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Monday, April 4, 2016

Morning Rounds by Megan Thielking

Happy Monday, Morning Rounds readers! Welcome to the week, and welcome to the day's big stories in science and medicine. 

Listen: What happens when a clinical trial patient dies? 

(Molly Ferguson for STAT)

There’s a rare genetic disease called Prader-Willi syndrome that’s marked by insatiable hunger — a feeling so strong that some patients have to live in controlled environments where food and fridges are kept locked down. “I’ve had kids say it feels like there’s 1,000 piranhas chewing at my stomach all the time,” said Jannalee Herman, an advocate for patients with the disease, one of whom is her son. Biotech company Zafgen was working on a cure for the disease, and for severe obesity across the board. But then, a patient in the drug’s clinical trial died. In the newest episode of the STAT podcast Signal, Meg Tirrell and Luke Timmerman bring you the story of how the stock market reacts to news of life and death in medicine, a field where uncertainty is ever-present. It’s a great listen — catch it here.

Here's where docs made the most money in 2015

A new report out this morning details how much money doctors took home in 2015. The biggest earners? Orthopedists, who earn an average salary of $443,000 a year. Cardiologists were close behind, taking home an average salary of $410,000. Other findings from the Medscape survey:

  • Male primary care physicians earn more than their female counterparts ($225,000 and $192,000, respectively). That disparity was seen among specialists, too ($324,000 vs. $242,000).

  • One bit of good news about those gender disparities: women’s salaries rose more, percentage-wise, than men’s salaries did between 2012 and 2016. 

  • Regionally, the highest average earnings docs were in the north central US ($296,000); the lowest were in the mid-Atlantic region ($268,000). Those differences are probably in part due to the compensation gap between rural and urban areas.

  • Among states, North Dakota had the highest average salary for doctors ($348,000), while Rhode Island landed at the bottom ($224,000).

Women are much more likely to be prescribed antibiotics than men

Women are 27 percent more likely than men to be prescribed antibiotics, according to a new systematic review of 11 studies that span 10 countries. And for women between ages 35 and 54, that rises to 40 percent. Researchers say a number of factors could contribute, including doctors' prescribing habits, differences in immunity between the sexes, and how often people visit the doctor. It's something for docs to keep tabs on, though, given the risks of overusing antibiotics. Read the research out this morning in the Journal of Antimicrobial Chemotherapy here.

FDA sued for delay in reviewing a risky chemical in food packaging

A handful of groups — including the Center for Science in the Public Interest and the Center for Food Safety — are suing the FDA for not acting quickly enough on a petition to remove perchlorate from food packaging. The EPA has said the chemical can be harmful to kids, and the FDA agreed in late 2014 to consider a ban on perchlorate, which has been used in plastic food packing for dry goods since it was granted approval in 2005. The FDA had six months to consider the petition but hasn’t taken action yet, leading those groups to sue. The FDA declined to comment on the lawsuit.

Testosterone boosts could reduce heart problems in some men

Testosterone treatments may help men with coronary artery disease (CAD) reduce their risk of heart attack and stroke, according to new research. Researchers studied 755 men, ages 58 to 78, who had low testosterone levels and CAD. They gave some of the men a boost of testosterone by injection or as a topical gel. After a year, more patients who didn’t get the testosterone supplements had experienced a major cardiovascular event than in the group who had received the supplements. The data were presented this weekend at the American College of Cardiology’s annual meeting.

Researchers eye parasite for human-to-human transmission

A type of malaria spreading from monkeys to humans in South Asia appears to be evolving to do so more effectively. A team of researchers at Harvard looked at how the parasite, called P. knowlesi, invades human red blood cells. The surface of those cells houses a sugar variant that normally keeps P. knowlesi at bay. The researchers looked at cells in the lab to see how the human variant — and how its counterpart in monkeys — responded to the parasite's attempts at invasion. They were concerned to find that the monkey malaria parasite could evolve to get around that barrier in human blood cells over time, find a different way in to infect the human population in a more virulent form, the researchers say in the new Nature Communications

Avoiding some statin side effects 

Statins, commonly prescribed drugs used to lower cholesterol levels, can cause achy or weak muscles in up to 20 percent of patients, leading some to quit treatment. But new research in JAMA suggests there might be a different drug solution for these people. Researchers recruited 511 patients with cholesterol problems alongside a history of statin intolerance. The researchers treated those patients with one of two drugs — ezetimibe and evolocumab — or a placebo, and followed how well they worked over 24 weeks. Both showed promise at lowering cholesterol without causing muscle side effects, but evolocumab was the more effective of the two. Worth noting, however: the study was funded by Amgen, maker of evolocumab under the brand name Repatha.

What to read around the web today

  • A hospital loses its way in caring for a VIP patient. Boston Globe
  • How a painkiller designed to deter abuse sparked an HIV outbreak. NPR
  • Officials sound the alarm over a deadly synthetic drug in Minnesota. Star Tribune

More reads from STAT

Correction: Friday's newsletter misstated that horseback-riding accidents are the most common cause of concussions in adults. They are the most common cause of sports-related concussions.

Thanks for reading! More tomorrow,

Megan

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