Category: Science/medical

Surgeon admits to lasering his initials into patients’ organs during surgery

A surgeon has admitted burning his initials into the livers of two transplant patients with a laser beam.

Consultant Simon Bramhall, 53, branded “SB” on the organs of a man and a woman undergoing transplant operations.

On Wednesday, he admitted two counts of assault by beating at Birmingham Crown Court but pleaded not guilty to alternative charges of assault occasioning actual bodily harm.

Liver surgeons use an argon beam to stop livers bleeding, but can also use the beam to burn the surface of the liver to sketch out the area of an operation.

It is usually not harmful and the marks would normally disappear.

But the female patient’s liver did not heal itself in the normal way and the initials were found in a follow-up operation.

Bramhall was a liver, spleen and pancreatic surgeon who worked at the liver unit within the Queen Elizabeth Hospital in Birmingham, West Midlands, for 12 years.

He was also involved in tutoring and examining medical students and supervising postgraduate students in higher degrees, management and research.

Bramhall pleaded guilty to assaulting a patient whose name is protected by a court order during an operation in August 2013. He also entered a guilty plea relating to an operation performed on an unknown patient in February of the same year and will be sentenced on January 12th.

Addressing the court after the pleas, the prosecutor, Tony Badenoch said: “This has been a highly unusual and complex case, both within the expert medical testimony served by both sides and in law.

“It is factually, so far as we have been able to establish, without legal precedent in criminal law.”

Florida insurance companies drop coverage of OxyContin 

FORT MYERS, Fla. — OxyContin has become one of the most recognizable brand names in the nation’s deadly opioid epidemic. Starting Jan. 1, the state’s largest health insurer will cease coverage of the drug in favor of a painkiller less easy to abuse.

Florida Blue’s alternate, Xtampza ER, is similar to OxyContin in that it is an extended-release, oxycodone-based product. 

The big difference, the company said Tuesday, is that Xtampza is more chemically suited to prevent users from crushing, snorting or injecting it — all means of getting a quicker, and potentially more lethal, high.

Florida Blue’s new policy will not apply to generic oxycodone, which is sold as an immediate-release drug at lower doses and is less likely to be so abused, said Scott McClelland, the company’s vice president of commercial and specialty pharmacy.

Florida Blue is taking the action because the abundance of opioids prescribed to its more than 5 million members represents a risk for abuse and provides evidence that doctors are doling out more than patients need of the powerful but addictive drug, said Scott McClelland, vice president of commercial and specialty pharmacy.

Opioids were the direct cause of 2,664 Florida overdose deaths in 2016 and showed up in the toxicology reports of 4,515 Floridians that year, according to an interim reportfrom the Florida Medical Examiners Commission.

“Imagine if you could take an 80-milligram extended-release (OxyContin) tablet and crush it and inject it and get it all at once, as opposed to a five-milligram oxycodone tablet,” McClelland said. “So, that’s the big reason there’s such huge concerns about these extended-release formulations. It’s a really big dose.”

The OxyContin ban applies to all Florida Blue individual and group plans. Medicare Advantage plans are excluded.

Xtampza ER is manufactured by Canton, Mass.-based Collegium Pharmaceutical Inc. Though it touts the drug’s “abuse-deterrent technology” it does not guarantee that the drug cannot be abused.

The company also notes: “Although Xtampza ER is formulated to make manipulation more difficult, it cannot entirely prevent abuse; abuse of Xtampza ER by injection and via the oral and nasal routes is still possible.”

The company’s decision to drop OxyContin follows a federal declaration earlier this year that the nation is in the grips of an opioid overdose epidemic. Shortly thereafter, Florida Gov. Rick Scott signed an executive order declaring the opioid epidemic a statewide public health emergency.

Fentanyl, morphine, and heroin were the top three causes of lethal opioid overdoses. Oxycodone was fourth.
Florida Blue typically pays for 1.5 million opioid prescriptions every year, according to the company. About 8% of that business is for prescriptions lasting longer than 30 days, a group at a higher risk for addiction and overdose.

Florida Blue already has quantity limits on long- and short-acting painkillers. It has also required prior approval for prescriptions of extended-release opioid painkillers, such as OxyContin and fentanyl.

The policy was updated Oct. 1 to include prior approval for short-acting painkillers needed for more than seven days, McClelland said.

“We want to prevent as much abuse and addiction and deaths related to these overdoses as possible,” he said. “We’re just trying to take an active role and prevent these deaths that are occurring on a daily basis.”

Cigna also announced it will continue covering the same OxyContin alternative,Xtampza ER, as   part of its efforts to cut opioid use by its customers 25% by 2019, CNBC reported.

“Our focus is on helping customers get the most value from their medications — this means obtaining effective pain relief while also guarding against opioid misuse,” Cigna Chief Pharmacy Officer Jon Maesner said in a statement Wednesday.

Woman sentenced to jail for refusing to vaccinate son 

A Michigan judge sentenced Rebecca Bredow to seven days in jail after she violated a court order to have her 9-year-old son vaccinated. Bredow’s case first made headlines last week after her ex-husband took her to court over her refusal to vaccinate their son, despite agreeing to do so in Nov. 2016, Fox 2 Detroit reported.

Bredow told Oakland County Judge Karen McDonald that she takes “full responsibility” for her actions, and that vaccinations go against her beliefs. Last week, McDonald had given Bredow seven days to get the boy vaccinated, but she told news outlets that she “would rather sit behind bars for standing up for what I believe in, than giving in to something I strongly don’t believe in.”

Bredow was found in contempt of court, and McDonald said the boy would be vaccinated today based on the Nov. 2016 agreement made between the woman and her ex-husband.

The mother-of-two was handcuffed in court and escorted out of the room by deputies. 

GOP scraps Obamacare repeal plan; can’t gather enough votes

WASHINGTON, D.C.-  Unable to come with enough votes in a limited amount of time, Senate Majority Leader Mitch McConnell has decided to move away from the health care repeal- for now.

Republican senators decided during their weekly conference lunch on Tuesday that it as best not to not take a vote on the measure to repeal the ACA. This move comes after the GOP considered  a lack of votes, since three senators have explicitly  stated they would vote “no” on the measure, while other law makers have expressed doubts about the bill.

“The decision was a joint one between Lindsey and Bill and the other two sponsors and also the leader that if the votes are not there, not to have the vote, but not to give up,” said Sen. Pat Roberts of Kansas, after leaving the lunch, referring to the latest health care bill’s co-sponsors, Sens. Lindsey Graham of South Carolina and Bill Cassidy of Louisiana.

With no Democrats supporting the repeal of Obamacare, Senate Republicans could afford to lose the support of only two of their 52 members and still pass the bill. On Monday evening, Sen. Susan Collins of Maine became the third GOP senator to publicly oppose the measure, delivering a fatal blow to what was already a last-ditch effort. Sens. Rand Paul of Kentucky and John McCain of Arizona had previously said that they were against the measure.

The Graham-Cassidy legislation was the latest version of a series of efforts to partially repeal and replace the Affordable Care Act, but none were able to find the 50 votes needed to pass.

The timing is critical for the GOP since the Senate only has until September 30 before reconciliation expires. Under reconciliation, a simple majority of 50 votes is needed to pass legislation instead of the usual 60.

House Republicans, who did pass a version of Obamacare repeal in May, were disappointed with their congressional colleagues.

Scientists use spinach To grow heart tissue

A team of researchers just demonstrated that spinach leaves may  be able to grow a heart.

In a paper published Wednesday, researchers from Worcester Polytechnic Institute (WPI), the University of Wisconsin-Madison, and Arkansas State University-Jonesboro detail how they used spinach leaves to grow heart tissue.

Since spinach leaves have a vascular system similar to the human vascular system, researchers pushed a detergent solution through the spinach’s veins, stripping it of its plant cells and leaving behind the structure that keeps those cells in place. They also filled the spinach veins with human cells that line blood vessels.

When human cardiomyocytes—heart muscle cells derived from pluripotent stem cells—were implanted onto the spinach leaf, capillaries carried all the necessary blood and nutrients to the cardiomyocytes. After five days on the leaf, the cardiomyocytes had received enough nutrients and grown strong enough to contract like a muscle, and continued to contract for 21 days.

“Adapting abundant plants that farmers have been cultivating for thousands of years for use in tissue engineering could solve a host of problems limiting the field,” Glenn Gaudette, a professor of biomedical engineering at WPI and corresponding author of the paper, says in a statement.

So far, researchers have achieved similar results in parsley, Artemesia annua (sweet wormwood), and peanut hairy roots, and even found that some plants have better networks than others.

For now, the WPI team is still working to create a vascular network for the outflow of blood and fluids from human tissue, and studying how human cells grow while they are attached to and nourished by plant-based scaffolds.

“We have a lot more work to do,” Gaudette says in the statement, “but so far this is very promising.”