Tuesday, November 15, 2016

Morning Rounds by Megan Thielking

Good morning, folks, and welcome to Morning Rounds. Here's what you need to know about health and medicine today. 

Hospitals asked to boost organ donor signups

There are 120,000 people waiting for organ transplants in the US but just 14,000 organ donors each year. Today, the government is turning to hospitals across the country to find new ways to narrow that gap. The Health Resources and Services Administration wants to see hospitals host educational events to raise awareness and register organ donors. They’re looking to add a little friendly competition, with the help of a new scorecard. Hosting educational and donation registry events would earn participating hospitals a certain number of points; at the end of the year, top scorers would be recognized by the agency and its partners. But will a scorecard actually motivate hospitals to pick up their outreach efforts? The agency’s taking comments now — more here.  

Insurers still discriminate against mental health care

Although a 2008 federal statute requires health plans and insurers that cover mental health and substance abuse to treat those as they do other medical conditions, these requirements remain an “unfulfilled promise,” concludes a report by the National Alliance on Mental Illness released this morning. “Despite federal law, discrimination still exists in health insurance coverage of mental health conditions when compared to other medical conditions,” said NAMI CEO Mary Giliberti. Among the findings from NAMI’s survey of 3,081 individuals with mental health conditions and mental health caregivers:

  • 1 in 4 people did not have an in-network mental health provider, compared to 1 in 10 who did not have an in-network medical specialist. A big reason: 45 percent of psychiatrists do not participate in insurance plans, the highest rate of any medical specialty.
  • 19 percent reported trouble finding a psychiatric hospital that would accept their insurance; 8 percent had such difficulties for other types of hospital care.
  • 8 in 10 people faced out-of-pocket costs of over $200 for psychiatric hospital or residential mental health care, compared to fewer than 6 in 10 for general hospital care.

The report is available here

Lab Chat: Cellular cannibals chow down on neighbors

A reproductive cell, in magenta, is forming a lobe when gut cells, in green, cut it off and digest it. (nyu langone)

It’s long been known that cells eat up bits and pieces of other cells as a method of clean-up, but scientists have a new idea as to why. Researchers focused on embryonic development in C. elegans worms — which are often used to study the mechanisms of human cells — were surprised by the sort of cannibalism they stumbled upon. Here’s what study author Jeremy Nance of New York University told me about the work, published in Nature Cell Biology.

What did you observe about cellular cannibalism?

This study was about special cells called primordial germ cells, which make up sperm and eggs. It had been know they extend these large protrusions, or lobes, during embryonic development and it wasn’t clear why. But we saw that neighboring cells actually bite off those protrusions and a lot of the PGCs' content is removed in that process. In particular, they lose most of their mitochondria, which are the powerhouses of the cells.

Why would neighboring cells eat off part of the PGCs?

The mitochondria in PGCs, relative to other cells in the embryo, produce high levels of damaging oxidants. So we suspect this is a way to protect the PGCs. As soon as they bite off a lobe, which is about half the size of a cell, they immediately digest it and those oxidants become non-functional.

How is that different than other types of cellular cannibalism?

There are other examples of cells in development that lose pieces of themselves, like synapses sliced off of neurons. If that doesn’t happen, there can be too much inflammation or nervous system damage. But that’s been thought to be passive — the cells are scavenging for pieces they can find. We show in this paper that it’s an actual, active biting mechanism.

Sponsor content by amgen

A rare inside look into biotech manufacturing

Ever wonder what it's like inside a facility where biologic medicines are made? Some who have strode past its stainless steel bioreactors, covered head to toe in multiple layers of appropriate garb so as not to disturb this highly sensitive environment, have likened it to visiting NASA. To learn more about this intricate facility, click here.


Inside STAT: Experts to track Trump's health policy

With policy developments in health and science coming left and right, it can be hard to stay on top of what's happening right ow — like whether Obamacare is gone for good, getting a facelift, or even just being renamed. A good source list can go a long way to keeping you in the loop as those answers come. We've compiled a round-up of folks on Twitter who have their ears to the ground about what Donald Trump and Congressional colleagues have in store for NIH, FDA, health care, and more — see here.

The bugs on your phone say a lot about who you are

Your phone holds a treasure trove of personal information even when it’s dead — scientists say they’re now able to accurately sketch out your lifestyle based just on the microbes thriving on your cell phone. A team of researchers swabbed a handful of spots on the hands and cellphones of 39 volunteers. Then, they used a technique called mass spectrometry to parse out what molecules were present on those phones. All of those bugs were then compared to a large database of molecules. They were able to pinpoint everything from what kind of coffee someone likes to what type of hair conditioner they use. Some, such as sunscreen, seemed to stick on phones for months after a person stopped using them. The UC San Diego scientists say that information could be used to drum up a personalized lifestyle sketch of a person, which could give detectives a jumping-off point for tracking down criminal suspects. The team is now turning to study the same microbial communities that have come to call our wallets and keys home. Read about the work in PNAS

New advice for doctors on a puzzling parasitic infection

More and more patients in the US are turning up with a puzzling parasitic infection known as leishmaniasis, transmitted by a sand fly so small it’s nearly invisible. That parasite is found in more than 90 countries, including many in Central and South America, the Middle East, Asia, Africa, and Europe. Doctors are worried it’ll grow increasingly common in the US, pointing to soldiers, immigrants, and eco-tourists traveling to and from Central and South America. Because it's still rare in the US, many doctors don’t suspect it when examining sick patients and don’t necessarily know what to do after making a leishmaniasis diagnosis. Infectious disease experts are looking to address that lack of knowledge and have released new guidelines for doctors. The guidelines also recommend that travelers use protective measures, such as wearing long sleeves and pants and using insect repellents and bed nets.  

Neighborhood violence tied to biological stress in kids

Neighborhood violence is correlated with biological markers of stress in black children in New Orleans, finds new research published in JAMA Pediatrics. Public health researchers at Tulane ran the NIH-funded study, which included 85 black children between ages 5 and 16 from 52 New Orleans neighborhoods. They measured two factors that change with stress: levels of the hormone cortisol and length of telomeres, which are caps on the ends of chromosomes that naturally get shorter with age.

The kids with higher levels of violent crime and a higher proportion of liquor and convenience stores in their neighborhoods had more reactive cortisol levels — when they experienced a stressful social situation in the lab, their cortisol levels took more time to recover.  They also had shorter telomeres. The major caveat: This study alone doesn’t show that these neighborhood stressors are the direct cause of those biological signs of stress. It’s entirely possible that some other factor causes all of these things. The authors also caution that the results may not apply to other demographics. 

What to read around the web today

  • Disasters are even more disastrous than we think. NPR
  • Scientists use big data for infectious disease surveillance. NIH
  • Is listening with ear buds bad for your ears? Washington Post

More reads from STAT

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