Friday, March 17, 2017

Morning Rounds by Megan Thielking

We made it to Friday — the weekend is in sight! I'm here with the big news in health and medicine to round out the week. 

The rural-urban gap in suicide rates is widening

Suicide rates across the country have been creeping up in recent decades, but they haven't been doing so in lockstep. The gap between rural and urban areas has begun to widen more in recent years. In 2015, the most recent available CDC data now show, the rate of suicide in the most rural of areas was nearly double the rate in the most metropolitan areas. That might be partly because of the recession, which hit non-urban areas hardest. 

Deb Stone, one of the authors, tells me rural areas would benefit from improved access to health care. But Stone said they might also might benefit from strategies that “promote connectedness,” such as group physical activities, neighborhood beautification projects, and other community engagement. And across the country, teaching resiliency could be a helpful intervention. “All communities may benefit from strategies that teach youth and adults coping and problem-solving skills,” she adds.

Biopharma watches for data out of cardiology meeting

The nation's cardiologists are flocking to D.C. today for the annual American College of Cardiology Conference, which runs through Sunday. The biopharma world is watching the meeting today as drug manufacturer Amgen readies to reveal its results of a long-term study to determine whether its cholesterol-lowering drug Repatha actually staves off heart attack and stroke. Amgen expected the drug to be a blockbuster and priced Repatha at $14,000 a year, but insurers haven’t wanted to pay for the treatment without evidence of its long-term benefits. 

How the climate might have shaped your nose

Cross your eyes (or look in a mirror) and take a long, hard look at your nose. The climate your ancestors lived in might've helped to shape what it looks like. Scientists set out to understand the evolution of the nose by studying the nostrils of people with West African, South Asian, East Asian, or northern European ancestry. They determined that nose size and shape varied too much between different climates to be merely by chance. Take people with wider nostrils — their ancestors likely evolved in regions with higher temperatures and greater humidity levels. Climate isn't a particularly strong factor here; the researchers suspect that other evolutionary forces, such as sexual selection, play a bigger part. But, they say, it might be worth sniffing around into whether the architecture of a nose impacts a person’s risk of having a respiratory disease to understand the evolutionary forces better.

Inside STAT: Artistic vision as a symptom of dementia

(Hyacinth empinado for stat)

Carol Spence had been an accomplished artist throughout her entire life. She made handcrafted miniature dolls and sold them at craft shows. But three years ago, her artistic vision changed. She started exclusively painting two-dimensional animals and people on canvas, painting for hours at a time. The shift in style was a curious symptom of frontotemporal dementia — a degenerative brain disease that afflicts roughly 250,000 Americans — which Spence was diagnosed with in 2008. As patients with the condition see their vocabulary begin to falter, their interest in artistic pursuits frequently begins to bloom. STAT’s Bob Tedeschi and Hyacinth Empinado have the story, along with a touching video, here.

Lab Chat: A secret regulator in eating and fasting

Scientists taking a closer look at uridine — a “building block” of RNA — have discovered the amount in your blood seems to be related to how hungry you are. The new work in mouse models, supplemented by an observational study in humans, suggests that uridine plays a part in how the body regulates temperature after eating. Here’s what study author Philipp Scherer of University of Texas Southwestern Medical Center told me about the findings, published in Science.

What did you discover about the role of uridine?

We found that there’s sort of a yin-yang relationship between liver and fat tissue. In the fasting state, the liver is responsible for keeping sugar levels reasonable. It kind of shuts down its uridine synthesis and fat cells take over the job. But they take over not only to offset liver production of uridine, they make even more. The circulating levels of uridine turn out to go up in your blood when you fast.

What do you suspect is driving those changing levels?

The fat cell is very susceptible to fasting. It starts to produce more uridine, relieving the liver and sending a signal to the whole system that now we need to reduce the overall energy expenditure. The question now is what happens when you eat. You get a fast drop in these uridine levels, you don’t want it around anymore. That uridine drop is actually explained by the liver. The liver is extracting it from the bloodstream and sending it to bile. Uridine accumulates in bile, which is injected into the digestive tract, where it helps with the absorption of nutrients.

Science community weighs in on budget blueprint

Researchers, health officials, and patient advocates continue to examine the potential impact of President Trump’s budget blueprint, which proposes deep cuts to HHS and the NIH. Some advocates are concerned that the proposed cut might mean the agency will put a full freeze on new grant applications for biomedical research. “This would dial the clock back after decades of progress that have occurred,” Jeff Allen, president of the Friends of Cancer Research, tells STAT. “It would put academic institutions and the future of the biomedical research enterprise on shaky ground.”

The proposal would completely cut the NIH’s Fogarty Center — an international health research and training program — as well as a grant program administered by HUD that helps improve residential health. Still, the health field is celebrating one victory in the proposal — it preserves a billion-dollar, four-year commitment to Gavi, a global vaccine alliance.

Treatment for eye disease tied to glaucoma risk

Patients who receive eye injections to treat vision loss actually go on to be at higher risk of needing surgery for glaucoma, researchers report in the new JAMA Ophthalmology. Doctors often inject a growth factor into the vitreous — the jellylike fluid behind the eye’s lens — to treat vision problems related to aging and diabetes. The drug, bevacizumab, is actually a cancer drug that doctors use off-label. Researchers found that patients who'd had seven or more injections in a year were at significantly higher risk of needing surgery for glaucoma than patients who'd not had injections. The study’s authors say doctors using the drug for eye disease should be aware of the potential risks of repeated injections.

What to read around the web today

  • What young people need to know about colon cancer. New York Times
  • Why perfectly healthy people are using diabetes monitors. Time
  • Drugs are killing so many people in Ohio that cold-storage trailers are being used as morgues. Washington Post

More reads from STAT

Thanks so much for reading! See you bright and early Monday morning, 


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