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Thursday, October 6, 2016

Morning Rounds by Megan Thielking

Happy Thursday, folks! Welcome to the Morning Rounds, where I get you ahead of the day's health news. For more STAT stories, like us on Facebook

Theranos shutters clinical labs, blood collection sites

Blood testing company Theranos is shutting down its clinical labs and blood collection sites. About 340 employees working for the company in Arizona, California, and Pennsylvania will be laid off. “After many months spent assessing our strengths and addressing our weaknesses, we have moved to structure our company around the model best aligned with our core values and mission,” Theranos CEO Elizabeth Holmes wrote in an open letter on the company's site. Earlier this year, federal regulators banned Holmes from owning or operating a clinical lab for two years — a decision which she appealed. She's now turned her attention to the miniLab, a Theranos technology that aims to consolidate the process of blood testing done on bulky machines into one tabletop device. More from Rebecca Robbins here

Obama administration pushes for zero traffic fatalities

The Obama administration is getting to work on a new public health goal: eliminating traffic fatalities in the US in the next 30 years. The new plan is in response to a 7 percent uptick in traffic deaths in the past year. The Transportation Department says they’ll focus on boosting seatbelt use, expanding the use of rumble strips on the roadside, and raising awareness about the dangers of drunk and distracted driving. The administration says the introduction of self-driving cars will help them push toward zero traffic deaths by eliminating many instances of human error, which plays a role in 94 percent of car crashes.

Lab Chat: Better blood sugar measures for diabetics

Doctors could get a better picture of glucose levels in diabetic patients thanks to new research into cellular aging. Researchers have figured out that blood cell age can distort results of a common blood glucose test called A1C — and they've come up with a way to account for its impact to get more accurate results. Here’s what lead researcher John Higgins of Harvard told me about the work, published in Science Translational Medicine.

What’s the problem with A1C tests?

The A1C is a huge advance over what was previously available, which was instant measurements of the blood sugar of diabetic patients. A1C gives you a glimpse into that longer-term, typical glucose level. The problem is it’s not as accurate as it could be. People who’ve had very intensive regular glucose measurements haven’t always had A1C results that correlate.

And how do red blood cells impact those results?

Red blood cells are slowly picking up glucose when they circulate and the typical red blood cell circulates for about 100 days. So if my glucose level is about the same as someone else’s, but my cells are circulating for 110 days and theirs are circulating for 100 days, our A1C will be different. We were trying to come up with an evidence-based guess of how much of that non-glucose variation in A1C levels comes from red blood cell age, and it turns out all of the non-glucose variation can be explained by it.

We developed a mathematical model that converts what we now know about glucose and red blood cell aging into some equations that let us infer a patient’s glucose level much more accurately than with A1C.

Sponsor content by precisioneffect

Leveraging the science of storytelling to change health behaviors

It can take years for medical advances to be incorporated into care pathways. While the pace of scientific change continues at rapid speed, the forces that perpetuate the status quo in medical practice and human behavior are mighty foes. Circumventing those forces, to spark interest, trial and adoption begins by understanding just what underlies current choices. Boston medical marketing agency, precisioneffect, has spent nearly 40 years uncovering motivation to change the minds and behaviors of physicians, patients and caregivers. Some of those stories start here.

Inside STAT: Cancer patients face impossible decision

Rachel lefebvre with her son. (matthew orr / stat)

Rachel Lefebvre and her husband Fred were sitting in her oncologist’s office, waiting to find out if a last-line chemo drug had worked to stop the spread of her liver tumors. It had — and that meant she was now eligible to try the promising experimental cancer treatment called immunotherapy. But for late-stage cancer patients like Lefebvre, picking a clinical trial can be a torturous decision. Immunotherapy trials often exclude patients who’ve already received similar treatments, meaning patients get just one shot. "You have to choose very wisely,” she said. “But it’s a little like eeny, meeny, miny, moe. It’s impossible to make a good decision.” STAT’s Bob Tedeschi has the story here.

What makes the airways of asthma patients unique

 Here's what your living, breathing airway looks like. (Cho et. al)

A new imaging technique is giving scientists a peek inside the airways of asthmatic patients to better understand what drives the disease. They're now able to examine airway smooth muscle, a bundle of tissue that wraps around the windpipe. It's activated during an asthma attack, narrowing the airway and making it difficult to breathe. There wasn't any way to visualize ASM in living patients before the newly developed technique, which revealed that airways of asthma patients are thicker than those of patients with allergies but not asthma, and that they also contracted differently in response to allergens than the airways of healthy controls. The researchers behind the technique are hopeful that it could be used to study other diseases of the airway like cystic fibrosis and COPD. 

The genetics behind some fatty-food cravings

Ever wonder what makes you grab a bag of pizza rolls instead of a bag of apples at the grocery store? Your biology may be slightly to blame, according to new research in Nature Communications. Scientists wanted to see whether a genetic mutation that makes people more likely to put on weight might also influence their preference for high-fat food. Participants in the study were given a tasty, if daunting, task — chowing down on an all-you-can-eat buffet of chicken curry. The participants were either lean, obese, or obese and carriers of the genetic mutation scientists were studying. They sampled a low-fat, medium-fat, and high-fat version of the dish without being told the difference between the three. People with the genetic mutation ate almost double the amount of the high-fat dish than lean individuals did, suggesting the gene may play a part in a person’s preference for high-fat foods.

Medical ethics conference heads to Capitol Hill

Bioethicists are descending on Capitol Hill this morning for a conference covering controversial and less-talked-about issues in the world of medicine. There's the type of panels you'd expect, like how to navigate the bioethical risks of editing the human germline. But it's not just CRISPR conversation — they'll also be discussing subjects like the ethical obligations of medical schools to their students, and how the field can better address depression and suicide among doctors. Also on the agenda: a conversation on how genetic counselors should talk with parents about the ethical issues surrounding "savior siblings," who are conceived primarily to provide organs, tissue, or stem cells to an ill older sibling. 

What to read around the web today

  • Study shows health is improving globally, but progress is patchy. Reuters
  • These scientists want to train kids to spot bad health claims. Vox
  • Secret rebates: Why patients pay $600 for drugs that cost $300. Bloomberg

More reads from STAT

  • Awakening the world to the whoosh: A patient's quest to explain pulsing in the ear. 
  • Humans can only live so long and we're nearing the limit, researchers say. 
  • Scientist using big data against heart disease wins $75 million award. 

Thanks for reading! Back tomorrow to wrap up the week, 

Megan

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