Month: June 2019 (Page 2 of 5)

https://www.usnews.com/news/health-news/articles/2019-06-10/drug-may-help-delay-onset-of-type-1-diabetes

Gordon, Serena. (June 10, 2019) Drug May Help Delay Onset of Type 1 Diabetes. U.S.News. Available at https://www.usnews.com/news/health-news/articles/2019-06-10/drug-may-help-delay-onset-of-type-1-diabetes

This article talks about a new drug, teplizumab, being able to potentially postpone the onset of Type I Diabetes. Type I Diabetes occurs when the pancreas creates little to no insulin. Teplizumab targets specific immune cells that destroy beta cells (cells that produce insulin). The treatment would not prevent the development of type 1 diabetes, but it would slow it down. The hope of the treatment is to decrease the social, economic, psychological, and biological burden of the disease.

The study had 76 participants older than 8 years. The majority of participants were under 18 years old. All participants had a very high risk of developing type 1 diabetes; they had a relative diagnosed with type 1 diabetes, there was evidence supporting the degradation of their beta-cells, and their bodies showed signs of improper blood sugar processing. The article doesn’t state where this study was conducted. I would assume participants would go to a health facility to receive treatment on a daily basis and carry out their regular routine otherwise. One group was given teplizumab and the other group was given a placebo intravenously for two weeks. After the two weeks, participants were followed until they developed type 1 diabetes. Some participants haven’t developed type 1 diabetes and are still being followed. The study found that teplizumab was able to postpone the onset of diabetes for an average of 48 months. Participants that were given the placebo developed type 1 diabetes in an average of 24 months. According to this study, teplizumab was able to postpone the onset of type 1 diabetes in high-risk populations for an estimated 1 year. Additionally, 43% of the group treated with teplizumab developed type 1 diabetes while 72% of the placebo group developed type 1 diabetes.

I am not that convinced by the claims about this intervention’s effectiveness. According to the article, teplizumab is a relatively new drug. Furthermore, teplizumab is “the first study to show any drug can delay type 1 diabetes diagnosis a median of two years,” says study lead author Dr. Kevan Herold. This makes me want to see more research testing the effectiveness of it. The article doesn’t state whether the differences observed between the treatment and control group was statistically significant. I am unsure if this difference was due to external environmental factors or not. The article also doesn’t mention if the study controlled for any additional medical conditions or environmental factors that could influence the rate at which beta cells are destroyed.

This intervention is likely to catch on. Millions of people are diagnosed with type 1 diabetes every year. People with type 1 diabetes need insulin and will have to purchase it no matter what price it is. The psychological burden of being diagnosed can be great. Solutions to cure or alleviate the complications associated with type 1 diabetes are in high demand. This article describes the innovators who begin to test a new drug to see how it affects the onset of type 1 diabetes. Early adopters will see this as something new, exciting, and positive for everyone. They will adopt this innovation quickly and easily. With enough research and success stories supporting that teplizumab can delay the diagnosis of type 1 diabetes, the early majority will adopt this intervention. If teplizumab has gained a good reputation and is already widely used, the late majority will slowly adopt the intervention. The laggards may be pressured to adopt the intervention by other groups or maybe finally persuaded by an overwhelming number of statistics in favor of the intervention. Key decision makers are likely to agree to recommend and fund this because of the reasons stated earlier. An intervention that prolongs the diagnosis of type 1 diabetes would affect millions of at-risk people and could greatly decrease the economic and psychological burden of the disease.

Preidt, Robert. (June 21, 2019) New Drug Combats Leading Cause of Dwarfism. U.S. News & World Report. Available at https://www.usnews.com/news/health-news/articles/2019-06-21/new-drug-combats-leading-cause-of-dwarfism (Accessed June 23, 2019).

The intervention that the article focused on was using a drug called vosoritide to regulate the bone development in children with the genetic bone disorder achondroplasia. Achondroplasia is the most common form of dwarfism. In the United States, France, United Kingdom and Australia a four-year phase 2 trial was conducted. 35 children aged 5-14 were separated into four groups and given daily doses of vosoritide in increasing quantities. This caused the children to increase in height an average of 2.4 inches a year. It increased the children’s growth rate on average by 50%. The side effects of the drug were generally minor. I am convinced of the effectiveness of this intervention because of the increased growth rate of the children with only minor side effects. Achondroplasia affects approximately 1 in 25,000 infants and is caused by a FGFR3 gene mutation which adversely affects bone growth. An overactive signal that stops development is what causes achondroplasia. This intervention is effective because vosoritide helps to stop that overactivity thus helping to solve the problem. The intervention is likely to catch on because from a policy perspective it is addressing the needs of these children by improving their future health on a yearly basis. The key decision makers are likely to agree to recommend and fund this intervention because it increased the growth rates of children with achondroplasia per year to nearly the same growth rates per year of children of average height. Many children with achondroplasia have other complications such as spinal chord compression, spinal curvature and bowed legs. These complications require corrective surgeries in approximately half of the children. This intervention may improve the children’s health outcomes, functioning and access to their environment which would increase the likelihood that it would be funded by key decision makers.

https://www.usnews.com/news/healthiest-communities/articles/2019-06-21/barber-backed-sex-talks-a-tool-to-curb-hiv-study-suggests

Williams, Joseph P. (June 21, 2019) Barber-Backed Sex Talks to Curb HIV. U.S. News and World Report. Available at https://www.usnews.com/news/healthiest-communities/articles/2019-06-21/barber-backed-sex-talks-a-tool-to-curb-hiv-study-suggests

The intervention is a primary intervention on educating an at risk population to prevent them from getting HIV by teaching them about safe sex practices through the Brothers talking with brothers program which has barbers talking about health issues with their clients. Since it can be awkward for people especially men to talk about safe sex with others Tracey Wilson, one of the lead authors on the study, helped come up with the idea of going into barbershops and having either the barber themselves do the talking or a health expert sit there and talk while the barber gives the client a cut. They decided this would be an effective venue for African American males as it is a place they frequent often and feel very relaxed during. The effectiveness was tested in fifty barbershops in the Brooklyn area and by their out comes they saw a little bit of success they feel they can build upon in the future. A group received a talk about the risks of unprotected sex in relation to HIV while a control group received a talk about prostate cancer. After 6 months they asked the groups about their sexual partners and their use of prophylactics. Reportedly of the 320 members of the HIV group 64% reported that they had not had any vaginal or anal sex without a condom in the past ninety days while comparatively the control group reported in at a 54% rate out of the 200 members. While I can see why they thought it was a success in comparing it with a control group they don’t offer information about the efforts to reduce confounding or alternate reasons for the improvement in condom use. I believe for me to trust the experiment a little bit more I would need the groups to know the originating information, i.e. the percentages of those who received either talk that always or mostly used condoms. If the starting percentages were 60% then I would feel like it was less effective than if the starting percentages were 30% or 40%.

I think that this intervention maybe likely to catch on especially in African American communities where going to the barbershop is a more meaningful time than some other communities where the men do not really have a relationship with their hair dresser. However the fact that for the African American male community it is in a place they feel more comfortable at, probably have a relationship with their barber that has fostered trust of the barber, and the inability to just walk away makes it ideal to offer health talks, especially to a group that is often disenfranchised and may not have as much access to resources on their own.