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Morning Rounds

FDA expends expiration dates of EpiPens amid shortage

In a bid to counter an EpiPen shortage, the FDA is extending the expiration dates of some lots of the drug. The lifesaving allergy medicine generally has a shelf life of 20 months. But the FDA reviewed stability data from Mylan and determined that certain batches could be stretched for another four months. The drugs were set to expire between April and December. That extension doesn’t apply to EpiPen Jr., which provides a half-dose for kids under 66 pounds. Another step that could help curb the shortage: The FDA recently approved the first fully generic version of EpiPen. It’s not clear yet when it might hit the market or how much it’ll cost.

Officials discuss public health prep for a nuclear incident

Government officials are meeting with public health and safety experts today to talk about how prepared the U.S. health care system is for a nuclear incident. Representatives from HHS, the Department of Energy, and the Department of Homeland Security will be at the meeting, convened by the National Academies. On the agenda: the current state of medical and public health preparedness and challenges to bolstering that capacity. Experts will also talk about what it’ll take to build up the ability to diagnose and treat survivors of a nuclear incident and monitor their long-term health outcomes. 

Lawmakers advocate for NIH lab chimps awaiting retirement

Two lawmakers are pushing to expedite the retirement for hundreds of chimpanzees in research labs. In 2015, the NIH promised to move chimps it owns or supports from labs to sanctuaries — but a report this year found 272 chimps are still housed in research facilities. The NIH has suggested it could finish the transition by 2026, but Sen. Bill Cassidy (R-La.) and Sen. Tom Udall (D-N.M) are trying to speed things up a little. They’re trying to tack an amendment on to a big bill winding through Congress this week that would cut off funding for the labs unless the NIH comes up a way to move all the chimps by the end of 2021. Senate leaders still have to decide whether the amendment will get a vote.

Inside STAT: The dogs were supposed to sniff out C. diff. Then they smelled breakfast

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the dogtor will see you now. (Michael Garron Hospital)

Having dogs that could sniff out patients with highly contagious infections in hospitals seemed like a great idea — but new research casts doubt on how well dogs can hunt out bacteria. Infection control teams in the Netherlands and Vancouver, Canada, have previously reported success with using dogs to sniff out patients or spots in the hospital with C. diff. But those studies only looked at a single dog. In the new study, two dogs, Chase and Piper, didn’t agree enough for researchers to feel confident they were reliable. “When I see that variability as a researcher or even as a clinician, it scares me as far as generalizability moving forward,” says author Dr. Jeff Powis. STAT’s Helen Branswell has more here.

At-home baby monitors aren't always accurate

New research raises concerns about the accuracy of baby monitors designed to detect oxygen levels and pulse rates. Baby monitors don’t have to be approved like a medical product before being marketed to parents. Pediatricians tested two commercially available monitors and found one inconsistently detected low oxygen levels. The other didn’t catch them and also often displayed inaccurate pulse rates. The same researchers penned a JAMA piece last year arguing that baby monitors widely marketed to parents can cause unnecessary stress and haven’t been shown to be beneficial for healthy babies. 

Testing reveals complex culprits behind overdoses

Concerned about what seemed like a growing number of overdoses due to synthetic cannabinoids, doctors at two Maryland emergency rooms partnered with researchers to analyze the drugs involved in 175 overdoses in 2016. But what they found was much more complex than they expected — only 26 involved synthetic cannabinoids, but two-thirds of patients tested positive for multiple substances. And in some cases, lab testing turned up different drugs than patients reported taking.

The findings underscore concerns about treating overdoses from unknown drug combinations or contaminated substances. Just last week, dozens of people overdosed around a Connecticut park after using synthetic marijuana that officials suspect was tainted.

What to read around the web today

  • Fighting dementia with memories of childhood and happy times. New York Times
  • China’s first cancer immunotherapy will be priced at about half of what it costs in the U.S. STAT Plus
  • Poll: Most Americans know about opioid antidote and are willing to use it. NPR
  • The Trump administration can’t decide whether drug industry middlemen are the enemy — or part of the solution. STAT
  • Religious conservatives’ ties to Trump officials pay off in AIDS policies, funding. Kaiser Health News 

Thanks for reading! More tomorrow,

Megan

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Wednesday, August 22, 2018

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