October saw its fair share of ground breaking research and outbreaks. Here is a bird’s eye view of the top 5 headlines in the medical world.

1. Ebola cases cross 10,000; experimental vaccine trials underway

The Centres for Disease Control and Prevention in the USA recently announced a travel-related case diagnosed at a hospital in Texas. Unfortunately, the patient passed away on October 8.¹ Two nurses who were attending to an Ebola patient also tested positive with the virus, but both are now stable and Ebola free.

Quickly identifying and isolating Ebola patients is an effective strategy to prevent further spread of the disease. Senegal and Nigeria, who’ve followed this practice, have both been declared Ebola-free.

On October 23, The National Institute of Health announced that an experimental Ebola vaccine was underway. The Lausanne University Hospital in Switzerland has announced that 120 volunteers will receive the experimental vaccine. These volunteers are healthcare workers who will join medical teams in Liberia, Guinea and Sierra Leone, the epicenter of the outbreak.²

The number of Ebola cases crossed 10,000 by the end of October and the number of deaths was nearing 5000.³

2. Risks of opioid analgesics far outweigh the benefits

October showed a sharp rise in overdose of narcotics and related morbidity. Compared to heroin, more than double the number of patients had fatal outcomes overdosing on prescription opioid analgesics.

On October 27, The Journal of American Medical Association published an article⁴ regarding a study of emergency department visits, which showed that 67.8% visits of overdose involved prescription pain medication.

The American Academy of Neurology further stated that physicians should refrain from prescribing narcotic opioid medications for chronic conditions such as headache & backache as the benefits afforded were negligible when compared to the risks, which range from death to serious side effects and of course, addiction.

3. All adults over 45 should be screened for diabetes, says American Diabetes Association

American Diabetes Association has recommended regular screening for diabetes in all adults above the age of 45.⁵ The US Preventive Health Services Task Force has stated that age alone is sufficient to check for diabetes.

Other high risk factors include strong family history, being overweight, diabetes during pregnancy and polycystic ovarian syndrome. A simple blood test which measures blood glucose fasting sample or haemoglobin A1C (HbA1C) is enough for a diagnosis.

4. Drugs used to treat Parkinson’s found to have surprising behavioral side-effects

Medications used in treatment of Parkinson’s disease and Restless Leg Syndrome have been found to exhibit curious behavioral side effects. The medicines in question are pramipexole, ropinirole and aripiprazole.

The behavioral problems are related to impulse control, from obsessive and compulsive behavior like obsessive sex to compulsive shopping or gambling. A study by JAMA⁶ showed that as high as one out of seven patients on these medications experienced side effects. Thus, it has recommended that physicians should exercise extreme caution while prescribing these drugs as the risks have been underestimated & the side effects can be quite disturbing.

5. New drug for testing familial high cholesterol

People diagnosed with familial and acquired hypercholesterolemia have been known to be at a higher risk of early death due to heart disease. According to a recent study published in the Lancet⁷, a new drug ‘Evolocumab’ seems to show promising results. This drug, injected in a solution form, inhibits the PCSK9 enzyme and helps the liver clear out extra cholesterol. The results on a short term basis seem to be promising but the safety of this medicine for longer duration needs to be assessed.

Have we missed out on anything? Do let us know in the comments.

References

1. Gire SK , Goba A , Andersen KG , et al . Genomic surveillance elucidates Ebola virus origin and transmission during the 2014 outbreak. Science 2014 ; 345 : 1369-1372
2. Ebola Cases Top 10,000 in Current Outbreak, WHO Says. WSJ, 25 October 2014. (http://online.wsj.com/articles/ebola-cases-top-10-000-in-current-outbreak-who-says-1414238153)
3. Centers for Disease Control and Prevention. Ebola outbreaks 2000-2014. (http://www.cdc.gov/vhf/ebola/resources/outbreaks.html)
4. Yokell MA, Delgado M, Zaller ND, Wang N, McGowan SK, Green T. Presentation of Prescription and Nonprescription Opioid Overdoses to US Emergency Departments. JAMA Intern Med. Published online October 27, 2014. doi:10.1001/jamainternmed.2014.5413.
5. American Diabetes Association. Standards of medical care in diabetes—2014. Diabetes Care. 2014;37(suppl 1):S14-S80
6. Thomas J, Joseph G,Donald R. Reports of Pathological Gambling, Hypersexuality, and Compulsive Shopping Associated With Dopamine Receptor Agonist Drugs. JAMA Intern Med. Published online October 20, 2014
7. Raal FJ, Honorpour N, Blom, et al. Inhibition of PCSK9 with evolocumab in homozygous familial hypercholesterolemia (TESLA Part B): A randomized, double-blind, placebo-controlled trial. The Lancet 02 October 2014. DOI: 10.1016/S0140-6736(14)61374-X

Disclaimer: This website is is not intended to provide any medical advice. By engaging in a general discussion about medical topics, we hope to raise awareness and provide visibility to issues of medical interest. Doctors must conduct further research for a more informed opinion and should not rely solely on any advice or information provided on this website.