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Thursday, May 5, 2016

Morning Rounds by Megan Thielking

Hello, everyone! Welcome to your daily dose of news in science and medicine. 

Tighter tobacco laws coming to California

California Gov. Jerry Brown has signed off on major new tobacco and e-cig restrictions, including bumping the statewide smoking age up to 21. Hawaii is the only other state to have raised its smoking age in the US, though the option is on the table in other states. The state will also regulate e-cigs as it does traditional cigarettes, as well as double down on smoking on school campuses and in workplaces. 

States vary widely when it comes to primary care


Whether people have a reliable place to seek medical care varies widely by state, show new data out from the CDC this morning. In Vermont, only 2.8 percent of residents say they're lacking a go-to place for health care. But in Nevada — which fares worse than the national average on a number of health measures — nearly 27 percent of people don't have a reliable source of health care. Also of note: The percentage of people who hadn't seen a doctor in the past year was lower in states that have expanded Medicaid under Obamacare. 

Next steps after Obama's visit to Flint

Next week, Michigan is expected to expand Medicaid coverage to more than 15,000 additional Flint residents in response to the contaminated water crisis in the city. President Obama visited the city yesterday to meet residents and local leaders affected by the lead contamination in the city’s water supply. It's been seven months since city officials acknowledged it isn't safe to drink unfiltered water in the city. Dozens of children in the city have elevated levels of lead in their blood. For more on the challenges to overcoming the anxiety and fear the crisis has caused, read this

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Join a new community of innovators

What does a health care market designed from the consumer in mind look like? It’s going to take a marketplace revolution. Find a bold vision for health care transformation this week on Oliver Wyman Health, a virtual collaborative convened by global management consulting firm Oliver Wyman. What’s your view of future health? Share your perspective and connect with other leaders in health care, from incumbents and new entrants alike. Join the community of innovators here.

The problem of over-dependence on ICUs

A small group of patients accounts for the bulk of costs associated with stays in hospital intensive care units, according to a new study published in Lancet Respiratory Medicine that looked at data from more than 1 million ICU patients. Just five percent of those patients racked up one-third of days spent in ICU beds.

The study’s authors say these cases of “persistent critical illness” often arise when a patient arrives with one condition — like pneumonia — and then in the middle of treatment, develops another — such as gastrointestinal bleeding — that requires a longer stay. Researchers say that warrants a new look at how to end dependence on the ICU. For terminally ill patients, that could mean improving access to hospice or dignified death services. For other patients, it could mean preventive care that reduces the chance of complicating conditions arising during an ICU stay.

Inside STAT: Why cancer is such tricky opponent for science

(Molly Ferguson for STAT)
Cancer is one of the trickiest adversaries scientists face. Tumors undergo thousands of genetic changes, and cancers that once responded to treatment can build up resistance to chemotherapy. Scientists are taking aim at cancer's ability to dodge the immune system, but those have had limited success. In the new episode of Signal, the STAT podcast, Luke Timmerman and Meg Tirrell talk about the impossibility of a single magic bullet for cancer. Listen here

New test could detect rare disease in babies, lead to earlier treatment

Scientists have developed a test of a newborn baby’s blood that could diagnose a devastating neurodegenerative disease that often is missed until later in childhood. Previously, doctors weren’t able to test newborns for Niemann-Pick type C — a condition marked by a buildup of cholesterol in the brain that kills cells — like they could with other rare inherited diseases.  "It's imperative to improve diagnostics and facilitate early intervention," the paper's authors say.

So they created the new test, described in the latest issue of Science Translational Medicine, which measures the amount of bile acid in the blood. Bile acid is a byproduct of cholesterol being processed in the body, so it is a useful biomarker for NPC. It successfully detected NPC in 44 samples of dried blood from patients with the condition.

Outdoor exercise in high-pollution cities gets a green light

Even if you live in a smog-filled city, walking and cycling outside is on balance good for your health, finds new research out of the University of Cambridge. There’s been a concern that people who exercise outdoors in cities with high pollution levels inhale a significant amount of toxins, which could harm their health. In a new study, researchers simulated the risks and benefits from walking or cycling in environments with varying levels of air pollution. For most cities it was a thumbs up, though for the worst 1 percent of cities, the health costs outweighed the exercise. And the risk-benefit relationship depends on how much time you spend outside. For instance in Delhi, the authors say, people can only cycle outdoors for about five hours a week before the health risks of inhaling pollutants outweigh the benefits of the exercise.  

These molecules might make you sneeze

A new study shows that blocking three inflammatory molecules works better than targeting each one individually to stop the symptoms of allergies, asthma, and skin inflammation. In a mouse model, researchers looked at what happened when they blocked or genetically deleted each of three different molecules tied to allergies. It didn’t do much of anything. But when they blocked all three molecules in the early stages of allergic disease, inflammation in the mice was reduced. Read about the technique in the new Science Translational Medicine.

What to read around the web today

  • Take a Valium, lose your kid, go to jail. ProPublica
  • One man's effort to do an extreme DIY fecal transplant. The Verge
  • Pregnant women in need of health care are the forgotten victims of war. NPR

More reads from STAT

  • In crisis, Prince rep turned to a pioneer in treating opioid addiction.
  • New advances in growing embryos could reignite an ethical debate
  • This biotech CEO is going all-in on a first drug approval.

I'll be back bright and early tomorrow! Thanks for reading, 

Megan

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