The Gustavo Franco Podcast
A curious student's journey exploring the intersections of medicine, business, and public health.
The Gustavo Franco Podcast
#12 - Healthcare News: March 2024 (Pig Kidney, World Happiness Report, Abortion Pill Case, Intermittent Fasting)
Stay informed with the latest in Healthcare News! In this episode, we explore the key developments of March 2024, touching on a range of topics but focusing on the Pig Kidney Transplant, World Happiness Report, Abortion Pill Case, and a Flawed Intermittent Fasting Study. To enhance your listening experience, we've added chapter markers and timestamps in the description below, making it easy for you to jump to the segments that catch your eye. Let us know your thoughts!
Timestamps:
(00:00) Episode Introduction
(01:20) Pig Kidney Transplant
(04:07) World Happiness Report
(06:41) Intermittent Fasting Study
(09:32) Abortion Pill Case
(13:18) IVF, Abortion, and Maternal Health
(15:10) Flawed Research
(15:28) Weight Loss Drugs
(16:35) Pharmaceuticals and Drug Stores
(17:08) Mental Health
(18:17) Viruses and Bacteria
(19:20) Medicare/Medicaid
(20:10) Well-Being
(23:27) Health Insurance (Cyberattacks)
(24:14) Global Healthcare
(25:13) Medical Devices, Biotech, and AI
(27:13) Drugs and Alcohol
(30:16) Politics
(31:32) Conclusion
(32:16) Outro
Linktree: linktr.ee/gustavofrancopod
Intro
Hey everyone and welcome to another healthcare news episode and today we’re gonna be covering everything from the month of March. Once again, I really appreciate everyone who left feedback on our last episode, and I’ll be implementing all of that here. Everyone seemed to really enjoy the detailed analysis of IVF, abortion, and flawed medical research news, so I’ll do the same for this month’s episode. Here we focus on a pig kidney transplant into a human, the world happiness report, a somewhat flawed study on intermittent fasting, and the abortion pill case. After that, just like last month, I run through the rest of all relevant healthcare news from this month so you can have a full picture of what’s going on, so sit back and enjoy today’s episode.
Pig Kidney Transplant
Let’s start with one of my favorites from this month. A pig kidney was transplanted into a human. You heard that right. A pig, like the animal we eat. A couple of Harvard surgeons in Boston were able to help this 62 year old black patient with kidney failure by transplanting this kidney from a genetically engineered pig. Being a bit of a science geek myself it’s no surprise that this was one of my favorites so let me break it down for you.
Cross-species organ transplants are not a first at all. Blood transfusions from animals date back to the 17th century and in the 1960s, a bunch of patients got kidney transplants from chimpanzees but all 13 patients ended up dying because of it. In the 90s there was even a baboon liver transplant but the patient also died pretty soon after.
But this time, things are a little different. Pigs have been found to be our best bet at organ transfers and in 2022 there was a pig organ transplant into a patient but the patient died two months after. This time, if everything works out, which it so far had, the FDA could approve clinical trials and it could mean that animal transplants become an actual medical standard. So you couple that with the organ shortage that we’ve always had and this is pretty revolutionary. The 3,000 people that would usually die every year waiting for a kidney transplant might now finally get a chance at a new kidney, even it’s not coming from a human.
Now, I’ll keep this part brief but the science behind all of this is pretty cool. If we were to implant any pig kidney into a patient it wouldn’t work because our bodies would immediately reject it and we would likely get many viruses. So that’s where gene editing comes into play. 69 genes of the genes in this pig had been editing. Some of them to remove markers in the pig’s cell surfaces, because our bodies can usually detect and reject foreign bodies because of different structure in the cell surfaces. Many of the gene edits were to inactivate viruses that became part of the pigs genetic information, so by removing them, we ensure these viruses don’t become active in our bodies.
Going back to the big picture. If this works, we could get clinical trials for animal organ transfer, not just kidneys, but livers and hearts. And the success of that could be a massive milestone for the 100,000 people waiting for organ transplants in the US, and the 17 that die every day waiting for an organ.
World Happiness Report
Now let’s talk happiness, what’s a good life if we’re not happy? And that’s the question that us in the young adult generation really should be asking ourselves because we just ranked 62nd in level of happiness by country. The 2024 world happiness report came out this month and once again Finland ranked number one followed pretty closely by Denmark. Actually, all 5 nordic countries ranked in the top 10 and a lot of eastern European countries have been doing really well. But when you look at the US, there is a dark story to be told. For the first time , the US was not ranked among the top 20 happiest countries. And this was driven by Americans under 30.
In 2017 and 2018 we had a descent in the world happiness report and there was even an article in the Washington Post titled: “Perhaps tired of winning, the United States falls in the World Happiness Report.” Well aren’t we tired of losing now? We ranked 23rd out of the 143 nations surveyed. Last year, we ranked 15th. We went down 8 places in just one year but now let’s break things down by age because it’s shocking. Young Americans under 30 ranked 62nd out of 143, and Americans age 60 or older ranked 10th. When ranking their happiness out of 10, the old adults were almost a full point higher than those under 30.
So what’s making us more miserable than parents and grandparents? Experts cite:
- Social Media
- Pandemic and Isolation
- State of the World: climate change, war in Gaza, and war in Ukraine
And although this age trend is similar in a lot of countries, it’s a lot more pronounced in the US. Some say that the expectation of happiness in the US can be at play here. The rhetoric around the United States places it as the land of opportunity and happiness so that’s what we grow up learning. But when reality hits us, and we realize that life isn’t all butterflies and rainbow, we get sad and it’s somewhat depressing. This realization usually comes in early adulthood and because of what I just explained, it can be a lot more pronounced in the US.
Intermittent Fasting
Now let’s talk about an interesting study from this past month that made headlines everywhere. It said that intermittent fast leads to a 91% increased likelihood of death from cardiovascular disease. Many articles said that this challenged the “previous misconception” that intermittent fasting was actually good for you. I don’t wanna get into the science behind intermittent fasting because there are a bunch of nuances and pros and cons that are hard to reconcile. But I do want to talk about this study because it kind of demonized intermittent fasting with all these articles being published about it, when the study wasn’t very sound study and the results virtually meaningless. Let’s break down why.
The study had 20,000 participants and each of them completed two 24 hour dietary recalls, where they reported when they started eating and stopped eating the previous day. Then, with this amazing, and definitely sufficient data, the researchers grouped the participants into groups based on average eating duration. They basically made the assumption that this was their typical eating habit and that they would continue to have that eating habit for the next 8 years which the study followed them to see if they actually had any health events.
So did they really group them by intermittent fasting or could they just have grouped them by people that had erratic eating habits? What if the group that reported an eating window of less that 8 hours was actually eating unhealthier food than the other group? There are many very weak assumptions in this study and no adjustment for income, education, quality of food, or many other variables that can impact the result they saw. And out of all the 20,000 people in the study, only 414 of them were in the 8 hour eating group, giving it a relatively poor effect size given all the other variables that could be at play here. And when we look at this variables, the 8 hour group tended to be less educated, have lower income, less access to food, and smoke more. So in my opinion the conclusions that were drawn from this study are not compelling at all, specially against all the research supporting intermittent fasting even if those may have flaws of their own. This is a field that needs a lot more research and I hope that this may serve as another lesson that we can’t take all research results at face value.
Abortion Pill Case
Now for the last detailed analysis of major healthcare news from this month, let’s talk about the abortion pill case, because this was making headlines everywhere. First let’s unpack the background a little bit. The case is about this drug called mifepristone, which is actually the most popular abortion pill in the US, being used for two thirds of all abortions. The drug has been around since 2000, but in this case, after the overturn of Roe v. Wade, a bunch of anti abortion doctors and organizations actually filled a lawsuit against the FDA. The plaintiffs want to invalidate the approval of the drug saying that it’s unsafe and that the FDA approval process was flawed. The FDA, of course, countered that and said that the drug is safe and effective and they cited many studies that show how rare serious complications from the drug actually are.
By the time the case really got to the Supreme Court, the main argument was around the changes that the FDA made in 2016 and 2021 to increase access to the drug. These changes were pretty drastic, honestly, they allowed patients to get their pills from telemedicine and also allowed the pills to be shipped to your house. So this means that you can get them even in states where abortion is banned. In 2016 the time frame for mifepristone use was also increased to 10 weeks from 7 weeks, so this case seeks to bring that back to 7 weeks, even thought it might not really have much of practical difference since physicians can really prescribe it 12 weeks into pregnancy, using “medical discretion.”
To be honest the story of how the case got here is a little confusing and I don’t wanna lose you guys so let’s just focus on what actually happened this month. When the case met the supreme court, which has a conservative majority, their response was genuinely pretty surprising. The justices seemed very skeptical of the claims from the plaintiffs since they have historically supported the FDA’s scientific expertise. Even the three justices appointed by Trump seemed like they supported the FDA as long as any doctors with objections weren’t forced to be involved with any abortions. It was rather weird to them that these doctors that oppose the use of abortion pills were complaining about how unsafe they are to patient even though they don’t even prescribe it to their patients and the scientific evidence says otherwise.
So what happens now. Well, the justices don’t make their decision on the spot. They meet privately a few days after the hearing to talk about it but the actual decision usually only comes 3 months after the court hears a case. So we can expect a decision some time in late June if this case follows their usual practice.
Quick News
With that, it’s time to move on to the next section of this news episode, where I’m just going to fire at you all the other news in healthcare from this month. This should give you a pretty good grasp at everything that happened related to healthcare this month. I encourage you to look up more about anything that you hear and find interesting. You should also send me a message or leave a comment and I would love to talk about any of them further.
IVF, Abortion, and Maternal Health
Since we just talked about the Abortion Pill Case we might as well start with all the news in Abortion, IVF, and Maternal health.
This month, Vice President Kamala Harris visited a Planned Parenthood abortion clinic in Minnesota, marking the first time ever that a VP or President visits an abortion clinic. This goes to show how abortion has become a major political issue since the overturn of Roe v. Wade, and how it will be a major player in the upcoming elections.
In IVF, clinics in Alabama reopened this month after a Protection Law was passed, shielding IVF clinics from any lawsuits against damaged embryos. This is not to say that patients aren’t reluctant about their treatments and many suffered psychological damaged. A interesting piece on NY Times even highlighted that some couples are skipping sex and going straight to IVF, citing that many like being able to pick the gender of their kid. This month, a democrat also won a State House seat running primarily on the IVF issue these past two months, which got a lot of support.
In women’s health, President Biden signed an executive order to boost women’s health research to overcome the underrepresentation of women in research. A large study in Canada found that teen pregnancies make you twice as likely to die before the age 31. Birth control is soon going to be available over the counter, mostly as the oral contraceptive Opill. In New York, birth control pills, vaginal rings, and contraceptive patches are all to be available over the counter.
Flawed Research
On the topic of flawed research, more research papers have been pulled away from Dr. Sam Yoon, the chief of cancer surgery at Columbia. We talked a lot about him last month so check the February news episode if you wanna heart more about this situation.
Weight Loss Market
In weight loss, these new GLP-1 drugs like Wegovy and Zepbound are defying a common trend with most prescription drugs: non-adherence. Doctors report all the time that there patients can’t stick to their medications consistently, but the story is different for weight loss drugs.
Wegovy has been approved this month for more than just weight loss. The FDA approved its use for its heart benefits such as reducing the risk of heart attacks, strokes and cardiovascular mortality in adults who have heart disease and are overweight or have obesity.
This month, researchers from Yale estimated that Ozempic takes between 89 cents and 4.73 dollars to make for a whole one month supply, while Novo Nordisk charges patients $1000 for a one month supply of the drugs.
Pharmaceuticals and Drug Stores
In other pharmaceutical news, Eli Lilly’s Alzheimer’s drug called donanemeb had its approval delayed. We expected the FDA to approve this drug that could slow the progression of Alzheimer’s this month but they will now convene to further assess the drug’s safety and efficacy.
As for CVS, Ohio fined the store for $1.5 million due to 27 cases involving safety and staffing concerns.
Mental Health
In mental health this month, California passes laws to establish their CARE court program, short for Community Assistance, Recovery, and Empowerment (CARE) Court. This program allows anyone with untreated schizophrenia or other psychotic disorders to receive a personalized treatment plan and support from a CARE team.
Proposition 1 also passed in California this month by a very slim majority. The proposition aims to expand treatment centers and supportive housing for individuals with mental illness and addiction. It seeks to authorize $6.38 billion in bonds for facilities and housing, amend the Mental Health Services Act to redirect about $140 million annually from counties to the state, and allocate approximately $1 billion for housing homeless veterans struggling with mental illness or addiction.
Viruses and Bacteria
In viruses and bacteria, Meningitis is on the rise. Last year there were 422 cases of invasive meningococcal disease in the US, the highest number since 2014. This year, we already had 143 cases, which is 62 more than the number of cases at the same time last year.
The measles outbreak also continues to worsen, and we’ve now reached more cases this year than in all of 2023.
For Covid news, a man in Germany had 217 Covid shots, and doctors say that his immune response remains remarkable and he appears to fight off Covid better than most.
The FDA also approved a new drug called Pemgarda, to help protect very immunocompromised patients who don’t get enough protection from the normal vaccines.
Medicare/Medicaid
In Medicare/Medicaid news, Medicaid has been coming after the family home. The Medicaid Estates Recovery Program allows Medicaid to ask for reimbursement after a person that had some type of long term care is deceased. They can go after a person’s assets to repay all of their long term medicaid costs. This could be from cash that they left or any stocks and bonds, but many times is comes down to being that person’s property, which is the only thing of value that many leave behind. Aside from a few exceptions, Medicaid usually takes the home away even when other family members are still living in the house, creating a ton of distress.
Well-Being
In general well being news from this month, there were a couple of interesting headlines.
First up is an article on colon cancer, which I wish had some more research put into it. The incidence of colon cancer among young adults is increasing, that’s an undeniable truth. This artible, by Knvul Sheikh in the NY Times tries to make sense of it. She mentions genetic mutations, lifestyle and dietary changes (such as increased consumption of red meat, ultraprocessed foods, sugary beverages, and decreased physical activity), and the rise in obesity rates. She also mentions changes in the gut microbiome, exposure to toxic chemicals in the environment, and geographic disparities, which may also play a role. But I really think that the biggest factor here is the decreased fiber consumption, which comes along with the increase consumption of ultraprocessed foods that she mentioned. Only 4% of mean and 12% of women really meet their recommended fiber intakes, and fiber plays a crucial role increased bowel movements, it binds to bile acids, and even has some evidence of lowering cholesterol. It keeps your gut clean so you’re less likely to get colon cancer, so make sure you’re eating your fiber.
But on a positive note, we may soon have a blood test for colon cancer.
Now this next article, I don’t even know why I’m putting it here.. It’s titled “Toddlers Smell Like Flowers, Teens Smell ‘Goatlike,’ Study Finds.” Uhhhh, yeah, I’m just gonna leave it at that.
Let’s talk abou the climate and our health. A new study found that only 10 out of 134 countries achieved the World Health Organization’s standards for particulate matter in their air. That’s a major no no for air quality and health.
The Government now finally banned the last form of Asbestos that was still in use, putting us among the 50 plus other nations that have banned the carcinogen.
Now let’s talk hangnails, you know those freaking pieces that hang right next to your nail and you pull them off and it hurts a ton. Well, I finally found an article on how to get rid of those. I haven’t tried it yet but you’re supposed to put your finger into warm water and then clip off the skin with something sterile and then put Aquaphor or Vaseline on it. And to prevent it just keep your hands moisturized. You can thank me later. If it works of course, I’m not sure if it does yet.
In San Francisco, officials reported that taking an antibiotic after sex reduces cases of Chlamydia and Syphilis, or at least it did in San Francisco, it literally cut the number of cases by half.
Health Insurance
In health insurance this month, Mount Sinai signed a deal with UnitedHealthcare to keep the major hospital system in the UnitedHealthcare’s network. If this deal wasn’t reached, thousands of UnitedHealthcare patients that go to Mount Sinai would have needed to find new doctors.
Cyberattacks
There was also significant news on cyberattacks in health insurance this month. And UnitedHealthcare is in the picture once again. Change Healthcare, a big unit of UnitedHealthcare had to shutdown parts of its operations late last month because of a cyberattack. Now, a bunch of hospitals, clinics, and doctors are frustrated because they are having to wait for their reimbursements.
Global Healthcare
In Global Healthcare news, let’s start with updates on the South Korea doctor strike. The government suspended licenses of thousands of doctors who were protesting, and many senior doctors even submitted their resignation. Some doctors were also arrested. This is weighing on President Yoon’s party as they near the elections.
In Gaza, children and pregnant women suffer the most from hunger and malnutrition.
In Haiti, hospitals have become either looted by gangs or abandoned by the employees. Those that still remain open are too dangerous for those who need care to get to.
As for female genital cutting, even though there are campaigns against it, numbers continue to rise. In Gambia, a 2015 bill banning genital cutting was overturned.
Medical Devices, Biotech, and AI
Now for Medical Devices, Biotech, and AI, there is a new way to do CPR. It’s a lot more complicated but it’s shown promising results. ECPR, or Extracorporeal Cardiopulmonary Resuscitation, is a medical procedure that involves using a machine to provide heart and lung support to patients in cardiac arrest when traditional CPR is ineffective. The machine pumps and oxygenates the blood outside the body, allowing the heart and lungs to rest and recover while the underlying cause of the cardiac arrest is treated. This is really hard to implement because of challenges in implementation, coordination, and training, and the need for collaboration between a bunch of different groups, which is hard to get in an emergency situation.
Next, the Impella heart pump, used to support the heart in patients undergoing complex procedures or with life-threatening conditions, has been linked to 49 deaths and dozens of injuries worldwide due to the risk of puncturing the heart wall. The FDA issued an alert but allowed the device to remain in use, criticizing the manufacturer, Abiomed, for not notifying the agency sooner about the perforation risk. This alert follows recent concerns about the deadly side effects of cardiac devices and is the third major FDA action for an Impella device in a year. Abiomed, now owned by Johnson & Johnson MedTech, claims there are no reported instances of heart-wall perforations related to product design or manufacturing. Despite the risks, some cardiologists believe the Impella devices are valuable and necessary in certain situations.
Drugs and Alcohol
Now let’s talk all drugs and alcohol. What’s new this month.
Starting off with alcohol, alcohol related liver disease deaths have jumped 39 percent in recent years. This condition usually arises when men have more than 14 drinks a week and women have more than 7 drinks a week for an extended period of time. The trick here is that you don’t notice anything until it’s too late and you can’t reverse it.
Still on alcohol, we are seeing a change in old adults drinking patterns. They seem to be drinking more and more after the pandemic. Many cite that it’s a way to combat loneliness and it’s the only time they feel good and happy.
Now let’s talk about weed. Biden even mentioned it during his State of The Union Address, signaling that he’s moving to embrace the issue.
In New York, illegal weed shops have far outnumbered those with legal licenses, with over 2,000 illegal shops and only 85 legal dispensaries. The state government has called to speed up the licensing process.
Many Americans are now using weed to help with their workout, saying that it helps with focus as well as with chronic pain. There is also an increased use of cannabis for anxiety. But people should be careful with how they are using it and more research is warranted in these areas.
Now for psychedelics, which seem to the new hot topic on social media. An ethics complaint was filed against one of the first and most prominent psychedelic researchers and believers from Johns Hopkins, Roland Griffiths. In the complaint, Matthew Johnson, one of Griffiths longtime collaborator, said that Griffiths was infusing his research with religious symbolism, and allowing donors with interests in drug legalization to assist in studies.
Ibogaine, a powerful psychedelic remains illegal in the US but there are optics that it could soon be used to treat PTSD, addiction, and brain injury. New research is being done on its potential in medicine as we speak.
In archeology, a almost 2,000 year old bone stash filled with black henbane seeds was discovered in the Netherlands. This could be some of the earliest evidence of psychedelics during the Roman Era.
In more drug news, the term “overdose” has been under fire, with critics saying blamed the victim for their death. They are suggesting that the word “poisoned” be used.
Oregon re-criminalized the possession of street drugs to try combat their rising overdose, or “poisoning,” deaths.
Politics
Now let’s end with some remarks from our President and former President on a few healthcare issues.
Let’s start with one of Trump’s tweet from his social media company’s account, Truth Social. He said:
“I'm not running to terminate the ACA, AS CROOKED JOE BUDEN DISINFORMATES AND MISINFORMATES ALL THE TIME, I'm running to CLOSE THE BORDER, STOP INFLATION, MAKE OUR ECONOMY GREAT, STRENGTHEN OUR MILITARY, AND MAKE THE ACA, or OBAMACARE, AS IT IS KNOWN, MUCH BETTER, STRONGER, AND FAR LESS EXPENSIVE. IN OTHER WORDS, MAKE THE ACA MUCH, MUCH, MUCH BETTER FOR FAR LESS MONEY (OR COST) TO OUR GREST AMERICAN CITIZENS, WHO HAVE BEEN DECIMATED BY BIDEN, HIS RECORD INFLATION, BAD ECONOMY, AFGHANISTAN CATASTROPHE, AND JUST ABOUT EVERYTHING ELSE. CROOKED JOE BIDEN IS, BY FAR, THE WORST PRESIDENT IN THE HISTORY OF THE UNITED STATES!”
Biden on the other hand finalized a rule to curb one of the former President’s policy, which expanded access to health plans that were cheaper but had fewer benefits than those sold under ACA marketplaces.
At the center of his re-election campaign, Biden appeared with Pelosi and Obama to celebrate the 14th anniversary of the Affordable Care Act.
Biden’s budget proposal seeks to lower healthcare costs. In New Hampshire this month, he emphasized how he will cap insulin prices, make permanent tax credits under the ACA, and limit out of pocket costs for prescription drugs. But we know how many of these promises usually go.
Conclusion
And that brings us to the end of March 2024 healthcare news. If any news that I mentioned particularly interests you, feel free to shoot me a message on one of our social media platforms, and I would love to chat with you there. And once again, please leave your feedback so that we can work on making the show better, and don’t forget to rate the show on your podcast listening platform.
I’ll see you guys for another healthcare news episode next month. And for now, stay curious, stay informed, and most importantly, stay healthy.
