<p id="E126">Welcome to the November healthcare news roundup, where we provide information on the latest developments in treatments, devices, and technologies in the medical field.</p>
<p id="E128">This month, we are focusing on a few technological advances, from cancer detection to improved senior care, as well as an innovative solution for antibiotic delivery. We also touch on a class of medications being restricted following safety results, how monkeypox may affect children, and the deaths caused by syrup medications in Indonesia.</p>
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<h2 id="E132">Artificial Intelligence Tool Identifies Melanoma Patients at Risk of Cancer Recurrence</h2>
<p id="E138">The use of an algorithm based on machine learning can pinpoint melanoma patients who have a higher risk of cancer recurrence. Early identification of these patients allows for more aggressive treatment in the early stages of melanoma, the most lethal form of skin cancer.</p>
<p id="E141">According to <a is="qowt-hyperlink" href="https://www.eurekalert.org/news-releases/969717" target="_blank" rel="noreferrer noopener">research done</a> by a team led by investigators from the Massachusetts General Hospital in the United States, the artificial intelligence-based method can be used to predict which patients are more likely to see their cancer return after being surgically removed. Surgical treatment is indicated in all patients with early-stage melanoma, and a type of medication called immune checkpoint inhibitors is usually reserved for those patients with more advanced cancer because of side effects. Using the method developed by the Mass General investigators, immunotherapy could be used earlier in selected patients so that their immune systems would be stronger and could battle cancer more effectively.</p>
<p id="E147">To validate their algorithm, the researchers collected samples of 1,720 early-stage melanomas and extracted 36 clinical and pathologic features of these cancers from the patients’ electronic health records to predict the risk of cancer recurrence. After validation, they discovered that tumor thickness and rate of cancer cell division were identified as the most predictive features.</p>
<p id="E153">According to the authors, their results “suggest that machine learning algorithms can extract predictive signals from clinicopathologic features for early-stage melanoma recurrence prediction, which will enable the identification of patients who may benefit from adjuvant immunotherapy.”</p>
<h2 id="E155">Using Red Blood Cells for Targeted Delivery of Antibiotics</h2>
<p id="E157">Antibiotic resistance is becoming one of the most pressing health crises across the globe. To overcome the problem, researchers keep trying to develop new antibiotics, but a team of physicists at McMaster University in Canada took a different approach: they <a is="qowt-hyperlink" href="https://scienmag.com/stealth-care-system-scientists-test-smart-red-blood-cells-to-deliver-antibiotics-that-target-specific-bacteria/" target="_blank" rel="noreferrer noopener">identified a natural delivery system</a> based on red blood cells, which can carry antibiotics through the body and selectively releases them near harmful bacteria.</p>
<p id="E162">To achieve this, the investigators developed a technique to open red blood cells and remove their inner components so that all that it is left is their shell. This shell, called a liposome, is then loaded with Polymyxin B, one of the world’s only remaining resistance-proof antibiotics. This antibiotic, while potent, is usually only used as a last resort due to its high toxicity and side effects.</p>
<p id="E164">By using the shell of the red blood cells, Polymyxin B can now travel through the body without</p>
<p>harming healthy cells in its path, the authors explain. “We designed these red blood cells so they could only target bacteria we want them to target,” says Hannah Krivic, a graduate student of biophysics at McMaster and lead author of the study.</p>
<p id="E170">Scientists are now exploring additional applications of this technology, including its potential use to deliver drugs directly to the brain, which would help patients with dementia or depression.</p>
<h2 id="E173">EMA and FDA Limit Use of JAK Inhibitors</h2>
<p id="E175">The use of Janus kinases inhibitors (JAKi), which have been considered a welcome alternative to tumor necrosis factor inhibitors (TNFi) to treat chronic inflammatory diseases like rheumatoid arthritis and atopic dermatitis, are now being heavily scrutinized by health authorities in the United States and Europe, which will <a is="qowt-hyperlink" href="https://www.biopharmadive.com/news/ema-jak-inhibitors-limited-use-high-risk-patients/635237/" target="_blank" rel="noreferrer noopener">limit their use</a>.</p>
<p id="E197">This decision comes after the safety problems that emerged from a large post-marketing study, which established a link between JAKi use and side effects such as heart attack, venous thromboembolism, and cancer.</p>
<p id="E203">Last year, the United States Food and Drug Administration (FDA) had already limited the use of JAKi, only allowing their use when TNFi did not work. Now, the European regulator has also stated that JAKi should be only used in certain patients when there are no other options. These include patients aged 65 years or older, those at increased risk of major cardiovascular problems (such as heart attack or stroke), those who smoke or have done so for a long time in the past and those at increased risk of cancer.</p>
<p id="E219">The product information for JAKi used to treat chronic inflammatory disorders will be updated with the new recommendations and warnings, and educational materials for patients and healthcare professionals will be revised accordingly.</p>
<h2 id="E230">Risks of Monkeypox May Be Higher in Children 8 or Younger</h2>
<p id="E234">Despite the relatively low number of monkeypox infections in children seen so far, pediatricians warn that <a is="qowt-hyperlink" href="https://www.newswise.com/articles/few-children-affected-by-monkeypox-so-far-but-risks-are-higher-in-children-8-or-younger" target="_blank" rel="noreferrer noopener">young children should be considered a high-risk group</a> for monkeypox complications.</p>
<p id="E239">As of November, more than 77,000 laboratory-confirmed cases of monkeypox were reported worldwide. Of these, only 672 were in children and adolescents under 18 years. Although in the current outbreak, sexual transmission appears to be the largest driver of infections, it is also true that monkeypox affects those with lower immunity. This includes individuals with HIV infections but also young children.</p>
<p id="E247">Although children may be at lower risk for infection, they can have more severe disease, the experts say. “Children are reported to have an increased hospitalization rate and increased mortality, even in high-income countries,” write Petra Zimmermann, MD, Ph.D., of the University of Fribourg, Switzerland, and Nigel Curtis, Ph.D., of The University of Melbourne and Murdoch Children’s Research Institute, Australia. The increased risk of complications, including potentially serious bacterial infections, is due not only to their less developed immune systems but also because they are more prone to scratch their lesions, spreading the infection to other parts of the body, including the eyes.</p>
<p id="E256">“Smallpox vaccination offers protection from monkeypox,” Drs. Zimmermann and Curtis conclude. “Should the current outbreak spread to children, authorities should be prepared to rapidly implement vaccination of this age group.”</p>
<h2 id="E258">Children Deaths From Cough Syrup Continue to Rise in Indonesia</h2>
<p id="E260">Indonesia’s National Agency of Drug and Food Control (BPOM, in the original wording) continues to investigate the causes behind the rise in deaths in children—now almost 200— due to acute kidney injury, and will possibly <a is="qowt-hyperlink" href="https://www.reuters.com/business/healthcare-pharmaceuticals/indonesia-may-seek-prosecution-pharma-firms-child-aki-deaths-rise-2022-10-24/" target="_blank" rel="noreferrer noopener">prosecute pharma companies</a> responsible for certain syrup-based medications.</p>
<p id="E267">These medications were banned last month after ethylene glycol and diethylene glycol were identified in their composition. These two chemicals are commonly used in industrial applications as antifreezes or brake fluids, but in this case were used as an alternative to glycerin, which acts as a thickening agent in cough syrups. While ethylene glycol and diethylene glycol can be used in small quantities for pharmaceutical applications, they are highly toxic when in excess, as is appears was the case for several batches of products coming from two companies, Samco Farma and Ciubros Farma.</p>
<p id="E288">Indonesian authorities are now examining the raw material supply chains and screening production processes to understand how the excess of these ingredients got into products, said Penny K. Lukito, chief of BPOM.</p>
<p id="E296">Children’ deaths in Indonesia are being analyzed in consultation with the with the World Health Organization (WHO), but unfortunately this is not the first case of deaths in children caused by syrups. Earlier this year, there was a similar incident in Gambia, with at least 70 deaths linked to syrup medications made by India’s Maiden Pharmaceuticals.</p>
<h2 id="E301">Technology Could Ease Senior Care</h2>
<p id="E303">As a significant part of the population grows older, there is an increased need to develop <a is="qowt-hyperlink" href="https://www.mobihealthnews.com/news/how-utilizing-technology-could-ease-senior-care-home" target="_blank" rel="noreferrer noopener">home care technology for seniors</a>. This is especially true for older individuals who wish to live independently in their own homes.</p>
<p id="E308">This issue was explored in a session dedicated to living independently that was part of the Parks Associates’ Connected Health Summit 2022. In the event, panelists focused on aspects of gathering and using data, remote monitoring devices, and how to repurpose existing technologies to keep people safe at their homes, while keeping cost-effectiveness in mind.</p>
<p id="E312">There is a growing demand for technology that can not only monitor the person, but that can also “proactively identify and respond to problems,” said Brandon Neustadter, vice president of sales of an artificial intelligence (AI)-based solution that detects and responds to falls. Other options include combining data on the person, such as their sleep patterns, water consumption, and medication intake, to provide insights on their overall health. Ultimately, we want solutions that can intervene in the right way, at the right time, to “either get a telehealth visit or get somebody to an urgent care, to their doctor, versus having to send them to an emergency room or send an ambulance to come out and pick them up” says Andy Droney, senior director of ADT Health.</p>
<p id="E333">The pandemic has illustrated two essential features for optimal remote senior care: telehealth and the ability to leverage devices for the benefit of caregivers and seniors within their home. The senior population is showing that they can adapt to new technologies if they are introduced in the right way, now its just a matter of integrating all aspects of those technologies in their lives.</p>
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