Saturday, December 14, 2019

MISCELLANEOUS

Intervention Cardiology May not be Effective After all 
A $100 million study, dubbed the ISCHEMIA study, shows that interventional cardiology may not be after all more effective than life style change, healthy diet, exercise and regimen of medication. The findings have been presented at the annual meeting of the American Heart Association. The trial involved patients with stable heart diseases, sometimes associated with angina, chest pains, or clogged arteries. The invasive stent procedure, or bypass, has not produced better outcomes than a combination of life style change, healthy diet, exercise and medication. By avoiding interventional cardiology, we can save hundreds of millions of dollars in the unnecessary healthcare costs.  

*******************  WEIGHT LOSS

Demand for Compounded Semaglutide Treatment Soaring
After the FDA's approval of weight loss drugs Ozempic and Wegovy in 2021, they have become cause celebre for the prompt positive outcome. A key ingredient of both Ozempic and Wegovy, Semaglutide, works as an agonist, which is defined as a substance that "mimics the action of a neurotransmitter, or hormone" as per Heath Research Board's National Drugs Library. Semaglutide, a key ingredient of Novo Nordisk's Ozempic and Wegovy, sends neurotransmission to the brain's GLP-1 receptors that regulate body's blood sugar levels by stimulating production of insulin to convert insulin, or sugar, into energy. Semaglutide is also found to help in guts by slowing down digestion, or in brain by stimulating signals to control appetite. 
As the demand for Semaglutide-based drugs such as Ozempic grows significantly, there is an alternative market for compounded Semaglutide treatment, which remains unregulated. Doctors are recommending caution to patients who are seeking weight loss treatment from medical spas that offer compounded Semaglutide treatment. This unregulated market is becoming popular and offers tremendous revenue potential to medical spa owners and operators. 

First Decrease in Obesity Reported
In a hopeful turnaround in nation's fight against chronic obesity and overweight, researchers found the first downward trend in nation's obesity rate in 2023, according to a study published on December 13, 2024 in the JAMA Health Forum. The researchers led by Ben Rader, scientific director of Boston Children's Hospital and assistant professor of Harvard Medical School, focused on data from 16.7 million adults between 2013 and 2023. 
Obesity is represented on the BMI (Body Mass Index) scale, with people with BMI between 18.5 and 24.9 are classified as of "Normal Wight", 25 to 29.9 as "Overweight" and 30 and above as "Obese"
The average BMI has increased every year between 2013 and 2021, then plateaued in 2022 and fallen slightly in 2023 to 30.21. The prevalence of obesity, or percentage of adults in the study with BMI 30 and over, in 2023 is 43.96% from 44.11% in 2022. Many healthcare experts believe, although jury is still out, the slight, but noteworthy, dip in the nation's overall prevalence of obesity is partly caused by rapidly growing access to GLP-1 [Glucagon-like Peptide-1] receptor agonist diabetic drugs such as Ozempic and Mounjaro as well as their weight-loss cousin, Wegovy. 
Region wise, researchers found some remarkable drop in the prevalence of obesity in the south (46% in 2022 to 45% in 2023) compared to the West, where prevalence of obesity had inched up, and other regions, where the prevalence of obesity remained flat. Researchers found a measurable correlation between the usage of GLP-1 receptor agonists and drop in obesity rate metric (prevalence of obesity). In the South, approximately 6% of the residents are taking GLP-1 receptor agonists such as weight-loss drug Wegovy and diabetic drugs Mounjaro and Ozempic, while 5.1% residents in the Midwest, 4.4% in the Northeast and 3.4% in the West take similar drugs. 

*******************  WEIGHT LOSS

Lack of Health Insurance Worst in Texas
The Dallas Morning News in its editorial on June 25, 2024 hit home on the ugly picture of millions of Texans lacking coverage of health insurance. According to the National Center for Health Statistics, circa 25 million people in the U.S. were without healthcare insurance in 2023, compared to 27.6 million people in 2022 and 33.2 million in 2019. 
In Texas, its ranks of 5 million people lacking health insurance account for 16.6% of all Texans in 2023, double the national average of 7.6%, placing the Lone Star State in the dead last. Among the children, Texas fared poorer compared to national rate: 10.9% of Texas children lack insurance compared 3.9% in 2023.

Legionella Found in Water Testing at Federal Facilities
The U.S. General Services Administration is running water testing for all federal facilities since January 2024. As part of that routine testing, the test results from the samples collected from the federal government's Social Security Administration and Centers for Medicare and Medicaid Services facilities in Woodlawn, Maryland came back positive with elevated level of Legionella Bacteria, key contributor to Legionnaires' Disease or Pontiac Fever. The Dallas Morning News published a report in the July 28, 2024, edition that facilities, out of abundance of cautions, had urged the employees to work remotely as the the water fixtures were being curated.  

Parkland Uses AI to Enhance Medical Decision-making and Augment Medical Services
Parkland Center for Clinical Innovation President and CEO Steve Miff in an Op-Ed published by The Dallas Morning News on August 13, 2024 wrote on the positive impact of AI and ML on  healthcare outcomes. The roots of AI go back to centuries, with the first predictive Mathematical algorithm credited to German Mathematician Carl Friedrich Gauss in 1795
However, AI and ML leapt significantly in recent decades because of the substantial advancement of the computing powers. The benefits of AI and ML don't come automatically, instead the PCCI focuses on defining and describing the use business cases and related success criteria to drive benefits from:
* Problem Definition and Articulation
* Assembling a multidisciplinary team
* Prioritizing Data Quality and Relevance

Experts Worried over Surge in Kratom Alternatives
The Dallas Morning News reported on October 5, 2024 that many vape stores in the DFW Metropolitan Area might be illegally selling some potent alternatives to Kratom. Kratom selling remains legal and its pain management benefit is acknowledged by many, but not all, medical experts. However, The Dallas Morning News' research shows that many vape storefronts are selling products containing high level of 7-OH, or 7-hydroxymitragynine, a chemical that's present in small traces in Kratom leaf. 
Texas legislature in 2023 passed Texas Kratom Consumer Protection Act that limited 7-OH to 2% of total alkaloid content. The Global Kratom Coalition submitted a letter to Attorney-General Ken Paxton in July 2024 that a lab testing had found alarming levels of 7-OH in products sold in five North Texas stores. 

*************************** NEW WORLD SCREWWORM ***************************
Eradicated in 60s, Flesh-eating Worms Worry Some U.S. Public Health Officials
The Dallas Morning News reported on January 2, 2025 that health authorities recently had found New World Screwworm, or NWS, in a cow near Mexico-Guatemala border, according to a December 30, 2024, press release by Texas Parks and Wildlife. The NWS was eradicated from the U.S. in 1966 and from Mexico in 1991. The reemergence of flesh-eating screwworm is worrisome, but people should not be panicked, according to the health experts. Texas border area ranchers and farmers are advised to keep a watch on any symptom related to NWS. The infection, known as the NWS Myiasis, spreads by NWS flies, which are bigger than most common house flies, laying eggs on the open wound on the flesh. The eggs on the open wound are the recipe for the New World Screwworm to hatch larva/maggot that can latch onto the skin. 

U.S. to Build Fly Breeding Facility to Fight Maggots
Agriculture Secretary Brooke Rollins said on August 15, 2025 at Austin that U.S. would build a $750 million facility in the Rio Grande town of Edinburg that would produce 300 million sterile male flies per week. The new facility will complement an $8.5 million fly dispersal facility in Edinburg. Maggots, the larva that New World Screwworm flies hatched on flesh, can spread on the open wounds of the cattle and decimate the Lone Star State's $15 billion cattle and ranching industry. The sterile flies will be released in the worst affected areas where those sterile flies can mate with fertile female flies, who can mate only once in the few weeks of their life. 
There are two other fly-producing facilities: Panama produces 117 million flies per annum and another facility in Mexico is getting remake to produce 60 to 100 million flies per week. 

First Human Case of NWS Reported
The Dallas Morning News reported in its August 26, 2025, edition that Maryland authorities had reported on August 4, 2025 the first human case of New World Screwworm. 
*************************** NEW WORLD SCREWWORM ***************************

Is Dire Wolf Recreated by Gene Editing? Or, Does the New Species Look Like Extinct Species?
Dallas-based Colossal Biosciences made waves with their announcement on April 7, 2025 that the "de-extinct company" was able to resurrect a long-gone wolf species--Dire Wolf--that used to roam the American highlands 12,000 years ago. However, other scientists are skeptical about the claim, saying that the three new pups--Remus, Romulus and Khalessi--are genetically closer to Gray Wolf, but look like Dire Wolf. They say that even human parents and children do have dozens of genetic differences, but that does not entail to them being different species, noting that Colossal has edited 20 genes of Gray Wolf. 
The Dallas Morning News published a front-page article on Colossal Biosciences' discovery in its April 11, 2025, edition. The Dallas Morning News referred the birth and sequence of events surrounding the birth to explanation and storylines provided by Colossal Biosciences' Chief Scientific Officer Beth Shapiro. Colossal collected the DNA of Dire Wolf from the two well-preserved fossils of the long-gone species: one a skull dating back to 20,000 years found in Utah and another one is a tooth found in Ohio that dated back to 13,000 years ago. The Colossal scientists then lined up the Dire Wolf genome with genes collected from the other species in canid family--Gray Wolf, Coyote, Dhole and Jackal. They found Gray Wolf and Dire Wolf to be distant cousins, and both shared 99.5% of the DNA. Gray Wolf is thought to have separated from the main Wolf genealogical tree six million years ago. 
Scientists from Colossal Biosciences obtained Endothelial Progenitor Cells, a class of stem cells not used for cloning before, from the Gray Wolf DNA. They leveraged CRISPR, a gene-editing tool with a scissor-like precision, to edit 14 genes to align traits similar to Dire Wolf and orchestrated those changes at 20 targeted spots to give a proximity in trait similar to Dire Wolf. Then these edited genes were inserted in the eggs obtained from domesticated dog. The embryos then were implanted in domesticated dog surrogates. 
Remus and Romulus were born in October 2024 and Khalessi was born in January 2025. They will not be released into wilderness, instead will be confined to a 2,000 acre preserve. 

"Virgin Birth" Research Unlocks Potential for Species Preservation, Birth Defect Treatment
The Dallas Morning News published an exciting article on asexual reproduction in its May 12, 2025, edition that alluded to the research published in the last month's Science Advance. The scientists were looking for a scientific reason and rationale on determining the root cause for Parthenogenesis, or so called "virgin birth". The scientists focused on a blind garden snake called the flowerpot snake
The flowerpot snake is only female only snake, and they reproduce without a male mate, a process called the Parthenogenesis. Scientists looked at the genetic structure, and they found 40 Chromosomes sub-grouped into three sub-genomes, also known as Triploidy. Humans do have 46 chromosomes, 23 pairs of Diploid Chromosomes. Flowerpot snakes do have an extra copy of Chromosome, making them a bearer of Triploid Chromosomes. For Humans, extra copy of Chromosome leads to birth defects. Scientists are researching what's different in genetic composition in humans from that of flowerpot snakes that for the same condition--Trisomy--one species has normal reproduction cadence while the other faces birth defects. 
Mammals are not known for Parthenogenesis, which are mostly common in invertebrates. There are two types of Parthenogens: (A) Obligate Parthenogens and (B) Facultative Parthenogens. Obligate Parthenogens reproduce only through pure Parthenogenesis, while the Facultative Parthenogens such as female sharks switch between Parthenogenesis and sexual reproduction
The researchers will now shift their focus on whiptail lizards, another species that displays pure Parthenogenesis. Mother nature and earth's diversity have blessed us with vertebrates such as snakes and lizards, with some of them having traits in pure Parthenogenesis

TYLENOL WARNING: Trump Issues Tylenol Warning for Pregnant Women
At a high-profile White House press conference, President Donald Trump, accompanied by HHS Secretary Robert F. Kennedy and CMS chief Dr. Mehmet Oz, said on September 22, 2025 that pregnant women taking Tylenol might be at a higher risk of having autistic baby. The connection between autism and Acetaminophen is not proven, thus alerting many professionals in the medical community. 

Domestic, International Criticism against Trump Admin's Tylenol Warning Mounting
A day after Trump's high-profile news conference in which the president linked Tylenol use by pregnant mothers and high risks of autism, both the domestic and international criticism was rising. On September 23, 2025, Britain's Medicines and Healthcare [products] Regulatory Agency, or MHRA, said that use of Acetaminophen, a key ingredient of Tylenol that Trump administration had linked to the high risk of autism, remained safe for pregnant women. On September 24, 2025, the World Health Organization joined the phalanx of vocal critics of Trump's warning. 

SB 2308: Abbott Grants $50 million for the Research to Assess Benefit of Psychoactive Drug
Given the growing pain of the families from the mental health crisis, including PTSD, even a Conservative state like Texas is open to explore the health benefit of psychoactive drugs such as Ibogaine, LSD and Psilocybin
In June 2025, Governor Gregg Abbott signed the Senate Bill 2308, granting $50 million to research institutions to experiment on the efficacy of Ibogaine in treating PTSD and other behavioral symptoms, affecting millions of Texans.