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Morning Rounds Shraddha Chakradhar

Good morning! This is STAT reporter Eric Boodman, filling in for Shraddha. She’ll be back tomorrow.

Battle set in Washington over competing drug pricing bills

A battle of drug pricing bills is set to play out this week in Washington. On one side of the ring is House Speaker Nancy Pelosi’s proposal, which would both use an international standard to cap prices and allow Medicare to directly negotiate the cost of certain medicines. In the other corner is a Republican document that includes some bipartisan policies already under consideration in the Senate, such as capping Medicare beneficiaries’ out-of-pocket expenditures at $3,100. The GOP suggestions were unveiled in a closed-door meeting Friday morning, just in time to compete with Pelosi’s bill, which is up for a vote in the House this week. In an added layer of tension, some Democrats may not vote for Pelosi’s bill if it doesn’t extend protections to uninsured patients.

New study proposes reclassifying some infant deaths

When an infant dies suddenly and unexpectedly, the tragedy is often compounded by medical confusion. A death that is labeled accidental suffocation in one state or county might be attributed to unknown causes or to sudden infant death syndrome in another. Now, a paper published in Pediatrics has proposed a new classification. Using computer models to examine birth weight, maternal smoking, and other characteristics for nearly 38,000 infant deaths, the authors found that those who stopped breathing at less than 7 days of age had different traits from those who died between 8 days and a year old. But others warn that data aren’t consistently collected when a baby dies within 24 hours of birth, and separating out these groups might hinder the detection of larger patterns.

U.S. flu season off to its earliest start in more than 15 years

Back in October, the symptoms started appearing in Louisiana doctors’ offices: the first signs of American flu season. To some experts, the fact that it’s starting this early is a sign that these viruses might do a lot of damage this year, because that was the case the last time the phenomenon was observed, in 2003-2004. But others say it’s too soon to tell. The season is declared officially underway when there’s a three-week period during which a significant percentage of U.S. doctor’s office visits are due to flu-like illnesses. The Centers for Disease Control and Prevention says that point has been reached — but it’s not yet clear how well this year’s vaccine protects against the viral strains that happen to be circulating.

Inside STAT: ‘You keep loving each other’: A window into dementia at the end of life

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Poul and Else Mathiassen in their house in Skanderborg in Denmark. (SOFIE MATHIASSEN)

For Poul Mathiassen, Parkinson’s disease came as a cascade of losses. First, he could no longer control his toothbrush. Then he couldn’t remember his friends’ names. During the four years his granddaughter, photographer Sofie Mathiassen, spent chronicling his experience of dementia, she captured images of his increasing frailty but also of the 57-year relationship he’d built with his wife, Else. These moments are at once difficult and tender, a testament to the tiny, everyday actions that constitute care. Else shaves Poul, keeping him steady with a thumb and finger on the back of his neck. She helps him take a few halting steps, holding his hands as if in a careful dance. You can see more of Mathiassen’s powerful photo essay here.

Using a betting game to predict opioid relapse

In America’s opioid epidemic, even those who are able to access treatment are often at a high risk for relapsing. To try to predict when those episodes might occur, New York University psychiatrists turned to a game that involved betting, with the idea that the willingness to take risks might correlate with a return to opioid use. Sure enough, the results they published in a new study showed that among 70 people receiving treatment for opioid use disorder in a community-based center, their willingness to make risky bets in the game was associated with increased odds of relapse. Though these preliminary results were observed in only a small group of patients, the researchers are now hoping to turn this game into an app.

Researchers call for better ways to track preemies’ nutrition

When a baby is born prematurely, nutrition is one of the important elements of care. But a new survey of 34 neonatal intensive care units found that doctors didn’t have optimal tools for determining a preemie’s caloric intake, and often ended up doing calculations by hand — which can both take up precious time and lead to errors, the authors say. Because it can be a complicated measurement to take, the method can differ from one NICU to another. The researchers are calling for a standardized, computerized system for tracking how many calories these babies are receiving, so doctors are better able to determine what yields the best outcomes.

What to read around the web today

Thanks for reading! More tomorrow,

Shraddha

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Monday, December 9, 2019

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