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Wednesday, May 31, 2017

Morning Rounds by Megan Thielking

Good morning, everyone, and happy last day of May! I'm here to get you ahead of the day's health news. If you're a fan of Morning Rounds, tell a friend who might like it to sign up, too. 

Telemedicine providers tout a victory in Texas

The telemedicine industry is trumpeting a victory in Texas, where the governor has signed a bill that says a patient-physician relationship can be established without an in-person visit. Back in 2011, the Texas Medical Board fired off a letter to Teladoc, a national telemedicine provider, saying doctors had to have an in-person meeting with a patient to be able to prescribe medications. Teladoc sued and said that those regulations suppressed patient access to health care and violated antitrust laws. That case is still ongoing pending a settlement, but state lawmakers took the matter into their own hands and eased some requirements for telemedicine providers anyway.

And also in Texas, legislators have just approved a bill that authorizes stem cell therapies that haven’t been approved by the FDA. The move puts Texas on track to become the first state to recognize the experimental treatments legally.

Most gluten-free food seems to actually be gluten-free

Good news for the gluten-free crowd: Nearly 100 percent of food products labeled as gluten-free actually met the FDA's standards in a new round of testing. The agency sampled more than 250 products on the market with “gluten-free” on their label. Just one of those products tested in the past two years didn’t comply with FDA requirements put in place in 2014: Honey Nut Cheerios. The agency tested five samples of the cereal, all of which violated the gluten-free standards. The Cheerio cousins, including the trusty Original, weren't implicated. In late 2015, General Mills recalled boxes produced at one facility, and now, they've all passed the FDA's gluten-free test. The agency set those standards to help consumers with celiac disease feel confident that a food that claims to be gluten-free is, in fact, gluten-free. 

New study suggests ketamine can't curb delirium 

Anesthesiologists sometimes give patients low doses of the anesthetic ketamine during surgery to tamp down on pain after a procedure, and in recent years, there’s been hope the drug might be able to prevent delirium after surgery, too. Post-surgical delirium — marked by confusion and agitation in patients — is tied to longer ICU stays and an increased risk of death. But a new paper suggests ketamine doesn’t seem to prevent delirium and, for some patients, can make recovery worse. Researchers looked at 672 surgical patients age 60 or older who either received no ketamine, a low dose, or a higher dose. Doctors saw no difference in the prevalence of delirium, but they did see more hallucinations and nightmares among patients who received ketamine, particularly at the higher dose. They say more research is crucial to understand how ketamine works.

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How the public wants the Senate to tackle the AHCA

(Kaiser family foundation)

Senate GOP leaders are still working away on a new draft repeal and replace plan, and a new poll out this morning gives lawmakers an idea of what the public would like to see happen. Roughly one-quarter of the public wants to see the Senate make minor tweaks to the AHCA, with another quarter saying they’d like to see big changes, according to the new Kaiser Family Foundation poll. Another 30 percent say they don’t want to see the Senate pass the bill at all. The chief concerns among those who don’t like the AHCA as-is: the cost of health care, the ability to get and keep insurance, and the quality of care they’re able to receive. 

Just one in five birth defects has an identifiable cause

Researchers are only able to pinpoint a definite cause for birth defects in one in every five infants affected, according to a new analysis out in the BMJ. That’s a significant gap in knowledge, particularly given how common birth defects are. One in every 33 newborn babies has a birth defect. Research shows that diabetes, smoking, and obesity among pregnant women are tied to some birth defects, but it’s often difficult to prove a definitive cause. Among 5,500 cases of birth defects looked at by University of Utah researchers, a definitive cause — largely chromosomal or genetic conditions — was only found in 20 percent of cases. The authors say that highlights a need for a better way to measure fetal development and track the impact of potential causes of birth defects. 

Inside STAT: The battle over helmet laws heats up

Pro-helmet activists have been aggressively lobbying state legislatures across the US to fend off motorcyclists who want the right to ride without a helmet. For years, riders have had the upper hand in that battle. But now, public health advocates are gaining traction with new evidence that helmet laws can save lives. Coalitions of insurance groups, doctors, and accident survivors have fought to defend helmet laws in 10 states already this year. And they've found one group of particularly sympathetic political allies: state legislators who are also practicing or retired doctors. STAT's Rebecca Robbins has more

Tobacco farming poses health harms to laborers

Today is World No Tobacco Day — and this year, the World Health Organization is putting a spotlight on how tobacco harms the health of not just smokers, but also of individuals who work on tobacco farms. Up to 70 percent of tobacco farmers are women, who are often put into close contact with potentially hazardous chemicals in pesticides. That work has an impact on kids, too. A Human Rights Watch report found that child laborers on tobacco farms in the US reported vomiting, headaches, and dizziness while working — all signs of acute nicotine poisoning in children.

What to read around the web today

  • Supreme Court rejects appeal of doctor who poisoned patients. Detroit Free Press
  • Two Medicare Advantage insurers settle whistleblower lawsuit for $32 million. Kaiser Health News
  • How the global gag rule may hurt India's health programs. Reuters

More reads from STAT

The latest from STAT Plus

Thanks for reading! More tomorrow,

Megan

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