Category Archives: Gene Medicine

The clinic helps children at risk of developing heart disease in the future due to high cholesterol.

They can now attend a ground-breaking clinic run by the familial hypercholesterolemia (FH) service at York Teaching Hospital NHS Foundation Trust.

FH is an inherited condition which can lead to extremely high cholesterol levels and is passed down through families in the genes.

The FH service, led by Dr Chandrajay, Consultant in Chemical Pathology and Metabolic Medicine, and Claire Tuson, Familial Hypercholesterolaemia Specialist Nurse, has recently extended their service to include children and adolescents.

Claire explained: Research has shown that children with FH start to develop a build-up of fatty plaque in their arteries before the age of 10. Once diagnosed, FH is easy to treat so it makes sense to work with families as soon as possible.

Last year, with the support of Consultant Paediatrician Dr Dominic Smith, we extended gene testing to all children aged 10 years old and over, who have a parent affected with FH. Testing children for FH could prevent a potentially fatal heart attack or stroke.

The first six children from York and Scarborough that were identified with FH have recently attended our new Yorkshire and Humber joint paediatric clinic for children and their families, which launched at the end of January.

FH is estimated to affect 1 in 250 people in the UK, including over 56,000 children.

It is an inherited disorder of cholesterol and lipid metabolism, caused by an alteration in a single gene where people have higher levels of bad cholesterol levels from birth. If left undetected and untreated FH can lead to the early development of heart and circulatory problems.

Kiera Pickering, aged 12, and her brother Connor, aged 11, from Scarborough, were two of the first children to attend the clinic.

Claire added: Its a real breakthrough to be able to identify and treat children with FH so early. Alongside dietary and lifestyle advice to maintain a healthy body weight, children can be considered for statin therapy from as young as 10 years old.

"Statin treatment can not only prevent, but potentially reverse, the build-up of cholesterol and allow children and young people to live a perfectly healthy life.

Despite the availability of genetic testing, more than 85 percent of people with FH in the UK are undiagnosed.

The British Heart Foundation estimates that currently only around 600 children in the UK have been diagnosed with FH, meaning that thousands more are not on treatment and remain unaware of their future risk of heart disease.

For more information about the FH clinics contact claire.tuson@york.nhs.uk

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Scarborough brother and sister, aged 11 and 12, with the genetic cholesterol condition FH are helped by new clinic - Whitby Gazette

Maverick Coltrin seemed like any other newborn when he first came home from the hospital, wearing his beanie cap with bear ears and blue-and-gray onesie and following the typical around-the-clock cycle of sleeping and breastfeeding. But within a couple of days, his parents noticed something was off. At 6 days old, Maverick completely stopped feeding. His arms and legs would stiffen and then release, the spasms punctuated by his cries.

His parents rushed him to Rady Childrens Hospital in San Diego, where EEG monitors recorded that he was having as many as 30 seizures an hour. Doctors scrambled to find the cause. Anti-seizure medicines didnt work, so he was sedated to stop the damage to his brain. His organs started to fail, and his skin turned a dusky blue. His mother, Kara Coltrin, walked into his empty nursery at home and cried.

So when doctors from Radys Institute for Genomic Medicine asked for permission to sequence Mavericks genome as part of a clinical trial of ultra-rapid sequencing for newborns who are critically ill from an unknown cause, Mavericks parents didnt hesitate. The doctors cautioned that they couldnt guarantee that they would pinpoint a genetic disorder or, if they did, that it could be treated. They gave the standard caveat about genetic testingthat identifying a genetic disorder could affect Mavericks eligibility for life insurance someday. But even if the sequencing didnt help him, his participation would contribute to a study that could benefit other babies. Obviously, the pros outweighed the cons manyfold, his mother says. We just wanted his pain to stop.

Within 36 hours, the Coltrins had an answer: Maverick has pyridoxine-dependent epilepsy, caused by a rare mutation of the ALDH7A1 gene, which codes for the enzyme antiquitin. By giving him high doses of vitamin B6 and controlling a couple of amino acids in his diet, doctors stopped the seizures. Maverick, now 2 years old, runs around like a normal, rambunctious toddler. He has hit all his developmental milestones, although they have been somewhat delayed. He hasnt had a seizure since his treatment began. Every once in a while, I think back on him being dusky blue and super skinny and hooked up to all these tubes, says Kara Coltrin. I look at him and its hard to believe that happened to him. People who see him on a normal basis would never know he was ever sick.

The technology that saved Mavericks life stretched the limits of bioinformatics, returning results far sooner than is typical for genetic testing. Rapid sequencing typically takes about seven days for a preliminary diagnosis, while Rady completes ultra-rapid sequencing in three days or less. (In 2018, Rady set a Guinness World Record by sequencing a babys genome in 20 hours and 10 minutes.)

But now ultra-rapid sequencing is moving from an investigational tool to a standard of care. Blue Shield of California is the first insurer to cover rapid and ultra-rapid sequencing of babies and children who have life-threatening and unexplained medical conditions. Since the new policy began in July 2019, 28 babies or children in California have received the testing through Blue Shield, which is just beginning to promote the new coverage.

Blue Shield expects that 250 to 500 newborns will be eligible for the whole genome sequencing each year, which represents about 10 percent of their insured babies treated in neonatal intensive care units in California. Company executive vice president Terry Gilliland said he will encourage other Blue Cross and Blue Shield plans around the country to adopt a similar policy. When you think about all the pain and suffering families go through with sick babies, this is going to be an enormous benefit, he says.

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Ultra-Fast Genome Sequencing Could Save the Lives of Newborns - WIRED

Deals and Financings

Nanjing Legend Biotech, a subsidiary of GenScript (HK: 1548) (OTC:GNNSF), has filed for an IPO on a US exchange. In 2017, Legend surprised the world when its CAR-T therapy produced a 94% response rate in pretreated multiple myeloma patients. Six months later, Johnson & Johnson (NYSE:JNJ) partnered the treatment in a deal that paid Legend $350 million upfront, plus unspecified milestones and royalties. The CAR-T candidate, JNJ-4528, is now in Phase II trials in the US.

Harbour BioMed (HBM) raised $75 million in a Series B+ round to advance its clinical-stage compounds and portfolio of next-gen biotherapies for cancer and immunological diseases. The company builds its portfolio by in-licensings and via its proprietary Harbour Mice program. Harbour develops drugs for China and US markets, while it has entered partnerships to discover candidates for China companies Innovent (OTCPK:IVBIY) and BeiGene (NASDAQ:BGNE), along with other prominent global biopharmas. The company previously completed an $85 million Series B financing in August 2018. HBM is headquartered in Cambridge, MA, and it conducts R&D in Suzhou and Shanghai.

GenFleet Therapeutics (Shanghai) closed a $57 million Series B financing, co-led by CDH Investments and Shenzhen Capital Group. Founded in 2017, GenFleet is developing novel large and small therapeutic molecules for oncology and immunology targets. The company says its projects are potential first-in-class therapeutics with technical advantages and large markets. It will use the capital for ex-China development and clinical trials of its existing pipelines, plus expanding its immunology platform, working on new projects and building an industrial base.

Arctic Vision of Shanghai in-licensed greater China rights to Xipere, a treatment for macular edema associated with uveitis, from Clearside Bio (NASDAQ:CLSD) in a $35.5 million agreement. Founded last year, Arctic in-licenses breakthrough ophthalmology products for China. Xipere is its first deal. Arctic plans to acquire China rights to 3-5 products and then expand to a combination of global rights and internal discovery for additional drugs. Clearside, which is located in Alpharetta, Georgia, said Xipere is a proprietary suspension of the corticosteroid triamcinolone acetonide.

Exuma Biotech (formerly F1 Oncology), a Florida-Shanghai company developing CAR-T products for solid tumors, closed a $19 million Series B round. The financing included investments from MSD Partners and F1 BioVentures, plus conversion of notes held by individual investors. Exuma's Logic Gated CAR-T products become activated only when the target antigen and the tumor microenvironment are both present, reducing off-tumor side effects. The company has started clinical trials of two candidates. Exuma's Shanghai subsidiary oversees the company's development, manufacturing, and commercial units in Shanghai and Shenzhen.

OBiO Technology (Shanghai) completed a B+ Round of more than $15 million for its viral-based gene therapy CRO services and genetic drug CDMO/CMO services. Founded in 2013, OBiO collaborated with GE Healthcare (NYSE:GE) to establish the first domestic GMP viral production workshop in China and supply CRO/CDMO/CMO services for viral drugs. At the same time, OBiO is incubating gene therapy drugs for cancer therapy with three ADC candidates for oncotherapy that have proprietary IP. The B+ Round investors included GP Capital, Sinowisdom and Efung Capital.

Shanghai OPM Biosciences raised $14 million from China Life Medical Fund to support its CDMO service platform. The company offers serum-free media for cell cultures based on animal cells, as well as a full-range of cell culture development services. It customizes high-quality personalized animal cell culture media to optimize the cell culture process and reduce production costs. OPM has developed a variety of chemically defined CHO/HEK293 cell culture media and nutritional products. The company claims its media improve cell growth and expression.

China Immunotech Biotech of Beijing completed a $6.5 million Series A financing, led by Jianxin Capital with Grower Venture Capital and Huacheng Group participating. Founded in March 2018, China Immunotech is developing TCR-T and CAR-T products that target hematological tumors, solid tumors and virus-related diseases. It has two unique technology platforms, STAR-T and TCR-T. The STAR-T platform uses a proprietary structure of antigen receptor complexes. The company believes the platform provides multi-targeted molecules with better efficacy, fewer side effects and easier development than traditional CAR-T products.

Chengdu's HitGen has signed a licensing agreement to develop a novel class of drugs for Kaken, a Japanese (TK: 4521) specialty pharma. HitGen has already used its large library of small molecule and macrocyclic compounds to identify potential candidates. Few details were released, but Kaken is known to be concentrating its R&D on inflammation/immunology (dermatitis, rheumatoid arthritis and osteoarthritis), pain relief and fungal infections. One year ago, the two companies formed a similar collaboration, presumably for other targets. HitGen will receive an upfront payment and be eligible to receive preclinical and clinical milestones.

Suzhou Ascentage Pharma (HK: 6855) announced approvals for three clinical studies of APG-2575, a novel Bcl-2 inhibitor, two in the US and one in China. APG-2575 is an oral drug designed to treat several hematologic malignancies by blocking Bcl-2 to restore the normal apoptosis process in cancer cells. According to Ascentage, the candidate is the first China-made Bcl-2 inhibitor to start clinical trials. In its Phase I clinical studies, APG-2575 did not exhibit any dose-limiting toxicity or tumor lysis syndrome (which is commonly associated with other Bcl-2 inhibitors).

Denovo Biopharma, a San Diego-Beijing precision medicine company, has discovered a novel genetic biomarker for depression that it intends to use with DB104, a triple dopamine, serotonin and norepinephrine reuptake inhibitor. The company made the discovery using its proprietary biomarker discovery platform. Denovo licensed DB104 from Albany Molecular Research. Bristol-Myers Squibb (NYSE:BMY) returned the candidate to Albany after two Phase IIb clinical trials in treatment-resistant depression. The biomarker is one of four DeNovo biomarkers aimed at psychiatric use.

I-Mab (NASDAQ:IMAB), a Shanghai clinical-stage biopharma, has started to develop TJM2 (TJ003234) to treat cytokine release syndrome in severe cases of COVID-19. TJM2 is an I-Mab-discovered neutralizing antibody that binds human granulocyte-macrophage colony stimulating factor (GM-CSF), an important cytokine that plays a critical role in acute and chronic inflammation. By binding GM-CSF, TJM2 prevents downstream signaling and target cell activation, inhibiting other inflammatory responses. I-Mab intends to start clinical trials in the US and expand to countries especially hard-hit by COVID-19.

Mesoblast (NSDQ: MESO; ASX: MSB), an Australia-based regenerative medicine company, announced plans to start trials of remestemcel-L, its allogeneic mesenchymal stem cell (MSC) product candidate, in patients with acute respiratory distress syndrome (ARDS) caused by COVID-19. The trial will be conducted in the US, Australia, China and Europe. ARDS is the principal cause of death in COVID-19 patients. In a small China trial, allogeneic MSCs cured or significantly improved all seven patients with severe COVID-19 pneumonia.

Ascletis (HK: 1672), a Hangzhou biopharma, reported that an initial group of 11 COVID-19 patients all recovered after being treated with a combination Ganovo and Ritonavir therapy. Ascletis's Ganovo, the first approved direct-acting anti-viral agent developed by a China company, was launched in 2018 to treat hepatitis C. Ritonavir is a generic anti-retroviral that is used in AIDS/HIV combination therapies. The small clinical trial was led by Dr. Hongyi Chen, the director of the Ninth Hospital of Nanchang.

Disclosure: None

Original Post

Editor's Note: The summary bullets for this article were chosen by Seeking Alpha editors.

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Week In Review: Nanjing Legend Files To Stage IPO In The U.S. - Seeking Alpha

A rare disease is defined as any disease that affects a small percentage of the population. In the United States, a disease is classified as rare when fewer than 200,000 individuals are affected by it. According to the National Institutes of Health, there are approximately 6,500 to 7,000 known rare diseases affecting an estimated 25 million Americans.

One of these is Loeys-Dietz Syndrome (LDS), a disorder of connective tissue that can affect blood vessels, including the aorta, as well as bones, joints, cognitive ability and internal organs.

Here, Michigan Medicine cardiologist Marion Hofmann, M.D., who typically treats 10 to 15 Loeys-Dietz patients each year, sheds some light on this complex rare disease.

LDS is caused by a mutation in the TGFBR1, TGFBR2, SMAD3, TGFB2 or TGFB3 genes, as we know today. More could be identified in the future.

Loeys-Dietz Syndrome is a genetic condition, but not always inherited. In patients with the condition, we usually recommend genetic testing of the parents and siblings to see if it is inherited or if it is a new mutation. If the parent or siblings of a patient diagnosed with LDS do not test positive for the genetic variant, we assume the variant is present for the first time in one family member. This occurs in approximately 75% of LDS cases. There is a 50% chance the gene will be passed on regardless of whether LDS was inherited or a first time mutation.

Because relatively common symptoms can camouflage LDS, the condition may go undiagnosed until a serious complication occurs. Patients might be diagnosed with Loeys-Dietz after an aortic aneurysm (a weakened or bulging area on the wall of the aorta) is found on a CT scan or echocardiogram, or after experiencing a life-threatening aortic dissection (a tear in the inner layer of the aorta) or a dissection in other arteries. If a patient experiences either of these vascular conditions, we would likely suggest genetic testing to determine if Loeys-Dietz Syndrome was the cause.

In approximately 20% of patients experiencing an unexplained aortic dissection, we find gene abnormalities, including LDS, that predispose to aortic disease.

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Some patients, but not all, are diagnosed because of certain skeletal characteristics that point to Loeys-Dietz. These include a chest wall deformity in which the chest wall pushes outward or appears sunken, scoliosis, long and slender fingers, flexible joints, flat feet, translucent skin, abnormal scarring of the skin and a bulging or widening of the spinal sac surrounding the spinal cord. However, the spectrum of the disease is very broad and were finding that not all LDS patients exhibit these characteristics.

Genetic testing confirms a suspected LDS diagnosis. Other similar disorders such as Marfan Syndrome and Ehlers-Danlos Syndrome can present similar characteristics, so genetic testing is important to differentiate these disorders. In recent years weve realized just how complex LDS is. As clinical genetic testing is more commonly used, diagnostic accuracy for LDS has improved and were learning more about how LDS presents. For example, were finding that family members carrying the same mutation are affected differently. Cardiac and genetic evaluation of all family members is important for patients with LDS to identify other relatives at risk for the condition.

Patients with Loeys-Dietz need regular checkups and vascular imaging to identify high-risk situations that could lead to aortic dissection. We recommend medication to avoid high blood pressure, which puts stress on weakened areas of the aortic wall, lifestyle modifications and preventive surgery to treat aortic aneurysms deemed to be at high risk for dissection. Patients with LDS are typically prescribed beta blockers or angiotensin receptor blockers.

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Anyone experiencing an aortic dissection or an aneurysm requires lifelong care as they are more likely to have a future event. Patients with LDS require special counseling for family planning and during pregnancy.

Additional information comes from nationwide patient support groups and their symposiums. The U-M Frankel Cardiovascular Center, in collaboration with the Marfan Foundation, is hosting the Detroit regional symposium for Marfan Syndrome and related disorders on April 25, 2020.

Weve been able to gain important knowledge about LDS and other aortic-related conditions through worldwide collaboration of researchers interested in LDS and aortic dissection in general. The International Registry on Aortic Dissection was launched in 1996 and the Montalcino Aortic Consortium was formed in 2013 to collect and share information about the genetic causes of aortic dissection. The next GenTAC Aortic Summit, which is committed to advancing research, education and treatment of heritable aortic diseases, will be held October 10 and 11, 2020, in Ann Arbor, Michigan, and will be hosted by Michigan Medicine cardiologist Kim Eagle, M.D. Through these resources, were learning more about the condition and gaining insight into diagnosis and treatment advancements.

Importantly, 10-20% of patients with a history of what was thought to be sporadic or unexplained aortic dissections actually have an identifiable genetic cause, including LDS. Being able to pinpoint the genetic causes of disease is very powerful. It allows health care providers to use a gene-based medical management strategy, which is the goal of personalized medicine. Genetic counseling and potentially genetic testing is very important for family members of patients with unexplained aortic dissections as well as with Loeys-Dietz Syndrome.

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Loeys-Dietz Syndrome A Rare and Complex Heart Disease - University of Michigan Health System News

Cells can both survive and multiply under more stress than previously thought, shows research from the Faculty of Health and Medical Sciences.

This was found by inhibiting the essential gene DNA polymerase alpha, or POLA1, which initiates DNA replication during cell division.

The discovery gives researchers new insights into DNA replication and may potentially be used for a new type of cancer treatment. Research Leader and Associate Professor Luis Toledo of the Center for Chromosome Stability at the Department of Cellular and Molecular Medicine states as follows:

'If we are visionaries, I would say that we might be at the birth of a whole new set of molecules that could be used in fighting cancer', adding:

'Basically, if we turn the finding on its head, this novel strategy aims at exploiting an in-built weakness in cancer cells and make them crash while they divide.'

Loose zippers

When a cell divides, the double DNA strand is opened lengthwise like a zipper that is unzipped. The new double strands are built at each of the separated strands, so that you gradually end up with two new "zippers".

Before the new halfs of the zipper are made, a bit of DNA is temporally exposed in single stranded form. This process is required for the new zippers to form. Nevertheless, large amounts of single-stranded DNA have traditionally been considered by researchers to be a sign of pathological stress during cell proliferation.

However, the researchers behind the new study discovered that DNA unzippers act more loosely than expected. This can generate large amounts of single-stranded DNA, which the researchers now show is no more than a form of natural stress that cells can actually tolerate in high quantities.

Still, for this tolerance to exist, cells require a sufficient amount of the protective protein RPA to cover the single-stranded DNA parts.

'We have seen that cells can duplicate their genome, even with large amounts of single stranded DNA. They can divide and go on living healthily because they have a large excess of RPA molecules that acts as a protective umbrella.' says the study's first author and former postdoc at the University of Copenhagen Amaia Ercilla, adding:

'But there is a flip side of the coin. When we make the cells generate single strand DNA faster than what they can protect, chromosomes literally shatter in hundreds of pieces, a phenomenon we call replication catastrophe. We always thought that we could use this for instance to kill cancer cells,' she adds.

Weapon against cancer

Both Amaia Ercilla and Luis Toledo explain that under normal circumstances it is extremely difficult to deplete a cell's reserve of RPA.

The same was true in the new study, when researchers used different types of chemotherapy to increase the amount of single-stranded DNA. Even when using the best compounds available so far it took around one hour to deplete the RPA reserve in a cell, provoking a replication catastrophe and the associated cell death.

However, the researchers behind the new study believe to have found what Luis Toledo calls 'the ultimate single-stranded DNA generator': When the researchers used a so-called POLA1 inhibitor, the cells met their final destiny after just five minutes.

'Although no new DNA can be made when we inhibit POLA1, the DNA unzippers keep advancing and generate single-stranded DNA at very high speed,' says the Associate Professor, adding:

'All cells can be sensitive to POLA1 inhibitors, including cancer cells, and we might speculate that the strategy could be especially useful against very aggressive forms of cancer that proliferate at a high pace'.

The next step of the research group is to find more molecules that biologically inhibits the POLA1 gene and which, in combination with other substances, may be used in the treatment of cancer patients.

Reference: Ercilla, et al. (2020) Physiological Tolerance to ssDNA Enables Strand Uncoupling during DNA Replication. Cell Reports. DOI:https://doi.org/10.1016/j.celrep.2020.01.067

This article has been republished from the following materials. Note: material may have been edited for length and content. For further information, please contact the cited source.

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DNA Discovery Could Lead to New Drugs for Aggressive Forms of Cancer - Technology Networks

By GENE ESPYStaff WriterI cant tell you what a blessing it is, Mrs. Carolyn Parker Wooten said about her medical mission trips.Every place I have been I have left a piece of my heart and I can barely speak about it without choking up and tears coming to my eyes because I see these people living in squalor and they have basically nothing except a cellphone and a television. I went to be a blessing to these people, but I was the one who received the blessing.Carolyn Wooten was born and raised in Trion and graduated at Trion High School a River Rat as she explained.I walked across the street to school every day, Mrs. Wooten said.When she graduated at THS, she went into nursing school and is a Registered Nurse with a Bachelors Degree in Nursing.When she first began her career, medical missions had not come into play yet.Years later, after she had raised her family, a missionary came to the church she and her husband were attending for a mission conference. He was planning a trip to Peru and he said he really needed medical people to with him.It was like God reached out and touched my shoulder and said, He was talking to you.On our way home, I looked over to my husband and I said I have something to tell you, and he said, You want to go to Peru dont you? Mrs. Wooten continued.It was like he already knew, she added.I said, yes, I do, Wooten answered.She didnt know anything about Peru except it was something she felt like she needed to do.Mrs. Wooten met with the missionary and he explained what they did they go into the country as tourists, under the guidance and under the umbrella of a local church with a local pastor.What the Medical Missions does is follow the outline of Matthew 25:31-36.The purpose is to go reach people for their physical needs in order to meet their spiritual needs, Mrs. Wooten explained. I cant tell you what a blessing it is. I went to be a blessing to these people, but I was the one who received the blessing.As a registered nurse, she is recognized in other countries as being a medical provider under the guidance of the team that she is with. They have one doctor and have nurses that are providers.We dont just need medical people, we need people who are willing to give of their time to help set up the clinics, to help rebuild a wall that falls down because most of the countries they go to are Third World countries, Mrs. Wooten said.She said one of the things that she finds in these countries is not brushing your teeth for a week with tap water and using bottled water.When you get in the shower they tell you to be sure to keep your mouth tightly closed and your head down so the water doesnt get up your nose just because of the things that are in that water our bodies are not used to, she continued. I grew up on Trion water and we drank that straight out of the ground.

GUYANAOn the recent trip the group went to Guyana, South America with the Truth for Today Medical Missions.When you think about Guyana, you think about Jim Jones, she added. The people there have not forgotten what happened. There is a lot of gang activity and the worst thing a gang member can call another is a Jonesy Boy.Her group was a small group, they went to five separate areas, doing five clinics in five days.That was a lot of work, you have to set up everything and at the end of the day you take it all down and this involves moving church pews.Most of the clinics were in churches which are metal roofs over cinder block walls and then some very hard seats.The week they were there they saw 90 patients the first day; the second day they saw 69 medical and vision saw 80; the third day they saw 51 medical and 54 in vision; the next day they saw 90 in medical and 125 in vision and the last day they saw 96 in medical and 74 in vision.In the medical area the patients would come in and see Mrs. Wooten or one of the other providers and they would sit down and talk.I would ask, What can I do for you today? What kind of problems are you having? she continued.Most of them are joint pain, back pain and what they call the flu, which is sinus or upper respiratory and we treat them accordingly.They also did a lot of teaching about high blood pressure and diabetes which they have a lot of because of their high carbohydrates diets.We make sure that we get them started on medication so they can continue their medication through their socialized medicine, which is a disaster, Wooten added.Vision is a very big part of the clinics. She said that the Rotary boxes of old gasses, many times end up on a mission trip and many glasses you think are trash or you dont need them anymore, to these people the eyeglasses are a treasure.A billboard the group saw advertised financing for eyeglasses from six months up to two years.To give those people a pair of glasses, they have a machine called a refractor, they check their eyes and go through all the charts and then they know the strengths needed. They then go through the boxes of hundreds and hundreds of glasses and find the strength they need.The look on these peoples faces when they put on their glasses for the first time, they can see and they can read now, Mrs. Wooten said.There is no charge to the patients for the medical or the eyeglasses.Everything is either volunteer or free.She explained that the worst case she saw was a 17-year-old boy who was six foot, eight, and he was very thin. He was educated and still in school, and he was complaining about everything that was textbook for a bad thyroid. He had a goiter and for someone that young that is something that is not a good outcome.Rarely did we see someone that smoked, Mrs. Wooten added.I bring away from my trips how rich, how blessed and how fortunate we are to live in America, Mrs. Wooten said. And to be free and to have the freedoms that we have.

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Wooten's Medical Mission Trip To Guyana: 'I Have Been The One Blessed' Not Patients - Thesummervillenews