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Tuesday, October 3, 2017

Morning Rounds by Megan Thielking
Welcome to Morning Rounds. Here's what you need to know about health and medicine today. 

Las Vegas hospitals rush to care for shooting victims

Las Vegas hospitals have been flooded with victims of the mass shooting that killed at least 59 people and injured more than 500 others. Civilians at the scene drove injured people in their own cars to hospitals. Police blocked off roads near University Medical Center, the city’s only Level 1 trauma center, to give emergency vehicles a clear path. The hospital received 104 patients, including more than 30 in the trauma center. Las Vegas police said five hospitals were treating patients injured in the shooting. Doctors, nurses, and other hospital staffers not scheduled to work were called in to help with the rush of patients and loved ones looking for those injured or missing. 

A report released yesterday highlighted the continued toll of gun violence in the U.S.. Researchers found that ER and inpatient costs alone for firearm-related injuries total $2.8 billion every year. Half of those cases were classified as assaults.

Half of people in Puerto Rico still don't have clean water

Officials in Puerto Rico are still scrambling to get medical care to individuals impacted by Hurricane Maria. Half of residents still don’t have access to clean drinking water. Dozens of hospitals, dialysis centers, and pharmacies, many damaged by the storm and running on generators, have received assistance to keep their doors open. HHS says all but two hospitals on the island are at least partially functional, but some facilities have evacuated patients in critical need to hospitals in the mainland U.S.. A floating hospital from the Navy — home to a massive trauma center — is also headed to the island and is expected to arrive later this week.

Two versions of this drug have wildly different price tags

Comparing price tags for two drugs to prevent preterm birth might give you sticker shock: The generic version costs an average of $206 per pregnancy. The brand-name? $10,917. Researchers dug into data from women who received either a compounded version of the drug or a prepackaged version, sold under the brand name Makena. There wasn’t any statistically significant difference in preterm birth rates between the two groups, but roughly 14 percent of women took the brand-name version. 

The drug had been used for years to prevent pre-term births when the FDA granted KV Pharmaceuticals “orphan drug” status to produce a branded version. That orphan drug designation gives drug makers a seven-year exclusive right to market the drug — and a window to significantly raise prices. But the FDA also continued to allow compounding facilities to continue making the drug, creating two clinically equivalent products with dramatically different price tags.

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Inside STAT: Alzheimer's patient in multimillion-dollar pharma ad may soon be homeless

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brian Kursonis in his apartment outside Charlotte, NC. (logan cyrus for stat)

Brian Kursonis, who was diagnosed last year with early onset Alzheimer’s at age 55, starred in the drug industry’s multimillion-dollar “Go Boldly” campaign. The PR push was designed to showcase the pharmaceutical industry’s commitment to develop cures for diseases such as Alzheimer’s. But the patient who anchored the campaign says the ground has fallen out from under his feet. Kursonis fears he will soon be homeless. He lives alone and sometimes forgets to eat. He recently got a federal notice letting him know he’s eligible for government insurance but couldn’t understand what to do with it, so Kursonis put it aside. His story sheds light on the complicated realities that compound the challenges of living with a disease like Alzheimer’s. More from STAT’s Rebecca Robbins here.  

Refunds sent out for unproven addiction treatment 

Federal officials are mailing out thousands of refunds to consumers who bought a product touted as a treatment for opioid addiction withdrawal. Sunrise Nutraceuticals claimed that Elimidrol — a powdered drink mix that contained herbs — could ease the symptoms of withdrawal. Of course, that claim wasn’t backed up by any evidence, and the product wasn’t approved by the FDA. The Federal Trade Commission is sending out refunds totaling more than $210,000.

Health providers weigh in on reused syringes

A troubling new study finds that 12 percent of doctors and 3 percent of nurses in the U.S. say that, against protocols, syringes get used on multiple patients in their workplace. We partnered with our colleagues at Figure 1, a learning platform for health professionals, to poll physicians and nurses about whether they'd seen the practice themselves. Here’s what they had to say:

  • "Why would you ever reuse? The only reason I could think of is pressure for financial savings from the institution. At my institution everyone’s hair lights on fire if you recap a syringe. I can’t even imagine reusing one." —Registered nurse 
  • "I've seen MD in ICU reuse same needle/syringe in attempting line placement or blood drawing... [despite] additional equipment immediately available and suggestions from staff to use new equipment." —Clinical nurse specialist
  • "This is not happening anywhere that has proper funding. I can only imagine this being done when you are desperate with no supplies. Even then I just can't imagine." —Licensed practical nurse

Hospitalizations for prescription overdoses fall as heroin rates rise

A new analysis finds that from 2008 to 2014, hospital discharges for heroin poisoning jumped more than 31 percent each year, while discharges for prescription opioid poisonings fell about 5 percent annually. The study’s authors say the decline in hospitalizations for prescription opioid overdoses coincides with public health initiatives to curb misuse, but it also could be due, in part, to some patients moving to heroin and synthetic opioids such as fentanyl. But they’re also cautiously optimistic that public health efforts have helped to reduce the role of prescription painkillers in the epidemic.

What to read around the web today

  • If you were starting a medical school from scratch, what would you do differently? WBUR
  • Controlled chaos at Las Vegas hospital trauma center after attack. New York Times
  • Few U.S. hospitals can fully share electronic medical records. Reuters

More reads from STAT

The latest from STAT Plus

Thanks for reading! More tomorrow,

Megan

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