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Morning Rounds

Exclusive: Psychiatrists call for rollback of Goldwater rule

Nearly two dozen psychiatrists and psychologists — including some of the field’s most prominent experts — are calling on the American Psychiatric Association to overhaul its controversial Goldwater rule, STAT’s Sharon Begley reports. The rule, adopted in 1973, bars APA members from sharing their views of a public figure’s apparent mental status or psychological traits. Their argument: The rule deprives the public of expert opinion on crucial issues. In a letter delivered today to the APA, they say psychiatrists and psychologists have “an affirmative responsibility” to publicly discuss “mental health issues discerned in public figures” when they pose “a clear and present danger to the public’s health and well-being.”

A new shingles vaccine is in short supply

When the Advisory Committee on Immunization Practices voted to tell doctors they should use GSK’s shingles vaccine over Merck’s last fall, experts on the panel worried it might lead to supply problems. They were right: Demand for the Shingrix vaccine is so high that GSK says people looking to be vaccinated against the painful condition — a reactivation of latent chickenpox virus — may have trouble finding a doctor or pharmacy with it in stock. The company has even held off on plans to run TV ads about Shingrix until the inventory is restocked, a GSK spokesperson tells STAT. Right now, GSK is urging that people who have already had the first of the two doses be given priority when it’s time to get their second dose.

A new drug could prevent more women's deaths after birth, study suggests

A drug to prevent severe bleeding after birth could save thousands of women’s lives in low-income nations, researchers report in the New England Journal of Medicine. Currently, the WHO recommends oxytocin to prevent excessive bleeding after birth. But the drug has to be kept cold — which is difficult in many low-income countries — and might be less effective when exposed to heat. In a randomized trial of 30,000 women who gave birth in 10 countries, another drug, carbetocin, was shown to be as safe and effective as oxytocin. Carbetocin doesn’t need to be refrigerated, which could make it more accessible than oxytocin in areas where cold storage is a challenge. The drug still needs to be reviewed by regulatory agencies. The WHO says it’ll ask its guideline development group to weigh whether carbetocin should become the first choice for preventing postpartum bleeding.

Concern grows about future of abortion access

The news that Supreme Court Justice Anthony Kennedy is retiring has sparked new concern about how a shift in the court's makeup could shape the future of nationwide abortion access. President Trump will likely nominate a more conservative justice to the court than Kennedy, who has sided with liberal justices on issues of abortion access. Reproductive rights groups are worried that a majority-conservative court could overturn Roe v. Wade or more frequently rule in favor of state laws that reduce abortion access.

On a related note: The annual meeting of the National Right to Life Committee — one of the nation's most prominent anti-abortion organizations — gets underway in Kansas today. The NRLC applauded Trump's first Supreme Court pick, Neil Gorsuch. 

Lab Chat: The gender differences in a bacterial infection


Caroline Genco and her colleages identified gender-specific signatures of gonorrhea infection. (CDC / Bill Schwartz)

New research has uncovered differences in gonorrhea infections between men and women — including in the genes that drive antibiotic resistance. Here’s what Caroline Genco of Tufts told me about the research, published in mSphere.

What did you set out to study?

The rise of antibiotic resistance in the sexually transmitted infection N. gonorrhoeae is a global concern. It infects the male and female genital tract, two very distinct environments in humans. Our study examined how the bacteria responds to these different environments.

What did you find?

We found that N. gonorrhoeae responses to infection differed in specimens taken from men and women, particularly antibiotic-resistance gene expression, which was increased in men. These sex-specific findings may provide a new approach to guide therapeutic interventions and preventive measures that are also sex-specific.

Lawmakers hammer out the details of HHS budget plan

The Senate appropriations committee is meeting today to hash out the details of the health department’s 2019 fiscal year budget. A bill passed by a subcommittee Tuesday would give the NIH $39.1 billion, a $2 billion increase from 2018. A big chunk of that increase in funding is dedicated to Alzheimer’s disease research, which would receive $2.34 billion in 2019. The National Cancer Institute would get a $182 million funding boost. And the bill would also give an additional $79 million for mental health programs through the Substance Abuse and Mental Health Service Administration.

What to read around the web today

  • ​Federal officials launch reviews into administration's handling of migrant children. Politico
  • Patients who have had suicidal thoughts are often excluded from antidepressant trials. The FDA says they don’t need to be. STAT
  • Genealogists turn to cousins' DNA and family trees to crack five more cold cases. New York Times
  • Medicaid must pay for drugs approved through FDA’s ‘accelerated’ pathway, agency tells states. STAT Plus
  • Opioid makers cut back on marketing payments to doctors. ProPublica

Thanks for reading! More tomorrow,


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Thursday, June 28, 2018


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