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Morning Rounds Shraddha Chakradhar

Federal court upholds Title X rule changes

A federal court yesterday upheld the Trump administration's changes to Title X funding for abortion providers. The rule, initially proposed in 2018, had been stopped from going into effect by lower courts in Washington, Oregon, and California. Yesterday's ruling means that the federal government can withhold funding through the Title X program to clinics that perform abortions or refer patients to abortion clinics. Health providers like Planned Parenthood rely on funding through the program to offer a range of care, including cancer screening, to low-income families. The organization has shared it would withdraw from the program and forgo $60 million in funding rather than limit the care its physicians could provide. The majority opinion in yesterday's ruling shared that the Supreme Court had already ruled in favor of similar regulations back in 1991, possibly making it unlikely that that court would take up the case again.

Most adults don't need tetanus and diphtheria booster shots, study concludes

Booster shots for tetanus and diphtheria have been a staple of adult immunization schedules, but new research finds that these regular updates may not offer any added benefit. Many countries, including the U.S. and France, recommend that adults get a booster shot every 10 years even after they've gotten the recommended childhood dose. But in a newly published study, researchers conclude that there was no difference in the rates of the two rare but dangerous diseases between countries that recommend adult revaccination every decade versus countries, like the U.K., without such a recommendation. The scientists looked at 15-year disease incidence data from 31 industrialized countries in North America and Europe. Dropping these revaccination requirements could also save over a billion dollars in health costs, study senior author Mark Slifka of Oregon Health and Science University tells STAT

Medication-based addiction treatment associated with sharp reduction in overdose deaths

Anti-opioid medication may be more effective in preventing overdoses and deaths from drug use than psychotherapy, according to new research. Looking at data from nearly 50,000 adults who were treated for opioid use disorder between 2015-2016 at outpatient facilities in Maryland, researchers found that those who were given medications such as methadone or buprenorphine — which are used to treat opioid addiction — were 82% less likely to die of overdoses than those who only underwent therapy, which is most often offered as a treatment option. However, after being discharged from treatment programs, both sets of patients had an equally high risk — more than fivefold — of dying from overdoses. The authors therefore suggest that efforts to combat opioid addiction ought to ensure that those with opioid use disorder can access long-term medication-based treatment. 

Inside STAT: Health worker infections underscore the chaos of coronavirus response

A worker in protective gear handles medical waste from coronavirus patients at a medical center in Daegu, South Korea. (LEE MOO-RYUL/NEWSIS VIA AP)

Health care workers are on the front lines of the ongoing Covid-19 outbreak in China, and thousands of them have already been infected. Beyond the risk of infection, these workers are also dealing with the daily toil of treating patients with a disease that is still largely a mystery — long hours, changing protocols, and the possibility of medical equipment shortages. This combination can make it difficult for workers to not only protect patients under their care, but also themselves. “You are expected to be there and stay there and take care of those people, but know that you are at risk and know that you have a family to go home to,” Salah Qutaishat, an infection prevention epidemiologist who was a health worker during the 2003 monkeypox and SARS outbreaks, tells STAT's Megan Thielking. Read more here

Company begins selling AI system to automate physician note-taking during exams

Note-taking is often listed as one of the most time-consuming parts of a physician's job, but a company is now hoping to make things easier. Speech software company Nuance announced that it's rolling out a new AI system — called Nuance DAX — that would allow technology wired into walls to listen in on conversations in doctors' offices and take notes. Beyond transcribing the conversation, however, the technology — developed in partnership with Microsoft — will also build a narrative of the patient's case, and will allow physicians to use voice commands to fill in specific fields within health records. The system is currently available only for a few specialties, such as orthopedics and dermatology, but a handful of hospitals, including Rush University Medical Center in Chicago, have already expressed their intention to use it. 

Marijuana use among older adults has nearly doubled

As more states have legalized marijuana for recreational and medical use, the percentage of adults aged 65 and older who report using the substance has nearly doubled since 2015, according to a new analysis. Looking at data from a federal survey on drug use, researchers found that the proportion of older adults who reported using marijuana in 2015 was 2.4%, but that increased to 4.2% in 2018. The increase was more pronounced in males and in those who were non-white. The shift in marijuana use is also trending toward the more wealthy: There was a more than threefold increase among college-educated individuals as well as among those whose family income was at least $75,000. Those who had sought mental health treatment in the year prior to being surveyed as well as those who reported tobacco use in the previous year also saw big increases.

Correction: I missed an essential detail yesterday about how quickly Alzheimer's disease is growing in the U.S. New cases of the disease are growing at the rate of one per minute daily. Sorry about the confusion!

What to read around the web today

  • Biologist exits prestigious post years after violating sexual harassment policy. Nature
  • In a historically old presidential field, candidates refuse to release health records. The Washington Post
  • OxyContin maker Purdue Pharma starts ad campaign for claims. Associated Press
  • Google’s labors to anonymize patient data suggest health systems face an uphill battle. STAT Plus
  • Industrial pollution is in your blood. Is that a form of battery? Undark

Thanks for reading! More tomorrow,


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Tuesday, February 25, 2020


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