One day into the major league season and, surprisingly, the Cubs are still in the thick of the pennant race. They beat the Pirates 3-1 in the first game of 2013 yesterday. Here in Chicago, North Side baseball fans have learned to celebrate the good times while we can.
Given the tumultuous changes now under way, it might be a useful habit for health care professionals to develop, too. In that spirit, here are four positive, if very random, developments that everyone involved in patient care can cheer about.
• In past posts, I've written about hopeful signs in the fight against HIV, and hopes rose higher with last month's news that doctors in the United States and France appear to have attained a "functional cure" for HIV in separate cases. In the American case, a baby was born in Mississippi to a woman whose HIV was not diagnosed until she had gone into labor. Thirty hours after birth, the child was put on a much more aggressive medication treatment than most HIV-positive infants receive, and now, at 2 and a half years old and after a year without meds, shows no signs of infection. In the French study, 14 adults were treated within the first two months of being infected with HIV and for up to seven years thereafter. While all still have HIV, the infection is undetectable by standard methods and they've been able to stop combination antiretroviral therapy. Experts caution that these are isolated, limited cases and more work needs to be done, but they're big steps forward in what had once seemed like a battle that might never end.
• We've known that gene mapping has the potential to transform how diseases are diagnosed and treated, but so far it's been too complex for most providers to take advantage of. That could be changing. The Wall Street Journal last summer reported on a new method that requires a much smaller amount of DNA to produce a more complete picture of an individual's genome, and to determine immediately whether a faulty gene is inherited from one parent or both. "If it turns out a genetic mutation is inherited from only one parent, then having a working copy of the gene from the other parent may stave off medical problems," wrote Amy Dockser Marcus. She noted that whole genome sequencing now costs around $10,000, but "the cost continues to drop rapidly" with some experts predicting it could fall to $1,000 in the near future, making it accessible to more patients and providers.
• Patients awaiting heart transplants often must spend months in the hospital. MedPage Today reported in January about a new portable artificial heart that allowed patients who were at imminent risk of death from biventricular failure to return home to await a successful transplant. The Total Artificial Heart has been used for high-risk patients, but, as MedPage Today reported, its configuration required those patients to remain in the hospital "attached to a large, heavy pneumatic driver (CSS console), which severely limited mobility." A new portable electromechanical driver can replace the CSS console, "affording patients complete ambulatory freedom." Allowing patients to be out of the hospital and in their own homes whenever possible is one of the major goals of the health care transformation now under way.
• This next advance might seem relatively minor in the scheme of things, but if you've ever met a child who is unable to speak, you know it's really a big deal. As reported in The New York Times, children with conditions such as speech apraxia can use electronic devices loaded with a text-to-speech application such as Proloquo2Go. But the voices are modified adult voices, which is startling to listeners because they sound nothing like a child's voice. In fact, David Niemeijer told the Times, they sound "like adult voices on helium." Adults are hired to to record voices for most text-to-voice products because, the Times notes, it's too difficult for kids to spend the hundreds of hours in the sound booth making the recordings. But AssistiveWare, of which Niemeijer is chief executive and lead developer, and its partner Acapela Group developed a new version of Proloquo2Go that features the voices of two children, called Josh and Ella. The application is available on iTunes. Kids who can't talk — and everyone who cares for them — can rejoice.