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Tuesday, September 12, 2017

Morning Rounds by Megan Thielking

Good morning, folks, and welcome to Tuesday. Here's what you need to know about health and medicine this morning. 

The many health care happenings on the Hill today

There’s a flurry of health care news from Capitol Hill this morning. Here’s a look at what’s going on:

  • There's a last-ditch effort to repeal Obamacare. GOP senators Bill Cassidy and Lindsey Graham are working on a health care bill that would end ACA funding for Medicaid expansion and insurance subsidies, swapping them instead for block grants. But the deadline to push a repeal bill through using the budget reconciliation process is September 30, and the Congressional Budget Office still hasn't scored the proposal. 

  • The Census Bureau is rolling out new numbers on uninsured rates. Also today, the Senate HELP and finance committees are each meeting to talk health insurance. 

  • In case you're keeping track, it's been more than a month since President Trump called the opioid crisis a national emergency — but he still hasn't gone through the steps to make it official.

Bacterial outbreak tied to puppies sold at Petland stores

Health officials say 39 people have been sickened in an outbreak of Campylobacter infections. The source: puppies. The outbreak, which started last year, has been linked to puppies sold through the national pet store chain Petland. The outbreak has spread to seven states and nine people have been hospitalized. If you want to stay safe while playing with a pup, the CDC recommends you wash your hands and properly dispose of dog poop, particularly in areas where kids might play.

How often do clinical trial results go unpublished?

Clinical trials often go unregistered and unpublished — and when they are published, there might be selective reporting of the results based on how the trial turned out, according to a new analysis in JAMA. In a study of 113 studies approved by a research ethics committee in Finland, just 61 percent were registered within a month of the trial’s start date, and the results were published for only 57 percent of the studies. The risk of skewing the study's results was an issue, too: One in five trials didn't declare a primary endpoint, or goal, when it was registered. The study is limited by a relatively small sample size. And while it wasn't carried out in the U.S., the issues noted in the new research have certainly been an issue here as well.

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Inside STAT: When life's 'miracles' get complicated

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(Maria fabrizio for stat)

Lisa Geller was 43 when doctors told her they could no longer treat her endometrial cancer, which had spread rapidly. She told her parents she wanted to be buried by her grandmother, and talked to them about her regrets. While her peers were finding love and hitting career milestones, she was trying to stay alive. Then, a longshot immunotherapy drug melted her tumors away, though Geller lives in constant fear her cancer will return. She's in a liminal state between living and dying, left wondering what comes next. STAT's Bob Tedeschi has more here

Those with developmental disabilities face hurdles to health care

New research breaks down the hurdles individuals with developmental disabilities often run into getting the health care they need. Ohio researchers surveyed more than 50,000 people and found that half of adults age 65 and older with developmental disabilities said they had unmet health care needs, compared to 17 percent of those without disabilities. Some of the shortcomings: Not having a doctor who explained things well and not having a primary care provider who had enough time to address their health concerns. The study’s authors say that points to a critical need for clinicians to be educated specifically about providing for patients with developmental disabilities to make sure patients get the care they need. 

The tiny clock ticking inside our cells

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here i am in green, signed, sealed, delivered — I'm your nuclear envelope. (Fang-Yi Chu and Alexandra Zidovska / New York University)

There's a tiny clock ticking and tocking inside your body’s billions of cells right now. It’s long been known that a cell’s nucleus changes over its lifetime, but scientists haven’t had a good understanding of how those changes happen day to day. Now, using a fancy fluorescent microscope, NYU researchers have observed that part of the nucleus called the nuclear envelope actually fluctuates every few seconds, but over time, those fluctuations become less dramatic. Those regular rollercoasters inside the nucleus give scientists an internal clock to gauge what stage in life a cell is at, and also a better picture of what’s going wrong in the nucleus in diseases such as cancer and muscular dystrophy. The research will be published in PNAS

Study tackles the idea of "metabolically healthy" obesity

People who are obese but otherwise healthy are still at a higher risk of some heart problems, according to a new analysis of health data from 3.5 million people in the U.K. Researchers grouped patients based on their BMI and whether they had one of three conditions: type 2 diabetes, hypertension, or high cholesterol. Over the subsequent years, researchers found, people who were obese had nearly a 50 percent increased risk of coronary heart disease and nearly double the risk of heart failure as someone who fell into a “normal weight” BMI category, even if both had no other risk factors. The caveats: BMI is an imperfect measure, and researchers didn’t have access to data about diet or physical activity. “The main takeaway message of the study is that ‘metabolically healthy’ obesity, on a population level, simply does not exist,” says author G. Neil Thomas. 

What to read around the web today

  • Houston's floodwaters are tainted with toxins, testing shows. New York Times
  • Sept. 11 first responder fights on behalf of others who rushed to help. NPR
  • Florida's hospitals weather the storm. Washington Post

More reads from STAT

The latest from STAT Plus

Thanks for reading! More tomorrow,

Megan

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