Thursday, December 15, 2016

Morning Rounds by Megan Thielking

Good morning, folks, and welcome to Morning Rounds! Here's what you need to know about the world of science and medicine today. 

HHS protects federal funding for Planned Parenthood

The Obama administration is making moves to protect the more than $500 million in federal funding Planned Parenthood receives each year. HHS has finalized a new rule that makes it clear states can't discriminate against any qualified health provider when doling out federally funded grants for family planning and preventive health services, which are provided for under Title X. Much of Planned Parenthood's federal funding comes from Medicaid and goes toward health services for low-income individuals. The new rule regulation can still be rolled back during the Trump administration. 

States challenged to push docs to use opioid databases

Prescription drug monitoring programs — databases that track the prescribing and distribution of controlled substances to patients — could help curb cases of opioid abuse and misuse. But even though every state now has a PDMP available, many doctors still aren’t using the programs. An analysis out this morning from the Pew Charitable Trusts and Brandeis lays out new guidelines to help states bump up use of the programs among prescribers. Among their suggestions is to allow prescribers to delegate someone such as a nurse to access the PDMP on their behalf. Being able to hand the task off to a designated helper could make busy doctors more willing to use the databases. Doctors are also required to apply for access before they can actually use a PDMP. Cynthia Reilly, director of Pew's substance use prevention and treatment initiative, suggests streamlining the paperwork involved. “Making this process faster and easier for prescribers can increase PDMP use,” she said.

Scientists grow pacemaker heart cells in the lab

(Mcewen center for regenerative medicine)

Scientists have turned human stem cells into functional pacemaker cells that can trigger a rat’s heart to beat — a potential first step toward making a biological pacemaker. There’s a specific type of cell in the heart, called sinoatrial node pacemaker cells, that functions as the body’s natural pacemaker. The cells activate electrical impulses that, in turn, cause the heart to contract. When such cells don’t work correctly, patients may have an electronic pacemaker implanted, but those devices can be tricky — they need to be replaced over time, and among pediatric patients, there’s no simple way to scale up their size as the heart grows. So researchers at the McEwen Center turned to human stem cells, which they were able to differentiate into pacemaker cells over a span of three weeks. The next step: Implant the lab-grown cells into animals to test for safety. Read about the work in Nature Biotechnology

Sponsor content by Biotechnology by Amgen

A rare inside look into biotech manufacturing

Ever wonder what it's like inside a facility where biologic medicines are made? Some who have strode past its stainless steel bioreactors, covered head to toe in multiple layers of appropriate garb so as not to disturb this highly sensitive environment, have likened it to visiting NASA. To learn more about this intricate facility, click here.


Inside STAT: The opioid crisis sweeps Cherokee Nation

Curtis wilson with his sister, cyndi. (Matthew orr / stat)

Dr. Anna Miller kicked her boots off and sat in an exam chair at Cherokee Nation W.W. Hastings Hospital, waiting for her first Suboxone patient of the day. She knows the odds are stacked against her patients struggling to get off opioids — the rate of drug-related deaths among American Indian and Alaska Native people has almost quadrupled since 1999. But she also knows she has a few singular advantages, unique to Cherokee Nation, in tackling the crisis that's plaguing much of the US. But those advantages are double-edged — like the fact that health care is free to members of Cherokee Nation. It gets rid of cost as a hurdle to care, but can make it difficult to get patients to buy into their recovery. And the closeness of the tribe, which can make for a good support system, can also drag down patients in recovery who still feel surrounded by addiction. That's a struggle one of her patients, Curtis Wilson, knows well. I've got the story from Cherokee Nation here

FDA sued over risks of Brazilian hair treatments

Two environmental groups are suing the FDA over the agency’s alleged failure to address the potential health risks of keratin hair treatments, a.k.a. "Brazilian blowouts." Some of the products applied to the hair in these procedures contain formaldehyde, which the EPA has classified as a probable human carcinogen. The hair treatment involves a liquid that’s applied to the hair and then heated with a blow dryer or straightener — which can then release formaldehyde into the air. The Occupational Health and Safety Administration has said the products can pose a health hazard to salon clients and workers if formaldehyde in the air exceeds the permissible limit, and can cause skin, eye, and lung irritation. The lawsuit, brought by the Environmental Working Group and Women’s Voices for the Earth, aims to get the FDA to restrict the products or pull them from shelves.

Which state ranks as the healthiest in America? 

The annual America’s Health Rankings report is out this morning, and Hawaii tops the list as the healthiest state in the US for the fifth straight year. The rankings are based on 34 health measures including drug deaths, air pollution levels, and obesity prevalence. The state with the most room for improvement: Mississippi. The national cardiovascular death rate ticked up slightly — from 250.8 deaths per 100,000 people to 251.7 — for the first time in the 27 years the survey has been conducted. The drug death rate also climbed up 4 percent nationally in the past year. You can find the full report here.

Mostly low-risk women got BRCA test after Jolie's news

A few small studies have found that BRCA testing — genetic assessment of whether a woman carries breast- and ovarian-cancer mutations — increased after Angelina Jolie’s 2013 announcement that she had the test and underwent a double mastectomy as a result. But a new study, the largest of its kind, goes further: Most of the women who had those $3,000 tests were not at high risk for breast cancer — the population for whom BRCA testing is recommended — and probably shouldn’t have undergone testing in the first place.

Researchers at Harvard Medical School analyzed data from over 9 million US women between ages 18 and 64 with private health insurance. In the 15 working days before Jolie’s announcement, there were about 7 tests per million women. In the 15 days after, there were about 11 per million — a rise of 64 percent. But while 10 percent of women who had BRCA tests had mastectomies in the months before Jolie’s announcement, only 7 percent did in the months after. That suggests that Jolie’s announcement inspired low-risk women to get tested, not women with a family history of breast or ovarian cancer, as Jolie had. Celebrity medical announcements “do not necessarily target those most at risk for developing a disease,” said study co-author Sunita Desai.

What to read around the web today

More reads from STAT

Thanks for reading! More tomorrow,


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