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Morning Rounds Shraddha Chakradhar

States sue EPA over tighter rules for asbestos 

Ten states and Washington, D.C., are suing the EPA over stricter asbestos regulations. The chemical has been linked to mesothelioma and other cancers, but some products, including construction materials, can still contain up to 1% of asbestos. In January, the states in the lawsuit petitioned to have the EPA require more data on how asbestos affects human health, but the agency rejected the petition in late April. California and Massachusetts are two of the states leading the coalition, which is urging the EPA to enforce tighter rules over asbestos, especially since symptoms from exposure can take years to show up. “While it’s troubling that we must once again take the EPA to court to force the agency to do its job, we won’t pull any punches,” California Attorney General Xavier Becerra said in a statement. 

How zebrafish helped save a 12-year-old’s life

Zebrafish are common model organisms, but the story behind a new study may point to just how essential these tiny fish could be. In the paper, researchers describe how they were able to save the life of a 12-year-old boy with a rare condition known as central conducting lymphatic anomaly, which causes vessels in the lymphatic system to proliferate uncontrollably and leak fluid into lungs and other organs. After identifying the mutation that caused the disease in the boy, researchers replicated the mutation in zebrafish and tested different possible treatments. One drug worked, and then the scientists, with the FDA’s blessing, gave it to the boy — and it worked again. The boy was being sized for a wheelchair before the treatment, but he’s now playing basketball and helping coach soccer. 

Scientists model early embryonic development using stem cells


Using a 3D model, researchers were able to simulate the moment in development when the body starts to separate into two distinct halves, here, yellow and green cells. (Laboratory of Stem Cell Biology and Molecular Embryology at The Rockefeller University)

Researchers have long struggled to observe the earliest stages of development, but a new model may clue us in to what happens soon after an embryo is formed. Using a 3D model of an embryo, researchers were able to replicate some key processes that happen roughly two weeks into a pregnancy. One of these is symmetry breaking, where a previously symmetrical embryo starts to take on more uneven features to become the fetuses — and babies — that we recognize. Using chemicals signals that the uterus releases to induce this stage, researchers recreated symmetry breaking in the stem cell model. Since this happens right after embryos attach to the uterus, having a reliable model could help scientists better study why more than half of all embryos don’t attach, which could lead to pregnancy loss. 

Inside STAT: New guidelines aim to enlist primary care physicians in transgender care

Endocrinologists have long been the doctors most often caring for transgender individuals, but new guidelines issued by the American College of Physicians look to better inform primary care and family medicine physicians about caring for these patients. “If you’re seeing 5,000 patients in a year, knowingly or unknowingly you’re going to see a couple dozen gender diverse people,” says Dr. Frederic Ettner, an Illinois family medicine physician. The guidelines cover terminology, transgender-specific surgeries, and legal issues, in addition to other care resources. More than 1 million adults in the U.S. identify as transgender, but they often face a lack of knowledgeable providers. STAT’s Lauren Joseph has more here.

Mental illness may increase likelihood of visiting the emergency room

Mental illnesses combined with physical conditions make it more likely that a person will visit the emergency department, according to new research. Scientists looked at more than 5 million adults in Quebec and found that in those with mental illness, each additional physical illness meant a higher likelihood of visiting the ED than in those without mental health conditions. For those who were bipolar or had other serious mental disorders and four or more physical conditions, the risk of going to the ED was more than 16%, compared to around 11% for those with no mental health disorders. Given the close tie between mental and physical health, more research to test interventions that could help those with mental illness could also reduce avoidable visits to the emergency department, the authors write. 

Judge clears way for delay of federal ‘conscience rule’

A federal judge in New York yesterday certified a change to when the Trump administration’s “conscience rule” for health care providers will go into effect. Instead of later this month, the rules will be in place starting Nov. 22. The rules were announced in May this year and would allow providers to decline medical care such as abortions based on conscientious or religious objections. At least three jurisdictions in California, including the city of San Francisco and the state itself, are suing the federal government, as is a coalition of states led by New York. HHS over the weekend agreed to the new date after a federal judge in the California cases made it official, while those opposing the new rules seek a preliminary injunction.

What to read around the web today

  • When routine eye surgery leads to debilitating pain. The Wall Street Journal
  • 10 medical myths we should stop believing. Doctors, too. The New York Times
  • Trump, California governor spar over immigrant health care. The Associated Press
  • Smithsonian says no to senator’s request to strip Sackler name from museum. The Washington Post
  • California's first surgeon general spotlights health risks of childhood adversity. NPR

Thanks for reading! More tomorrow,

Shraddha

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Tuesday, July 2, 2019

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