Morning Rounds Shraddha Chakradhar

Trump administration prepares to ban flavored e-cigarettes

E-juice, used in e-cigarette vaporizers, is displayed at a San Francisco shop. (JUSTIN SULLIVAN/GETTY IMAGES)

Following a recent spate of severe lung illnesses and deaths related to vaping, the Trump administration just announced that it would look to ban flavored e-cigarettes. E-cigs have also become a source of concern because of their rapidly growing popularity among youths, perhaps in large part because they come in fruit and other flavors. “We will not stand idly by as these products become an on-ramp to combustible cigarettes or nicotine addiction for a generation of youth,” HHS Secretary Alex Azar said in a statement. The FDA has taken steps to crack down on e-cigs, including sending a warning letter to Juul earlier this week about its marketing practices. Still, the agency has had the ability to ban flavored e-cigs since 2016, but has thus far resisted taking the step. 

Purdue Pharma reaches tentative settlement over opioid lawsuits

OxyContin maker Purdue Pharma has tentatively reached a settlement with more than 2,000 cities and counties, as well as with 23 state attorneys general who sued the company over its alleged role in the U.S. opioid epidemic. Under the proposed deal, the Sackler family — which owns Purdue — would give up control of the company. The company would file for bankruptcy, and would then set up as a trust dedicated to fighting the opioid crisis. The deal could be worth up to $12 billion, a quarter of which could be personal funds from the Sacklers. Still, some of the states involved were contesting the deal, arguing that the family’s contribution was insufficient. 

And as many such opioid cases get settled, physicians and others on the front line of the crisis are urging that the money from these settlements be used to fight the opioid crisis — unlike what happened with money from tobacco settlements years ago. More here.

1 in 6 children come from families who have trouble with medical bills

A new report finds that some 17% of children in 2017 lived in a family that had trouble paying medical bills. Here’s more from the report: 

  • Overall trends: Problems paying medical bills declined 20% between 2013 and 2017, but some 13 million children in 2017 came from families who reported trouble. 

  • Family income: Children from low-income backgrounds — at or below 250% of the federal poverty level, or around $61,000 for a family of four in 2017 — were more than twice as likely to have families who reported financial hardship with medical bills. 

  • Insurance: 80% of children in low-income families were either uninsured or had health problems in the family. In 2017, some 5% of children overall were uninsured, but nearly 20% lived with a family member who was uninsured.

Inside STAT: Hospitals starting to address sexual harassment by patients 

Tales of health care providers harassing their patients have been well-publicized, but what gets less attention is when it’s the other way around. Whether it’s a Mayo Clinic female doctor who was groped by a male patient in front of co-workers or a University of Michigan professor of medicine who was verbally assaulted by a male patient, these stories may be more common than we think. One survey of 6,000 physicians found more than a quarter had been harassed by patients. STAT's Jacquelyn Corley, who reported this story after her own experiences as a neurosurgery resident, says, "I can think of many instances when a patient acted inappropriately toward me, and I think it really surprises people to hear that patients often are doing the harassing.” Read more here.

Nurse who developed at-home elderly care program recognized with ‘Human Condition’ award

Sarah Szanton, a nurse at Johns Hopkins in Baltimore, is this year’s winner of the Heinz Award for the Human Condition for developing a program that provides the elderly with at-home care. Called the “Community Aging in Place Advancing Better Care for Elders,” or CAPABLE, program, it involves providing handyman services to low-income seniors — including installing handrails or fixing tripping hazards — as well as at-home nursing and occupational therapy visits. CAPABLE first began in Baltimore and now operates in 14 states. Szanton and winners of the other four categories of Heinz Awards, which are presented by the Heinz Family Foundation, will each receive a $250,000 cash prize at a ceremony in Pittsburgh next month. 

Immunotherapy could also help against certain heart conditions

Immunotherapy — in which a patient’s own T cells are modified to help better fight disease — have largely been used against cancer, but new mouse research suggests it could also prove valuable against heart conditions. Specifically, researchers looked at using the therapy against cardiac fibrosis, which is a stiffening of heart muscle that leaves it unable to function properly. Scientists modified mouse T cells to target the heart cells that lead to fibrosis. Mice were engineered to develop heart disease and one set was injected with these modified T cells — these mice were less likely to develop cardiac fibrosis than the control mice who were untreated. Scientists also engineered mouse T cells to target a specific protein within fibrosis-producing heart cells, and mice that received an infusion of these cells had reduced fibrosis as well as better heart function. 

What to read around the web today

  • Why so many cancer drugs fail: Genes thought ‘essential’ for tumor survival are not, study finds. STAT
  • Can a new diagnosis help prevent suicide? Undark
  • Aging infrastructure is making Americans sick. The Atlantic
  • Dutch court clears doctor in euthanasia of dementia patient. The New York Times
  • In a CRISPR first, therapy intended to cure HIV patient appears safe — though ineffective. STAT

Thanks for reading! I'll be back with more tomorrow,


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Thursday, September 12, 2019


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