Wednesday, November 16, 2016

Morning Rounds by Megan Thielking

Good morning, folks! Here's what you need to know about the world of health care today. For more STAT stories, find us on Facebook

Why don't we have more answers about Zika yet?

It's been about a year since the WHO first warned that an outbreak of Zika virus might be responsible for a rise in microcephaly among newborns in Brazil. But even still, a firm count of how often an infection during pregnancy results in birth defects is lacking. At the American Society of Tropical Medicine and Hygiene's annual meeting in Atlanta yesterday, Dr. Albert Ko, an infectious diseases epidemiologist at Yale University, pointed to the seven-month long Congressional funding stalemate as one reason why.

Ko said the lack of funding slowed down a lot of critical elements in Zika research, including the setting up of big studies meant to follow women infected early in pregnancy to try to determine the rate at which birth defects occurred. "It was extremely frustrating for us," said Ko, who has been working on Zika in Brazil. A number of studies are now up and running that should bring the full picture of Zika's impact on pregnancy into focus. "Hopefully this will be coming out in the next six, eight months," Ko said.

Scientists use CRISPR in humans for first time

Revolutionary gene-editing technique CRISPR has been used in a human patient for the first time, Nature reports. A team of researchers led by oncologist Lu You of Sichuan University in China genetically modified the immune cells of a patient with aggressive lung cancer, and then injected them back into him late last month. They specifically used CRISPR to disable a gene that codes for PD-1, a protein that cancers can use to grow. Those tweaked cells were allowed to multiply and then injected back into the patient. The goal: Get those edited cells to battle against the cancer. The work is part of an ongoing clinical trial that was approved by a hospital review board back in July. A US trial planned to launch in early 2017 will similarly use CRISPR in three genes as a potential cancer treatment. Researchers in Beijing have proposed three trials to test CRISPR in bladder, prostate, and renal-cell cancers next year, but those trials haven’t been approved yet.

Teen birth rate remains highest in rural counties


The teen birth rate has made a dramatic tumble in recent years, but teen births are still much more prevalent in rural counties than in other parts of the country, according to data from the CDC out this morning. Large, urban counties have the lowest teen birth rates in the country — and also saw the most significant declines. From 2007 to 2015, the teen birth rate fell 50 percent in large, urban counties. In rural counties, the birth rate fell 37 percent during the same time frame. An eye-catching, positive exception: Rural counties in Connecticut, which saw a 73 percent decline in the teen birth rate. 

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Inside STAT: How illicit drug use has changed over time

(Natalia Bronshtein / STAT)

The markets for illegal drugs such as cocaine, crack, and methamphetamine are largely hidden from public view. There’s limited information on drug prices and purity, but what data we do have offers interesting insights into changing markets. One source of that data is a DEA system that tracks drugs confiscated by law enforcement or bought by undercover agents. Those samples are fired off to labs for purity analysis. STAT’s Natalia Bronshtein and policy researcher Greg Midgette broke down that information in an interactive visualization — check it out here.

Doctors debate how to combat soaring drug prices

Doctors across the country are getting to work addressing the issue of skyrocketing drug prices in the US — but they don’t all agree on how that should get done. The American Medical Association is out with a new policy, adopted by doctors at the organization’s meeting this week, as part of the effort. They embrace what's called value-based care: Tie drug prices directly to the benefits they offer. Among the group's recommendations: Prices should be set by independent entities, determinations should be made based on rigorous scientific data, and affordability for patients must be taken into account.

Another effort by a different subset of physicians goes more directly after drug makers. On Friday, a crew of about 100 doctors and supporters will picket the D.C. headquarters of drug industry trade group PhRMA to protest high drug prices. “As a physician, I think I have a critical role in advocating for patients' access to medications,” says Dr. Adam Gaffney, a critical care doctor who lectures at Harvard Medical School and is attending Friday’s protest. But while he shares the AMA’s goal of tackling those steep bills, Gaffney said he sees value-based care as an “oversold” solution to the problem. “Aspirin is a lifesaving drug for people having a heart attack,” Gaffney says. “By the ‘value-based drug pricing’ principle, does that mean we should raise its price?”

How online grocery shopping could change SNAP

The House Agriculture Committee will hold a public hearing today on how online grocery retailers could fit into SNAP, the federal food assistance program. The 45 million people who rely on SNAP to help them afford food have to go to the store to shop for meals. So SNAP is limited for people who live in food deserts, neighborhoods that lack grocery stores or other sources of healthy, non-processed foods like fruits and vegetables. Online retailers could help more people access healthy foods. Today's hearing is the 16th and final meeting in a two-year series of hearing examining SNAP. 

New campaign addresses loneliness in seniors

A new national campaign is launching today to raise awareness about an often-overlooked part of aging — loneliness, which has been increasingly tied to disability, cognitive decline, and premature death. “This is a public health issue of growing concern,” says Lisa Marsh Ryerson, president of AARP Foundation. The foundation is working with the National Association of Area Agencies on Aging on the campaign to help seniors find practical ways to get connected with other people. For more information on the new program, read this

Correction: Yesterday's newsletter misidentified what was swabbed off cell phones in a PNAS study. Scientists swabbed molecules, not microbes, though microbes have been tested in previous research. 

What to read around the web today

  • The road to Ward 17: My battle with PTSD. Reuters
  • From America's doctors: A letter to our patients in the Trump era. Medium
  • Walgreens claims Theranos voided 11.3 percent of test reports. Wall Street Journal

More reads from STAT

  • The WHO has stumbled in its response to emergencies. Can this man get the next one right?
  • The players who are set to influence Trump on health care. 
  • I'm a high school senior. Is medical school the best path to becoming a health care leader? 

Thanks for reading! More tomorrow,


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