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Morning Rounds Shraddha Chakradhar

Americans haven’t made big improvements with meeting diabetes targets

A new analysis of nearly 2,500 adults finds that, over a 10-year span, there hasn’t been a significant improvement in meeting diabetes treatment and care targets. Here’s more: 

  • The study: Researchers looked at data at three different time periods between 2005-2016 and assessed changes in diabetes care, including various treatment goals. 

  • The findings: Some 94% of adults between 2013 and 2016 were getting care for their diabetes, a rate that was similar in the 2006-2008 group as well as the 2009-2012 group. Only about 40% were able to keep their cholesterol and blood pressure levels under control, a rate that was once again similar across the different time periods. 

  • The takeaway: The study authors recommend increased diabetes screening, expanded access to health insurance, and implementing strategies to increase patient adherence to medication.

A denture mishap prompts call for more caution before surgery

The painful case of a 72-year-old man has physicians recommending removing dentures before surgery. A new BMJ report details how the man went into a U.K. hospital to have a harmless abdominal lump removed, and, unbeknownst to medical staff, had his dentures get stuck in his throat during the surgery. The man, who was on anesthesia during the operation, went home to return six days later complaining of bleeding and difficulty eating solid food. Imaging of the man’s chest and throat revealed the stuck dentures, which had caused internal swelling and blistering. But the saga didn’t end there: Doctors performed an emergency surgery to remove the dentures, but complications from having them in his throat meant the man came back to the hospital several more times and eventually needed a blood transfusion.

UCSF, Stanford launch microbiome research centers

UCSF and Stanford are each launching a research center dedicated to studying all things human microbiome. The new facilities point to the growing recognition that the microbiome influences not only human health but also how we respond to treatments. Bay Area philanthropists Marc and Lynne Benioff donated $35 million to get the centers up and running. UCSF’s Benioff Center for Microbiome Medicine, which will focus on developing therapeutics and diagnostics for early childhood diseases including asthma and allergies, will get $25 million of the donation. The remaining $10 million will go toward work at the Stanford Microbiome Therapies Initiative, which will work on building new microbial communities and engineering therapies based on these communities of bacteria, fungi, and viruses. 

Inside STAT: The human brain in ‘unprecedented’ detail

(Brian L. Edlow, M.D./Massachusetts General Hospital)

Want to get the most detailed brain images ever recorded? An MRI that has a 7-tesla magnet — versus the 0.5 T to 3 T magnets that are usually in MRI machines — might help. In addition, the images are of the brain of a 58-year-old woman, who died of viral pneumonia and whose brain could therefore be imaged for hours on end and could stay perfectly immobile. Top these qualities off with state-of-the-art software that can direct the machine to optimize a host of parameters, from a tiny bleed to swelling gray and white matter. Read more about the images — and see the MRIs in action — from STAT’s Sharon Begley here

Teens who use e-cigs are more likely to also smoke marijuana

An analysis of more than 20 studies finds that adolescents who use e-cigarettes are also more likely to smoke marijuana. Looking at data from nearly 130,000 teens, researchers found that those who reported e-cig use were about 3.5 times more likely to also smoke marijuana than those teens who didn’t use the devices. Those aged 12-17 who used e-cigs were more than four times as likely to smoke marijuana. In contrast, young adults aged 18-24 who used e-cigs were about twice as likely to smoke marijuana. The findings point to an association and not a cause, but the researchers write that there are public health implications. Because both nicotine — found in e-cigs — and marijuana can have a harmful effect on the brain and memory, curbing e-cig use could also be an effective way to reduce marijuana smoking among youth, the authors suggest. 

California sees an uptick in sex misconduct claims against physicians 

There has been a 62% jump in the number of sexual misconduct complaints against California physicians since the fall of 2017, according to a new Los Angeles Times analysis. The jump coincides with the beginning of the #MeToo movement, the report says. California’s medical board received more than 11,400 complaints against physicians and surgeons as of the end of June, the most number of complaints the board has ever received in a single fiscal year. The investigation also found that there were 280 complaints in the fiscal year 2017-2018, compared to about 173 the previous year. But disciplinary action is taken in only about 4% of such cases, a number that has dropped recently, according to the LA Times. For instance, 21 physicians were disciplined in the 2016-2018 fiscal years, while 13 physicians were disciplined in 2018-2019 for sexual misconduct.

Correction: Yesterday's item on physician-assisted deaths had a typo that incorrectly suggested how people died. More than three-quarters of people who ingested lethal medication had cancer. 

What to read around the web today

  • For the first time, clinical trial data show Ebola drugs improve survival rates. STAT
  • Parents block California's effort to investigate 'fake' vaccine exemptions. San Francisco Chronicle
  • As elephants and whales disappear, they take valuable cancer clues with them. Undark
  • The heart-stopping reality of cardiac arrest. Mosaic
  • Kenya hopes its first human milk bank will save infants’ lives. Quartz

Thanks for reading! More tomorrow,

Shraddha

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Tuesday, August 13, 2019

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