Vaccine science and technology is advancing. Next generation vaccines could change how we combat infectious diseases, and it’s important to understand how the technology works.
Vaccines are rigorously studied and tested — but there are challenges along the way.
Vaccines are about to change the world…again. mRNA Vaccines are currently being used to battle COVID-19, and have the potential to eradicate diseases like HIV, herpes, sickle cell anemia, and even cancer. Learn how the vaccines work and where the technology could be headed in this explainer video.
Currently, the Pfizer-BioNTech and Moderna vaccines for COVID-19 use the mRNA technology developed at Penn by infectious disease expert Drew Weissman, MD, PhD, along with longtime research collaborator Katalin Karikó, PhD, an adjunct associate professor. Dr. Weissman has been studying mRNA vaccines for decades. This technology could change the way future vaccines are made to prevent countless other diseases.
Observation is a non-surgical approach in which we allow the stone to pass on its own. The smaller the stone, the better the chance that it will pass. The benefit of observation is that you avoid having surgery.
As new coronavirus variants sweep across the world, scientists are racing to understand how dangerous they could be. WSJ explains. Illustration: Alex Kuzoian/WSJ
Walmart, America’s largest grocer, launched a primary care clinic called Walmart Health, in September 2019. Analysts say the big box retailer faces several hurdles in its quest to scale up nationally with a roster of highly paid doctors and dentists. But with more than 35 million people uninsured as of 2019, and millions more with high deductible health plans, could Walmart Health’s low price point be the future of healthcare in America?
As states and hospitals in the U.S. race to roll out the first Covid-19 vaccines, WSJ’s Daniela Hernandez hears from a hospital administrator and immunization expert about the logistical challenges involved in this first phase of the vaccination process.
Photo: Victoria Jones/Zuma Press
Travertine stone used extensively in Mayo Clinic buildings has provided a research team from Mayo Clinic and the University of Illinois with an unexpected – and beautiful – clue about kidney stones.
It has taken time — some say far too long — but medicine stands on the brink of an AI revolution. In a recent article in the New England Journal of Medicine, Isaac Kohane, head of Harvard Medical School’s Department of Biomedical Informatics, and his co-authors say that AI will indeed make it possible to bring all medical knowledge to bear in service of any case.
Properly designed AI also has the potential to make our health care system more efficient and less expensive, ease the paperwork burden that has more and more doctors considering new careers, fill the gaping holes in access to quality care in the world’s poorest places, and, among many other things, serve as an unblinking watchdog on the lookout for the medical errors that kill an estimated 200,000 people and cost $1.9 billion annually.
“I’m convinced that the implementation of AI in medicine will be one of the things that change the way care is delivered going forward,” said David Bates, chief of internal medicine at Harvard-affiliated Brigham and Women’s Hospital, professor of medicine at Harvard Medical School and of health policy and management at the Harvard T.H. Chan School of Public Health. “It’s clear that clinicians don’t make as good decisions as they could. If they had support to make better decisions, they could do a better job.”
Comprehensive care in patients with diabetes and CKD
Management of CKD in diabetes can be challenging and complex, and a multidisciplinary team should be involved (doctors, nurses, dietitians, educators, etc). Patient participation is important for self-management and to participate in shared decision-making regarding the management plan. (Practice point).
We recommend that treatment with an angiotensin-converting enzyme inhibitor (ACEi) or an angiotensin II receptor blocker (ARB) be initiated in patients with diabetes, hypertension, and albuminuria, and that these medications be titrated to the highest approved dose that is tolerated (1B).
Lifestyle interventions in patients with diabetes and CKD
We suggest maintaining a protein intake of 0.8 g protein/kg)/d for those with diabetes and CKD not treated with dialysis (2C).
On the amount of proteins recommended in these guidelines, they suggest (‘recommend’ becomes a ‘suggest’ at this level of evidence) a very precise intake of 0.8g/kg/d in patients with diabetes and CKD. Lower dietary protein intake has been hypothesized but never proven to reduce glomerular hyperfiltration and slow progression of CKD, however in patients with diabetes, limiting protein intake below 0.8g/kg/d can be translated into a decreased caloric content, significant weight loss and quality of life. Malnutrition from protein and calorie deficit is possible.
We recommend that patients with diabetes and CKD be advised to undertake moderate-intensity physical activity for a cumulative duration of at least 150 minutes per week, or to a level compatible with their cardiovascular and physical tolerance (1D).