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Thursday, April 7, 2016

Morning Rounds by Megan Thielking

Happy Thursday, everyone! Here's what you need to know to jump ahead of the news in science and medicine today. For more STAT stories, see our full site

Inside STAT: Thorny ethical issues arise in Google's Verily

Verily Life Sciences, the biotech offshoot of Google, has awarded a research contract to a clinic primarily owned by Verily's own CEO Andrew Conrad. That arrangement has prompted questions within Verily and among outside experts about whether that contract poses a conflict of interest. Asked why he promoted a deal for his own clinic despite the potential conflict, Conrad said in an interview with STAT, “Because I think it’s cool. Because it’s super efficient to have everything in one spot.” Conrad said ethics officers from Google gave the contract the go-ahead.

Another potentially thorny ethical issue — Verily is making moves to sell a wealth of personal data from volunteers in the company’s health study, dubbed the Baseline project, to pharma companies. More from STAT’s Charles Piller here.

Labeling food with the exercise it takes to work the calories off

Would you drink a soda if you knew it’d take you half an hour to walk off the calories? A new proposal in the BMJ suggests labeling foods with how much exercise it’d take to burn off the calories they contain. 

"The big picture goal of this idea is ultimately to combat obesity, encourage people to be more active in their lifestyles and to be more mindful of the calories they are consuming," Matt Keracher of the UK's Royal Society for Public Health told me. But that doesn't mean the food industry is going to buy into the idea, he added. Meanwhile the obesity epidemic is growing more prevalent — a recent study found that for perhaps the first time ever, there are more overweight or obese people in the world than underweight people.

Reframing the debate over e-cig use

A central question in the debate over e-cigarettes is whether they’re a good way to minimize health risks to smokers, an idea laid out in a new article in the New England Journal of Medicine. “If current smokers were to switch to e-cigarettes, or if people who would have become smokers pick up e-cigarettes instead of combustible cigarettes, they would substantially reduce their harm while still satisfying their nicotine addiction,” study author Sharon Green of Columbia told me.

sponsor content by cvs health

Data: Improving patient outcomes and delivering lower costs 

Pharmacy Benefit Managers (PBMs) — organizations that administer prescription drug benefits on behalf of employers, health plans, and government agencies — are playing an increasingly important role in improving patient outcomes. In fact, research from the CVS Health Research Institute shows that cost-saving PBM strategies — mail pharmacy delivery, promoting generic utilization, and automatic refill programs — also can help boost medication adherence and improve patient health. Learn more about the ways CVS Health is addressing prescription drug costs and improving patient health in CVS Health’s drug trend data.

Lab Chat: The cells that sweep trash out of your brain

Microglia (in green) engulf dead cells in the brain. (Salk institute)
 
Special immune cells protect your brain by sweeping away dead or dysfunctional cells. Now, scientists have discovered that they have another role, as targeted assassins of sick cells. Here’s what lead researcher Greg Lemke of the Salk Institute told me about the research on mouse brains, published in Nature.

How does the brain clear out dead cells?

In these areas of the brain where you’re giving rise to new neurons, it was known that during that process a large number of the newly born cells die. In the hippocampus, this is about 80 percent. Those cells have to be cleared away, and the cells that do that are called microglia. Those microglia cells use two specific receptors to recognize the dead cells and then start the process of eating them.

What else did you see the microglia do?

[We saw] it was highly likely that a significant amount of death that you see in neurogenesis is not because the cells themselves die intrinsically. It’s that they’re actually killed by microglia. They're eaten alive. Some of these cells aren’t healthy, and they may be expressing the “eat me” signals that are normally expressed by dead cells. It must be a mechanism, we guess, for selecting the healthiest and fittest cells.

Potential alternative for treating heroin addiction

There’s a new treatment option that could help people with chronic heroin addiction who haven’t had any luck with typical drugs like methadone. Doctors sometimes give patients who’ve struck out with other treatments a series of controlled doses of pharma-grade prescription heroin to ease their addiction. But injections of hydromorphone, currently approved as a painkiller, seem to work just as well as the pharma-grade heroin injections, according to initial clinical trial data. Read more in JAMA Psychiatry.

Abnormal heartbeats can make other health problems worse

Having an abnormal heartbeat makes older adults particularly vulnerable to losing strength and balance, and that risk rises as people age, according to a new study. Atrial fibrillation (AF), a condition marked by an irregular or too-fast heartbeat, commonly develops in people over age 70. The study, which will published in Circulation: Arrhythmia and Electrophysiology, found that patients with AF took 20 seconds longer to complete a short walk than patients without. But the study just found correlation; there could be other factors that contribute both to a person having AF and to a rapid physical decline. And in another new study, researchers found that losing a spouse puts a person at greater risk for AF in the months afterward.

That apple-a-day cliche seems to be true

People who eat fresh fruit might also have a lower risk of heart attack and stroke than people who don't, according to a study of 500,000 people in China published in the New England Journal of Medicine. There, fruit consumption is quite low but stroke rates are quite high, so the researchers combed through medical and death records to see if the two might be connected. It’s not clear whether snacking on fresh fruit actually protects your heart, though — it’s just an association between the two.

What to read around the web today

More reads from STAT

  • In a high-tech hub, this scientist hunts for cures in the greenhouse. 
  • After failed Allergan merger, Pfizer considers splitting up the company. 
  • As hospitals go digital, human stories get left behind

As always, thanks for reading! Back tomorrow, 

Megan

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