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Monday, September 19, 2016

Morning Rounds by Megan Thielking

Happy Monday! I'm STAT reporter Rebecca Robbins, filling in for Megan this morning. Let's get started on the health news you need to know to start the week. 

Jimmy Kimmel cracks an EpiPen joke at the Emmys

HAVE WE OFFICIALLY REACHED PEAK EPIPEN? | YOUTUBE

Outrage over high drug prices has hit the Emmys. At the awards show last night, comedian Jimmy Kimmel handed out peanut butter sandwiches to the star-studded audience. "If you're allergic to peanuts, uh, well, I guess this is goodbye — because we could only afford one EpiPen," he said. Here's the full clip.

Kimmel was alluding, of course, to the widespread public anger over the cost of the lifesaving device, which has jumped by 450 percent since 2004. The device's manufacturer, Mylan Pharmaceuticals, will send CEO Heather Bresch to testify before Congress on Wednesday.

Just half of painkillers post-surgery are needed

Overprescribing is a known problem driving the opioid crisis — but good data has been lacking on where to draw the line between necessary pain relief and excessive prescribing. A new study published today in the Annals of Surgery helps to fill that gap. Researchers at Dartmouth-Hitchcock hospital looked at 642 patients who were prescribed painkillers following breast surgery, hernia repair, or gallbladder surgery. They found some patients were prescribed more than 100 pills but only ended up taking 15. Overall, they estimated that these surgery patients need just 43 percent of the opioids they're typically prescribed.

Researchers gather to strategize against leprosy

In 2000, leprosy was globally eliminated as a public health problem, meaning that its prevalence had dipped below a certain threshold. But there's still work to do: There are still more than 200,000 new leprosy cases annually, mostly in India, Brazil, and Indonesia. And there's no vaccination or diagnostic test for the disease.

That's why 1,500 academics and public health experts are gathering in Beijing this week for a conference with the theme of "unfinished business." Among the expected highlights: The promising early results of a pilot program from Novartis's philanthropic arm, which aimed to distribute a drug to at-risk people to decrease their chances of developing leprosy.

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Inside STAT: An exclusive interview with Joe Biden

THE VP PLANS TO PROMOTE CANCER RESEARCh FOR “as long as I'm alive" (STAT/Getty Images)

With the clock running out on his time in office, Vice President Joe Biden sat down with STAT reporter Dylan Scott for a wide-ranging interview at Rice University on Friday. Here are some of the highlights:

  • On the future of his cancer moonshot: "One way or another, we, I, am gonna keep this going. I guarantee you."
  • On a Hillary Clinton presidency: "I’m not going to stay on in the administration. What Hillary talked about is, as I understood it, me being able to have the same authority over elements of her administration from the outside that I have now from the inside."
  • On a Donald Trump presidency: "I don’t think he’s that crazy" to neglect federal investment in medical science.
  • On Hillary's recent pneumonia disclosure: "I’ve just found that, in my career, just transparency and disclosure works the best, even when there’s bad stuff."

Here's a full transcript of the interview.

Speaking of vice presidents: Republican candidate Mike Pence over the weekend releaseddoctor's letter that gave him a clean bill of health, while noting several surgeries and a cardiovascular condition in his medical history. No word on whether Pence would be the healthiest individual ever elected to the vice presidency.

When the default assumption of 'cardiac problem' is wrong

When someone collapses and dies suddenly, the default assumption is that it was caused by a cardiac problem. But new research published in Neurology estimates that each year, 10,000 to 25,000 of these sudden deaths are actually caused by neurological conditions like strokes, intracranial bleeds, or epilepsy. I called up the senior author on the study, UCSF arrhythmia specialist Dr. Zian Tseng, to learn more. (For the rest of our conversation, check out today's Readout.)

Why are so many sudden deaths being mislabeled?

Here’s the epidemiologic definition of sudden cardiac death: Somebody collapsing and dying suddenly within an hour of symptom onset if you’re witnessed [it], or last being seen alive and well 24 hours prior if [there are no witnesses]. It’s difficult because 90 percent of these events happen out of the hospital and therefore are medical examiner or coroner cases — and a natural death from their eyes is typically low priority for an investigation. So only 10 to 15 percent of such deaths ever get investigated with an autopsy.

How did you get around that?

I partnered with the medical examiner here in San Francisco to do a comprehensive study of such sudden deaths, just to really for the first time define every single underlying cause. Every sudden death that I capture through the medical examiner’s office gets a full investigation. My team and I take all that data — including pre-mortem, the paramedic runsheet, any prior studies they’ve had, and then the detailed autopsy results if they had one — and then we come together in a room and review every case. As we started doing cases, we discovered that a surprising number of these deaths were actually due to neurologic causes.

Weak opioid too risky for kids, pediatricians' group says

Codeine is a relatively low-strength opioid that has long been used in over-the-counter cough medications or prescribed to kids who get their tonsils taken out. Now, with cold and flu season approaching, the American Academy of Pediatrics is out with a new report advocating that products containing codeine no longer be given to kids due to safety concerns. The pediatricians' group notes that some kids' bodies can break down the drug so rapidly that it puts them at risk for life-threatening breathing problems. 

The curious case of the DNA that wasn't actually stolen

Researchers have long studied the genes of the famously hardy residents of the Italian island of Sardinia, who can be five times as likely as Americans to make it to their 100th birthday. Then last week the international media caught wind of a story straight out of a paperback mystery: Thousands of vials of Sardinian residents' DNA had been reported stolen from a local gene bank, prompting a police investigation.

It turns out, though, that the samples were never stolen in the first place; they've actually been stored in another facility in Sardinia for the past three years. But the case isn't closed yet, because it's not clear who owns the samples or has the right to use them, Nature News reported on Friday. I'm eagerly awaiting the next twist.

FDA warns ‘Stiff Bull’ coffee contains Viagra analog 

The FDA has a message for consumers: Steer clear of "Stiff Bull" instant coffee — marketed as "the relationship saver" — because it contains an undeclared chemical similar to the active ingredient in the erectile dysfunction drug Viagra. Questionable brand name aside, it's a serious issue: The chemical could dangerously lower blood pressure in people taking certain cardiac medications. The agency notes that the coffee is the latest in a "growing trend" of dietary supplements or foods often marketed as all-natural that contain hidden drugs.

What to read around the web today

  • How opioid makers fought state-level measures to stem the opioid crisis. Associated Press
  • The 'five-second rule' for food dropped on floor isn't true. New York Times
  • Your memories of important events are probably wrong. CNN
  • In Illinois, a landmark Senate race between two physically disabled candidates. Washington Post

More reads from STAT

Thanks for reading! More tomorrow,

Megan

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