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Wednesday, August 23, 2017

Morning Rounds by Megan Thielking

Good morning, folks! I'm here to get you ahead of the day's news in health and medicine. 

Menthol cigarettes come under fresh scrutiny

A group of Senate Democrats is urging FDA Commissioner Scott Gottlieb to ban menthol cigarettes, which they argue pose a serious public health risk. A report from the Tobacco Products Scientific Advisory Committee in 2011 concluded that cutting menthol from cigarettes could prevent hundreds of thousands of deaths in the U.S. The senators — who sent a letter to Gottlieb yesterday outlining their requests — want a firm timeline from the FDA on its plans to address the risk of menthol cigarettes. Some local governments have already passed restrictions on menthol cigarette sales. Just last month, the FDA announced it would move to slash nicotine levels in cigarettes to make them less addictive.

Health groups step in as fighting escalates in Iraq

As fighting escalates in the Iraqi city of Tal Afar, local health officials and the WHO are rushing to staff mobile medical clinics to meet urgent health care needs around the clock. Iraqi forces are attempting to reclaim the city — which fell to the Islamic State in 2014 and is still home to thousands of civilians. Global health groups have also delivered emergency medical supplies and trauma kits to regional field hospitals and primary care centers, which are bracing for an influx of trauma patients as more people flee the city.

Steroids aren't a good alternative to antibiotics for chest infections

Steroids are increasingly being used as a treatment for certain chest infections as a way to avoid antibiotic overuse, but a new study in JAMA finds they don’t do much to help. Researchers ran a clinical trial testing oral steroids against a placebo in 398 adults with acute lower respiratory infections; they didn’t have asthma or chronic lung disease, which can complicate a patient’s treatment plan. Roughly half of the patients received five days of prednisolone. But their coughs lasted just as long and their symptoms were just as severe as the patients who received a placebo treatment. The researchers say that while antibiotics are often an inappropriate treatment for chest infections, their findings don’t support using steroids for this particular group of patients, either.

Inside STAT: Evidence for detox device falls short

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(Mike reddy for stat)

The Bridge, a wearable medical device touted as a way to help opioid users overcome withdrawal, has been endorsed by doctors in a private Facebook group about the product. Patients in the group describe it as a miracle. One of the group’s administrators, an addiction medicine specialist, asks patients and providers if they wouldn’t mind speaking with reporters about the device, which has been cleared by the FDA. But the Bridge has never been tested in a controlled clinical trial for its effectiveness in treating opioid withdrawal. The only published study testing it as a detox device is flimsy — and was co-authored by a doctor with a financial incentive to promote the Bridge. STAT’s Max Blau has the story here.

Lab Chat: A potential new tactic to treat a tricky cancer

Esophageal cancer is notoriously difficult to treat, and the prognosis is often poor. But new research suggests that a drug called ibrutinib, which is already used to treat other types of cancer, might also be effective in treating certain cases of esophageal cancer. Here's what Dr. Irene Chong of London's Institute of Cancer Research told me about the work

What did you set out to study? 

The majority of patients present with disease that cannot be cured with an operation because it has spread too far. The average prognosis is less than one year, and treatment options are extremely limited. We know from recent DNA sequencing studies that certain genes drive the growth of esophageal cancer, including the MYC gene, [which] is amplified in about one-quarter of esophageal cancers.

How did you target MYC?

MYC has been considered undruggable. However, our study shows that exposing MYC-amplified esophageal cancer cells to ibrutinib (a small molecule that's used to treat B cell cancers) leads to inhibition of MYC. 

What happens after a patient survives an overdose?

New research finds Medicaid enrollees continue to use opioids at a persistently high rate even after overdosing. There are roughly 30 nonfatal opioid overdoses for every fatal overdose in the U.S., and experts say each one of those nonfatal overdoses represents an opportunity for clinicians to intervene. But the new study — which examined data from more than 6,000 Medicaid enrollees who were treated for an overdose in Pennsylvania — finds the health system’s response to those overdoses is lacking. The number of patients who filled an opioid prescription after their overdoses fell only 10 percent compared with the period beforehand. The rate of medication-assisted treatment among that same group went up just 12 percent.

What to read around the web today

  • Transplant recipients find catharsis in holding their old organs. The Atlantic
  • Public hospitals treat greater share of mental health patients. New York Times
  • Statues of medical racist who experimented on slaves should also be taken down. The Outline

More reads from STAT

The latest from STAT Plus

  • These companies actually want to pay higher fees — and the FDA is poised to make that happen. 
  • Advocacy group is upset that India granted Pfizer a patent for a vaccine

Thanks for reading! More tomorrow,

Megan

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