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Morning Rounds Shraddha Chakradhar

Hope everyone had a restful long weekend! Let's catch up on the news. 

Teva settles with Oklahoma ahead of opioid trial

Teva Pharmaceuticals has agreed to pay the state of Oklahoma $85 million ahead of an opioid trial set to begin today. The state has accused the generics company and two other pharma companies — Purdue Pharma and Johnson & Johnson — of downplaying the risks of taking opioids while also overstating their benefits, which caused doctors to unnecessarily prescribe the drugs. It could take up to two weeks for the terms of Teva’s settlement to be finalized. Oklahoma Attorney General Mike Hunter said that the trial would still continue as planned against J&J, the only remaining defendant in the trial. Back in March, Purdue agreed to pay $270 million to Oklahoma. In a statement, Teva maintained that its settlement does not mean it is admitting to any wrongdoing.  

Trump administration looks to roll back health care protections

The Trump administration proposed rules late last week that would roll back Obama-era health care protections for certain vulnerable populations, including transgender individuals, immigrants, and women who have previously had an abortion. If the rules are finalized, physicians and other health care professionals could refuse to treat people because of conscientious objections. The rules will likely face legal challenges. Already, several medical groups have spoken out against them: The American Psychological Association, for instance, said that discrimination can exacerbate mental health problems and is a factor in chronic stress-related health disparities. 

In other health policy news, Missouri’s governor signed into a law a ban on abortions after eight weeks of pregnancy, while Mississippi’s ban on abortions after six weeks was blocked by a federal judge. Finally, Colorado became the first state to pass a law capping insulin prices: Insured patients will have to pay no more than $100 a month for the drug. 

Physician burnout costs up to $4.6 billion a year

The economic cost of physician burnout — from fewer hours in the clinic or from having to replace those who leave the profession — could be up to an average of $4.6 billion yearly, a new study finds. Looking at data from nearly 7,000 physicians who were surveyed about burnout in 2014, researchers calculated the economic costs to organizations could be anywhere between $4,100 to $10,200 per physician. The study only looked at direct costs and didn’t include other indirect expenses, including costs associated with delivering poor care, which is a symptom of physician burnout. The authors of the report write that their study provides an economic incentive for organizations to invest in alleviating burnout.

Inside STAT: New fetal surgery for spina bifida may be safer for both baby and mom

Gilda and Arnuf Giron with their newborn daughter, Abigail. (KENDRICK BRINSON FOR STAT)

For many expecting parents who learn that their growing baby has spina bifida — a birth defect that that could mean possible paralysis and other nerve damage — the diagnosis often means a lifelong shunt in the child’s brain. Those who choose not to terminate the pregnancy but want another option may now have a new surgical alternative, one that operates on a 25-week fetus fetus directly in the womb. The procedure is supposed to be easier for both the mother and the growing baby, and early results from a pilot trial seem promising. STAT contributor Usha Lee McFarling has more on the Giron family’s experience with the new operation here

High opioid prescription rates for dental disorders

A new study looking at opioid prescription patterns among young adults and teens in the U.S. finds that most prescriptions came out of emergency department visits, and the most common reason was dental disorders. Some 15% of nearly 192 million ED visits between 2005 and 2015 resulted in an opioid prescription, and of these, nearly 60% were due to dental problems. 

In a separate study, researchers found that in 2016, U.S. dentists prescribed opioids at a proportion that is 37 times greater than U.K. dentists. U.S. dentists also prescribed a range of opioids, including long-acting pills, while U.K. dentists stuck to one type of opioid that was not long-acting.

Cholera vaccination begins in the Congo

The WHO, along with local and international partners, just kicked off a cholera vaccination campaign in the Democratic Republic of the Congo to reach more than 835,000 people by June 1 in six areas across the country. More than 10,000 people have fallen ill with the disease since the beginning of the year, and the outbreak has led to more than 240 deaths. The campaign is underway in the same region of the DRC as the Ebola outbreak that has been in full force since August last year. As of Sunday, the crisis has resulted in 1,912 cases and 1,277 deaths. Following a Saturday attack on the response, another health worker — the fifth such person — has died.

What to read around the web today

  • 'A cavalier approach’: Experts urge the companies behind brain wearables to rein in their claims. STAT
  • In newly released deposition, OxyContin owner defends response to reports of abuse. The Wall Street Journal
  • We want your pick for the best health and science books to read this summer. STAT
  • Frances Arnold turns microbes into living factories. The New York Times
  • I survived the casteism of senior doctors—not everyone can. Quartz

One last thing: This is the final week to submit entries for NIH's essay contest for high schoolers writing about mental health. If you know of any interested teens, feel free to let them know! 

See you tomorrow!


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Tuesday, May 28, 2019


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