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Thursday, June 8, 2017

Morning Rounds by Megan Thielking

Happy Thursday! I'm here to get you ahead of the day's news in health and medicine. 

What to know about the (other) hearing happening today

If your eyes aren’t already glued to a different hearing this morning, HHS Secretary Tom Price is headed before the Senate Finance committee to testify about his boss’s budget plans. President Trump’s proposed 2018 budget includes massive cuts to the agencies housed under HHS, including a 17 percent cut to the CDC, a 31 percent cut to the FDA, and an 18 percent cut to the NIH. Price defended similar cuts in Trump's initial budget proposal, citing "indirect expenses." The hearing, which you can watch live here, gets underway at 9:45 a.m. ET. And elsewhere on the Hill, House leaders are examining the role that the health department can and should play in maintaining health care cybersecurity. That's timely: Just last month, a huge number of hospitals in the UK were hit by a ransomware attack that locked providers out of patient records unless they paid the hackers.  

Standard melanoma surgery doesn't improve survival

The standard surgical treatment for melanoma that has spread to at least one major lymph node doesn’t improve survival outcomes, according to a new study published in the New England Journal of Medicine. Melanoma patients whose cancer has spread to key lymph nodes often will have all lymph nodes near their original tumor removed and biopsied. Researchers ran a randomized trial with 1,900 patients who either received the surgical dissection or, alternately, close observation of the lymph nodes near the original tumor site. Surgery didn’t increase overall survival rates three years out. And nearly 25 percent of patients who had the surgery suffered from lymphedema — serious swelling that can happen when lymph nodes are removed — compared to just 6 percent in the control group. The researchers say that while the surgery is still an option, it shouldn't be standard for all patients.

Unearthing the world's oldest human

Paleoanthropologists have discovered the oldest known humans on the planet, courtesy of fossilized remains hidden in a Moroccan cave alongside stone tools and animal bones. Experts estimate those fossils are about 315,000 years old, making them more than 100,000 years older than the oldest Homo sapiens fossils known to date. They found flint blades that had been burned in the same layer of sediment as the bones. They calculated how long it had been since those blades were burned — about 300,000 years — and determined the skulls found in the same layer must have been from the same time. The finding rewrites the history of our species, showing that Homo sapiens evolved across Africa much earlier and in different places than we realized. It also gives an idea of how humans have evolved — while the faces of early Homo sapiens were quite similar to a modern human mug, their brains weren't shaped the same way ours are today. 

Inside STAT: Narcolepsy and George Church's ideas

church stands whenever possible in his office to keep from falling asleep. (Kayana Szymczak for STAT)

Renowned biologist George Church has spent decades living with narcolepsy, a condition that causes a person to fall asleep suddenly. He lists it as part of his personal history, and has sparked curiosity among fans who’ve asked “How does George Church manage his narcolepsy?” on Quora. He and his daughter, who also has narcolepsy, once fell asleep together while talking with her teacher. His condition has convinced him that society could benefit from more people with diverse brain states, from OCD to dyslexia, contributing their unique perspectives. And for Church, most of his best ideas and solutions to problems have come either while he was asleep or somewhat asleep, at the beginning or end of a narcoleptic nap. STAT’s Sharon Begley has more here.

Lab Chat: Making leaky blood vessels on demand

a little magnetic magic helps realign actin filaments, in green. (Laboratory of Biomolecular Engineering and Nanomedicine/Rice University)

Scientists have figured out a way to make blood vessels leaky on demand — which, despite how it may sound, can be a good thing. Blood vessels are lined by tightly organized endothelial cells to keep blood where it’s supposed to be. But researchers have figured out a potential way to quickly open the connections between those cells to let large molecules slip through and then close them back up again. Here’s what bioengineer Gang Bao of Rice University told me about the work, to be published this morning in Nature Communications.

What's the value of a leaky blood vessel? 

Drug delivery through IV injection is a common approach for treating many diseases. However, it works only with small molecule drugs, not for large molecules such as proteins and antibodies, since the blood vessel wall is a major barrier for them. Usually the blood vessels are leaky only in tumors. For normal tissues, the blood vessels are not leaky, so delivery of large-molecule drugs, including proteins, through these vessels is a major challenge.

How did you make blood vessels leaky on demand? 

We [found] that the permeability of normal vessels can be increased by delivering iron oxide nanoparticles into endothelial cells that line the blood vessel — and using an external magnetic field to temporarily disrupt cell-cell junctions. [That can] make the blood vessel transiently leaky, enabling the delivery of large-molecule drugs.

What's driving the drug crisis, according to economists

Economic experts are testifying today about the supply and demand system that’s continuing to fuel the opioid crisis. The hearing before Congress's Joint Economic Committee will be focusing on the business of prescription painkillers, heroin hauled in from Mexico, and fentanyl that makes its way to the U.S. from China. One of those testifying is Ohio Attorney General Mike DeWine, who last week sued several major pharmaceutical companies over their role in the opioid epidemic in Ohio. The state is accusing drug makers of marketing the drugs in a way that misled doctors and patients about the risk of addiction.

What to read around the web today

  • Whistle-blower files suit over alleged double-booked surgeries. Boston Globe
  • If the insurance market crashes, can lawmakers put the pieces back together? Kaiser Health News
  • They're on Obamacare, they voted for Trump, and they're already disappointed. Vox

More reads from STAT

The latest from STAT Plus

Thanks for reading! More tomorrow,

Megan

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