Longer looks: Exercise to treat depression; crowdsourcing treatment decisions; nitroglycerin shortage

Mar 28 2014

Every week, KHN reporter Marissa Evans selects interesting reading from around the Web.

The Atlantic: Prescribing Exercise Before Pills 
Depression is the most common mental illness-;affecting a staggering 25 percent of Americans-;but a growing body of research suggests that one of its best cures is cheap and ubiquitous. In 1999, a randomized controlled trial showed that depressed adults who took part in aerobic exercise improved as much as those treated with Zoloft. A 2006 meta-analysis of 11 studies bolstered those findings and recommended that physicians counsel their depressed patients to try it. ... Exercise, like any other treatment, won't work for every depressed patient. But the psychiatrists who incorporate it into their practices are finding that the only way it can work is if it's treated like real medicine  (Olga Khazan, 3/24). 

The Washington Post: Crowdsourcing Medical Decisions: Ethicists Worry Josh Hardy Case May Set Bad Precedent
The story of how Joshua Hardy -; a first-grader from Fredericksburg, Va., who is fighting off an infection after getting a bone-marrow transplant -; got access to an unapproved treatment when others with similar requests were turned down highlights the ethical conundrums facing doctors, companies and regulators in the era of Facebook and Twitter. ... Critics of the strategy say they sympathize with Josh's parents and admire them for being willing to do anything to save their child, but they decry the crowdsourcing of medical decisions and warn that the case may set a dangerous precedent  (Ariana Eunjung Cha, 3/23).

Mobile Ala. Press Register/Al. News: Johnsoncare? Debate Not As Contentious, But Original Medicaid Was Not All Smooth Sailing
A year after a new law took effect offering federal funds to pay for health insurance for the poor, only about half of the states have taken the bargain. Affordable Care Act, 2014? Try Medicaid, 1966. In some ways, the intense debate over whether states should accept federal funds to expand coverage under Medicaid parallels the origins of program. Then, as now, the program was voluntary (Brendan Kirby, 3/27).

The New York Times: Nitroglycerin, A Staple Of Emergency Rooms, Is In Short Supply 
The drug nitroglycerin has long been an emergency room staple, a front-line drug that is often the first thing doctors try when a patient shows up with a heart attack. So when Baxter International, the country's only manufacturer of injectable nitroglycerin, recently told hospitals that it was sharply cutting shipments of the drug, the news sent pharmacists and emergency room doctors into a panic. Hospitals have been struggling for years with intermittent shortages of the drug, but with the latest news, doctors worried they could actually run out (Katie Thomas and Sabrina Tavernise, 3/25). 

Wired: The Next Big Thing You Missed: The World's Best Weight-Loss Technology Is Shame
Jeff Hyman has a message for anyone trying to lose weight with mobile apps and tracking gizmos: Without a human in the loop, you're probably going to fail. New mobile technology that tracks your daily behavior certainly can help you lose weight and keep it off, he says, but you also need face-to-face support from real live experts who can provide tips, moral support, and accountability. Hyman calls it "hugging and kicking," and that's what you get from the fitness and weigh-loss service offered by his startup, Retrofit (Ryan Tate, 3/25). 

The Christian Science Monitor: Why Heroin Is Spreading In America's Suburbs
Ana's anguished journey from conscientious student to heroin user is one confronting many young people in suburbs across the country. From Los Angeles to Long Island, Chicago to New Orleans, parents and police are struggling with a rise in heroin use in suburban neighborhoods more often concerned with SAT scores and the length of lines at Starbucks. The rise is being driven by a large supply of cheap heroin in purer concentrations that can be inhaled or smoked, which often removes the stigma associated with injecting it with a needle. ...ronger heroin is only one reason behind the nation's growing addiction problem. The other – and more prevalent cause, say police and medical experts – is the nation's pill culture (Kristina Lindborg, 3/23). 

The New York Times: Selling A Poison By The Barrel: Liquid Nicotine For E-Cigarettes 
A dangerous new form of a powerful stimulant is hitting markets nationwide, for sale by the vial, the gallon and even the barrel. The drug is nicotine, in its potent, liquid form -; extracted from tobacco and tinctured with a cocktail of flavorings, colorings and assorted chemicals to feed the fast-growing electronic cigarette industry. These "e-liquids," the key ingredients in e-cigarettes, are powerful neurotoxins. Tiny amounts, whether ingested or absorbed through the skin, can cause vomiting and seizures and even be lethal. A teaspoon of even highly diluted e-liquid can kill a small child. But, like e-cigarettes, e-liquids are not regulated by federal authorities (Matt Richtel, 3/23).

Mosaic Science: How Malaria Defeats Our Drugs
When Nosten first arrived in South-east Asia almost 30 years ago, malaria was the biggest killer in the region. Artemisinin changed everything. Spectacularly fast and effective, the drug arrived on the scene in 1994, when options for treating malaria were running out. … Artemisinin used to clear P. falciparum in a day; now, it can take several. The parasite has started to become resistant. The wonder drug is failing. It is the latest reprise of a decades-long theme: we attack malaria with a new drug, it mounts an evolutionary riposte (Ed Yong, 3/25).