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Wednesday, December 30, 2015

Morning Rounds by Megan Thielking

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Good morning, everyone! Here's what's driving the news in science and medicine today. 

Pharma company run by Martin Shkreli files for bankruptcy

Delaware-based pharma company KaloBios Pharmaceuticals has filed for bankruptcy, Reuters reported early this morning. Until his recent arrest for securities fraud, embroiled Turing Pharmaceuticals exec Martin Shkreli was also the CEO of KaloBios. Two other execs resigned from the company this week, and the company's stock had been put on hold by the Nasdaq stock market after Shkreli's arrest. KaloBios' bankruptcy filing lists the company's value between $1 and $10 million. 

Exclusive: Worry over drug abuse is changing how docs prescribe

Growing alarm over opioid abuse is affecting the way doctors treat patients, with nearly 70 percent saying the concerns have led them to prescribe fewer opioids now than in the past, according data to be released today. In a survey commissioned by the White House and conducted by WebMD and Medscape, nearly all doctors voiced concern about the potential for abuse, given the reported rise in overdose cases. Nearly all doctors also said they discussed with their patients how and when to take opioids. But far fewer (just over half) also talked to their patients about safe storage and proper disposal, steps that could help prevent misuse of the drugs. 

Lab Chat: How liquid salt can deliver drugs through your skin

Molten salt: cooler (and hotter) than it looks. (Samir Mitragotri)

The latest innovation in drug delivery: turning medicines into liquid salt. Researchers at the University of California at Santa Barbara took a drug commonly prescribed for chest pain or high blood pressure and altered it on the molecular level to let it seep into skin. The researchers hope the technique could be used with other, injectable drugs to make them easier for patients to take. Here’s what lead researcher Samir Mitragotri told me about the findings, published in the new issue of the journal Technology.

What makes it difficult to deliver drugs through patches and gels on the skin?

A lot of medicines do not want to permeate the skin because the skin is a good barrier to keep things out. And when you deliver new molecules to the skin that aren’t native to it, that can cause irritation like redness and itching.

What did you design to get around those two problems?

The medicine that we tested is a charged molecule. It has a slight positive charge, which makes it difficult to permeate across the skin, because charged molecules don’t diffuse very easily, and the charge then is responsible for the irritation. So we converted that molecule to a molten salt by pairing it with a negatively charged counter-ion, and that makes a thick liquid that you can put on the skin to deliver the medicine.

Pep up your Twitter feed with these science and medicine accounts

STAT reporter Helen Branswell has rounded up this great list of science and medicine folks to make your Twitter feed much more interesting, strange, and smart. There’s quite the range, from Yale cardiologist Dr. Harlan Krumholz and his critical looks at big medical journals to macabre tidbits from medical historian and author Lindsey Fitzharris. If you want to follow all 18, we’ve compiled a list for you on Twitter here.

Handling hospitalizations of kids for issues with drugs, alcohol, or self-injury

Adolescents who are admitted to hospitals because of drug or alcohol use or self-injury have a much higher risk of death or emergency readmission than peers who haven’t, according to a new study published in PLOS Medicine. The study focused on hospital admissions in the UK from 1997 to 2012. Medical guidance suggests psychiatric analysis for kids admitted with self-inflicted injuries, but not necessarily for drug or alcohol abuse. That, the authors say, is a problem given what the data show.

Why is it so hard to get enough participants for clinical trials? 

One in five publicly funded clinical trials for cancer don’t enroll enough participants to drum up solid results, according to a new analysis in the Journal of the National Cancer Institute. “When you consider the results of cancer treatments in the US, there are an awful lot of results where the results stink,” Levine Cancer Institute oncologist Dr. Derek Raghavan, who penned an editorial to accompany the analysis, told me. The issue, Raghavan said, often comes down to poor study design or a failure to enroll enough patients in the trials in the first place.

“If you live a thousand miles from anywhere that has skyscrapers, it can be very very hard to get onto a trial,” Raghavan explained to me. In the case of more rare cancers, several trials might be competing for the same base of participants, making it more difficult for any one trial to enroll enough patients to produce sufficient results. One suggestion for fixing the problem — scattering trial sites geographically to get more patients and particularly those in small towns to participate, an idea that some researchers are starting to pick up on. Read the analysis of trial participation and find the accompanying editorial here.

Inside STAT: A pediatrician brings his cartoons into the exam room

Hyacinth Empinado / STAT

Pediatrician Dr. Jack Maypole grew up around cartoons — his mom sketched and sold greeting cards. Now, he’s sharing that creative side with the children he treats, picking up pen and paper to entertain and soothe young patients to make them see the doctor’s office isn’t such a scary place after all. Watch Maypole make magic happen in this video from STAT multimedia producer Hyacinth Empinado. 

What to read around the web today

  • Martyrs to science? When research participants die. Discover
  • Here's why you eat more than you drink. Time
  • Mixing venture capital with health startups makes for pseudoscience. The Verge

More reads from STAT

Thanks for reading! Back tomorrow with a special edition before the holiday, 

Megan

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