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Morning Rounds Shraddha Chakradhar

Missouri commission to decide whether state’s only abortion provider can operate

A Missouri commission that acts as an independent mediator in cases involving state agencies and private entities will be meeting over the course of this week to discuss the fate of the only remaining abortion provider in the state. The facility is operated by Planned Parenthood. Missouri has taken steps to restrict access to abortion, including an attempted ban on abortions performed after eight weeks of pregnancy that was blocked by a federal judge. In June, the state refused to renew a permit application for the Planned Parenthood facility in St. Louis to be able to perform abortions, but the organization appealed and eventually won a stay. Depending on what the commission decides, Missouri could become the first state since 1973’s Roe v. Wade decision to have no legal abortion providers. 

Researchers will test if a meningitis vaccine could also protect against gonorrhea

Can the mounting problem of drug-resistant gonorrhea be curbed by an existing vaccine designed to protect against another pathogen? Some U.S. scientists are going to try to find out. With NIH funding, researchers just announced they will enroll 2,000 volunteers in a Phase 2 study to see if the GlaxoSmithKline meningitis B vaccine Bexsero also prevents gonorrhea. The bacteria that cause the two diseases are related, and there have been signals for years that rates of gonorrhea are lower among people vaccinated against meningitis. In 2017, researchers from New Zealand reported that teens and young adults vaccinated with Bexsero in the early 2000s were 31% less likely to develop gonorrhea. Given the speed at which the gonorrhea bacteria develop resistance to antibiotics, having additional help in the form of a vaccine could have a major impact, the researchers say. 

FDA may finalize requirement to include males in breast cancer trials 

The FDA may soon be finalizing a proposed rule that would require those developing breast cancer drugs to include males in the clinical trials. Back in August, the agency published a guidance document outlining the new rule — it was then subject to a 60-day comment period, which ended over the weekend. As currently written, the rule would require drug developers to account for the inclusion of both men and women in clinical trials and to provide a scientific rationale if they were planning on excluding men. The agency also stated that it did not think low recruitment numbers were a proper reason for excluding males. Only 1% of breast cancer patients are male, which explains why they’ve been historically left out of trials, but new research also suggests that these patients have a higher mortality rate than women. 

Inside STAT: Democrats' new logic: Slightly fewer medicines OK if it means lower prices


Rep. Darren Soto (D-Fla.) (STEVE CANNON/AP)

In a surprise move, Democratic lawmakers have begun to show more candor about an idea that’s long been controversial: Lowering drug prices might be worth the payoff even if it means a dip in biomedical innovation. The industry group PhRMA has pushed back on House Speaker Nancy Pelosi’s drug pricing bill, saying it represented a “nuclear winter” for the development of new medicines. But instead of backing away from the proposed legislation, some members of Congress have turned to pragmatism. “Three hundred forty-five billion dollars in savings versus the cost of eight to 15 fewer drugs over 10 years,” Rep. Darren Soto (D-Fla.) said at a recent hearing before the House Energy and Commerce Committee. “I frankly think it’s worth it.” STAT’s Lev Facher has more from Washington here

More marketing and availability of nontraditional flavors could be driving youth vaping 

A new study provides evidence to back up the notion that e-cigarette use among youths is driven by marketing. Researchers looked at nearly 10,000 youths ages 12-24, and found that more than 70% of those who said they never used tobacco products saw e-cigarette advertisements in the month before being surveyed in 2014-2015. A year later, these respondents were 53% more likely to say they had experimented with vaping. 

At the same time, another survey asked Los Angeles high school students who used e-cigarettes about their flavor choices, and found that nearly 94% used a nontraditional flavor — fruit or other sweet blends — in the six months prior to being surveyed. These students were also more likely to continue vaping than those who reported using traditional flavors such as tobacco, mint, or menthol. 

Three countries with serious maternal and infant health care problems see improvements

Nigeria, Ethiopia, and India — three countries with an especially high burden of maternal and infant health problems — have made progress against ensuring health care access, but underlying inequities still remain. Researchers looked at eight indicators of health — including the number of mothers who received some prenatal care compared to all who gave birth, and those who initiated breastfeeding within an hour of giving birth — and found that the study sites in Nigeria and India improved on two of the eight, while Ethiopia saw positive changes in five areas. And although there were improvements, gaps also grew: The poorest women in 2015 had the same access to delivery facilities that the least poor women had in 2012, but coverage for this latter group also increased 60% compared to three years prior. 

What to read around the web today

  • Trump considers retreat from ban of mint, menthol vaping flavors. Bloomberg
  • Medicine may work better if your doctor seems to believe it will work, new study suggests. STAT
  • Breaking HIV’s hold. San Antonio Express-News
  • Farmworkers face daunting health risks in California’s wildfires. Kaiser Health News
  • More kids should get weight-loss surgery, even some preteens, pediatricians say. The Associated Press

Thanks for reading! More tomorrow,

Shraddha

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Monday, October 28, 2019

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