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Thursday, April 14, 2016

Morning Rounds by Megan Thielking

Good morning! Here's what you need to know about the world of science and medicine today. 

New recommendations for helping hospitals fight antibiotic resistance

The White House has called for hospitals and health care providers to put “antibiotic stewardship” programs in place by 2020 to curb the growing issue of antibiotic resistance. This morning, the Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America are out with new recommendations to make sure those programs actually work.

One major suggestion: Require that doctors get approved to give antibiotics before they start prescribing, a process called pre-authorization. The recommendations also suggest putting more emphasis on rapid diagnostic testing in patients with respiratory symptoms to determine whether antibiotics are actually needed. The guidelines were published in Clinical Infectious Diseases this morning.

Bacterial bombs are exploding inside your body

Baby you're a firework (of extracellular material). (University of tsukuba)

Scientists have discovered the world’s tiniest bombs, made of exploding bacteria. It’s a process called explosive cell lysis, which helps bacteria produce biofilms, the cellular goop that forms on places like your teeth. Those biofilms have bits of bacterial DNA and proteins, but it hasn’t been clear how those were released outside the cell. In a new study published this morning in Nature Communications, researchers took a disease-causing bacterium and watched it using live-cell microscopy. They saw it first change from a rod shape to a circular shape, then explode. That eruption, they discovered, was driven by an enzyme called Lys. Interfering with that process, then, may be a potential way to disrupt some harmful biofilms from forming. 

Watch a surgery live in virtual reality

Step inside the operating room this morning as Dr. Shafi Ahmed performs surgery at Royal London Hospitalon a colon cancer patient to remove a tumor from the man’s bowel — live and with a 360-degree view If you’ve got a smart phone and some virtual reality goggles lying around, as I'm sure you all do, you can watch using this app.

Sponsor content by johnson & johnson

Why we need a new approach to improving global health

Paul Stoffels, Johnson & Johnson’s chief scientific officer, heard troubling news from health care providers at a clinic in a southern African country: All of the HIV medicines that his company made and donated never reached the clinics. They weren’t benefiting the patients’ — or their communities’ — health. Read about Stoffels' defining moment that set a course for a new approach. 

Inside STAT: The surgeon who provides procedures for the uninsured

Doctors from Cirugia sin Fronteras performed surgery on Salvador Montelongo’s hands. (J. Emilio Flores for STAT)

Dr. Jorge A. Enriquez has made his home in Kern County, Calif., a region where about half the residents are Latino and one-fifth of families live at or below the poverty line. Many make their livings in jobs without health insurance, and for patients living with debilitating conditions, that’s a massive problem. Enriquez set out to change that reality by founding Cirugia sin Fronteras, or Surgery without Borders, an organization that arranges low-cost surgical procedures for people who don’t have health insurance. More on Cirugias sin Fronteras and the patients it is helping from contributor Patricia Leigh Brown here.

Chemo-vaccine combo could boost treatment of cervical cancer

Combining chemotherapy and the HPV vaccine could help spur the body’s immune response to late-stage cervical cancer, according to new data from a small clinical trial. HPV, or human papillomavirus, is an infection that’s sexually transmitted and can lead to cervical cancer. The HPV vaccine, recommended for adolescents, is typically used to prevent cancer, not treat it. In the trial, the chemo worked by inhibiting blood cells that suppress the immune system response. Then, the vaccine comes in to spark an anti-tumor response in immune T cells.  The strategy is currently being tested in a larger clinical trial.

Your body's clock is powered by magnesium

Thank magnesium for helping your body run a tight ship. The mineral — which we consume in things like whole grains, leafy greens, and nuts — helps cells keep time like a clock. In a new study published in Nature, scientists observed how levels of magnesium change throughout the day in human cells, as well as in algae and fungi. "It is plausible that our identification of magnesium rhythms will have an impact on when we believe drugs to be most effective," the study's author Gerben van Ooijen of University of Edinburgh told me. But first, he said, they need to "find out how these fundamental new results from cells translate to whole tissues like a human liver, for example."

Should marijuana be reclassified due to medical use? 

A heated question in the conversation about medical marijuana — whether the drug should be reclassified as something other than a schedule 1 drug with “no currently accepted medical use” — takes center stage in a Brookings debate tonight. The decades-old policy that treats marijuana on par with drugs like heroin plays a part in the federal stance on medical marijuana. You can sign up to watch the discussion live online here — it’ll begin around 6:15 p.m. ET.

The big challenge facing cancer vaccine development

The booming field of cancer vaccine research has some significant hurdles to jump, say scientists who penned an interesting new perspective in Science Translational Medicine. Cancer vaccines aim to harness the body’s immune system to treat tumors, but they haven’t seen much success in clinical trials. An international effort called the Human Vaccines Project is pushing to accelerate cancer vaccine development, but that’s easier said than done, the authors say. One challenge that stuck out to me: There’s no “normal” baseline of immunological fitness, or how well a person’s immune system is able to create long-lasting responses to stimuli like vaccines. But that would be a necessary parameter in creating effective vaccines that could be widely used.  “Defining these would be a daunting task,” the authors say.

What to read around the web today

  • New guidelines say surgeons must tell patients about double-booked surgeries. Boston Globe
  • First-time moms in Miami are likelier to deliver by C-section than in many other cities. Miami-Herald
  • Could menstrual leave be the next work-life benefit? Fast Company
  • An unknown billionaire's quest to reverse aging. Forbes

More reads from STAT

Thanks for reading! More tomorrow,

Megan

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