods rich in beta-cryptoxanthin might affect the development of lung cancer in humans.

Source

http://cancerpreventionresearch.aacrjournals.org/content/9/11/875

http://www.cancer.org/cancer/non-small-cell-lung-cancer/about/key-statistics.html

http://www.lung.org/lung-health-and-diseases/lung-disease-lookup/lung-cancer/resource-library/lung-cancer-fact-sheet.html?referrer=http://www.medicalnewstoday.com/articles/315404.php

Frank Magliochetti is Managing Partner for Parcae Capital

  • North Andover, Massachusetts

This column of posts is directed at the Healthcare Industry.  Frank plans to release new sites dedicated to the industry. Frank currently assists companies who are building, restructuring, transforming and resurrecting there business’s. An example of his client base are, Xenetic Biosciences , IPC Medical Corp, Just Fellowship Corp, Environmental Services Inc., Parsons Post House LLC, ClickStream Corporation as well as having a business talk radio show; The Business Architect on the URBN network.

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Wearable Sensors: Identify Early Signs of Disease

Wearable Sensors May Help Identify Early Signs of Disease

Wearable technologies may be able to do much more than monitor a person’s blood pressure or total number of steps each day, according to a new study, which suggests wearable sensors can detect early signs of serious disease.

Wearable biosensors, otherwise known as wearables, are a low-cost technology capable of measuring physiological parameters continuously or frequently. Biosensor technology is a promising approach to monitoring physiological measurements, and these devices could potentially identify significant changes in health conditions. Capable of passive and routine recording, the technology can provide immediate real-time delivery of multiple measurements to the wearer or physician. Software simplifies the technology, so using wearable biosensors requires minimal training and attention from the wearer or the clinician.frank-magliochetti-biosensors-healthcare-report

In addition to physiological measurements, wearable devices can capture the wearer’s physical activities, such as walking, running, and biking, often in conjunction with a GPS to provide information about the location of the activity.

Wearables can Track Health and Provide Useful Health Information

The newest generation of portable biosensors can measure health-related physiology changes during various activities. The goal of the study, published in PLOS Biology in January 2017, was to investigate the use of portable biosensors in this capacity and their potential role in health management, specifically in the diagnosis and analysis of disease.

The researchers fitted participants with between one and seven commercially available activity monitors. Over the course of the study, the scientists recorded more than 250,000 daily measurements, including participants’ heart rate, skin temperature, blood oxygen, sleep and calories expended collected from up to 43 individuals. The scientists then combined biosensor information with medical measurements to develop a personalized, activity-based normalization framework, which they used to identify abnormal physiological signals and detect disease.

Several participants reported minor cold-like illnesses in the study’s first two years. At the onset of these illnesses, the sensors detected higher than normal readings for skin temperature and heart rate. Blood tests showed an increase in inflammation before symptoms occurred.

Biosensors-frankmagliochetti-reportThe devices could detect physiological differences, namely variations in heart rate patterns, between insulin-sensitive and insulin-resistant individuals. The researchers also found interesting physiological changes associated with alterations in environment. Participants’ blood oxygen levels decreased during high-altitude flight, for example, and this decrease in oxygen levels correlated with fatigue.

The wearables even detected physiological changes in one person – lead author of the study, Michael Snyder – who later turned out to have Lyme disease. The geneticist never developed the telltale bulls-eye rash that usually precedes the condition, but his smart watch and other sensors detected changes in his own oxygen levels and heart rate. Shortly afterwards, Snyder developed symptoms and received an official diagnosis of Lyme disease.

The researchers concluded by saying the portable biosensors can provide information useful for the monitoring of personal activities and physiology. These devices will likely play an important role in health management and access to care by those traditionally limited by geography or socioeconomic class.

Lead author of the study, Michael Snyder, said in a press release that today’s wearables are “the equivalent of oral thermometers but you’re measuring yourself all the time.” He added wearables might someday act as a “check engine” light that tells the wearer when it is time to see a doctor.

Source

http://journals.plos.org/plosbiology/article?id=10.1371/journal.pbio.2001402

http://www.biosciencetechnology.com/news/2017/01/testing-wearable-sensors-check-engine-light-health-0

Frank Magliochetti is Managing Partner for Parcae Capital

  • North Andover, Massachusetts

This column of posts is directed at the Healthcare Industry.  Frank plans to release new sites dedicated to the industry. Frank currently assists companies who are building, restructuring, transforming and resurrecting there business’s. An example of his client base are, Xenetic Biosciences , IPC Medical Corp, Just Fellowship Corp, Environmental Services Inc., Parsons Post House LLC, ClickStream Corporation as well as having a business talk radio show; The Business Architect on the URBN network.

New Study on Personal Health Care Spending

New Study Sheds Light on Personal Health Care Spending Trends in the U.S.

The amount of dollars the Unites Spends on healthcare surpasses every other nation on the planet; all in all accounting for 17% of the economy in the U.S.

Frank Magliochetti

People spend more for health care in the United States than in any other nation on earth and, according to results of a new study published in JAMA, they spend more on diabetes and ischemic heart disease than on any other health condition.

Health care spending continues to rise in the U.S., now accounting for 17 percent of the nation’s economy. health-spending-Frank-MAgliochetti-ReportDespite this spending, there is very little information on how spending varies by condition, age and through time. Joseph L. Dieleman, PhD, from the Institute for Health Metrics and Evaluation, University of Washington and a team of researchers hoped to estimate national spending on personal health care by various factors.

U.S. Spending on Health Care Trends

The researchers included 183 sources of data in the study. Data sources included insurance claims, government budgets, household surveys, facility surveys, and official U.S. records from 1996 to 2013. The scientists grouped ICD-9 codes to form 155 conditions, such as diabetes and ischemic heart disease, for consideration in the study.

One of the more interesting findings of the study was that many of the top 20 conditions of health care spending were chronic conditions with a relatively high prevalence and health burden – many of them were also preventable. This group of conditions included diabetes, ischemic heart disease, chronic obstructive pulmonary disease (COPD), and cerebrovascular disease, all of which are attributable to modifiable risk factors.

Total costs of care

Americans spent $30.1 trillion on personal health care during the years included in the study. The researchers looked at how Americans spent that money, estimating the costs of treating 155 conditions. They found that, at an estimated $101 billion, Americans spent the most on treating diabetes. Spending for ischemic heart disease came in second at $88 billion; spending for low back and neck pain was a close third at $87 billion.

Increases in costs of care

Spending for personal health care increased for 143 of the conditions investigated over the course of the study. Spending on low back and neck pain increased $57 billion during those 18 years, and spending on diabetes US-healthcare-costs-FrankMagliochettiincreased $64 billion during that period.

Of all the conditions included in the study, 57 percent of spending went towards the top 20 conditions. Spending on emergency care and retail pharmaceuticals rose the fastest, at 6.4 percent and 5.6 percent annual growth rate, respectively. When it came to spending on diabetes, 57.6 percent went to pharmaceuticals while 23.5 percent was for ambulatory care.

The study was important in that it was the first to provide modeled estimates of U.S. personal health care spending. The results were revealing in that they showed that diabetes, ischemic heart disease, and low back and neck pain presented the highest costs to American consumers. The study was limited in that it used population-weighted data to represent total national spending, which excludes incarcerated persons and those receiving care from a Veterans Affairs (VA) facility. The University of Washington institutional review board reviewed and approved the project.

The information presented in the study may be useful to health care policy makers and health care providers working towards making health care spending more cost effective for the conditions that most commonly affect people living in the United States.

Source

http://jamanetwork.com/journals/jama/fullarticle/2594716

Frank Magliochetti is Managing Partner for Parcae Capital

  • North Andover, Massachusetts

This column of posts is directed at the Healthcare Industry.  Frank plans to release new sites dedicated to the industry. Frank currently assists companies who are building, restructuring, transforming and resurrecting there business’s. An example of his client base are, Xenetic Biosciences , IPC Medical Corp, Just Fellowship Corp, Environmental Services Inc., Parsons Post House LLC, ClickStream Corporation as well as having a business talk radio show; The Business Architect on the URBN network.

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Prenatal Fish Oil – Lower Risk of Asthma in Children

Prenatal Fish Oil Supplementation May Lower Risk of Asthma in Children

Taking fish oil supplements during pregnancy may lower the risk of asthma in children, according to a new study published in the New England Journal of Medicine.

The study shows that supplementation with long-chain polyunsaturated fatty acids (LCPUFA) during the third trimester can reduce the risk of asthma or persistent wheeze in the babies. LCPUFA supplementation also reduces the risk of lower respiratory tract infections (LRTIs) in the offspring.

Pregnant woman

Asthma in Children is a Significant Problem

Asthma is a common problem in children born in the United States. Approximately 7.4 percent of adults and 8.6 percent of children in the nation have asthma, according to the Asthma and Allergy Foundation of America (AAFA), and the number of children with the breathing disorder has been increasing since the 1980s.

Hospitalization rates for asthma are historically higher in the Northeast. Massachusetts has the highest prevalence rate for asthma at 12 percent, according to statistics presented by the Centers for Disease Control and Prevention (CDC), with several other northeastern states following with asthma prevalence rates topping 10 percent.

Fish Oil-Derived LCPUFAs in Pregnancy and Asthma in Offspring

Reduced intake of LCPUFAs may contribute to the increased incidence of wheezing and asthma in children. The researchers in the NEJM study hoped to evaluate the effects of maternal LCPUFA supplementation on offspring.

The scientists enrolled 736 pregnant women at 24 weeks of gestation into the study then randomly assigned the subjects to control and test Asthma-prenatal-fish-oil-frank-magliochetti-report-healthcaregroups. Participants in the test group received 2.4 g of n−3 LCPUFA derived from fish oil each day, while those in the control group took a placebo containing olive oil daily.

The participants’ offspring became the Copenhagen Prospective Studies on Asthma in Childhood (COPSAC) cohort. The researchers followed this group of children for several years, with pediatricians collecting clinical data for visits at 1 week after birth, and then at 1, 3, 6 months and every 6 months until the children reached 36 months of age. The pediatricians then saw the children yearly until the participants were 5 years old.

Neither the researchers nor the participants knew which group the children belonged to for the first three years of follow-up studies. During the next two years of follow-up studies, only the scientists were unaware of the group assignments.

The researchers looked primarily for persistent wheezing and asthma, but included LRTIs, eczema, asthma exacerbations, and allergic sensitization as secondary endpoints.

Ninety-five percent of the 695 children included in the COPSAC cohort completed the 3-year, double-blind follow-up portion of the study. The researchers found that the risk of asthma or persistent wheeze in the treatment group receiving LCPUFA was 16.9 percent, while the risk was 23.7 percent in the control group. This means consuming fish oil-derived LCPUFAs can lower the risk of persistent wheeze or asthma and LRTIs in offspring by nearly 7 percentage points, or one-third. Analysis of the secondary endpoints showed that supplementation reduces the risk of LRTIs, but there was no association between supplementation and asthma exacerbations, allergic sensitization, or eczema.

These findings would be extremely helpful for expectant mothers hoping to reduce the risk of asthma and other breathing problems in their children.

Source

http://www.nejm.org/doi/full/10.1056/NEJMoa1503734

http://www.aafa.org/page/asthma-facts.aspx

https://www.ncbi.nlm.nih.gov/pubmed/12214899

https://www.cdc.gov/asthma/most_recent_data_states.htm

Frank Magliochetti is Managing Partner for Parcae Capital

  • North Andover, Massachusetts

This column of posts is directed at the Healthcare Industry.  Frank plans to release new sites dedicated to the industry. Frank currently assists companies who are building, restructuring, transforming and resurrecting there business’s. An example of his client base are, Xenetic Biosciences , IPC Medical Corp, Just Fellowship Corp, Environmental Services Inc., Parsons Post House LLC, ClickStream Corporation as well as having a business talk radio show; The Business Architect on the URBN network.

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NSAIDs May Prevent Colorectal Cancer

NSAIDs May Prevent the Development of Colorectal Cancer after Polyp Removal

A recent study published in the British medical journal suggests that NSAIDs may help prevent colorectal cancer after polyp removal – This post goes into more detail on the study.

Frank Magliochetti

Taking non-steroidal anti-inflammatory drugs (NSAIDs) may prevent the recurrence of advanced neoplasia, a type of polyp that is the precursor of colorectal cancer, after the surgical removal of pre-existing polyps. Recurrence rates of benign polyps and advanced neoplasia are quite high, so clinicians are eager to find easy-to-follow treatments to reduce recurrence.frankmagliochettireport-healthcare-cancer-treatments

A team of scientists from across the United States recently collaborated with Mayo Clinic researchers to determine how well NSAIDs, aspirin and other supplements prevent the recurrence of precancerous or cancerous polyps. The results of the study, published in the British medical journal BMJ suggest NSAIDs may offer the greatest protection.

About Colorectal Cancer

Colorectal cancer is the third most common type of cancer in men and woman in the United States, according to the Centers for Disease Control and Prevention (CDC), and it is the second leading cause of cancer-related deaths among cancers affecting both men and women.

Colorectal cancer, characterized by abnormal cell growth in the colon or rectum, is one of the few preventable types of cancers. Removing precancerous polyps during colonoscopy prevents those polyps from turning cancerous but it does not prevent recurrence of advanced neoplasia, also known as advanced adenomas or adenomatous polyps. A study published in PLOS showed a recurrence rate of 50.5 percent for polyps, and a 32.9 percent recurrence rate for neoplasia.

Research Suggests Non-Aspirin NSAIDs Reduces Risk of Recurrence of Precancerous Polyps

The results of the BMJ study showed that non-aspirin NSAIDs, particularly ibuprofen, work better than aspirin or many other nutritional supplements for most patients when it came to preventing the growth of advanced neoplasia. The researchers note that, because most colorectal cancers develop from neoplasia, frank-magliochetti-report-healthcare-cancer-preventionchemoprevention with NSAIDs has a favorable risk to benefit profile when it comes to reducing recurrence in those with a history of high-risk neoplasia.

  1. Hassan Murad, M.D., preventive medicine physician and clinical epidemiologist at Mayo Clinic, is the study’s senior author. “Approximately 85 percent of all colorectal cancers are thought to result from untreated adenomatous polyps,” says Murad, M.D., in a press release published by Mayo Clinic. “If we can find a way to stop their growth, we could prevent a majority of these cases.”

“We knew that aspirin and other NSAIDs have a protective effect, and that a number of other nutritional supplements have also been studied for their effectiveness in preventing cancer,” says Dr. Murad. “What we didn’t know is how they compared to each other.”

The research team conducted a meta-analysis from data obtained from 15 randomized control trials. The scientists reviewed information from 12,234 patients who were taking various supplements and medications. The researchers looked at low- and high-dose aspirin therapy, NSAIDs, vitamin D, calcium, and folic acid, and then compared each treatment alone and in different combinations.

Analysis of the information showed that non-aspirin NSAIDs worked better than all the other therapies for preventing adenomatous polyps recurrence within three to five years after removal through colonoscopy. Because these non-aspirin NSAIDs pose other health risks, this treatment may not be appropriate for all patients.

“It is important that patients and doctors have a discussion on the various risks and benefits of any medication or other therapy,” says Murad. “While a research publication may contain promising findings, it is generalized information, and each individual is different. So their care will be individualized, as well.”

Source

http://www.bmj.com/content/355/bmj.i6188

https://www.cdc.gov/cancer/colorectal/statistics/

http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0050990

Frank Magliochetti is Managing Partner for Parcae Capital

  • North Andover, Massachusetts

This column of posts is directed at the Healthcare Industry.  Frank plans to release new sites dedicated to the industry. Frank currently assists companies who are building, restructuring, transforming and resurrecting there business’s. An example of his client base are, Xenetic Biosciences , IPC Medical Corp, Just Fellowship Corp, Environmental Services Inc., Parsons Post House LLC, ClickStream Corporation as well as having a business talk radio show; The Business Architect on the URBN network.

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Spending Trends: Health Care for Children

Spending Trends 1996 – 2013: Health Care for Children

Spending on health care for children has risen in the past 20 years and a new article sheds light on where the money goes.

Frank Magliochetti

Personal health care spending for children skyrocketed 56 percent between 1996 and 2013, according to a new study published online by JAMA Pediatrics. Increased spending in health care for children reflects the increased spending for patients of all ages, according to the statistics presented by frankmaglochetti_healthcare-report-trendsthe Centers for Medicare & Medicaid Services (CMS). The United States spent about $3.2 trillion for health care in 2015, or $9,990 per person, up 5.8 percent from the year before.

Spending Trends for Children’s Personal Health Care in the U.S., 1996 – 2013

While health care spending on children continues to rise, there is very little data on differences in spending for specific conditions, age groups, gender, and type of care. There is also a paucity of information on how spending patterns have changed over the years. To shed light on these spending patterns, Joseph L. Dieleman, Ph.D., of the University of Washington, Seattle, and his team of researchers used 183 sources of data and 2.9 billion patient records gathered from the Institute for Health Metrics and Evaluation Disease Expenditure 2013 project database. They performed annual estimates for each year from 1996 through 2013 and used inflation-adjusted 2015 dollars to report estimates.

They found that spending for pediatric health care increased from $149.6 billion in 1996 to $233.5 billion in 2013. Spending per child rose from $1,915 in 1996 to $2,777 in 2013.

frankmagliochetti_report-trends-childrenhealthcareMost of the money went for well-newborn care in inpatient settings, attention deficit/hyperactivity disorder (ADHD) and well-dental care. Payers spent $27.9 billion for inpatient well-newborn care, which was the largest condition leading to health care spending.

ADHD and well-dental care services were the second and third largest conditions leading to health care spending in children, with $20.6 billion for ADHD care and $18.2 billion for well-dental care. At $9 billion, asthma care garnered the fourth highest level of spending.

The researchers found that, at $11,741, the greatest spending per child was for infants younger than 1 year in 2013. Spending per child increased over time, rising from $1915 in 1996 to $2777 in 2013. Ambulatory care among all types of care and inpatient well-newborn care, ADHD, and asthma showed the greatest growth.

Just over 30 percent of total children’s health care went for inpatient care, 38.6 percent went towards ambulatory care, and 7.8 percent was spent on retail pharmaceuticals in 2013. More was spent on males than on females.childrenhealthcarecosts-frank-magliochetti

The findings provide information about spending trends for child health care and serve as a guide for future spending. Payers can expect larger health care spending growth rates for inpatient well-newborn care and ADHD, for example, while health care professionals can gear up to provide an increased amount of care for these conditions.

“The next step should be analyzing the factors driving increased health care spending and determining whether changes in particular subcategories of spending have been associated with improvements in processes or outcomes. It is crucial to understand whether spending increases have been appropriate or misguided and how we might target spending increases and reductions now and in the future,” the authors conclude in a press release.

Source

http://jamanetwork.com/journals/jamapediatrics/fullarticle/2593700

https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/downloads/highlights.pdf

http://media.jamanetwork.com/news-item/how-much-money-is-spent-on-kids-health-care-where-does-it-go/

Frank Magliochetti is Managing Partner for Parcae Capital

  • North Andover, Massachusetts

This column of posts is directed at the Healthcare Industry.  Frank plans to release new sites dedicated to the industry. Frank currently assists companies who are building, restructuring, transforming and resurrecting there business’s. An example of his client base are, Xenetic Biosciences , IPC Medical Corp, Just Fellowship Corp, Environmental Services Inc., Parsons Post House LLC, ClickStream Corporation as well as having a business talk radio show; The Business Architect on the URBN network.

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Trends 2017: Human Metapneumovirus (hMPV)

Human Metapneumovirus Trends

Frank Magliochetti Report

Human  is a respiratory virus that can cause lower and upper respiratory tract infections, including bronchitis and pneumonia, and may even trigger asthma. Acute respiratory tract infections are the most common reason for doctor office visits, according to the American College of Physicians. Illness associated with hMPV can be severe; the virus is associated with an associated 20,000 hospitalizations of children aged 5 and younger in the United States each year. Elderly and immunocompromised individuals are at higher risk of the disease.

History of hMPV

Until just a few short years ago, the hMPV virus was different from other common respiratory viruses as PCR-based methods using virus genome-specific primers and immunological assays using virus-specific antibodies failed to identify the pathogen. It was only after the application of a molecular biology tool, known as randomly primed PCR, could researchers identify portions of the virus’s genomic sequence.frank-magliochetti-report_hmpv_metapneumovirus_

In 2001, a team of scientists headed by B.G. van den Hoogen identified hMPV in children with respiratory tract infection by using randomly primed PCR to obtain a genomic sequence of the pathogen. Based on the sequence data currently available, the human metapneumovirus seems to be a close relation of another member of the Metapneumovirus genus, the avian pneumovirus.

Since its discovery just over 16 years ago, laboratory testing has confirmed the virus in patients around the globe. Today, scientists recognize human metapneumovirus as an emerging pathogen that may have been causing respiratory tract infections for at least 60 years.

Testing and Treatment of hMPV

american_lung_association_frankmagliochettireportTesting is not yet widely available, according to the American Lung Association, but the most common method is by swabbing and testing secretions from the nose or throat. Bronchoscopy may be used to collect specimens in hospitalized patients.

There is no direct treatment for hMPV infection so treatment focuses on alleviating symptoms of fever, runny nose, cough and sore throat. The symptoms of human metapneumovirus typically last for 2 to 5 days. Management focuses on the use of over-the-counter fever and pain remedies along with decongestants.

hMPV Trends in the United States and By Region

hMPV infections typically develop during flu season in winter and early spring, according to a report published in April 2016, and typically after the onset of respiratory syncytial virus (RSV).

The Centers for Disease Control and Prevention (CDC) collects weekly laboratory PCR and antigen testing result data and cdc-frankmagliochettireporttracks trends of hMPV by region. In nationwide testing, positive results by PCR testing for the year 2016 peaked at 9 percent in the middle of February while the number of positive antigen tests peaked at 9.5 percent in March.

hMPV peaks later in the Northeast, with positive PCR test results peaking at the end of February and March and a spike in positive antigen results of 10.4 percent at the end of April 2016.

The Midwest had the highest rates of positive test results in 2015, with about 13 percent of hMPV tests returning positive results. The southern section of the United States sees its peak hMPV tests in March with a 10 percent positive antigen testing rate and 8 percent positive PCR rate. The West had high hMPV positive test rates throughout February, reaching their 2016 PCR positive test peak of 11.3 percent in the last week of February. Antigen detection tests yielded unsteady results in that region.

The CDC and other agencies will likely collect more information about hMPV trends and treatments as diagnostic tools become more available.

Source

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1539100/

https://www.acponline.org/acp-newsroom/acp-and-cdc-issue-advice-for-prescribing-antibiotics-for-acute-respiratory-tract-infections-in

http://www.medscape.com/viewarticle/861392

https://www.ncbi.nlm.nih.gov/pubmed/11385510

http://www.lung.org/lung-health-and-diseases/lung-disease-lookup/human-metapneumovirus-hmpv/diagnosing-hmpv.html?referrer=http://www.lung.org/lung-health-and-diseases/lung-disease-lookup/human-metapneumovirus-hmpv/learn-about-hmpv.html?referrer=https://www

http://pediatrics.aappublications.org/content/early/2016/03/31/peds.2015-2927

https://www.cdc.gov/surveillance/nrevss/hmpv/index.html

Frank Magliochetti is Managing Partner for Parcae Capital.

  • North Andover, Massachusetts

This column of posts is directed at the Healthcare Industry.  Frank plans to release new sites dedicated to the industry  – .  He currently assists companies who are building, restructuring, transforming and resurrecting there business’s. An example of his client base are, Xenetic Biosciences , IPC Medical Corp, Just Fellowship Corp, Environmental Services Inc., Parsons Post House LLC, ClickStream Corporation as well as having a business talk radio show; The Business Architect on the URBN network.

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