Tuesday, March 14, 2017

Morning Rounds by Megan Thielking

Good morning! I'm here with what you need to know to get ahead of the day's health news. The second round of STAT Madness is now open — cast your votes for the best innovations in science and medicine here

Washington's scorekeepers weigh in on GOP bill

The Congressional Budget Office released its much-anticipated report on the stakes of the American Health Care Act. Here's your rundown of the projected impact:

  • An estimated 14 million Americans would lose insurance by 2018-19 under the new plan.
  • By 2026, 24 million more would be uninsured after significant changes to Medicaid. That would drive the total number of Americans expected to be living without health insurance up to 52 million by 2026, compared to 28 million under Obamacare. 
  • Federal spending in Medicaid would fall by $880 billion by 2026, with a projected 14 million fewer people enrolled in the program than if Obamacare stayed in place.
  • Cuts to federal Planned Parenthood funding would mean 15 percent of people who “would probably reside in areas without other health care clinics or medical practitioners would lose access to care." 
STAT's D.C. bureau has the key takeaways on the report. 

Harvard to offer free online class on the opioid crisis

Harvard is launching a free online course designed to educate people about the opioid epidemic in the US. Instructors will cover the medical basics, such as how opioids are used to treat pain and how pathways in the brain can play a part in addiction. They'll also touch on the epidemic's legal aspects — including how law enforcement and public health experts are combatting overdose deaths — and social aspects, such as what the path to recovery might look like, as told by recovering addicts themselves. The class gets underway March 27; you can find more info here.

Painting the chromosomes inside a cell

a fireworks show, courtesy of your chromosomes. (University of Cambridge and MRC Laboratory of Molecular Biology)

Scientists have created a new 3-D visualization of an intact mouse genome that’s full of intricate details about how cells organize their genetic information. They snapped pictures of the distribution of DNA in a mouse embryonic stem cell, then assembled them together, painting DNA from each of the 20 chromosomes a different color. "Previous studies have all employed data recorded from a population of cells, but because chromosome and genome structure varies so much from cell-to-cell, [scientists] cannot study genome folding using such data," study author Ernest Laue of the University of Cambridge tells me of how the new paper advances previous work. "Our approach allows [scientists] to study genome folding for the first time inside individual cells." 

The researchers are hopeful the visualization technique could be used in the future to illustrate the genomes of cancer cells. That might give scientists the chance to see what goes wrong in the structure of those cells — and shed light on new opportunities to intervene.

Inside STAT: A revolutionary experiment in West Africa

An entomological technician sprays a home as part of work to measure the density of mosquitoes in the village. (sophie garcia for stat)

In a small village of mud-brick homes in West Africa, scientists are prepping for what could be one of the most promising and frightening biological experiments of our time. They’re working on the possible release of mosquitoes equipped with gene drives, a technology that gives every new mosquito a specific genetic trait that normally only half would acquire. Scientists are hopeful it could nearly eradicate a species of mosquito and with it, slash the rate of malaria across Africa. No living mammal, insect, or plant with a gene drive has ever been released into the wild. Residents across Burkina Faso told STAT’s Ike Swetlitz they’re eager about the potential to eliminate the disease. But scientists have another hurdle to jump — they have to make sure those in the community understand and accept the genetic technology and the unknowns that come with it. More here.

CDC sounds new warning about Zika in Florida

More women in Florida may have been at risk of contracting Zika during pregnancy last year than was previously recognized, the CDC said yesterday. The agency's analysis of the Florida cases revealed that local transmission of Zika probably started as early as June 15 of last year. That's six weeks earlier than the previous cutoff date of August 1, after which women who got pregnant in Miami-Dade, Broward, and Palm Beach counties had been told that Zika testing was recommended. The CDC singled out in particular women who used donor sperm to get pregnant during that time frame as possibly being at risk. About 85,000 women from the three counties have become pregnant since June 15, the CDC said, and as many as 5,000 of those pregnancies may have involved sperm donation or assisted reproduction. Currently, there is no commercially available Zika test for semen. 

AMA launches a new push to fight replacement plan

One of the nation’s most prominent doctors’ groups is urging the public to "put patients before politics" — and join their fight against key parts of the American Health Care Act, the GOP's bill to replace Obamacare. The American Medical Association has launched a new site that breaks down developments in health care reform, giving users an easy way to contact members of Congress and ask them to support affordable health coverage and protect Medicaid. It’ll even give users a way to draft up their own proposal for health care reform.

The doctors' association has made it clear it won’t support the current legislation. “We cannot support the AHCA as drafted because of the expected decline in health insurance coverage and the potential harm it would cause to vulnerable patient populations,” the AMA’s chief executive, Dr. James Madara, wrote in a letter earlier this month.

Are military docs trained to treat transgender patients?

A new study sparks concern that some military doctors aren’t well-equipped to provide care to transgender patients or those with gender dysphoria. It’s estimated that nearly 13,000 transgender individuals serve openly in the military, about 200 of whom will seek treatment related to gender dysphoria in a given year. Researchers surveyed 180 family doctors who provide care for military members and their families. Three-quarters of those doctors hadn’t received any training whatsoever on transgender health care, and 87 percent said they didn’t have enough education to provide cross-hormone therapy for patients who wanted to transition to the opposite gender. The study’s authors say that because family doctors are a first point of care for many in the military, it’s critical they're trained to treat transgender patients. 

What to read around the web today

  • An AIDS museum: The challenges are huge, but the timing is right. New York Times
  • How one hospital is using superbug-sniffing dogs. Vancouver Sun
  • The saga of the Irish Giant's bones dismays medical ethicists. NPR

More reads from STAT

Thanks for reading! More tomorrow,


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