Latest / Morning Medical with Dr. Chow / Rare Diseases, HIV PrEP Access, and Innovations in Pediatric Cardiac Surgery

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Rare Diseases, HIV PrEP Access, and Innovations in Pediatric Cardiac Surgery · Morning Medical with Dr. Chow

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  Welcome to Morning Medical with Doctor Chow, your daily update on the latest medical and
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  health news from around the globe, brought to you with the help of artificial intelligence.
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  I'm Doctor Chi-Ming Chow, your host for today.
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  As a cardiologist and professor at the University of Toronto, I'm here to guide you
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  through today's top stories in the world of health and medicine.
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  Our first story takes us into the world of rare diseases and the challenges faced by those
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  living with them.
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  Recently, singer Celine Dion revealed her diagnosis of stiff-person syndrome, a rare
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  neurological disorder that causes progressive muscle stiffness and severe spasms.
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  This condition can significantly impact a person's quality of life, leading to chronic
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  pain, falls, and even loss of mobility over time.
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  A man named Jon Kelf, who shares this diagnosis with Dion, has raised concerns about her
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  planned comeback performances.
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  Kelf, a former marathon runner, was diagnosed with stiff-person syndrome in 2019.
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  He has spoken out about the potential risks Dion might face during her upcoming shows,
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  which are set to take place in September and October at the Paris la Défense Arena.
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  Kelf warns that the emotional stress and noise associated with large crowds could be
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  "triggers" for Dion, exacerbating her symptoms.
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  He shared his personal experience with the disease, noting how it has forced him to quit
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  his job and significantly altered his life.
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  Despite these challenges, Kelf acknowledges that Dion has access to top-notch medical care,
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  which may help her manage her condition during her performances.
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  While Kelf admires Dion's determination and views her tour as potentially inspiring for
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  others with the condition, he also cautions against underestimating the seriousness of the
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  disorder.
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  He hopes Dion's public battle with stiff-person syndrome will raise awareness and lead to more
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  support for others suffering from the disease.
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  This story highlights the importance of understanding the impact of rare diseases on
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  individuals' lives and the need for continued research and support.
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  As we learn more about conditions like stiff-person syndrome, it's crucial to foster
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  empathy and awareness in society.
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  Let's dive into our next story, which highlights a significant gap in the use of HIV
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  preexposure prophylaxis, or PrEP, among youth who are at risk.
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  A national analysis of claims data has revealed that only 1.6 percent of at-risk youth filled a
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  prescription for PrEP between 2018 and 2022.
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  This study, conducted by researchers led by Doctor Nicholas Venturelli at Boston Children's
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  Hospital, underscores disparities faced by minors, young women, and those living in the
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  southern United States.
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  The study analyzed prescription data for over 100,000 youth aged 13 to 21 years who had a
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  documented sexually transmitted infection or exhibited high-risk sexual behavior.
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  Despite these risk factors, a mere 1.6 percent filled a PrEP prescription during the study
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  period.
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  The findings, published in JAMA Pediatrics, highlight a persistent gap in preventive HIV
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  care for young people, even among those at higher risk, such as individuals with a prior
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  syphilis diagnosis.
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  One striking finding from the study is the significant gender disparity.
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  Young men were 15 times more likely than young women to fill a PrEP prescription.
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  Moreover, those aged 20 to 21 years were three times more likely than minors aged 13 to 17
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  years to receive PrEP.
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  Geographically, the study found that PrEP fill rates were 26 percent lower in the Midwest and
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  31 percent lower in the South compared to the Northeast.
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  The researchers noted the critical nature of the PrEP gap between young men and women,
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  particularly given that women accounted for 18 percent of all new HIV diagnoses in 2021.
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  The perception that PrEP is primarily a tool for men who have sex with men may contribute to
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  this gap, potentially leading to delays in young women getting the preventive care they
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  need.
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  Interestingly, the study also pointed out that perceived sexual behaviors, rather than
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  sexually transmitted infections, led to most of the PrEP indications.
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  This finding emphasizes the importance of screening for sexual behavior as well as
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  infections.
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  Yet, the high number of youth with bacterial sexually transmitted infections who did not
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  receive PrEP points to missed opportunities in HIV prevention.
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  The researchers call for tailored and more effective interventions to improve PrEP access
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  and use among at-risk youth.
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  They suggest integrating HIV services with housing support, behavioral healthcare, and
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  transportation assistance to improve continuity of care, particularly for youth navigating
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  multiple support systems.
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  This could be particularly beneficial for those living in states with progressive LGBTQ+ laws,
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  where youth were found to be 36 percent more likely to receive a PrEP prescription.
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  While the study highlights significant gaps, it's important to note some limitations.
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  For example, the dataset lacked information on race, ethnicity, gender identity, or sexual
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  orientation.
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  Despite these limitations, the study provides a crucial insight into the challenges of HIV
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  prevention among youth and the need for more inclusive and accessible healthcare models to
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  better serve this vulnerable population.
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  In recent news, a significant issue is unfolding within the National Health Service in
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  England, as doctors continue to strike over job security and pay conditions.
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  Doctor Melissa Ryan, a pediatric registrar, has voiced concerns that the National Health
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  Service may "end up without doctors" if the ongoing dispute is not resolved.
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  This marks the fifteenth strike organized by the British Medical Association, with doctors
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  taking to the picket lines to demand better working conditions and pay.
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  Doctor Ryan, who works at Lincoln County Hospital, expressed her frustration over the
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  government's decision to cut training places, which has resulted in long waiting times for
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  children needing medical assessments, particularly for conditions like Attention
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  Deficit Hyperactivity Disorder.
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  The government, on the other hand, insists that the expectations set by the doctors are
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  unrealistic.
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  Health Secretary Wes Streeting has highlighted the financial burden of the ongoing dispute,
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  estimating that it has cost the National Health Service around three billion pounds so far.
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  Despite receiving pay increases amounting to thirty-three percent over the past four years,
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  the British Medical Association argues that doctors' real wages have decreased by twenty
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  percent since 2008 when adjusted for inflation.
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  Doctor Becky Lavelle, speaking from the picket line outside Hull Royal Infirmary, emphasized
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  that doctors have experienced the worst pay erosion compared to any other profession in
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  both the public and private sectors over the last seventeen years.
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  She pointed out that the three billion pounds spent on the dispute could have been used to
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  meet the doctors' demands from the beginning.
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  Lavelle also criticized the cancellation of appointments at Hull hospital due to a shortage
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  of doctors to maintain full coverage.
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  The government had previously offered a package of measures, including one thousand additional
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  training places, in an attempt to resolve the dispute.
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  However, this offer was withdrawn after the union announced further industrial action.
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  Doctor Ryan underscored the critical shortage of doctors, which has led to long waiting times
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  for medical appointments and assessments.
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  She argued that doctors should not be viewed as a financial burden but rather as essential
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  resources needed to reduce waiting lists.
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  Doctor Lavelle noted that the lack of specialty training places is hindering the progression of
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  resident doctors into consultant roles.
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  She stressed the importance of these training opportunities to ensure that there are enough
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  specialists to meet future healthcare needs.
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  The current situation in the National Health Service, particularly at Hull University
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  Teaching Hospitals NHS Trust, which has been identified as the worst performing hospital
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  trust by NHS England, highlights the urgent need for solutions to address these systemic
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  issues.
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  Our final story today is an exciting development in the field of pediatric cardiac
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  surgery.
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  Surgeons in Birmingham, England, are pioneering the use of three-dimensional printing
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  technology to create lifelike models of hearts for practicing complex procedures.
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  This innovative approach is particularly beneficial for surgeries on infants with
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  congenital heart defects, such as Tetralogy of Fallot.
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  Tetralogy of Fallot is a rare condition that affects about five out of every ten thousand
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  babies.
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  It involves four heart defects that result in oxygen-poor blood flowing out of the heart and
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  into the rest of the body.
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  This can lead to serious complications if not corrected with surgery.
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  The stakes are incredibly high, and the precision required for these surgeries is
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  immense.
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  For the parents of babies diagnosed with this condition, like little Penny from Stourbridge,
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  the day of surgery is fraught with emotion.
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  They describe it as a day when their "world will stop." Understandably, the ability for
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  surgeons to practice on a three-dimensional model of Penny's heart before the actual
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  operation offers a significant comfort.
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  The three-dimensional heart models are created using detailed imaging data from scans of the
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  patient's heart.
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  This allows surgeons to rehearse the operation multiple times, ensuring they are familiar with
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  the unique anatomy of each patient's heart.
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  By practicing on these precise models, surgeons can refine their techniques, potentially
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  increasing the success rates of these delicate procedures.
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  This advancement in medical technology not only enhances the skillset of surgeons but also
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  represents a step forward in patient safety.
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  By minimizing the unknown variables in surgery, it reduces the risk of complications during the
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  actual procedure.
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  It's a remarkable example of how technology can be harnessed to improve outcomes in healthcare.
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  As we continue to see the integration of technology in medical practices, it's stories
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  like these that highlight the potential for innovative solutions in healthcare.
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  From three-dimensional printing to artificial intelligence, the future of medicine is bright
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  and filled with promise.
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  That's all for today's episode of Morning Medical with Doctor Chow.
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  Thank you for joining me as we explored these compelling stories at the intersection of
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  health, technology, and society.
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  Until next time, stay informed and take care of your health.