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Morning Rounds Shraddha Chakradhar

Vaping-related lung injuries resemble chemical burns, report finds

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Biopsy images from patients with vaping-associated lung injury. (The New England Journal of Medicine)

A new report finds that lung injuries in those who suffered vaping-related illnesses resemble damage in those exposed to harmful gases or chemical spills. Looking at biopsies from 17 patients, researchers found signs of inflammation of the lungs — known as pneumonitis — and damage to the airway and lung tissue. And although the report didn’t offer clues as to which chemicals might be responsible, it did seem to refute earlier evidence that inhalation of fats may be to blame. But in keeping with a report last week that found many of those who became sick vaped THC, 70% of the patients in the new study reported vaping the marijuana compound.

Women surgeons earn less than male co-workers in fee-for-service system

Previous research has suggested that female physicians in a salary-based system, like in the U.S., earn less than their male co-workers, but new data indicates the same can be true in a fee-based system. Canadian surgeons get paid a fee based on the services they render, and that system is theoretically supposed to be free of bias. Looking at data from nearly 3,300 surgeons, researchers found that female surgeons earned roughly 24% less per hour than their male colleagues. The disparity existed even when accounting for medical specialties, with the largest hourly wage differences among cardiothoracic and orthopedic surgeons. Female surgeons were also more likely to perform common procedures with the lowest hourly earnings, such as in gynecology. 

Twin births in the U.S. are on the decline

New data from the CDC suggest that the twin birth rate in the U.S. continues to be on the decline. Here’s more: 

  • Overall trends: Although the twin birth rate was increasing slowly from 1980 to 2014, the rate declined by 1% per year between 2014-2018. 

  • Birth mother trends: The older the mother, the higher the decline in twin births. Twin births among women ages 30-34 declined by 10% since 2014, while the rate declined by nearly 25% in those over the age of 40. 

  • Trends by race: In 2014 and 2018, twins were most likely to be born to black mothers, followed by white mothers and then Hispanic mothers. White women, however, saw the biggest decline — 7% — in twin births since 2014.

Inside STAT: As vaping injuries climb, doctors struggle to wean youth off nicotine

The 16-year-old was seriously sick. She’s one of the 805 patients across the U.S. with vaping-related lung injury, at least 12 of whom have died. But when Dr. Melodi Pirzada asked her about quitting, the response was a surprise. “She said, ‘OK, the THC, that is fine, but the nicotine — I really love the feeling that I get with it. I don’t know if I’m ready to give that up,’” Pirzada recalled. As anxiety about these pneumonia-like symptoms has grown, more and more teens are thinking about kicking their e-cigarette habits. Yet even as states consider restricting the sale of vaping products, getting rid of a nicotine addiction is easier said than done. STAT's Eric Boodman has the story.

Some Arkansans report difficulty understanding new Medicaid work requirements

Arkansas was the first state last year to implement work requirements for Medicaid recipients, and two new analyses find that although most people are aware of the new rules, many don’t understand how they work. Nearly 20,000 Arkansans are no longer covered by Medicaid, and in one report, participants who had lost health insurance under the new criteria shared that the state’s online system for reporting work hours was difficult to use and often unavailable. In another report, Supplemental Nutrition Assistance Program recipients in the state said in interviews that they are confused by the new work requirements, and some have lost access to SNAP and Medicaid in the process. The interviews for both reports were conducted with a small group of participants, however, so the findings may not be generalizable. 

Tufts-Harvard event marks the 50th anniversary of White House nutrition conference

This year is the 50th anniversary of a nutrition conference launched by President Nixon — the only such White House event. Its mission was to focus on nutrition’s impact on health with an aim to “put an end to hunger in America for all time.” To mark the occasion, nutrition researchers from Tufts University and the Harvard T.H. Chan School of Public Health are holding a conference today and tomorrow to examine current food and nutrition challenges as well as outline policy solutions, including for health care. There will also be an event in Washington on Oct. 30 in collaboration with Hunger Free America to look more deeply into issues of hunger and food justice as well as health and sustainability. 

What to read around the web today

  • Opinion: Data standards may be wonky, but they will transform health care. STAT
  • Judge rules Philadelphia supervised injection site does not violate federal law. The Washington Post
  • FDA challenges testing used by lab that found a carcinogen in Zantac and other heartburn meds. STAT Plus
  • ‘I am fearless again’: New veterans’ group gives women a sense of belonging. The New York Times
  • Football's concussion crisis is awash with pseudoscience. Wired

Thanks for reading! More tomorrow,

Shraddha

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Thursday, October 3, 2019

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