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Friday, September 16, 2016

Morning Rounds by Megan Thielking
Good morning! STAT reporter Andrew Joseph filling in today for Megan. Here’s what’s happening in health and medicine.

Prosecutors pushed to help tackle opioid crisis

The Justice Department will be sending off letters to all 94 US attorney offices soon pushing prosecutors to share prescription drug abuse info across state lines, Attorney General Loretta Lynch said in an interview with USA Today. Lynch says they'll ask prosecutors to be better about sharing information on over-prescribing physicians that could help flag drug traffickers and trafficking routes. They'll also be urging prosecutors to coordinate their strategy with public health officials to boost both prevention and treatment. The move is part of a larger, renewed effort by the Obama administration to tackle the opioid crisis in the US. 

Kids’ cancer death rates fall

Some good news to start your Friday: Cancer death rates for Americans younger than 20 have continued to drop. According to new data from the National Center for Health Statistics, the cancer death rate for kids and adolescents dropped 20 percent from 1999 to 2014. The declines were seen among all ages, with the greatest decline — 26 percent — in kids 1 to 4 years old. 

During the 15-year period, brain cancer overtook leukemia as the deadliest form of youth cancer. In 2014, it was responsible for three in 10 cancer deaths in this age group. There wasn't a statistically significant difference in the cancer death rates for black and white children.

Tobacco industry's ups and downs

It’s been about a month since it became illegal for anyone under age 18 to buy e-cigarettes, and the Food and Drug Administration has made its first crackdown. On Thursday the agency sent 55 warning letters to tobacco retailers after minors sent in on a sting were able to buy e-cigarettes, e-liquids, or cigars. Tobacco companies, meanwhile, are still fighting to restrict the FDA's broader assertion of jurisdiction over e-cigarettes — and one of the biggest tobacco companies has newly acquired some serious political sway. Former House Speaker John Boehner, known for his smoking habit, has joined the board of tobacco company Reynolds American Inc., the company announced Thursday.

Sponsor content by phrma

More than 300 medicines in development for autoimmune diseases offer patients and families more hope than ever before

Today, there are more than 300 medicines in development for autoimmune diseases like arthritis, psoriasis, lupus, type 1 diabetes and MS. This is exciting news for the more than 23.5 million patients with autoimmune diseases, as the need for innovation in medicines has never been greater. Learn more here about how America’s biopharmaceutical researchers are fighting autoimmune diseases.

A multifaceted look at maternal mortality

The Lancet is out with six new papers this week on maternal health around the world. They find that maternal deaths have fallen 44 percent globally since 1990, but regional disparities have grown worse: The gap has doubled between the top 10 and bottom 10 countries for maternal mortality. In the final paper, researchers outline steps to meet the UN's Sustainable Development Goals target of fewer than 70 maternal deaths per 100,000 live births. That'll take better surveillance, more coverage for maternal health services, and beefing up health care facilities, they say.

Inside STAT: When dementia changes a person’s wishes

(Molly Ferguson for STAT)

Judith Graham’s sister had clearly spelled out her wishes for her end-of-life care: Stay at home, no feeding tube, nothing aggressive. But when she was diagnosed with dementia at only 56 years old, her approach to life began to change. “And I found myself wondering whose wishes we should respect,” Graham, a STAT contributor, writes in a moving essay. “My sister, as she had been? Or my sister, as she was now?” Read her story here

Lab Chat: What mice can teach us about hepatitis

Hepatitis A causes thousands of acute illnesses every year, including more than 89 people in a current outbreak linked to frozen strawberries. Though it doesn't cause chronic liver problems, it does infect the liver, producing symptoms including fever, fatigue, and nausea. Now scientists at the University of North Carolina at Chapel Hill have developed a new mouse model to better understand how the virus invades the liver. STAT chatted with UNC’s Jason Whitmire, an author of the new research, which was published in Science:
 
What did you learn about how hepatitis A infects the liver?
 
We think this molecule called MAVS causes [liver cells] to [self-destruct] during an infection. The notion is when a cell is infected, it just kills itself, and maybe takes the virus with it. But hepatitis A wants to get in the cell and prevent it from dying. It also needs to interfere with the interferon immune responses, and it does so by cleaving MAVS. By doing that ... it prevents the cell from undergoing cell death, and then the virus is able to replicate.
 
What does this mean for our understanding of hepatitis?
 
It gives some clues into how the virus causes disease in people. We know some of the molecules involved, so in principle we could maybe target those molecules or interfere with the [self-destruction] process. We’re interested to see if what we learn from hepatitis A also applies to other [liver-harming] viruses.

Bettering STEM education falls to states

Politicians love to talk about the importance of STEM (science, technology, engineering, and math) education. A federal law signed by President Obama late last year might help improve the teaching of those subjects — but states are going to have to take some initiative, writes Adam Gamoran, who advised Congress on STEM policy, in a new piece in Science. The law, the Every Student Succeeds Act, goes into effect next fall and enables states to weigh science more heavily in their standards. The law also allows states and local districts to use federal funding to improve STEM instruction and start STEM specialty schools, but states will need to act to realize those goals, Gamoran says.

Small business owners talk Zika

There’s perhaps no voting bloc politicians love to tout more than small business owners. Now, the Obama administration has enlisted some of them to pressure Congress to approve emergency Zika funding. In a call with reporters Thursday, owners of businesses in Miami’s Wynwood neighborhood said the local spread of Zika there had hurt business dramatically; Owen Bale of R House restaurant said revenue was down 75 percent from last summer, forcing the restaurant to lay off staff and cut hours. 

And in other congressional news, a bipartisan group of lawmakers introduced a bill Thursday that would require drug makers to justify price increases of more than 10 percent by providing documentation to HHS. But in most states where similar laws have been proposed, the pharmaceutical industry has successfully lobbied against their passage. 

What to read around the web today

  • EpiPen maker quietly steers effort to protect its price. New York Times
  • How thousands of people who weren’t dying wound up on hospice care. The Washington Post
  • Diners want healthier foods. Even Cup Noodles is trying to please them. LA Times
  • Chinese actress’s death sparks cancer treatment debate. BBC

More reads from STAT

  • Get a new body part and go home the same day: The rise of the bedless hospital
  • Fetuses exposed to Zika are 50 times more likely to develop microcephaly, study finds
  • 5 takeaways from this week's Clinton-Trump medical circus. 

Thanks for reading! We'll be back with more bright and early Monday,

Megan

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