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Wednesday, October 19, 2016

Morning Rounds by Megan Thielking

Good morning, everyone! I'm here with the morning's news in health and medicine. For more STAT stories, like us on Facebook

WHO warns of cholera outbreak in Yemen

World Health Organization officials are growing increasingly concerned about the spread of cholera in Yemen. The country has seen 340 suspected cases of the intestinal infection, which can cause acute diarrhea and dehydration. No deaths have been reported yet, but those populations are already plagued by food shortages and a lack of access to health care. Two-thirds of Yemeni residents don’t have access to clean water and sanitation services due to ongoing conflicts, which could further the spread of the bacteria.

The agency says it’ll cost more than $22 million from global health partners to address the disease’s spread — and a good chunk of that money is needed now to provide support for medical labs and increase access to health services for residents. Without a speedy, efficient response, the WHO estimates there could be up to 76,000 cases of cholera across the country.

FDA moves to pull two ADHD drug approvals 

The FDA is moving to yank its approval of two generic alternatives to a commonly prescribed ADHD drug, Johnson & Johnson's Concerta. Patients have reported that two types of the extended-release generic tablets — one made by Kremers Urban Pharmaceuticals and another by Mallinckrodt Pharmaceuticals — wear off faster than the brand-name version does, causing unexpected symptoms to crop up. (There’s a third generic, marketed by Actavis, that hasn’t shown the same troubles.)

A 2013 investigation into the drugs identified differences between the generics and Concerta that could mean the generics have less of a therapeutic effect. In 2014, the FDA told the generic drugmakers that they had 6 months to reaffirm their products were as safe and effective as the brand-name equivalent. Kremers submitted data that the FDA deemed inadequate, while Mallinckrodt didn’t provide further data. Now the clock’s ticking — the two companies have until mid-November to request a hearing on the agency’s decision. 

The future of gene sequencing in space

NIH director Francis Collins — who led the Human Genome Project on Earth — has his eye on the genetics research happening in space. Yesterday Collins interviewed virologist and NASA astronaut Kate Rubins, who has spent the summer aboard the International Space Station sequencing mouse, bacterial, and viral DNA. 

Rubins sees a handful of advantages to sequencing DNA outside Earth’s atmosphere, including gleaning more information on what impact microgravity has on the human body and studying life forms that scientists might find on other planets. Collins had one question: What if aliens don’t have DNA? Rubins said the sequencing technology should be able to deal with “things are are nucleic acid-ish.” The ISS will serve as a testing ground for genetic tools that could accompany humans on a future Mars mission, Rubins said.

Sponsor content by johnson & johnson innovation

Female pharmaceutical leaders share their inspiration to become scientists

“I grew up in the UK, and generally received good remarks in all curricula. But one teacher I had when I was 13 made the subject of biology so interesting for me — she absolutely inspired in me a love of human biology,” says Anuk Das, PhD, Head of Scientific Innovation, Janssen Human Microbiome Institute. “I always gravitate toward challenges — when someone says ‘that’s too hard,’ or ‘that’s impossible,’ I say, ‘why?’” Read more about Das and other female J&J leaders, here.

Inside STAT: Primary care docs stay out of opioid fight

Española, New Mexico, has one of the highest opioid overdose rates in the country. But in the community of about 10,000 people, just three doctors are qualified to treat residents with addiction disorders. It’s an issue that is echoed in communities across the country: Few primary care doctors treat patients dealing with addiction, instead referring those individuals out to addiction centers and Narcotics Anonymous. Some primary care doctors don’t want to treat those patients, while others say they simply don’t know how. “We’re just watching the ship sink, even though we have the pumps to easily keep the water out,” said Dr. R. Corey Waller, an addiction-treatment specialist with the American Society of Addiction Medicine. STAT’s Bob Tedeschi has more on how patients and doctors are coping in Española — read here.

Lab Chat: Leukemia cells dodge chemo to spread again

Leukemia cells in red make moves near blood vessels, in blue. (EDWIN HAWKINS AND DELFIM DUARTE/IMPERIAL COLLEGE LONDON/NATURE)
Leukemia, a cancer of the blood, has one of the highest mortality rates across all types of cancer. There’s a high relapse rate, often blamed on cancer cells that stick around after chemo, resisting treatment and spreading again. Scientists suspected that might be because the cells were hiding away — but new research suggests that's not the case. Here’s what lead researcher Cristina Lo Celso of Imperial College told me about the discovery, published in Nature.

What did you find about leukemia cells that survive chemo?

Contrary to what everyone in the field expected, we demonstrated that leukemia cells that survive chemotherapy are very motile and don’t seem to entertain any long-lasting interactions with their surrounding environment. This suggests that novel interventions aimed at slowing down these resistant cells may make chemotherapy more effective.

And what else do we know about what those cells do?

While leukemia cells do not care about where they are, their presence leads to the destruction of bone marrow areas known to support healthy blood production. This suggests that if we find ways to preserve these areas, we may combat the loss of healthy blood cells that leukemia patients have to battle with.  We now want to find out whether these unexpected behaviors are shared by other types of leukemia.

Scientists battle infection-causing biofilms

Scientists have zeroed in on a crucial protein bacteria use to create biofilms, slimy layers that can grow on the surfaces of medical devices like catheters and put patients at risk. Biofilms often don’t respond to antibiotics or disinfectants, making them quite tricky for hospitals to deal with. New research shows that a particular protein dubbed MapZ is key to the the building up of biofilms. When researchers tweaked bacteria to take away MapZ’s functionality, the bacteria weren’t able to grow biofilms as effectively as bacteria still packing the protein. 

Jennifer Lopez could bring CRISPR to primetime

Move over, Jennifer Doudna— there's a new Jenny on the CRISPR block. Jennifer Lopez is reportedly interested in producing a drama for NBC called C.R.I.S.P.R. The Hollywood Reporter says it'll be a"procedural thriller set five minutes into the future that explores the next generation of terror: DNA hacking." Potential plots: a "genetic assassination attempt on the president" or "the framing of an unborn child for murder." And in the real-life drama of CRISPR, today's the day biotech company CRISPR Therapeutics makes its initial public offering, putting 4 million common shares up for sale at $14 apiece. 

Doctors behind three-parent birth share new details 

Scientists who created the embryo of a recently born baby combining DNA from two women and one man are releasing new details on the case. Dr. John Zhang — a New York fertility doctor who led the team — will be presenting at the American Society for Reproductive medicine meeting today. The doctors used a novel "three-parent" technique that promises to help mothers with faulty mitochondrial DNA have healthy children by replacing their mitochondria with healthy ones from another woman. The procedure and the birth took place in Mexico because the US currently bans the practice. An expert panel has said the US should conduct a clinical trial on the technique. Keep an eye out for announcements on Twitter — attendees are tweeting under the hashtag #ASRM2016.

What to read around the web today

  • Are insurers discriminating against HIV patients? Kaiser Health News
  • VA shuffles managers, then declares "new leadership." USA Today
  • To curb unintended pregnancy, Texas turns to IUDs in the delivery room. Texas Tribune

More reads from STAT

Thanks so much for reading! Back tomorrow morning, 

Megan

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