Latest / Morning Medical with Dr. Chow / AI in Breast Cancer Screening, Journavx Update, and Omega-3's Role in Aging

Transcript

AI in Breast Cancer Screening, Journavx Update, and Omega-3's Role in Aging · Morning Medical with Dr. Chow

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  Welcome to Morning Medical with Doctor Chi-Ming Chow, where we bring you the latest updates in
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  medical and health news from around the globe.
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  I'm Doctor Chi-Ming Chow, your host for today.
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  As always, I'm here to help you navigate the complex world of healthcare with insights and
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  updates that matter to you and your loved ones.
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  Today, we're diving into a pressing issue affecting nursing homes across the United
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  States.
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  With new tariffs set to take effect, these facilities are facing skyrocketing costs,
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  without any relief in sight from a healthcare carveout.
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  These tariffs, declared by the United States government, target goods imported from Canada,
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  China, and potentially Mexico, with a hefty 25% tariff on Canadian and Mexican goods and a 10%
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  tariff on Chinese goods.
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  While the tariff on Mexico has been delayed for a month, the impact on Canada and China is
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  already being felt.
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  These tariffs could have significant repercussions for the healthcare sector,
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  particularly nursing homes that are already operating on thin margins.
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  Many of the products affected by these tariffs include essential healthcare items and
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  pharmaceutical ingredients, many of which are imported from these countries.
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  For example, China is a major supplier of active pharmaceutical ingredients, and any
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  disruption in this supply chain could lead to increased medication costs, impacting seniors
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  who often rely on multiple medications daily.
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  One of the biggest challenges faced by nursing homes is their inability to pass these
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  increased costs onto consumers.
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  Unlike other industries, where costs can be transferred to the end-user, nursing homes rely
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  heavily on payments from Medicaid and Medicare.
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  These rates are set by the government and do not adjust quickly to sudden cost increases,
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  leaving these facilities in a precarious financial situation.
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  Industry insiders, like Brian Perry from Direct Supply, have been vocal about the strain these
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  tariffs are placing on the sector.
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  Perry points out that while tariffs act as a tax on the American consumer, for senior care,
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  the burden eventually falls back on the government.
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  However, in the short term, it's the already strained providers who are left struggling to
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  maintain operations without the ability to increase their prices.
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  Organizations like the American Society of Consultant Pharmacists are working to assess
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  the potential impact on drug costs and availability.
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  They're concerned about the United States' reliance on foreign-made pharmaceutical
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  ingredients and the need for greater domestic production to ensure quality and availability.
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  Meanwhile, the Healthcare Distribution Alliance warns that these tariffs could strain the
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  pharmaceutical supply chain further, affecting American patients through increased costs or
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  reduced availability of essential medications.
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  The situation is further complicated by the potential impact on medical devices, with
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  Mexico being a top supplier.
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  If tariffs are imposed, it could lead to shortages of critical medical devices used in
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  patient care, from nebulizers to surgical tools.
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  The Medtech Association is advocating for exemptions similar to those granted during
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  previous tariff implementations to mitigate these risks.
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  As these developments unfold, nursing homes and their suppliers are bracing for immediate
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  impacts, particularly on food prices, given Mexico's significant role in supplying produce
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  to the United States.
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  Companies like Sysco are preparing contingency plans to manage these changes, aiming to
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  continue providing essential supplies at manageable prices.
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  Let's delve into an exciting development in the world of breast cancer screening.
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  The National Health Service in the United Kingdom is embarking on a significant trial
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  involving artificial intelligence to enhance breast cancer screening.
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  Nearly 700,000 women will be recruited to participate in this groundbreaking trial, which
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  will be conducted across 30 sites starting in April.
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  The trial aims to evaluate the effectiveness of five different artificial intelligence
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  platforms in speeding up diagnosis and easing the workload on radiologists.
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  This initiative is part of a broader effort by the government to shape a national cancer plan,
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  which is expected to be launched later this year.
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  Artificial intelligence is already being utilized in various capacities within the
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  National Health Service, including cancer treatment delivery, managing waiting lists, and
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  reviewing cancer scans.
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  However, this trial represents the largest effort yet specifically targeting breast
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  cancer.
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  As part of the trial, women who are scheduled for routine National Health Service screenings
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  will be invited to participate in the Early Detection using Information Technology in
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  Health trial, also known as the Edith trial.
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  This trial is backed by an £11 million investment.
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  The screening program offers mammograms to women between the ages of 50 and 53 and
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  continues every three years until they reach the age of 71.
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  During these appointments, X-rays, referred to as mammograms, are conducted to identify
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  cancers that are too small to be detected by touch or sight.
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  Currently, the process requires two radiologists to review each screening to ensure
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  accuracy.
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  The hope is that artificial intelligence will allow one radiologist to complete the review
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  process, thereby freeing up radiologists to see more patients and potentially reducing waiting
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  lists.
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  Given that more than two million mammograms are performed annually under this screening
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  program, the trial could significantly impact radiologists' workload.
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  Professor Lucy Chappell, the chief scientific adviser for the Department of Health and Social
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  Care, has expressed optimism, suggesting that the study could mark a significant step forward
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  in cancer care.
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  Health Secretary Wes Streeting echoed this sentiment, stating that urgent action is needed
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  as cancer survival rates are currently lagging behind those of other countries.
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  He emphasized the importance of the upcoming national cancer plan in positioning Britain as
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  a leader in cancer care innovation.
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  To support this effort, the government has issued a call for evidence, encouraging
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  patients, healthcare professionals, and experts to share their insights and ideas on the Change
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  National Health Service website.
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  However, Dr.
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  Katharine Halliday, president of the Royal College of Radiologists, cautioned that while
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  artificial intelligence holds immense potential, the National Health Service is still
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  facing a 30% shortfall in the number of radiologists needed.
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  She stressed the urgent need to build radiology capacity, noting that the results of this study
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  will take time to manifest.
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  Every year, tens of millions of Americans are prescribed medications to manage moderate to
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  severe pain.
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  According to a study, approximately 80 million people in the United States fill these
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  prescriptions annually.
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  Notably, about half of these prescriptions are for opioid medications, which carry the risk of
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  dependence and addiction.
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  This is a significant concern for both healthcare providers and patients.
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  However, there's a promising development in the realm of pain management.
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  For the first time in 25 years, the Food and Drug Administration has approved a new type of
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  pain medication that is not an opioid.
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  This new drug, named Journavx, is being hailed as a potential game-changer in the treatment of
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  pain because it does not carry the same risk of addiction that opioids do.
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  Doctors are optimistic about Journavx, as it provides an alternative for patients who either
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  cannot take opioids due to the risk of addiction or who have had difficulties with
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  these medications in the past.
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  However, like any medication, Journavx may not be effective for everyone, and some patients
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  may still require other forms of pain management.
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  This development raises important questions about the future of pain medication and how we
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  manage pain.
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  As more non-opioid painkillers become available, it's crucial for both patients and
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  healthcare providers to stay informed about these options and consider the potential
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  benefits and limitations of each.
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  It's an exciting time in pain management, with the potential for more innovative solutions on
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  the horizon.
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  In an intriguing development, a post-hoc analysis of the DO-HEALTH trial data has
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  suggested that consuming one gram of omega-3 daily may slow down the rate of biological
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  aging in humans.
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  This trial, which originally tested the effects of three daily interventions—two thousand
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  International Units of vitamin D, one gram of omega-3, or a strength-training program—was
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  conducted on older adults across Europe.
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  Specifically, a study involving 777 Swiss participants found that one gram of omega-3
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  daily could slow aging on three out of four DNA methylation clocks: PhenoAge, GrimAge2, and
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  DunedinPACE, over a period of three years.
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  Doctor Heike Bischoff-Ferrari from the University of Zurich and her colleagues
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  reported these findings in the journal Nature Aging.
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  They observed that the standardized treatment effects ranged from 0.16 to 0.32 units from
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  baseline to year three.
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  This indicates that daily omega-3 supplementation slowed biological aging by
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  approximately 2.9 to 3.8 months.
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  Notably, this effect was consistent regardless of participants' sex, age, or body mass index.
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  The DO-HEALTH trial also explored the additive benefits of the three interventions on one
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  epigenetic clock, PhenoAge, although this wasn't seen with the other clocks.
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  Doctor Bischoff-Ferrari remarked that one of the crucial questions in rejuvenation research
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  is whether a treatment can effectively rejuvenate humans, as opposed to just mice.
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  Given the well-documented health benefits of omega-3, the researchers were keen to see if it
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  influenced the most reliable molecular markers of biological age: epigenetic clocks.
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  The main findings from the DO-HEALTH clinical trial indicated that vitamin D, omega-3, or
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  strength-training interventions did not lead to statistically significant changes in systolic
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  or diastolic blood pressure, nonvertebral fractures, physical performance, infection
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  rates, or cognitive function among the 2,157 older European participants who did not have
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  major comorbidities.
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  However, in smaller sample analyses, omega-3 was found to lower the risk of falls, and a
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  combination of omega-3, vitamin D, and exercise reduced risks of pre-frailty and invasive
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  cancer.
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  Dame Linda Partridge of University College London, who wasn't involved in the study,
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  highlighted the challenges faced by clinical trials investigating aging interventions.
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  These include the wide range of possible health outcomes and the lengthy time required for
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  benefits to manifest, making biomarkers essential.
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  The study used several well-validated DNA methylation clocks, which are trained to
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  predict biological rather than chronological age.
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  Individuals can differ in the rate of change of these clocks, with these deviations being
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  better predictors of time to death than chronological age.
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  Julian Mutz from King's College London noted that while the findings offer valuable new
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  data, the relatively small sample size and the healthier-than-average composition of the
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  participants suggest that these results should be considered preliminary.
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  Future trials should aim to assess the generalizability of these findings,
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  particularly in younger populations.
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  The 777 Swiss participants in the DO-HEALTH trial had a mean baseline age of 75 years, with
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  59% being women.
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  About half were considered healthy agers, free from major chronic diseases, disabilities,
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  cognitive impairments, and mental health limitations.
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  Most were physically active, with 29% active one to three times a week, and 59% more
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  frequently.
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  All had DNA methylation measures taken at baseline and after three years.
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  Doctor Bischoff-Ferrari acknowledged that the study targeted generally healthy adults and
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  that there might be a conservative bias since the epigenetic analyses were only performed on
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  Swiss participants, many of whom were already healthy agers at baseline.
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  The biological clocks used in this analysis have not yet been translated to clinical care
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  due to a lack of validation in major studies.
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  She mentioned plans to use DO-HEALTH as a platform for validating novel aging biomarkers,
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  such as protein-based markers that reflect the biological age of individual organs in still
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  healthy adults.
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  In a concerning development, health experts in the United States are facing significant
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  challenges due to the removal or lack of updates of crucial federal health data.
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  This situation has arisen following the implementation of executive orders under
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  President Donald Trump's administration, which included the elimination of diversity, equity,
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  and inclusion language from federal agencies.
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  The ramifications of these changes are being felt across the healthcare sector, even in
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  areas where diversity, equity, and inclusion are not central components, such as flu and
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  COVID-19 case data.
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  Georges Benjamin, the executive director of the American Public Health Association, has
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  expressed deep concern over the loss of this data.
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  He emphasized that without access to comprehensive health data, experts are
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  "absolutely blind" in managing outbreaks and addressing health disparities.
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  The absence of this information could lead to more people falling ill and potentially higher
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  mortality rates.
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  On the Centers for Disease Control and Prevention's website, a message has been posted
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  indicating ongoing modifications to comply with the executive orders.
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  This has resulted in the removal or freezing of updates on flu cases, HIV infection statistics,
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  and other critical datasets.
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  Some datasets have been edited and re-posted, omitting references to diversity, equity, and
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  inclusion.
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  For instance, descriptions of COVID-19 vaccine coverage have been altered to refer
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  specifically to "pregnant women" instead of "pregnant persons."
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  The sheer number of disabled and stalled data sites has alarmed health officials.
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  Richard Besser, a former acting director of the Centers for Disease Control and Prevention,
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  described the situation as "chilling," highlighting the risk it poses to public
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  health.
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  He noted that while it's normal for different administrations to have varying policies,
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  concealing scientific information is highly unusual and unacceptable.
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  The impact of these changes is particularly concerning for HIV doctors, who rely heavily on
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  the Centers for Disease Control and Prevention's data to care for patients.
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  Colleen Kelley, an infectious disease doctor at Emory University, emphasized the essential
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  nature of this information, stating that the Centers for Disease Control and Prevention's
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  website is the most comprehensive resource available.
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  With the removal of this data, healthcare providers must now depend on data backed up by
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  researchers.
• 16:35
  Holden Thorp, editor-in-chief of the Science family of academic journals, expressed
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  disbelief at the demands for Centers for Disease Control and Prevention scientists to
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  retract any unpublished papers that violate the executive orders.
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  He remarked that such actions are unprecedented in the United States, drawing parallels to
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  situations in other countries where scientists face government threats.
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  The removal of health information from federal websites has broader implications for at-risk
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  populations.
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  These websites serve as authoritative sources of up-to-date information on various health
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  issues, aiding in research and revealing trends in disease outbreaks.
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  For example, the Youth Risk Behavior Surveillance System, which monitored young
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  people for health threats like HIV and alcohol use, has been taken down.
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  The survey included questions about sexual and gender identity, crucial for understanding
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  at-risk populations.
• 17:32
  Angela Rasmussen, a virologist and research scientist, voiced her concerns about the lack
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  of information on queer and women's health.
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  She questioned the implications of such omissions, highlighting the critical role of
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  this data in acknowledging and addressing health issues.
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  Eileen Barrett, president-elect of the American Medical Women's Association, echoed these
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  concerns, warning of the dangerous politicization of science and medicine.
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  In response to the disappearance of these web pages, researchers and journalists have
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  mobilized to preserve essential data.
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  Efforts to archive key Centers for Disease Control and Prevention databases at risk of
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  deletion are underway, coordinated by science journalist Maggie Koerth.
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  Meanwhile, Caitlin Rivers, an epidemiologist at the Johns Hopkins Center for Health Security,
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  has taken extraordinary measures to gather data, such as visiting all 50 state health
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  department websites to compile flu activity information herself.
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  The absence of readily available data has tangible consequences for individuals,
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  particularly those with health vulnerabilities.
• 18:40
  Caitlin Rivers noted that many people rely on her updates to make informed decisions about
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  their daily lives, such as attending social events or wearing masks.
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  The lack of timely data availability can disrupt these decisions and impact public
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  health safety.
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  As we conclude today's episode, it's clear that the availability of health data is not just a
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  matter of policy; it's a lifeline for public health management and individual
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  decision-making.
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  The absence of comprehensive data can leave us flying blind in the face of health crises,
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  highlighting the importance of transparency and accessibility in health information.
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  Thank you for tuning in to Morning Medical with Doctor Chi-Ming Chow.
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  Stay informed and take care of your health.
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  Goodbye for now.