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Friday, June 9, 2017

Morning Rounds by Megan Thielking

Good morning, folks. Here's what you need to know about health and medicine this morning. 

Cholera outbreak in Yemen tops 100,000 cases

The number of suspected cholera cases in Yemen has climbed to more than 100,000, with 791 deaths blamed on the bacterial disease. Children under the age of 15 account for nearly half of those cases, while individuals over age 60 represent one-third of all fatalities. Health officials are focusing their efforts on hot spots to try to tamp down on the disease's spread. But two years of conflict in the country complicates that effort — less than half of the country's health facilities are fully functional anymore. And an estimated 14.5 million people have been cut off from reliable access to clean water and sanitation, both of which are key to curbing cases of cholera. 

The policy issues on the AMA's plate this weekend

Doctors nationwide are convening this weekend for the American Medical Association’s annual meeting in Chicago, and they’ve got a full agenda. They’re hoping to come to a consensus on a slew of thorny political issues that cropped up within the first few months of the Trump administration. On the list: 

  • Should pharma ads have to mention drug prices? Prescription drugs that are advertised directly to consumers tend to be newer and pricier drugs, according to the AMA. The group is considering lobbying federal officials to require drug ads include the suggested retail price for a medication.

  • How can we keep international doctors and medical students coming? One in every four doctors practicing in the U.S. graduated from an international medical school. President Trump’s executive order on immigration threw the status of both international doctors and international medical students coming to the U.S. for residency into limbo.

  • What's the best way to rein in drug prices? The group is considering signaling support of price transparency bills, such as the legislation in Nevada that would require drug makers to report pricing histories and notify state officials and insurers before hiking prices more than the inflation rate.

Two babies contract Legionnaires' after water births

Two babies born in birthing tubs in 2016 have contracted Legionnaires' disease, a severe bacterial infection that can cause fever and pneumonia and, in some cases, death. There was just one case of Legionnaires' disease in an infant under one month between 2011 and 2015. But the CDC reports that in the first quarter of 2016, there were two cases in infants, both tied to water births.

Health officials say they saw serious gaps in infection prevention in the cases. Both births occurred in tap water, which isn’t sterile. One of the births took place in a rented Jacuzzi tub in water that had been kept for a week at 98 degrees Fahrenheit, a prime temperature for Legionella bacteria to grow. It’s not the first time health officials have seen this happen: In 2014, an infant died after contracting Legionnaires' disease during a water birth in Texas. Health officials have responded to the latest cases by releasing new guidelines for midwives assisting in water births.

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Inside STAT: Soon-Shiong's next move

Dr. Patrick Soon-Shiong — the billionaire entrepreneur who launched his own cancer moonshot — is still reeling from the controversies surrounding his philanthropic and business initiatives. Investigations by STAT and Politico earlier this year raised questions about how Soon-Shiong's research and charitable efforts are benefiting his own business interests. Since STAT’s second report, his company NantHealth has been hit by investor lawsuits and the stock has tumbled. Now, he's set to open an oncology clinic in Los Angeles, which he's billing as the world-class cancer center that the city is sorely lacking. It still needs final regulatory clearance from the state, but Soon-Shiong has said it'll open later this summer. STAT's Rebecca Robbins has the story
 

How do you stay awake when your body is sleepy?

this is your brain on morning newsletters. (Gradinaru lab/Caltech)

Scientists are finally investigating the question your newsletter writer asks every morning: How do we make ourselves wake up when our bodies really just want to sleep? To dig into how our bodies override the natural need to sleep, researchers used optogenetics to control a group of neurons in a part of a mouse's brain known as the dorsal raphe nucleus. When they flipped on those neurons during a time mice would normally be snoozing, the animals woke up and stayed awake. And when they flipped off those neurons in some mice and played loud noises, those mice kept sleeping. The control mice woke up, likely very disgruntled. The scientists' conclusion: Those neurons are key to feeling awake when you'd otherwise (and maybe rather) be sleeping. 

CDC settles Zika reporting issues with Puerto Rico

The CDC has settled a conflict with health officials in Puerto Rico over how to tally the number of babies born with Zika-related birth defects. The CDC hasn't reported Zika pregnancy data from the US territoriy for months because Puerto Rico was using a different counting system. Sources told STAT earlier this year that Puerto Rico was hiding cases. Now, the CDC says all territories are now using the same criteria to report cases. The news comes alongside an analysis of pregnancy outcomes in five U.S. territories. Of 2,549 pregnancies in women infected with Zika, 122 resulted in babies born with birth defects or fetuses that were miscarried or aborted with those defects — a rate of just under 5 percent.

After a C-section, patients may get too many opioids

Anesthesiologists are out with a warning this morning that prescribers might be doling out too many opioids to women who’ve just had a C-section. Researchers surveyed 720 women who had a C-section at an academic medical centers in the U.S. Women reported receiving twice as many pills as they actually ended up taking and, at the time of the survey, almost none of those patients had disposed of their excess pills. In response the researchers developed a new decision-making tool for doctors and patients decide the appropriate prescription amount. In a preliminary study, the number of pills prescribed fell by 50 percent, while the refill rate for those prescriptions remained low. The authors say that shows that a discussion about drug needs after C-sections could help cut down on the prevalence of leftover drugs that could be misused.

What to read around the web today

More reads from STAT

The latest from STAT Plus

Thanks for reading! Have a happy weekend,

Megan

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