Tuesday, November 1, 2016

Morning Rounds by Megan Thielking

Good morning, folks! I'm here to get you ahead of the day's news in health and medicine. 

Obamacare's open enrollment kicks off today

Welcome to open enrollment season! Today marks the first day the insurance exchanges are open for 2017 signups. HHS has estimated that by the time open enrollment wraps, 13.8 million people will have picked a marketplace plan. That’s a projected increase of 9 percent since last year’s open enrollment period. The biggest chunk of those sign-ups will likely be return customers — an estimated 9.2 million of the 13.8 million projected. About 3.5 million previously uninsured people are projected to sign up, along with 1.1 million people projected to make the switch from plans outside the marketplace.

Potential WHO leaders talk future of global health

The WHO’s hunt for its next director-general is gearing up. The six candidates in the running are taking the stage today and tomorrow to present their visions for the leading global health organization. They’ll also each face half an hour of grilling from representatives of the 194 member-states of the WHO. The election is shaping up to be a consequential one for the organization — the new director will step in amid an ongoing conversation about financing the WHO, which finds itself continually short on funds. The organization’s executive board will put up to three candidates on the ballot at its annual meeting, the World Health Assembly, in May 2017. The candidate who wins the election will take office on July 1, 2017. You can watch the livestream of this week’s speeches here.

Lab Chat: The paralyzing power of broken blood cells

Patients with sickle-cell disease, malaria, and sepsis often suffer from hemolysis, or the breakdown of the body’s red blood cells. That condition comes with a much higher risk of bacterial infection among those patients, but it’s never been clear why. Now, scientists have nailed down the molecular culprit to blame. Here’s what researcher Sylvia Knapp at the Austrian Academy of Sciences told me about the discovery, published in Nature Immunology.

What did scientists previously think was driving increased risk of infection?

For decades it was assumed that the high rate of bacterial infections was due to the higher availability of iron coming from the breakdown of red blood cells, because iron is an essential nutrient for bacteria. Iron is so essential that the body has developed numerous ways to withhold iron from bacteria once there is an infection. But we discovered that the higher availability of iron does not explain the higher susceptibility to bacterial infections upon hemolysis, against the old belief.

What does explain it? 

We discovered that [iron] very potently inhibits the ability of macrophages and neutrophils to [eat] bacteria. In the presence of higher heme levels, the very immune cells required to eat and eliminate bacteria are paralyzed and cannot do their jobs. As a result, bacteria can replicate almost unrestricted, causing serious, systemic, and deadly infections. Using a drug screening approach we revealed that quinine, the drug used to treat malaria, can reverse the inhibitory effect of heme on immune cells and restore the proper immune response to bacteria.

Inside STAT: Opioid users flock to supervised spots

Supportive sites are gaining steam in the US as a way to provide drug users a safe place to stay while they're high. Nurses monitor users for signs of an overdose, and the facility can connect drug users to rehab programs. It's the same idea behind needle exchanges and supervised drug injection sites, which are illegal in the US but can be found in Canada, Europe, and Australia. The goal: reduce immediate harm while connecting drug users with the resources they might need to quit. But those facilities have riled up a fair amount of opposition, too. STAT contributor Allison Bond has more on the back-and-forth here

Capturing the constant chatter in your brain

who's to say what your neurons are saying? (Rockefeller University/Nature Methods)

It takes an abundance of neurons chattering away with each other in the brain to come up with a single thought. Now scientists have figured out a new way to record those cellular conversations as they happen. The method relies on a technique called light sculpting — which flashes short pulses of laser light toward the brain to light up neurons — to capture the activity of neural signals. It first scans on a flat plane, then quickly refocuses the light on neurons above and below to capture an image in 3-D. The team of researchers from Rockefeller University used that technique on mice with neurons that were engineered to light up when they started talking to one another. They’d previously seen success in using the method on the brains of zebrafish, whose transparency make them an easier initial target. Read about the work in Nature Methods

Food allergy labels cause consumer confusion

Nutrition labels aren't well understood among a crucial subset of consumers — those with food allergies or kids with food allergies — according to a new survey. Half of the 6,500 respondents said food allergy labeling is required by law. But that’s not the case — the US only requires food manufacturers to warn consumers if a major allergen like nuts or milk is an intended ingredient. Any other labeling — like “manufactured on shared equipment” — is voluntary.  

And one-third of respondents said they thought allergy labeling language is based on how much of an allergen like nuts or milk might be in a product. That’s not true, either. Because the language on allergy labels isn’t standardized, there’s no go-to guide to how much of an allergen warrants a specific warning. The study’s authors say the results underscore a need to make those labels uniform to cut down on consumer confusion and prevent potentially dangerous allergic reactions. The paper will be published in the Journal of Allergy and Clinical Immunology. 

A majority of American adults are trying to shed weight

About 60 percent of adults in the US are currently trying to lose weight, and whether those individuals are obese could color how they see their weight loss efforts, according to a new poll out this morning. Americans who are obese are nearly twice as likely to call their work to shed weight a "frustrating" experience as those who aren't obese. They're also less likely to say the effort was worthwhile — 46 percent of obese individuals said their weight loss efforts were time well spent, compared to 64 percent of non-obese individuals. Read the full findings from the poll, conducted by NORC at the University of Chicago, here

What to read around the web today

  • Judge tells NFL to reveal some secrets about concussions. New York Times
  • Burning "Inferno" question: How fast can a deadly virus spread? NPR
  • India says it's committed to global tobacco-control treaty. Reuters

More reads from STAT

  • Get ready for more drug ads — Facebook is making a bid for pharma dollars.
  • Raising "good" cholesterol doesn't protect against heart disease after all, study finds. 
  • Hospitalizations of toddlers for opioid overdoses tripled over 15 years. 

Thanks so much for reading! Back tomorrow morning, 


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