Latest / Morning Medical with Dr. Chow / FDA Approves FluMist, Rhabdomyolysis Incident, and Ethics in Body Donation Programs

Transcript

FDA Approves FluMist, Rhabdomyolysis Incident, and Ethics in Body Donation Programs · Morning Medical with Dr. Chow

• 0:00
  Good morning, everyone!
• 0:01
  Welcome back to another episode of Morning Medical with Dr.
• 0:04
  Chow.
• 0:05
  I am your host, Dr.
• 0:06
  Chi-Ming Chow, and today we're diving into some fascinating updates in the medical world.
• 0:12
  Our first story is about a significant development in the fight against influenza.
• 0:17
  The United States Food and Drug Administration has approved FluMist, the nasal spray flu
• 0:23
  vaccine, for home use by either a patient or an adult caregiver.
• 0:29
  This marks a groundbreaking step, as FluMist has been in use for a couple of decades, but
• 0:34
  this is the first time a vaccine for influenza has been approved for self-administration
• 0:40
  without a healthcare provider.
• 0:41
  Dr.
• 0:46
  Peter Marks, the director of the FDA’s Center for Biologics Evaluation and Research,
• 0:50
  emphasized the importance of this approval.
• 0:53
  He stated, 'Today’s approval of the first influenza vaccine for self- or
• 0:58
  caregiver-administration provides a new option for receiving a safe and effective seasonal
• 1:03
  influenza vaccine, potentially with greater convenience, flexibility, and accessibility for
• 1:08
  individuals and families.'
• 1:11
  Fox News medical contributor Dr.
• 1:13
  Nicole Saphier also weighed in on this development.
• 1:16
  She noted that the home version of FluMist would be available starting next year.
• 1:21
  Dr.
• 1:21
  Saphier appeared on 'Fox and Friends' to discuss how this new option could simplify the
• 1:26
  process of getting vaccinated.
• 1:29
  'A lot of people don’t get the flu shot because of the logistics of going to the doctor’s
• 1:33
  office or the pharmacy, or because of severe needle phobia,' she explained.
• 1:38
  'This is a good alternative for those people—especially because over the last two
• 1:42
  decades, FluMist has shown just about the same efficacy as the traditional vaccines.'
• 1:47
  Dr.
• 1:48
  Marc Siegel, senior medical analyst for Fox News and clinical professor of medicine at New
• 1:55
  York University Langone Medical Center, also commented on the usefulness of FluMist.
• 2:01
  He pointed out that the nasal spray vaccine is particularly beneficial for children who may
• 2:06
  have needle phobias.
• 2:08
  'I am glad it is being made available over the counter beginning next year,' he told Fox News
• 2:13
  Digital.
• 2:13
  'It can help to overcome vaccine non-compliance.' However, Dr.
• 2:18
  Siegel emphasized the importance of keeping doctors in the loop.
• 2:22
  'It is a live virus vaccine, and so it should not be given to those who are immunocompromised
• 2:28
  or to pregnant women,' he added.
• 2:31
  The statistics from the Centers for Disease Control and Prevention are a stark reminder of
• 2:36
  the importance of flu vaccinations.
• 2:38
  Each year between 2010 and 2023, the flu caused between 9.3 million and 41 million illnesses,
• 2:47
  100,000 to 710,000 hospitalizations, and 4,900 to 51,000 deaths.
• 2:55
  FluMist is approved to protect against influenza virus subtypes A and B in people aged
• 3:00
  2 through 49 years, according to the FDA’s website.
• 3:05
  It was first approved in 2003 for people aged 5 through 49, and its approval was extended to
• 3:11
  include children aged 2 through 5 in 2007.
• 3:15
  The most common side effects of FluMist include fever in children between 2 and 6, runny nose
• 3:21
  and nasal congestion in people aged 2 through 49, and sore throat in adults aged 18 through
• 3:28
  49.
• 3:29
  A prescription will be required to obtain the home version of FluMist, which will be shipped
• 3:34
  directly from a third-party online pharmacy to eligible patients.
• 3:38
  The Centers for Disease Control and Prevention recommends that everyone 6 months and older get
• 3:44
  vaccinated against influenza.
• 3:47
  Dr.
• 3:48
  Saphier also discussed last year’s flu vaccine, which had an efficacy of a little less than 50%
• 3:54
  in terms of keeping people out of the doctor’s office and the hospital.
• 3:58
  'Does that mean that everyone needs to get one?
• 4:01
  That’s really up to the individual,' she said, adding that people should talk to their doctor,
• 4:07
  especially if they are high-risk.
• 4:10
  Dr.
• 4:11
  Peter Marks reiterated that getting annual vaccinations is the best way to prevent
• 4:16
  influenza, 'which causes illness in a substantial proportion of the U.S.
• 4:21
  population every year and may result in serious complications, including hospitalization and
• 4:27
  death.'
• 4:28
  In a concerning incident at Tufts University, three men’s lacrosse players remain
• 4:33
  hospitalized after a voluntary, supervised 45-minute workout led by a Navy SEAL graduate.
• 4:39
  This session, which took place on September 16, resulted in a dangerous condition known as
• 4:45
  rhabdomyolysis for nine players, as confirmed by university officials.
• 4:50
  Patrick Collins, the Executive Director of Media Relations for Tufts University, provided
• 4:56
  more details about the workout.
• 4:58
  He mentioned that the session was conducted by a Tufts alumnus who recently graduated from the
• 5:02
  Basic Underwater Demolition/SEAL training program.
• 5:06
  'Approximately 50 team members participated in the workout.
• 5:09
  All have been evaluated by medical professionals, with a total of nine requiring
• 5:14
  hospitalization for rhabdomyolysis,' Collins stated.
• 5:18
  As of Monday, three players are still in the hospital.
• 5:22
  Rhabdomyolysis, or rhabdo, is a rare but potentially life-threatening condition that
• 5:28
  occurs when muscles break down or even disintegrate after intense physical activity.
• 5:34
  According to the Cleveland Clinic, the breakdown of muscle fibers releases large
• 5:39
  amounts of elements like potassium and phosphate into the bloodstream, which can lead
• 5:43
  to severe complications, particularly with the kidneys.
• 5:48
  Dr.
• 5:49
  Shruti Gupta, an associate physician at Brigham and Women’s Hospital specializing in kidney
• 5:53
  disease, explained more about rhabdo in an interview with CNN affiliate WCVB.
• 6:01
  'The most common symptoms are prolonged muscle stiffness, discomfort, and weakness,' Dr.
• 6:06
  Gupta said.
• 6:08
  'Usually, we see these cases more in isolation, so it’s puzzling for it to happen in
• 6:13
  particularly …
• 6:14
  people who are athletes.'
• 6:16
  In response to the incident, Tufts University has postponed team practices and appointed an
• 6:22
  external independent investigator to review what happened.
• 6:26
  'The university continues to closely monitor the condition of the team, and some individual
• 6:31
  team members have been medically cleared to resume training,' Collins added.
• 6:36
  'The team is a tight-knit group of young men who have shown remarkable resilience,
• 6:41
  understanding, and care for each other throughout this episode.
• 6:45
  We will continue to monitor and work with them closely, and we hope for a rapid return to good
• 6:50
  health for all involved.'
• 6:53
  In our final segment today, we're delving into a topic that has been a cornerstone of medical
• 6:59
  education for decades: the use of cadavers in medical training.
• 7:04
  Despite the advent of new technologies like full-size replica human models and virtual
• 7:10
  reality programs, hands-on training with cadavers—referred to as donor
• 7:14
  dissection—remains an essential component of medical education.
• 7:19
  Joy Balta, who chairs the body donation committee for the American Association for
• 7:23
  Anatomy, emphasized the irreplaceable value of this hands-on experience.
• 7:29
  'Everyone was excited about using technology and virtual reality, which has been great, but
• 7:35
  now people are starting to realize that it's a supplementary tool, and it will not replace the
• 7:40
  work with the donors,' said Balta, who is also the director of the Anatomy Learning Institute
• 7:46
  at Point Loma Nazarene University in San Diego.
• 7:50
  Annelise Silva, the national president of the American Medical Student Association, echoed
• 7:56
  this sentiment.
• 7:57
  She described her experience with donor dissection as 'a really pivotal moment,'
• 8:02
  especially when she started her surgery rotations during her third year of medical
• 8:06
  school.
• 8:07
  'It's such a privilege and an honor to have the opportunity to learn through donor dissection,'
• 8:13
  she said.
• 8:14
  'It was a really powerful thing for me to connect that with the donor experience.
• 8:18
  And I think it was invaluable to prepare me once I went into surgery to be able to build
• 8:23
  those skills.'
• 8:25
  Margaret McNulty, vice chair for education in the department of anatomy, cell biology, and
• 8:30
  physiology at Indiana University School of Medicine, pointed out that students gain much
• 8:35
  more than just anatomical knowledge through donor dissection.
• 8:41
  'A lot of research has shown that students are able to foster these non-traditional skills,
• 8:45
  like empathy [and] emotional intelligence,' she said.
• 8:49
  'It's also an exposure to death and dying.'
• 8:53
  The demand for hands-on experience with cadavers is higher than ever.
• 8:58
  According to Balta, some of this increase is due to the limited time medical students now
• 9:03
  spend in clinical settings.
• 9:05
  Additionally, several medical residency programs, such as general surgery, offer donor
• 9:11
  dissection to help residents develop skills that cannot be tested on living patients.
• 9:18
  The practice has also become popular in training other medical professionals, including
• 9:24
  physician assistants, nurse practitioners, physical therapists, occupational therapists,
• 9:29
  athletic trainers, and kinesiologists.
• 9:33
  Ethical concerns, however, do exist.
• 9:36
  Recent controversies have cast a shadow over the practice, such as reports of a Texas state
• 9:41
  medical school selling or leasing body parts from unclaimed deceased individuals.
• 9:47
  Last year, federal prosecutors uncovered a similar scheme within the morgue at Harvard
• 9:52
  Medical School.
• 9:54
  Joy Balta acknowledged these incidents but pointed out that they are rare and due to the
• 9:59
  under-regulation and under-supervision of body donor programs in the United States.
• 10:05
  'There is no oversight or regulation on how human material could be used in the United
• 10:11
  States,' Balta said, adding that the Uniform Anatomical Gift Act, enacted in 1968 and
• 10:18
  revised in 2006, does provide some regulation around the donation process.
• 10:25
  Margaret McNulty spoke about the ethical considerations and the importance of consent in
• 10:30
  body donation programs.
• 10:32
  'Getting consent is a huge part of the process, and we, anatomists, take that very seriously,'
• 10:38
  she said.
• 10:39
  McNulty highlighted that the field of anatomy has shifted significantly away from its darker
• 10:45
  days.
• 10:46
  Many experts now prefer the term 'donor dissection' over 'cadaver' to show respect for
• 10:51
  individuals who have made the ultimate gift by donating their bodies.
• 10:56
  McNulty explained that her institution follows a straightforward process: an individual
• 11:02
  chooses to donate their body, and upon their death, family members contact the program.
• 11:08
  A representative then takes care of the donor's body from pick-up until the cremated remains
• 11:13
  are returned to the family.
• 11:15
  She emphasized that body donation programs do not solicit donors directly, and her
• 11:20
  institution receives about 400 donations annually, all of which were agreed upon prior
• 11:26
  to death.
• 11:27
  Most institutions also hold a student-led memorial service every year to honor the
• 11:31
  donors, with families invited to attend.
• 11:35
  In conclusion, while new technologies provide valuable supplementary tools, the hands-on
• 11:41
  experience with donor dissection remains irreplaceable in medical education.
• 11:46
  It not only teaches the fundamentals of human anatomy but also fosters essential
• 11:51
  non-traditional skills like empathy and emotional intelligence.
• 11:55
  As we advance in medical education, it is crucial that we continue to respect and honor
• 12:01
  the invaluable contributions of body donors.
• 12:05
  That's all for today's episode of Morning Medical with Dr.
• 12:09
  Chow.
• 12:10
  Thank you for joining us, and we hope you found today's discussions enlightening.
• 12:14
  Stay tuned for more updates on the latest in medical and health news.
• 12:19
  Have a great day, everyone!