Santo Domingo.- Carlos Bonilla, the Minister of Housing and Buildings, has unveiled details about the upcoming Mario Tolentino Dipp Hospital, assuring that its infrastructure will rival that of medical centers in the United States and Europe.

During an interview on a special program called “El Gobierno de la Mañana” in Santo Domingo Norte, the Minister elucidated that the hospital will feature over 200 beds and encompass a sprawling area of nearly 20,000 square meters.

Bonilla emphasized, “At the Ministry of Housing, we believe that not only do Dominicans deserve the finest national hospitals, but also internationally. It should be on par with hospitals in the United States or Europe because Dominicans deserve the best.”

The Mario Tolentino Hospital, funded with an investment of nearly 3 billion pesos, is poised to become a modern healthcare hub that caters to a spectrum of medical needs.

The facility will house five state-of-the-art operating rooms, each equipped with a laparoscopy tower. This cutting-edge technology will be present in every operating room, setting the hospital apart.

Complying with both national and international health standards, the hospital aims to raise the bar for healthcare offerings in the country. Minister Bonilla underscored that the Mario Tolentino Hospital encompasses multiple medical disciplines, including internal medicine, gynecology, obstetrics, cardiology, pediatrics, and even specialized rooms for psychology.

The hospital will boast a comprehensive range of amenities and services, such as a pharmacy, an emergency department, advanced imaging equipment, and more. The expansive list of services includes a CT scanner, laboratories, sterilization facilities, dentistry, dermatology, surgical units, an ICU, hemodialysis areas, and pathology departments.

Minister Bonilla assured that the medical personnel working in the hospital will receive thorough training to ensure top-notch care. The hospital will gradually open to the public in various phases, catering to a wide range of medical needs.

With its comprehensive range of services and world-class facilities, the Mario Tolentino Dipp Hospital aims to provide the highest level of medical care to the Dominican population, reflecting international standards of excellence.

When it comes to cancer treatments, most people are familiar with chemotherapy, radiation and surgery. 

Yet there is another emerging, lesser-known therapy that is showing promising results in treating blood cancers.

With CAR T-cell therapy, the patient’s T-cells are taken from the blood, engineered to attack cancer cells and then infused back into the patient’s body through an IV, Dr. Noopur Raje told Fox News Digital.

Raje is the director of Multiple Myeloma at Mass General Cancer Center, which is a member of the Mass General Brigham system. Mass General Brigham has a Gene and Cell Therapy Institute that helps advance gene and cell therapies like CAR-T.

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"I think it's made a big change in people's lives and how we take care of people," she told Fox News Digital in an interview. 

"It's one of the most personalized ways of taking care of some of the blood-related cancers."

At Mass General, Raje and her team treat patients with multiple myeloma, a rare form of blood cancer that attacks the plasma cells. 

Most of their patients are between 60 and 70 years old, she said.

CAR stands for chimeric antigen receptors, which are proteins that enable T-cells to target the tumor antigens produced by cancer cells.

T-cells are a type of white blood cell that helps to fight germs and prevent disease, per the Cleveland Clinic.

There are currently six CAR T-cell therapies that are FDA-approved to treat leukemia, lymphomas, multiple myeloma and other blood cancers.

"We are taking our patients’ T-cells, which are the immune cells, and then activating them and putting a chimeric antigen receptor (CAR), which can recognize a protein on a cancer tumor," Raje said.

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Because Raje treats multiple myeloma, her team started off by doing studies against a protein called BCMA, which is found in cancerous plasma cells.

The re-engineered T-cells continue multiplying in the body, so they can seek out and kill more tumor cells, the doctor said.

"We are seeing extremely high response rates, between 82% and 100%," she told Fox News Digital. "Now we need to do a better job of maintaining that response."

Before CAR T-cell therapy, Raje said, patients were started on a treatment and then stayed on it for an indefinite length of time.

"This is the first time that patients are getting a ‘one-off’ treatment, and then we're just watching them with no more treatment at all," she said.

While the treatment can be a little "involved" at the beginning, Raje said, once it’s complete the patient receives no new therapies for up to three years.

"And I have some patients who are on no treatment for way longer than that, which is a big advancement," she added.

"Obviously, we need to do better — we need to cure people," Raje said. 

"We're not quite there, but the next step is to start the treatment earlier, so we can start seeing more control of the disease over a longer period of time."

As of now, the FDA has approved CAR T-cell therapy as a "last resort" when the disease has persisted through all other available treatments; but Raje hopes that soon, it will be available to patients earlier in the course of their cancers.

CAR T-cell therapy is expensive — costing anywhere from $500,000 to $1,000,000, per WebMD. Raje pointed out, however, that many insurance plans cover at least some of the cost. It is also covered by Medicare.

"I think one has to start looking at the time saved in terms of quality of life in not coming back to the hospital and not being on any other meds," she said.

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There is some risk of side effects for those receiving CAR T-cell therapy, primarily a condition called cytokine release syndrome (CRS). It can occur when the immune system responds too aggressively to infection.

"When the CAR T-cell kills the tumor, it produces a bunch of proteins, and when it does that, it can make you quite sick," Raje said.

"But as we've used more and more of these therapies, we've gotten pretty good at managing this, and we have the antidotes for these kinds of toxicities," she added.

Another potential side effect is a condition called ICANS, or immune effector-mediated neurotoxicity. 

"With this, people can get confused, sometimes to the extent that they can actually go into a deep coma," Raje said. "It's important to recognize and treat these conditions earlier."

Sandy Caterine, a retired accountant who lives in Rye, New Hampshire, was part of a clinical trial for CAR T-cell therapy. 

She was diagnosed with multiple myeloma in August 2019. 

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"It kind of came out of nowhere," Caterine told Fox News Digital. "In retrospect, maybe I had a couple of little symptoms."

Caterine had experienced some back pain, fatigue and nausea, but initially chalked it up to dehydration. 

When the symptoms didn’t go away on their own, she saw her primary care physician and got some blood tests, which led to her diagnosis.

"I had never even heard of multiple myeloma," Caterine said. "All I heard was that it was incurable and no one could predict what the life expectancy might be."

For several months, Caterine was on a regimen of numerous drugs, infusions and radiation, none of which fully resolved her cancer. Then she learned about the clinical trial for CAR T-cell therapy.

"Sandy has what is known as high-risk disease, based on the genetics of the cancer," said Raje. "This usually doesn’t have good outcomes, but Sandy had a great response to the trial."

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Caterine, who is 62, did experience the CRS illness as a side effect, which caused her to endure nausea, fatigue, fever and disorientation. 

She remained in the hospital for 15 days.

"It took me a while to get my strength back," she said. "I do remember them taking very good care of me."

Caterine has gotten periodic bone marrow scans every three months since her infusion.

"So far, there has been no sign of the disease," she said. 

"Dr. Raje told me the hope was that it would work for two to three years, and I am already over two years."

Caterine’s experience has helped her appreciate each day more than she did before, she told Fox News Digital.

"These are two years that I never thought I would get when I was first diagnosed," she said. 

"It's just great that I can continue to live my life and be with my family."

CAR T-cell therapy started out for use in leukemia, later branching out to other blood cancers like lymphoma and multiple myeloma. 

Raje is hopeful that the treatment eventually will become available for other types of cancers, including cancers of the breast, colon and brain.

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"We have an ongoing study where we are looking at CAR T-cell therapy in glioblastoma, a type of brain cancer, which we would have never thought of doing early on," she said. 

"And we have a whole host of new CARs coming down the pike against different antigens."

The doctor emphasized the significance of teaching the body’s own immune cells to fight against cancer cells.

"In my mind, it's probably the most personalized way of being able to take care of your own disease, which is amazing," she said.

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For more than five million women in the U.S., getting maternity care is difficult or impossible.

More than one-third (36%) of U.S. counties are considered "maternity care deserts," which means they do not have any obstetric providers or birth centers.

In just one year, the number of birthing hospitals has decreased by 4%. Since 2018, a total of 301 birthing units have closed.

These are some of the key findings from the March of Dimes’ latest report, "Where You Live Matters: Maternity Care Deserts and the Crisis of Access and Equity," which explores the state of maternity care throughout all 50 states, Washington, D.C., and Puerto Rico.

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A nonprofit organization based in Arlington County, Virginia, the ​​March of Dimes aims to improve the health of mothers and babies. 

This is the sixth iteration of the maternity report, but it’s the first one to break down the numbers by state and county.

"In the report, we’re looking at every aspect of these maternity care deserts, from miles being driven to chronic conditions, as well as socioeconomic and racial backgrounds," explained Dr. Elizabeth Cherot, the newly appointed CEO of March of Dimes in New York City, in an interview with Fox News Digital.

As more units and providers are closing, the number of maternity deserts is on the rise, putting women and babies at risk, warned Cherot, who was an OB/GYN for 30 years.

Dr. Suzy Lipinski, a board-certified OB/GYN at Pediatrix Medical Group in Denver, Colorado, has seen firsthand the impact of what she calls a "maldistribution of care."

Where Lipinski practices in Denver, there are six to seven hospitals that offer obstetric care and high-risk specialty care within 30 minutes between each facility — but some are receiving patients who are transported from the rest of Colorado and surrounding states.

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"In the entire state of Wyoming, there is not a hospital with a dedicated high-risk OB team or neonatal intensive care unit to take care of preterm infants," Lipinski said. 

"The high-risk patients are transferred, often by helicopter or plane, to Denver and Salt Lake City."

She added, "As I meet these patients, they tell me they drove over an hour to get to the hospital they were transferred from — and now they are getting care six to eight hours away from home, without family support and potentially without the ability to keep their job."

In Colorado, many of the mountain towns do not have maternity units, so patients must travel 60 to 100 miles over mountain passes — which may close during snowstorms — to get to the closest hospital, Lipinski said.

Before coming to Denver, she trained and then practiced for 10 years in Iowa, where about 70% of rural obstetrics units have closed since the late 1990s. 

Many of her patients drove 100 miles to get specialty care — or were brought in by ambulance after delivering their babies in their cars while trying to get to the hospital.

A pregnant woman who lives in a maternity desert will have to drive to the next county that has available care. For the lucky ones, that might mean crossing a nearby county line — but for others, it could require hours of driving, which could be dangerous during active labor or a medical emergency.

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"Women will do anything they can to overcome these barriers," Lipinski said. "I cannot begin to name all the ways they struggle to get the care they need."

Some women choose to limit the care they get, perhaps only attending half of the recommended prenatal visits, for example. 

Others might choose to live with a family member who is closer to a maternity care provider, so they know they can get to the hospital in time, Lipinski said. 

"Some will seek out community midwives who aren’t licensed and do not have consistent training," she said. "Or they might go to their closest ER when they think something is wrong, but never have consistent care from a regular provider."

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More dangerous still, some women are bypassing prenatal care. 

"Women who don't get prenatal care are three times more likely to have a worse outcome," Cherot said.

Some women go into labor while trying to reach a hospital.

"It’s not uncommon for me to get a call that the mom just delivered at the gas station, and then I just wait for them at the emergency department," Dr. Kristy Acosta, a family medicine/OB provider at Brownfield Regional Medical Center in Texas, told March of Dimes.

Kali Bautista, who lives in Terry County, Texas, gave birth while living in a maternity desert in Texas. Her hometown is 30 to 45 minutes away from the city of Lubbock.

"One of my biggest fears and concerns was what if I deliver on the way there, and not knowing what to do," she told March of Dimes. 

"Living in rural areas, there’s a lack of resources in general. There’s a lot of poverty here."

The states with the highest rates of maternity care deserts include North Dakota, South Dakota, Alaska, Oklahoma and Nebraska, which are all states with more rural populations, according to the March of Dimes report.

In North Dakota, 71.3% of rural residents live at least 30 minutes from a maternity care hospital, with an average distance away of 54.7 miles, Cherot said.

In terms of quality of care, New Mexico has the highest rate of inadequate prenatal care — closely followed by Hawaii.

There is a racial and socioeconomic component as well, Cherot said, with Black and Native American women experiencing the worst outcomes and the highest rate of inadequate prenatal care.

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Many factors contribute to the closure of a hospital or maternity unit, with staffing-related struggles topping the list.

Obstetricians have been shown to have one of the highest burnout rates in health care, according to the March of Dimes press release — which makes it harder to attract and keep staff.

"We need more trained obstetricians," Lipinski said. "There is a shortage in the U.S., and as many [doctors] are in their 50s and 60s, there will be a large wave of retirements in the coming years, and there are not enough new OBs coming out of training to replace them."

Midwives can provide support, she noted — but they don’t perform any of the surgical procedures, such as Cesarean sections, operative vaginal deliveries, cervical cerclage (stitches to prevent a preterm birth), turning a breech baby or any of the procedural elements of obstetrics care.

Low birth volumes, rising costs and lack of financial reimbursement also contribute to the problem, per the March of Dimes report.

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More than half of the births in maternity care deserts are reimbursed by Medicaid, according to the American Hospital Association. 

This means the hospitals have lower reimbursement rates, which can cause them to actually lose money by providing obstetrics care.

"It all goes back to economics," Cherot said. "We're not prioritizing moms and babies, even though they’re the entry point for all of health care."

She added, "We are not prioritizing families and that first year of life and all the support that moms need. 

The complicated issue of maternity deserts requires a "multi-layered approach," Cherot said. "If there was one clear solution, we would have done it already."

The March of Dimes has several programs in place that aim to improve the availability and quality of maternity care.

These include working to expand postpartum care in the Medicaid space, bringing mobile care units into high-risk areas to provide prenatal visits and offering a range of support mechanisms for families, Cherot said.

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Additionally, the March of Dimes is helping to find, train and provide doulas — trained childbirth professionals who help patients during and after delivery.

The organization is also funding Prematurity Research Centers (PRCs) to assist with the care of premature babies. 

Through its Innovation Fund, the March of Dimes also invests in early-stage companies that aim to overcome maternal and infant health challenges.

"We need more support for rural hospitals in maternity care deserts to reopen units to provide care," Lipinski said. 

"This requires systems that are designed to provide these hospitals with support. To provide care, they may need to partner with specialty doctors who will either come do satellite clinics or arrange transport to the higher levels of care."

Added Cherot, "Every baby deserves the healthiest start to life, and every family should expect equitable, available, quality maternal care."

She added, "These new reports show that the system is failing families today, but it paints a clear picture of the unique challenges facing mothers and babies at the local level — the first step in our work to put solutions in place and build a better future for all families."

Santo Domingo.- The First International Congress “Let’s educate about autism” concluded successfully after two days of debates, presentations, and interviews. The event was organized by the Refidomsa Foundation and the Manos Unidas por Autismo Foundation, bringing together health professionals, psychologists, students, and relatives of individuals with autism.

The congress took place at the National Library, starting on Wednesday the 26th, and featured panels led by the Argentine psychologist Ramiro Mitre and educator Sarah Dájer, who resides in the United States.

During the inauguration, Franklin Soriano, coordinator of the Social Plan of the Dominican Oil Refinery (Refidomsa), expressed gratitude to the attendees for their interest in this significant societal issue. He emphasized that as a company, they are committed to contributing to the benefit of society, and their president, Dr. Leonardo Aguilera, supported this first meeting as the beginning of many others.

The attendees had the opportunity to hear the inspiring testimonies of Margel Engel and Iván Oviedo, a couple whose three children are autistic, on the first day of the congress.

On the second day, participants engaged in discussions with Ramiro Mitre and Sarah Dájer, and also had the chance to interact with doctors Luis Ortega, a psychiatrist, and Dayanna González, a neurologist.

In the closing remarks, Odile Villavizar, president of the Manos Unidas por Autismo Foundation, highlighted the importance of such events in promoting a more inclusive state for the Dominican Republic.

The congress concluded with the exhibitors receiving certificates from executives representing both organizing institutions. The successful completion of the congress signifies a step forward in raising awareness and education about autism in the country.

Guyana has agreed to go ahead with the next step of China’s physical infrastructure-centered Belt and Road Initiative, according to a joint statement issued by the two countries to mark the end of President Irfaan Ali’s one-week official visit to that Asian giant. “The Guyana side expressed willingness to discuss and conclude the Joint Action ...

“The problem is the hepatitis B treatment, which we demand also be assumed by the program,” asked Luisa Paradas, president of Funpaheinm, who also requested that the ARSs include the treatments in their coverage, as she had told journalist Olga Vergés, of Hoy newspaper.

Paradas explained to the reporter that, although the treatments for hepatitis B and C virus are low in comparison with other diseases, not all patients have the resources to afford them.

He reiterated that health authorities should disseminate more information about the need for hepatitis testing to identify infected people through hepatitis screening days.

More lethal than malaria
The World Health Organization (WHO) recommends preventing new infections and deaths from hepatitis B and C, facilitating access to treatment for all pregnant women living with hepatitis B, or providing vaccines against this disease for newborns.

It also sets desirable objectives to diagnose 90% of people living with hepatitis B and C and ensure treatment for 80% of those diagnosed.
In the case of hepatitis B, mother-to-child transmission during pregnancy is the most common. It occurs primarily in the Western Pacific, Africa, and Southeast Asia, where screening pregnant women with hepatitis B testing is crucial in curbing transmission.

However, a new WHO report shows that only 78% of the countries surveyed (64 out of 82) reported having a national policy on hepatitis B testing during pregnancy.

Of these, only half (32 out of 64) reported finally implementing these measures in antenatal clinics.