Medicine

TLDR: the current treatment requires anesthesia, a ride home, bowel prep with laxatives and clear liquid diet, and it is painful once the stones come out. The new procedure doesn't require anesthesia or bowel prep, patients can drive home alone after a 30 minute treatment, and the patient reports that there is "no real pain" when the stones come out. The article suggests this is because the stones are whittled down to be smaller than the current treatment can do.

Some excerpts:

Now 67 years old, Chiquita has been a regular patient at the Stone Centre at Vancouver General Hospital, receiving screenings and treatment for recurrent kidney stones. Surgical removal is the last resort in kidney stone treatment; so, after his first procedure, Chiquita has mostly received a treatment called extracorporeal shock wave lithotripsy (ESWL).

ESWL directs many intense bursts of acoustic sound waves — between 60 to 120 per minute — to each stone to break it apart from the inside out. Because of its intensity, the treatment requires sedation and accompaniment home from the hospital. Patients must also take a laxative and follow a clear liquid diet prior to the procedure.

“The bowel prep the day before was awful,” says Chiquita, who has received dozens of these treatments over the years. “After ESWL, the stones would come out in a couple of days. If they came out all at once, the pain was over a 10 out of 10.”

When Chiquita was approached by Stone Centre urologist and Vancouver Coastal Health Research Institute researcher Dr. Ben Chew about a new procedure called Break Wave Lithotripsy (BWL), he was intrigued and signed up to participate in the first ever clinical trial of the novel technology, led by Chew.

“Dr. Chew told me that, with Break Wave, there is no need for anesthesia, bowel prep or X-ray; so, I said: ‘sign me up!’” Chiquita recalls.

Because BWL uses low-intensity sound waves, anesthesia is not required. Patients can drive themselves to and from the hospital, with the procedure lasting around 30 minutes. Clinicians use non-radiating ultrasound imaging, with BWL able to piggyback on existing ultrasound machines, making the technology smaller and more portable than ESWL equipment, which is only available at certain hospitals.

“BWL has potential applications in rural and remote communities that do not have access to the larger, dedicated machines needed to perform ESWL,” notes Chew. “For BWL, we can replace the diagnostic generator component of existing ultrasound machines with a therapeutic one used to send ultrasonic waves to treat the stones.”

BWL whittles down stones from the outside in, carving larger stones into smaller pieces that are easier to pass.

“With BWL, the stones seemed to come out one or two weeks later and with no real pain,” Chiquita shares.

While Chiquita was thrilled with the procedure and its overall results, there was a downside: having to hold his breath for extended periods of time.

Copying the At a glance section from CIHR site:

Issue

Neonatal sepsis is the third major cause of death for babies 28 days or younger. It is difficult to diagnose sepsis in newborns and if not treated quickly it can cause developmental delays, learning disabilities and death. Research

Dr. Bob Hancock and his team, including MD/PhD student Andy An at UBC and collaborator Dr. Amy Lee from Simon Fraser University, developed a software program that can predict sepsis in newborns, even in babies that do not have any symptoms of the condition.

The article isn't that long, and worth a read if you're curious. Here are some excerpts:

Two babies are born minutes apart.

One is lethargic, has a fever and is breathing rapidly.

The other is alert, has a normal temperature, and is breathing regularly.

Both have sepsis. Both could die if the sepsis is left untreated.

That’s the challenge with neonatal sepsis. It is hard to detect, hard to diagnose and the longer you wait to treat it, the more life threatening it becomes.

Sepsis is an overwhelming response to an infection that spreads throughout the bloodstream. Normally the body uses its immune system to fight infection, but in sepsis, the immune response is impaired causing serious damage to tissues and organs.

Sepsis is one of the leading causes of death in newborns in The Gambia. Microbiologist Dr. Bob Hancock and his lab at the University of British Columbia extracted RNA from blood cells collected from 700 babies in the West African country to find out why neonatal sepsis rates were so elevated. They sequenced the RNA to look for changes in gene expression linked to sepsis. Out of the 700 babies, they detected that 15 had sepsis in the first week of life.

“The Eureka was when we went back and looked at the babies, we saw big changes occurring at the time of birth in babies that were going to go on to acquire sepsis compared to babies who just had a local infection, or babies who didn't have any infection at all,” said Dr. Hancock. “In other words, sepsis was already starting, even though those babies looked healthy.”

The team used their findings to apply bioinformatics tools—software programs that analyze gene expression patterns in the blood of newborns—to identify specific molecular markers associated with sepsis. “So, we can predict sepsis before it occurs,” Dr. Hancock explained, “and that is astonishingly important because those babies can now be carefully monitored and treated as early as possible, rather than waiting until they're really getting sick.”

A relatively small number of babies born in Canada have sepsis—1 to 5 cases per 1,000 live births—but those that do can be born in rural or remote areas where getting rapid lab results is challenging. A predictive tool like the one Dr. Hancock’s lab developed could help physicians detect sepsis in newborns more quickly, averting long term health issues and even death.

CIHR recently awarded Dr. Hancock’s collaborators a grant to conduct clinical studies on a predictive tool for sepsis in the general population. The tool is integrated into a point-of-care device that enables physicians to predict sepsis at the patient’s bedside, accelerating treatment and improving chances of recovery.

Drugmaker Sarepta Therapeutics said late Friday it won’t comply with a request from the Food and Drug Administration to halt all shipments of its gene therapy following the death of a third patient receiving one of its treatments for muscular dystrophy.

The highly unusual move is a latest in a string of events that have hammered the company’s stock for weeks and recently forced it to lay off 500 employees. The company’s decision not to comply with the FDA also places future availability of its leading therapy, called Elevidys, in doubt.

The FDA said in a statement Friday night that officials met with Sarepta and requested it suspend all sales but “the company refused to do so.” The agency has the authority to pull drugs from the market, but the cumbersome regulatory process can take months or even years. Instead, the agency usually makes an informal request and companies almost always comply.

While the results of this study may seem obvious, studies like this are necessary in order to change / guide public policy. Excerpts below:

Background

Private equity (PE) investment in U.S. nursing homes has increased significantly over the past two decades. The emergence of this novel ownership model has prompted concerns regarding its effects on nursing home performance, especially quality.

Highlights

• ownership is linked to reduced CNA and LPN hours, with little to no increase in RN staffing.
• Increased deficiencies, mortality, and hospital visits were observed post-acquisition.
• Clinical care processes, including medication use, remained largely unchanged after PE acquisition
• PE ownership did not consistently improve financial margins.
• PE-owned NHs billed Medicare more, largely due to financial restructuring.

Authors:

• Jamie Benham | Endocrinologist & Assistant Professor, Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary
• Pauline McDonagh Hull | PhD Candidate, Department of Community Health Sciences, Cumming School of Medicine, University of Calgary
• Robyn Vettese | Research Assistant (Community Scholar), Department of Medicine, Cumming School of Medicine, University of Calgary

Polycystic Ovary Syndrome (PCOS) is a hormonal imbalance that affects ovaries, periods and fertility in about one in 10 Canadian women. Different from ovarian cysts, PCOS is associated with infertility, pregnancy complications, heart disease and a general decreased quality of life, and yet fewer than half of those affected even know they have it.

This under-recognition and under-diagnosis is a significant problem, because a recent Canadian study suggests these women are 20 to 40 per cent more likely to experience negative health outcomes during their lifetime than the general population, including hypertension (high blood pressure), kidney disease, gastrointestinal disease, eating disorders, depression and anxiety.

Just a week had remained before scientists in South Africa were to begin clinical trials of an HIV vaccine, and hopes were high for another step toward limiting one of history's deadliest pandemics. Then the email arrived.

Stop all work, it said. The United States under the Trump administration was withdrawing all its funding.

The news devastated the researchers, who live and work in a region where more people live with HIV than anywhere else in the world. Their research project, called BRILLIANT, was meant to be the latest to draw on the region's genetic diversity and deep expertise in the hope of benefiting people everywhere.

At least 27 people have been hospitalised in West Baltimore following suspected drug overdoses.

Citing officials from the region's fire department, the BBC's US partner CBS News reports that seven people had been admitted in a critical condition - but there have been no fatalities reported.

The incident took place near an intersection in the Penn North area of the city on Thursday morning.

Officials have not disclosed what substances they suspect may have been involved.

Scientists have hijacked the herpes virus and turned it into a cancer-busting ally.

A decade after the United States Food and Drug Administration (FDA) approved the first virus-based cancer therapy, another potentially life-saving treatment is on the horizon.

A genetically modified herpes simplex virus, called RP1, has now been shown to destroy advanced melanoma tumors, even when they exist deep in the body, according to a phase 1/2 clinical trial.

The trial involved injecting RP1 into melanoma tumors on or just below the surface of the skin, or deeper in the body like in the lungs or liver. In patients who responded positively to the treatment, even tumors not directly injected with the medicine began to shrink.

The first malaria treatment suitable for babies and very young children has been approved for use.

It's expected to be rolled out in African countries within weeks.

Until now there have been no approved malaria drugs specifically for babies.

Instead they have been treated with versions formulated for older children which presents a risk of overdose.

Study: http://dx.doi.org/10.1038/s41591-025-03773-w

A 64-year-old man went to the emergency department of Brigham and Women’s Hospital in Boston with a painful festering ulcer spreading on his left, very swollen ankle. It was a gruesome sight; the open sore was about 8 by 5 centimeters (about 3 by 2 inches) and was rimmed by black, ashen, and dark purple tissue. Inside, it oozed with streaks and fringes of yellow pus around pink and red inflamed flesh. It was 2 cm deep (nearly an inch). And it smelled.

The man told doctors it had all started two years prior, when dark, itchy lesions appeared in the area on his ankle—the doctors noted that there were multiple patches of these lesions on both his legs. But about five months before his visit to the emergency department, one of the lesions on his left ankle had progressed to an ulcer. It was circular, red, tender, and deep. He sought treatment and was prescribed antibiotics, which he took. But they didn't help.

With the realm of possibilities large, they started with the man's medical history. The man had immigrated to the US from Korea 20 years ago. He owned and worked at a laundromat, which involved standing for more than eight hours a day. He had a history of eczema on his legs, high cholesterol, high blood pressure, and Type 2 diabetes. For these, he was prescribed a statin for his cholesterol, two blood pressure medications (hydrochlorothiazide and losartan), and metformin for his diabetes. He told doctors he was not good at taking the regimen of medicine.

His diabetes was considered "poorly controlled." A month prior, he had a glycated hemoglobin (A1C or HbA1C) test—which indicates a person's average blood sugar level over the past two or three months. His result was 11 percent, while the normal range is between 4.2 and 5.6 percent.

NOTE: The original title was "Artificial intelligence-assisted detection[...]", so I modified it to be more specific.

Background:

Nasopharyngeal carcinoma is highly curable when diagnosed early. However, the nasopharynx’s obscure anatomical position and the similarity of local imaging manifestations with those of other nasopharyngeal diseases often lead to diagnostic challenges, resulting in delayed or missed diagnoses. Our aim was to develop a deep learning algorithm to enhance an otolaryngologist’s diagnostic capabilities by differentiating between nasopharyngeal carcinoma, benign hyperplasia, and normal nasopharynx during endoscopic examination.

Findings

Endoscopic images used in the internal study (Jan 1, 2017, to Jan 31, 2023) were from 15 521 individuals (9033 [58·2%] men and 6488 [41·8%] women; mean age 47·6 years [IQR 38·4–56·8]). Images from 945 participants (538 [56·9%] men and 407 [43·1%] women; mean age 45·2 years [IQR 35·2– 55·2]) were used in the external validation. STND in the internal dataset discriminated normal nasopharynx images from abnormalities (benign hyperplasia and nasopharyngeal carcinoma) with an area under the curve (AUC) of 0·99 (95% CI 0·99–0·99) and malignant images (ie, nasopharyngeal carcinoma) from non-malignant images (ie, benign hyperplasia and normal nasopharynx) with an AUC of 0·99 (95% CI 0·98–0·99). In the external validation, the system had an AUC for the detection of nasopharyngeal carcinoma of 0·95 (95% CI 0·94–0·96), a sensitivity of 91·6% (95% CI 89·3–93·5), and a specificity of 86·1% (95% CI 84·1–87·9). In the multireader, multicase study, the artificial intelligence (AI)-assisted strategy enhanced otolaryngologists’ diagnostic accuracy by 7·9%, increasing from 83·4% (95% CI 80·1–86·7, without AI assistance) to 91·2% (95% CI 88·6–93·9, with AI assistance; p<0·0001) for primary care otolaryngologists. Reading time per image decreased with the aid of the AI model (mean 5·0 s [SD 2·5] vs 6·7 s [6·0] without the model; p=0·034).

(emphasis mine)

Interpretation

Our deep learning system has shown significant clinical potential for the practical application of nasopharyngeal carcinoma diagnosis through endoscopic images in real-world settings. The system offers substantial benefits for adoption in primary hospitals, aiming to enhance specificity, avoid additional biopsies, and reduce missed diagnoses.

cross-posted from: https://lemmy.world/post/32060710

The U.S. Food and Drug Administration has approved the drug lenacapavir as a twice-yearly injection to prevent HIV.

The drug, called Yeztugo from company Gilead Sciences, was approved Wednesday based on data from clinical trials that showed 99.9% of participants who received it remained HIV negative.

Daniel O'Day, Gilead's chairman and chief executive officer, called the approval a "milestone moment in the decades-long fight against HIV."

"Yeztugo will help us prevent HIV on a scale never seen before. We now have a way to end the HIV epidemic once and for all," O'Day said in a news release.

According to the Centers for Disease Control and Prevention, there were 31,800 estimated new HIV infections in the United States in 2022, the most recent year with available data.

While the drug's approval meets an existing need, the Trump administration's funding decisions have rolled back progress for a vaccine.

Last month, the administration moved to end funding for a broad swath of HIV vaccine research, saying current approaches are enough to counter the virus.

As cannabis use among youth rises in Canada — and THC potency reaches record highs — emergency departments are seeing a surge in cases of a once-rare condition: cannabis hyperemesis syndrome (CHS).

Characterized by relentless vomiting, abdominal pain and temporary relief through compulsive hot showers or baths, CHS is increasingly affecting adolescents and young adults. Yet few people — including many clinicians — know it exists.

Canada ranks among the highest globally for youth cannabis use, with 43 per cent of 16-19-year-olds reporting use in the past year. Usage peaks among those 20–24 years, with nearly half (48 per cent) reporting past-year use.

This rise in regular, heavy use coincides with a 400 per cent increase in THC potency since the 1980s. Strains with THC levels above 25 per cent are now common. As cannabis becomes more potent and accessible, clinicians are seeing more cases of CHS, a condition virtually unheard of before 2004.

CHS unfolds in three phases:

1. Prodromal phase: Nausea and early morning discomfort begin. Users increase cannabis consumption, thinking it will relieve symptoms.

2. Hyperemetic phase: Intense vomiting, dehydration and abdominal pain follow. Hot showers or baths provide temporary relief — a hallmark of CHS.

3. Recovery phase: Symptoms resolve after stopping cannabis entirely.

Diagnosis is often delayed. One reason is because CHS mimics conditions like gastroenteritis or eating disorders, leading to costly CT scans, MRIs and gastric emptying tests. One telltale sign — compulsive hot bathing — is frequently overlooked, despite its strong diagnostic value.

Youth face unique risks. The brain continues to develop until about age 25, and THC exposure during this critical window can impair cognitive functions like memory, learning and emotional regulation. Heavy cannabis use is associated with heightened risks of anxiety, depression, psychosis and self-harm.

I've copied some of the story below

Dr. Donald Craig greeted by surprise guest during award presentation in Saint John

Dr. Donald Craig was an intern at the old General Hospital in Saint John on a snowy night in January 1968 when a doctor asked him for help.

The doctor had to deliver a baby at nearby St. Joseph's Hospital, but a woman at the General was also about to give birth. That child was three months premature and expected to be stillborn.

"Can you handle this?" the doctor asked.

Craig had delivered babies before, but only under the supervision of a doctor or a resident. So he grabbed a book on human labour and began to review it.

Then a nurse came and told him the baby was breech — something the doctor hadn't mentioned. So he went back to his book to look that one up. A few hours later, a nurse came to take him to the delivery room.

"She screams at me, 'Craig, she's ready, she's pushing and she's crying. Let's go.'"

Craig had to break the baby's clavicle on its way out, but he manged to deliver the baby, still expecting it to be stillborn.

And then the baby started to cry.

"My heart took off faster than the baby's heart, and the mother started crying, 'Is that my baby crying?'"

The baby was alive and Craig's thoughts quickly turned to her survival. She weighed two pounds and was three months premature. Her odds of survival weren't great.

He knew the General had just hired a pediatrician who specialized in newborn child care and premature births — and she happened to be in the hospital overnight in case she was needed during the storm.

Craig said that doctor soon appeared, wearing a bathrobe over her pyjamas. She looked at him and asked, "Did you deliver that by yourself? Give me the baby."

He said the doctor "let the mom kiss her baby and said, 'We're just taking the baby down the hall. We're going to be fine.' Then she disappeared."

To this day, Craig says the doctor's skilled care was critical to the survival of the baby, who was in the hospital for a month before being released. Craig checked on her every day and gave updates to her mother, who wasn't allowed to stay in the hospital with her.

"I delivered that baby, but [the doctor] had the skill, and was trained to handle it from there," Craig said.

More than 55 years later, Craig is retired after a decades-long career in family and emergency medicine. He has served as president of the College of Physicians and Surgeons of New Brunswick and the Saint John Medical Society.

He also founded the New Brunswick Medical Education Foundation, which provides scholarships to the province's medical students who agree to set up practice here — a critical part of the efforts to increase the number of doctors in New Brunswick.

In April, the foundation gave Craig the Champions of Care Founder's Award at a gala at the Saint John Trade and Convention Centre. The person who presented him with that award was Krista Barczyk, the premature baby he delivered as an intern decades ago during that January snowstorm.

It was a planned reunion the foundation kept secret from Craig until the moment Barczyk was called to the stage.

"I didn't hear half of her speech because I was so shocked," Craig said. "Then I got a copy of her speech and I printed it off to put up on my wall."

Diabetes Canada says it's received a surge in reports from people who've seen ads for or bought products that use the charity's logos without authorization.

Since January, Diabetes Canada says it's had over 300 calls to its 1-800 line and emails from people reporting misleading advertisements for diabetes products that have the charity's logo.

Diabetes Canada isn't the only organization being affected. Products ranging from purported medications and supplements to devices that claim to be blood glucose monitors are also carrying the logos of Obesity Canada and Health Canada. Some of the groups say they want the ads taken down and social media companies are doing that, but new ads keep appearing.

So, you’ve got a receding hairline in 2025. You could visit a dermatologist, sure, or you could try a new crop of websites that will deliver your choice of drugs on demand after a video call with a telehealth physician. There’s Rogaine and products from popular companies like Hims, or if you have an appetite for the experimental, you might find yourself at Anagen.

Anagen works a lot like Hims—some of its physicians have even worked there, according to their LinkedIn profiles and the Hims website—but take a closer look at the drugs on offer and you’ll start to notice the difference. Its Growth Maxi formula, which sells for $49.99 per month, contains Finasteride and Minoxidil; two drugs that are in Hims’ hair regrowth products. But it also contains Liothyronine, a thyroid medication also known as T3 that the Mayo Clinic warns may temporarily cause hair loss if taken orally. Keep reading and you’ll see Latanoprost, a glaucoma drug. Who came up with this stuff anyway?

The group behind the Anagen storefront and products it sells is HairDAO, a “decentralized autonomous organization” founded in 2023 by New York-based cryptocurrency investors Andrew Verbinnen and Andrew Bakst. HairDAO aims to harness the efforts of legions of online biohackers already trying to cure their hair loss with off-label drugs. Verbinnen and Bakst’s major innovation is to inject cash into this scenario: DAO participants are incentivized with crypto tokens they earn by contributing to research, or uploading blood work to an app.