Bioprinting Technology May Ease Donor Organ Deficit

Each year, about 120,000 Americans need organ transplants, yet the demand for donor organs far outweighs the supply. The solution: Bioprinting. A 3-D printer is used to dispense different cells, creating layers of cells that form tissue. So far, artificial organs are successfully functioning in animals. Mice, for instance, were able to conceive and give birth by means of prosthetic ovaries.

However, as this new industry emerges, so does the opportunity to capitalize on it. A company in China estimates that the market in America for artificial livers is approximately $3 billion annually. With that sort of potential for profits, larger companies have taken an interest in the future of bioprinting. Well-known companies are making significant progress printing skin for burns and ulcers. A company in Pennsylvania has developed a method to print skin directly onto the patient by spraying stem cells onto the area in need of new skin. Such interest by major companies is advancing this new technology.

From The Economist, “Printed human body parts could soon be available for transplant”

Excerpt from article:

But a lack of suitable donors, particularly as cars get safer and first-aid becomes more effective, means the supply of such organs is limited. Many people therefore die waiting for a transplant. That has led researchers to study the question of how to build organs from scratch.

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The New Trump Presidency Brings Uncertainty to the Health Care Industry

As one of his first items of business after taking the Oval Office, President Trump signed an executive order “instructing federal agencies to grant relief to constituents affected by the Affordable Care Act.”  In an already unstable market, this order leaves many questions unanswered, not only for states and other lawmakers, but also for consumers, medical professionals, and insurance companies. Senate Republicans insist that they are working with the Trump Administration to ensure “an orderly process.” However, without a replacement plan in place, many stakeholders are concerned that several insurance companies will leave the state health insurance exchanges by 2018, and Trump’s executive order will result in anything but an “orderly” transition away from Obamacare.

From The Washington Post, “With executive order, Trump tosses a ‘bomb’ into fragile health insurance markets”

Excerpt from article:

The political signal of the order, which Trump signed just hours after being sworn into office, was clear: Even before the Republican-led Congress acts to repeal the 2010 law, the new administration will move swiftly to unwind as many elements as it can on its own — elements that have changed how 20 million Americans get health coverage and what benefits insurers must offer some of their customers.

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Successful Implantation of Ovary Frozen Prior to Puberty Gives Hope to Young Women Struggling with Fertility

For women who struggle with fertility as a result of damage to reproductive organs by radiation treatment for cancer and other health conditions, a breakthrough procedure in the United Kingdom may offer hope and a new alternative. Moaza Al Matrooshi became the first woman in the world to give birth to a child conceived from an ovary that was frozen before she entered puberty. Before undergoing chemotherapy for a blood disorder at the age of nine, Moaza decided to have her ovaries removed and frozen. Years later, at the age of twenty-four, she was able to give birth to a healthy baby after relying on in vitro fertilization to restore her fertility using the frozen ovaries. Moaza believes her pregnancy and childbirth are a true miracle.

From The Telegraph, “Woman Gives Birth to Baby Using Ovary Frozen in Her Childhood in ‘World First’

Excerpt from article:

“This is a huge step forward. We know that ovarian tissue transplantation works for older women, but we’ve never known if we could take tissue from a child, freeze it and make it work again.”

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Relocating to Afford Medical Treatment

A recent CNN.com article follows two stories about families forced to relocate because of the lack of care their disabled children receive under Florida’s Medicaid program. Families and patients’ rights organizations have brought multiple cases against the state for poor management of the program. The spokesman for Florida’s Agency for Health Care Administration stated that the problems occurred prior to the state’s transition to a managed care system; under the new system the problems have been resolved. However, parents are not willing to take that risk and are moving to states where providers will not refuse to see them due to delayed insurance payments and where life-saving medicines are easily accessible for their disabled children.

From Cnn.com, “Health care refugees: Family flees Florida to save daughter’s life”

Excerpt from article:

Like nearly half of all children in Florida, Abby has Medicaid, the state-run health insurance. Her parents say that instead of being helpful, Florida Medicaid refused to pay for lifesaving medicines and took so long to pay some of her health care providers that at times, they refused to treat her.

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How Long is Too Long? Medical Interns Soon to Be Working Much Longer Hours

The current rules state that medical interns cannot work longer than 16 consecutive hours. This rule is in place to prevent accidents and mistakes as a result of fatigue. Recently, The Accreditation Council for Graduate Medical Education has proposed a change that would allow interns to work almost twice as long, for 28 hours without a break. The Council argues that this change would help expose interns to real-life practice. However, opponents of the rule argue that allowing these long hours is a severe risk to patients.

From npr.org, “Medical Interns Could Work Long Without A Break Under New Rule”

Excerpt from article:

“For years, medical interns have been limited to working no more than 16 hours without a break to minimize the chances they would make mistakes while fatigued. But that restriction could soon be eased.”

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The Link Between C-Sections and Obesity

This article reports on a study showing that the method of childbirth might affect that child’s weight well into adulthood. Babies who were delivered by caesarean have a 15% higher risk of being obese than babies who were delivered vaginally. The article suggests causative links, but the study did not prove that a caesarean section is a cause of obesity.

From TheGuardian.com, “Babies born by caesarean more likely to be obese as adults, study suggests”

Excerpt from article:

“Birth by caesarean was linked to a 15% higher risk of obesity in children compared with vaginal birth.”

 To read full article: Babies born by caesarean more likely to be obese as adults, study suggests

Grim Numbers: Two Studies Show Link between Being Uninsured or on Medicaid and Lower Chances of Survival

Two studies show that the numbers comparing health outcomes show significant disparities between those who are privately insured and those who are either uninsured or on Medicaid.

One study of patients with testicular cancer, found that of the 10,200 surveyed, “those who were uninsured were 88 percent more likely to die from cancer, and Medicaid patients were 51 percent more likely to die of the disease.”

Excerpt from the article:

“There were some treatment differences, as well, between the patients with private insurance, and those who either had Medicaid or were uninsured. And those treatment differences could affect survival.”

To Read Full Article: Studies Link Cancer Patients’ Survival Time To Insurance Status

 

Americans are Increasingly Turning to Medicaid for Long Term Care Coverage

Currently, about 62% of nursing home beds in the U.S. are paid for by Medicaid. Many elderly individuals cannot afford to pay for such long term care—the average total cost of long term care received from age 65 to death is $91,100 for men and up to double that amount for women, based on the presumption that women live longer. Low income individuals rely on Medicaid to pay for these expenses and other middle-class individuals are forced to spend down their assets to qualify for Medicaid coverage for their long-term care.

Medicaid was created to provide health insurance to low-income individuals, and not to cover long term care for the majority of the elderly population. Yet, it has evolved into a “safety net” for millions of Americans who cannot afford to pay for their long-term care.  As the baby boomer generation continues to age, Medicaid spending on long term care is expected to rise by almost 50% by 2026, putting pressure on a system that was not designed to carry such a burden.

State and federal officials are working to control Medicaid costs. Some states, for example, are contracting with managed care companies to provide long term care services to Medicaid beneficiaries. However, many health advocates are concerned that these managed care companies, which traditionally provided only medical care, will restrict the coordination of care for the elderly.  California most recently announced that it will hold informational hearings to discuss possible resolutions to the increasing cost of long term care.

 Sources: http://www.npr.org/sections/health-shots/2016/08/03/488385286/medicaid-safety-net-stretched-to-pay-for-seniors-long-term-care

Tags: Long Term Care Coverage, Burdened Medicaid System, Lower and Middle Class Americans

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Will Transgender Identity Be Declassified as a Mental Illness?

According to the current Internal Classification of Diseases (ICD) set forth by the World Health Organization, being transgender is considered a mental illness.  There have been proposals, however, to declassify transgender identity as a mental illness in the new ICD-11, which is expected to be approved in 2018.

Instead of removing the diagnosis altogether, Geoffrey Reed, a Professor of Psychology and consultant on the ICD-11, proposes a new diagnosis called “gender incongruence” that would be found in a new medically and biologically oriented chapter called “Conditions Related to Sexual Health.” It is important that the transgender classification is not removed from the ICD entirely to ensure that transgender individuals have continued, and hopefully improved, access to health care.

Yet, many transgender activists see this change as only “a small battle won” in the “war being waged for trans rights”. One activist, Alok Vaid-Menon, explains that stressors related to being transgender come from the outside world and there are bigger issues than the ICD classification that must be addressed, including violence, poverty, homelessness, and housing discrimination. “The true victory,” according to Vaid-Menon, “would be to de-stigmatize diversity and difference itself.”

Sources: http://www.chicagotribune.com/news/nationworld/ct-transgender-mental-illness-classification-20160729-story.html

Tags: Transgender Rights, ICD-11, Declassify Mental Illness, De-stigmatize diversity, Transgender Health Care Access, Gender Identity

Field Trial Supports Removal of “Transgender” from Mental Health Classification

The first field study was recently conducted in Mexico City to assess the transgender diagnosis listed in the mental disorders chapter of the World Health Organization’s (“WHO”) International Classification of Diseases. Senior author of the study, Professor Geoffrey Reed from the National Autonomous University of Mexico, explained that such diagnosis stigmatizes transgender individuals which, in turn, impacts legalization, human rights, and appropriate access to healthcare. These misconceptions have negatively impacted transgender rights across the globe, with many countries denying transgender individuals autonomy, such as in their legal documents and child custody rights.

The study consisted of interviewing 250 transgender individuals, ranging from 18 to 65 years old. The participants answered a series of questions, such as, when they first became aware that they were transgender, their experiences of gender, social rejection, violence, etc. Participants disclosed that they were often victims of violence and family rejection. Majority of participants cited their adolescent years as the highest period of distress.

The researchers believe that eliminating the transgender diagnosis from the WHO classification would be the first step in diminishing the stigma and abuse of transgender individuals. Dr. De Cuypere, from University Hospital in Belgium, and Dr. Winter, from Curtin University in Australia, stated: “‘Transphobia is a health issue’. This study prompts primary caregivers and psychiatrists to be aware of a ‘slope leading from stigma to sickness’ for transgender individuals, and to contribute to their mental health by a gender-affirmative approach.”

The study was published in The Lancet Psychiatry on July 26, 2016 and is now being replicated in Brazil, France, India, Lebanon and South Africa. These subsequent studies are being performed as an effort to build enough clinical evidence to remove transgender from the list of mental health disorders.

Source: http://www.eurekalert.org/pub_releases/2016-07/tl-tlp072516.php, http://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(16)30165-1/abstract

 

Tags: Clinical Ethics, Mental Health, Bioethics, Access, News, Gender Orientation