Thursday, November 3, 2016

Morning Rounds by Megan Thielking

Welcome to Thursday, everyone! Here's what is driving the news in science and medicine this morning. We're trying to hit a new milestone on Twitter followers ahead of STAT's first birthday Friday — if you don't follow us, you can find us here

Smoking may hurt HIV outcomes more than HIV itself

Smokers with HIV could see smoking shorten their lifespan more than the disease itself does, according to new research to be published in the Journal of Infectious Diseases. Researchers modeled the impact of HIV using the most up-to-date treatment and life expectancy data. They found that for adults who stick to their HIV treatment plan, smoking reduces life expectancy by about twice as much as the HIV itself does. Adults starting HIV care at age 40 who kept smoking lost about 6 and 1/2 years more of life expectancy than their peers who never smoked. That’s of particular concern given that smoking is twice as prevalent among HIV-positive individuals as in the general population. Those who quit by age 40 while on HIV treatment gained back about 5 years of life expectancy, give or take half a year based on gender. Doctors keeping tabs on smokers with HIV should also put helping those patients quit at the top of their priority list, the authors conclude. 

World Trade Center program talks survivor health care

The World Trade Center Health Program’s scientific advisory committee is meeting today to talk about health coverage for rescuers and survivors of the 9/11 terrorist attacks. The program is responsible for providing both treatment and medical monitoring for those individuals. In today’s meeting, the committee will make recommendations on the process to add new health conditions to the list that the program covers for people injured or exposed to toxins on 9/11. They’re now legally required to include an independent peer review of the scientific evidence before adding a new health condition. The committee is going over how exactly that peer review should be carried out, and how the program ought to track down independent experts to do it. The meeting starts at 9 a.m. ET and is open to the public online here.

Health officials target dangerous infections after surgery

Surgical site infections — which are caused by bacteria working their way into the body through surgical incisions — put millions of patients at risk each year and can exacerbate the problem of antibiotic resistance. In high-income countries like the US, they’re the second most common hospital-acquired infection, and in low- and middle-income countries, they top the list. Now, the WHO is taking action to prevent SSIs with a new set of global guidelines. Among the recommendations:

  • Warming devices to normalize a patient’s body temperature during surgery are OK to use to prevent SSIs.

  • Hair shouldn’t be removed before surgery unless absolutely necessary, and if it is, should be cut with clippers. Shaving a patient’s hair is strongly discouraged.

  • Doctors shouldn’t unnecessarily prolong the use of antibiotics for post-surgery patients just to prevent SSIs.

  • Antimicrobial sealants applied to a patient’s skin before surgery to stave off SSIs aren’t actually recommended.

The organization is hopeful that the new recommendations can both prevent SSIs and cut down on excessive antibiotic use that can worsen the problem of antibiotic resistance.

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Shifting power to the patients: Patient Connect from Deloitte

Previously life science organizations developed and marketed therapies without patient contact, but the changes in technology and the health care ecosystem are increasing the patient’s role in decision making and reshaping their health expectations. Now, there is an opportunity to help patients navigate the complexities involved in receiving the original diagnosis, deciding on treatment, securing financial assistance, connecting with other patients and community experts, and supplementing clinical education.  Patient Connect™ by ConvergeHEALTH can help.

Inside STAT: Genetic tests promised me peak fitness

STAT reporter Rebecca Robbins has a genetic variant that predisposes her for either high aerobic fitness or low aerobic fitness — it depends on which mail-order genetic test result she's reading. She took five of the most popular genetic tests marketed directly to athletes, whether professional or recreational like herself. They made big promises to help her reach peak fitness potential, achieve optimal wellness, and deliver "unprecedented insights." But what they really delivered was a mess of contradictions, offering up conflicting interpretations of what different spots in her genome meant. Read her fascinating take on those test results — and what she ended up gleaning from them — here

Lab Chat: A lab-grown heart gets a beat

(Weinberger et al, science translational medicine)

Scientists have created lab-grown muscle tissue out of stem cells, and used it to heal damaged hearts in an animal model. The team of researchers genetically engineered a mix of human heart and endothelial cells to create engineered human tissue, or EHT. They hoped those tissues would survive better when put into the body than other lab-grown tissues have — and it seemed they did, at least in guinea pigs with heart damage. Here’s what researcher Thomas Eschenhagen of University Medical Center Hamburg-Eppendorf told me about the work, published in Science Translational Medicine.

How did you grow this EHT?

We are growing EHTs by mixing heart cells, like from human induced pluripotent stem cells, with a hydrogel. [We] pour the mix in a small rectangular casting mold, with a pair of silicone posts inserted from above. We don't do anything after the initial casting, just feed them and try preventing bacteria contaminating the cultures. The cells spread out, touch each other, form a network and contract the matrix between them, e.g. by “squeezing out the water.” Like that, the floppy gel becomes more and more a dense tissue similar to a real heart.

What do the EHTs look like when they start beating?

We are producing the strips at a length sufficient to span the scar [after a heart attack]. After 10 to 14 days, [the cells form] a spontaneously and coherently beating heart tissue. It’s still not really clear why exactly the heart cells beat. It’s one of the biological paradigms that heart cells, particularly immature heart cells, beat autonomously. But we saw a clear, quite remarkable improvement of heart function by EKG [after implantation].

Kids are eating way too much salt

Kids in the US are consuming salt well above the recommended daily amount, putting them at risk of developing heart problems later in life. A new study of the eating habits of more than 2,100 kids between ages 6 and 18 found the average sodium intake was 3,256 milligrams; nutrition guidelines recommend 1,900 to 2,300 milligrams a day, depending on kids' age. It wasn’t just one age group tipping the scales. Nearly 90 percent of the children included in the survey were consuming more sodium than recommended for their age group. About 40 percent of sodium intake was happening at dinnertime, with another 16 percent coming from snacks. Among the top culprits: pizza, Mexican food, savory snacks, and cheese. Parents might want to keep an eye on sodium levels of food they give to children, the study’s authors say. Anything under 140 milligrams per serving is considered low-sodium.

Looking to the future of alcohol abuse research

The NIH's alcohol abuse branch is hosting its annual speech today, with this year's talk given by Dr. Michael Charness, a longtime researcher who studied how alcohol interferes with a fetus’s developing nervous system on a molecular level. It's not just a look back on his work — it's also a look ahead to what's promising in the field of alcohol abuse research. “An area of great excitement is the ability to use mobile technology,” Charness says. The alcohol and addiction crises have outstripped our resources, he said, noting that he feels there aren’t enough psychiatrists in the US to care for all the children affected by fetal alcohol spectrum disorder or adults affected by addictive disorders. He sees mobile apps as a potential means of addressing that issue. “This is something that is in its infancy, and an opportunity that the current crisis is going to require us to exploit more quickly than anyone had anticipated,” he said. 

What to read around the web today

  • Personalized nutrition isn't going to solve our diet problems. Vox
  • Why Connecticut's medical examiner's office just lost national accreditation. New Haven Register
  • In Pakistan, illegal kidney trade flourishes as victims await justice. NPR

More reads from STAT

Thanks so much for reading! Back tomorrow morning, 


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