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Minggu, 04 Desember 2011

U.S. medical 'trash' saving lives abroad

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Priscilla was diagnosed with a brain tumor three years ago, but she is now thriving thanks to donated medical supplies.Priscilla was diagnosed with a brain tumor three years ago, but she is now thriving thanks to donated medical supplies.Third World hospitals are saving lives with discarded medical materials from the U.S.These supplies are clean, safe and unused but are thrown out for various reasonsBy salvaging surplus supplies, nonprofits are also reducing waste in America

(CNN) -- Doctors will often prepare for surgical procedures by opening instrument and supply kits that contain up to 100 items.

Many of these items, such as scalpels, needles or sponges, go unused; they're just not needed for that particular procedure. But because of government or hospital regulations in the United States, they are frequently thrown away, even when they are still wrapped.

"There are thousands of tons of medical supplies thrown away every day that are unused or clearly reusable," said Dr. Bruce Charash, a cardiologist in New York.

Fortunately, some nonprofit organizations, including Charash's Doc2Dock group, are finding ways to salvage these items and get them to people who need them desperately around the world.

In Uganda, for example, many medical facilities lack the necessary supplies and equipment needed to perform surgery. The outlook is normally grim for children such as Priscilla, who was diagnosed with a brain tumor when she was 7.

But one Ugandan hospital, CURE Children's Hospital in Mbale, has been able to operate on Priscilla and more than 1,100 other kids thanks to its partnership with MedShare, a nonprofit that collects surplus supplies and equipment from the U.S.

"Brain tumors happen to children all over the world," said Derek Johnson, executive director of CURE Uganda. "The main difference in Uganda is that there are so few resources. But we were able to save Priscilla with supplies we get from MedShare."

'Our trash becomes their riches'

In the United States, surgical supplies aren't the only useful medical items tossed away.

Richard St. Denis, one of the Top 10 CNN Heroes of 2011, collects discarded wheelchairs through his nonprofit, World Access Project. With help from another U.S.-based nonprofit, Hope Haven, the wheelchairs are refurbished by senior citizen volunteers and prison inmates in Iowa before being shipped to rural Mexico.

St. Denis first visited Mexico in 1997, and he met many people with disabilities who didn't have access to wheelchairs, walkers or canes.

"I was shocked to see people using branches for crutches, being pushed in wheelbarrows and crawling," said St. Denis, who lost the use of his legs during a skiing accident in 1976.

Now, he has a permanent residence in Mexico and continues to do everything he can to help the people around him.

"We want to distribute the more than 75,000 wheelchairs we estimate get thrown away in the U.S. every year," he said. "What we call our trash becomes their riches, and it makes an incredible difference in their lives."

A win-win for everyone

In addition to saving lives, there's another benefit to sending unused supplies abroad.

"We are diverting a certain amount of waste that would be landfilled," said Dr. William Rosenblatt, a professor of anesthesiology at Yale University School of Medicine and founder of the nonprofit Remedy.

"At the end of a surgical procedure, our staff surveys the scrub table where the kit items remain and segregates all the materials that have been unused," Rosenblatt said. "It gets sent down to (a) decontamination area, and Yale undergraduate students sort through it and take what is useful. From here, it is packaged in bulk and given to a charity to be taken overseas."

Sometimes, perfectly good equipment is thrown away.

"Why would (hospitals) throw out a working sonogram machine or a working hospital bed?" Charash said. "One, it's not pretty enough. Secondly, there might be new technology available. In general, no one wants to use a 2005 (model) if a 2012 is available."

Occasionally, a hospital will simply switch brands and get rid of an entire line of unused items.

Supply manufacturers have been known to send items directly to the nonprofits if a box is so much as dented in transport -- items that could mean life or death for an individual in a Third World hospital.

The need greatly outstrips the supply

"On my first trip to Africa, the hospital director showed me a patient dying of malaria," Charash said. "He showed me a room with hundreds of bottles of medicine that would save his life, but (the medicine was) not given to him because they had no intravenous lines.

"That day, our Doc2Dock container arrived with reconstituted IV lines and 3,000 to 4,000 syringes. The doctor got an IV line, the patient got the medicine and was saved."

But while unused medical equipment is saving many people around the world, only a small percentage of hospitals ever actually receive these items.

"If you look at the volume of appeals we get versus the amount we are able to help, we are able to find funding for a quarter of the bona-fide projects," said David Pass, chief advancement officer for MedShare. "There is a great need out there."

The effort to find more funding is worth it, said Tanya Weaver of the American Foundation for Children with AIDS. Her nonprofit works in four African countries and has been able to help more than 100,000 people there thanks to surplus medical supplies from a couple of hospitals.

"If we can do this with the help of just two U.S. hospitals, imagine how many more could be served if others got involved," Weaver said.



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Technology

Rabu, 28 September 2011

Stem cell treatments abroad

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Indianapolis Colts quarterback Peyton Manning reportedly flew abroad for stem cell treatment for a chronic neck injury.Indianapolis Colts quarterback Peyton Manning reportedly flew abroad for stem cell treatment for a chronic neck injury.Colts quarterback Peyton Manning reportedly sought a stem cell therapy in EuropeMedical tourism as an industry is projected to grow 35% annuallyExperts say it's dangerous to try treatments that haven't been approved and regulated

(CNN) -- There's great potential in the field of regenerative medicine, but doctors caution against seeking experimental treatments in an unregulated environment.

Having had three surgeries for a neck injury already, Indianapolis Colts quarterback Peyton Manning reportedly took a private jet to Europe to get a stem cell treatment that is not approved in the United States. The therapy involved injecting fat cells from Manning's body into his neck, according to Fox Sports.

Colts head coach Jim Caldwell declined to discuss Manning's health situation when asked about the stem cell treatment at a press conference Monday. Further details of Manning's treatment are not available.

Discussing the choice to go abroad for stem cell treatments puts researchers in an awkward position, because the therapies offered abroad are unregulated and not confirmed to work, but they are based on concepts that the American medical community believes have potential. Generally, however, the consensus is that patients should not try to seek experimental stem cell treatments elsewhere, as there's no telling if they will work or have serious side effects.

"We believe that there is merit to this approach, we just want to see it (carried out) well, ethically and rigorously," said Dr. Joshua Hare, director of the Interdisciplinary Stem Cell Institute at the University of Miami's Miller School of Medicine. Scientists like Hare are trying to gather medical evidence through clinical trials to ensure that these treatments are safe and effective.

Leaving the country to seek experimental treatments abroad is common, experts say, although no one has exact numbers for how many people seek stem cell treatments in other countries. Medical tourism as an industry is projected to grow 35% annually, and could reach 1.6 million American patients going elsewhere for treatments by 2012, according to the Deloitte Center for Health Solutions. (The agency had previously predicted 6 million by 2010, but those numbers have not panned out.)

Besides orthopedic injuries like Manning's, there are stem cell therapies available elsewhere aimed at heart disease and neurological conditions, even autism. Germany, Panama and Thailand are all popular countries for seeking these kinds of treatments, Hare said.

The basic idea is that stem cells have regenerative potential, and can even form new tissues. Mesenchymal stem cells are a particular kind that can become a variety of cell types, including bone cells and cartilage cells.

While there is a lot of exciting research going on in the field of stem cells, the results aren't all good. A 2009 study in the journal PLoS Medicine documented the case of an Israeli boy who had gone to Russia to get fetal stem cells injected into his brain and spinal cord. He developed a brain tumor, apparently as a result of the treatment, although the tumor was slow-growing and benign.

And earlier this year, authorities closed down a large stem cell clinic in Germany called the XCell-Center, which had operated through a loophole in the country's regulations regarding unapproved experimental treatments. The clinic had been implicated in the death of an 18-month-old boy after a stem cell treatment; a 10-year-old almost died after receiving something similar.

One problem with going abroad for these unapproved treatments is that there's no follow-up; you won't have anyone back home to take care of any complications that might result, Hare said. In cardiac stem cell trials conducted in this country in people with advanced heart disease, medical professionals do follow up with patients and treat any complications that may arise.

Another concern is that, without proper regulation, any given stem cell therapy abroad may actually be different every time you receive a treatment, said Jeffrey Karp, director of the Laboratory for Advanced Biomaterials and Stem-Cell-Based Therapeutics at Brigham & Women's Hospital in Cambridge, Massachusetts.

There also may not be any regulations on the quality of the treatment, so you really don't know what you're getting, he said.

"Regulatory agencies such as the FDA can ensure that cell therapy that reaches patients is safe, effective, and that quality control is established for isolating the cells, manipulating them outside of the body, and delivering them," Karp said.

A lot of parents believe that stem cell therapies could help their children with autism, although there haven't been any clinical trials in the U.S. to substantiate this, Hare said. In orthopedics and cardiology, on the other hand, there are ongoing investigations; someone like Manning could have potentially joined a clinical trial instead of going abroad, although there's no guarantee that he would have received the treatment rather than a placebo.

The idea of placebo also comes into play here, as with any therapy -- sometimes, just believing strongly that a treatment will heal you actually does change your body, even if that "treatment" isn't actually doing anything.

But there are still significant risks from anything that's unregulated, Karp said.

"While stem cell treatments have been shown to have significant placebo effects during controlled clinical trials, I think patients considering unregulated stem cell treatments need to be aware that they are not optimized and may even do harm," he said.



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