Health and Disability

TSS is back in the news because a model — who lost her leg to the disease in 2012 — is on an awareness campaign to teach young girls about the dangers of tampons. Her story is horrifying, and is only more depressing now that she may have to have a second leg amputated. It seems all the scarier when you realize that she hadn’t even left the offending tampon in for very long (in fact, based on her telling of it, she felt ill before she put one in).

Every woman I know heard these tales as a kid and had one takeaway: we were all definitely going to get TSS if we left a tampon in for even a minute longer than the prescribed eight hours. In 9th grade I accidentally left one in for 12 hours and genuinely thought I’d narrowly escaped death. But it turns out almost everything that I and other girls my age believed about TSS is flat-out wrong. Let’s clear up a few misconceptions, starting with the basics.

Could you remind me ahem, my friend what TSS actually is?

Don’t be embarrassed. I would venture a guess that most folks don’t really know what TSS is, besides “a horrifying disease that you get from tampons.”

Toxic shock syndrome isn’t really a disease in and of itself. It’s a complication of a bacterial infection. There are two kinds of bacteria, staphylococcus aureus and group A streptococcus, that can produce a toxin called TSST-1 (toxic shock syndrome toxin 1). TSST-1 is a superantigen, which means it prompts the immune system to massively overreact to an infection. The resulting storm of immune cells causes the body to go into shock as inflammation spreads and a fever rises, and if left unchecked will eventually cause multi-organ failure. And the toxin can enter the bloodstream even if the bacteria are isolated to one area, so an infection in a single part of the body can end up killing you. Other toxins can also cause TSS, but TSST-1 is the most common one for tampon-related cases.

TSS is actually really rare

In 2016, the CDC reported a grand total of 323 cases. That’s not insignificant, but is pretty tiny when you consider that there are roughly 63 million women between the ages of 15 and 44 in the United States. That’s a rate of 0.0005 percent. Even fewer people died of it that year — just 26 men and women. This isn’t to minimize those losses, because for the victims and their families, TSS was devastating. But on the spectrum of possible causes of death to worry about, toxic shock syndrome is exceedingly unlikely.

And for all you youths out there who are terrified to leave a tampon in for more than a few hours, rest assured that millions of adults regularly fail to remove tampons in a timely fashion. It’s generally not a problem, and TSS doesn’t often have much to do with tampons anyhow.

A third of all TSS cases happen in men

That’s right — men. Do you know who is arguably the most famous person to die from TSS? Jim Henson, the creator of The Muppets.

This is startlingly good news.....

https://goo.gl/hzVVSH

Analysis showed 50% reduction in emphysema progression.

Regular aspirin use was associated with a more than 50% reduction in emphysema/chronic obstructive pulmonary disease (COPD) progression in an elderly cohort over a decade in a longitudinal analysis of data from a large lung study.

The association was seen across aspirin doses and was greatest in older study participants with significant airflow obstruction.

Results were similar in ever-smokers and for doses of 81 mg and 300-325 mg. A greater magnitude effect was seen among participants with airflow limitations.

Our elected officials and health care providers may hope to curb the opioid epidemic through traditional addiction recovery programs and criminalization, but it’s time for them to consider the potential that medical cannabis has to offer in this effort.

All year, researchers from all over the country have been publishing concrete evidence proving that the legalization of medical marijuana leads to happier, healthier patients. Another study, released this week, has found that patients are replacing their prescription drugs with medical marijuana.

Published in the Journal of the American Medical Directors Association, the study concluded that chronic pain sufferers who were legally able to use medical cannabis eventually ended up using fewer opioids and other dangerous prescription drugs.

CVS Health, the largest retail pharmacy chain in America, announced early this month that it planned to purchase Aetna, one of the largest health insurance companies. It was a move analysts say was meant to keep the brick-and-mortar pharmacy juggernaut competitive as e-tailer Amazon moves in to disrupt the prescription drug industry.

Over the last few years, CVS has become all-but-synonymous with “drug store” for much of the U.S., wiping out independent pharmacists as its outlets have marched through cities coast-to-coast. CVS has been on a tear during the last decade, with stores in 49 states, Washington, D.C., Puerto Rico, and Brazil. The number of CVS storesgrew more than 30 percent to more than 9,700 from 2012 to 2017. More than 1,600 are located inside Target stores, which in 2015 sold its pharmacies to CVS for $1.9 billion.

The state of Idaho, however, has only two lonely CVS outposts. Both are inside Targets, and neither is in Boise, the fast-growing high-desert capital city of 223,000. The company has been trying to remedy that situation: In October, a developer filed an application to build a single-floor 12,000-square-foot CVS retail pharmacy on Boise’s West State Street, an urban gateway that links multiple neighborhoods to the city’s downtown.

To make space for the store and its parking lot—which would have occupied nearly a city block—the developer planned to demolish three homes and a building with 23 low-income residences, at a time when the city’s downtown is quickly gentrifying and concerns about low-income residents being pushed out are intensifying.

“If I can do that, that would be a very healing experience,” he said. “Well, repealing net neutrality may screw that up. They may charge those patients a zillion dollars for the necessary bandwidth I need to communicate and to do my job better.”

Cyber protection, competition

Another hurdle to telemedicine if net neutrality is repealed involves encryption. Everything that is transmitted through telemedicine portals has tomust be encrypted to meet HIPAA laws.

“Say an ISP decides they no longer want encrypted traffic to go across their network because they want visibility into everything that goes across their line. At that point we’re just hoping that they’re going to continue to pass that traffic,” Greg Hall, IT director for the Center for Telehealth at the University of Mississippi Medical Center, told Healio.com. “If they decide they don't want to or want us to pay them additional fees to have the traffic that is encrypted then suddenly we’re stuck. They could very easily block it all and we can no longer do a telehealth encounter because we can’t pass our traffic over our networks. Our business is completely stopped because one ISP somewhere on the chain has decided that they don't like that kind of traffic.”

Even if major ISP providers such as AT&T, Verizon and Sprint continue to operate under the guidelines of net neutrality and do not restrict access, there still could be hurdles to telemedicine, Hall said.

“You have a small rural ISP that decides, ‘Hey, no we don’t want to play all those games, we want to charge a certain fee for certain traffic’ and say that happens to be the video traffic that we push across the internet at some point. All of the sudden, that small little provider, just because we happen to pass some traffic across their network, could very easily cripple access at that point.

“The main concern is not even just, ‘Hey, our bill comes from AT&T every month.’ It doesn't always just go over AT&T lines, so we have to worry about every ISP that our traffic happens to go across to get from one location to another.”

In what is thought to be one of the biggest breakthroughs in the treatment of neurodegenerative diseases in the last 50 years, researchers have created a drug that may one day slow the progression of Huntington's disease. 

A tragic neurodegenerative disease, Huntington's is caused in most people by a single genetic mutation, although a small number of others do develop the genetic fault through random mutation. The gene in question codes for a protein known as huntingtin that builds up in the brain, causing the progressive degeneration of the nervous system and significantly harming movement, learning, thinking, and emotions.

The new drug is designed to disrupt the expression of this faulty gene, preventing the production of huntingtin and thus hopefully slowing the onset of the disease.

Known as IONIS-HTTRx, the drug does not target the gene itself, but is instead a piece of synthesized genetic code that binds to the piece of messenger RNA that transports the information needed to build huntingtin around the cell. By doing this, the drug destroys the messenger molecule before the damaged proteins form. The researchers were able to dramatically cut the levels of this protein found in the brain.

It is important to stress that the trials carried out so far were not looking at whether or not the new treatment prevented the symptoms of the disease from progressing, so the researchers cannot say unequivocally that it works. Instead, they were looking at the level of the toxic protein found in the nervous system.

Airports Are Big. Flights Are Long. Plan Ahead.

• Purchase your tickets well in advance so you can select your seat – and buy as much comfort as you can afford. Take Business class if you can swing it. If you’re in economy, try to get a seat with extra leg room. And take the window seat. If I can avoid basic economy center seats for the rest of my life, I will.

• Get to the airport early and check your luggage. Even if it’s a carry-on size roller-bag. When I fly by myself, I only carry on the backpack that I can put under the seat in front of me. Managing extra luggage just means additional pain for my hands and wrists.

• Use a wheelchair. When I asked for travel tips, one of the things my friends and family repeatedly advised was “swallow your pride.” I have a hard time with this. I want to muscle through. But, even in small airports, I find it’s a mistake to think I can muscle through and go without a wheelchair. (And even if I can, I’ve then spent a spoon or two that I might want to save for after I land at my destination!)

You can reserve a free wheelchair service when you buy your ticket. But whether you reserved it ahead of time or not, when you arrive at the ticketing counter to check that luggage, let the agent know that you need a wheelchair. Usually, someone wheels a chair out for me to sit in while they dispatch a “pusher” out to me. Again, planning well in advance is necessary, because this can take a while if it’s a smaller airline and has a shared pool of wheelchair attendants. The service is always free, but it is customary to tip your wheelchair attendants. They are so nice and friendly, it’s hard not to overflow with gratitude.

If approved, the $69 billion acquisition -- $77 billion including debt -- would drastically remap the healthcare industry. CVS Health (CVS)is a massive drugstore chain and prescription drug insurer, while Aetna (AET) is one of the nation's largest health insurers.

The acquisition is not a done deal. It will have to be approved by antitrust regulators, who have been skeptical of similar health care mergers.