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Morning Rounds Shraddha Chakradhar

Good morning! Elizabeth Cooney here, working with Shraddha, who's reporting from the Aspen Ideas Health Festival over the next few days.

Trump’s ‘gag rule’ on abortion gets green light from appeals court

Federal appeals court judges ruled yesterday that the Trump administration’s “gag rule” on abortion could go into effect immediately. The policy, which makes clinics ineligible for federal funds if they provide abortions or referrals for them, was fought by 21 states when it was put forth in March. It could drain as much as $60 million in Title X money from Planned Parenthood clinics, which provide cancer screenings, HIV tests, and birth control and serve most of the 4 million low-income people receiving health services through Title X. “This is shocking and devastating because we’re talking about millions of people who will no longer be able to access health care,” Dr. Leana Wen, president of Planned Parenthood, told Shraddha in Aspen. The ruling undoes preliminary injunctions in California, Oregon, and Washington, but other legal challenges are expected.

Called too lax on opioid approvals, FDA floats new criteria

The FDA has taken heat for approving powerful painkillers that have fueled the opioid crisis and its trail of addiction, overdoses, infections among people who inject drugs. The agency has also come under fire from people desperate to ease their chronic pain. To walk the line between those competing concerns, the FDA outlined its plans yesterday for approving new opioid medications. Open to comment for 60 days, the draft would weigh the broader health consequences of a new drug and compare it to existing painkillers. Drug makers would have to lay out how their proposed drug would reduce the known risks of overdose, misuse, or addiction, compared to drugs already available — and any new risks their drug might pose. More for STAT Plus subscribers here.

Inside STAT: Peering deep inside cells with a ‘DNA microscope’ 

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Each dot represents a cell, with colors indicating what DNA sequences they contain. (Broad Institute of MIT and HArvard)

Just look. A new “DNA microscope,” brainchild of Broad Institute postdoc Joshua Weinstein, combines the precision of electron microscopy with DNA sequencing to reveal DNA and RNA in a cell — and identify the exact nucleotides (the A’s, T’s, C’s, and G’s) of each molecule. Here’s how STAT’s Sharon Begley explains it: Customized sequences of DNA drop into cells to tag DNA and RNA molecules. The tags grab the genetic material and then make hundreds of copies of the molecules that collide and undergo chemical reactions, producing new paired nucleotide sequences. After a DNA sequencer decodes them, a computer algorithm reconstructs the molecules’ original locations in the cells along with its nucleotide sequence. Weinstein has used these mesmerizing images to track cancer cell lines. One day, they might guide immunotherapy.

After surviving cancer, living with chronic pain

The good news is more people are surviving cancer. The aging population and better ways to detect and treat cancer may yield 26.1 million survivors by 2040 — a jump from 15.5 million in 2016. The bad news? One-quarter of cancer survivors live with chronic pain stemming from their treatment, according to a new national survey. That pain — double what adults in general report — can impair their quality of life, make them stop treatment, and push up their health care costs. Chronic pain was more prevalent in people with bone, kidney, throat, pharynx, and uterine cancers. It was also higher in survivors who were unemployed, underinsured, and poor. The survey authors call solutions for such pain an important unmet need among the growing ranks of survivors.

Filling a gap: Europe will study drug safety in pregnant and breastfeeding women

We know we don’t know nearly enough about whether a given medicine is safe for pregnant and breastfeeding women to use — or even whether it will work. Only 5% of prescription drugs are understood well enough to say how they might affect these women. Now ConcePTION, a sweeping $32 million effort launched by drug makers and the executive branch of the European Union, aims to fill that knowledge gap by bringing together more than 200 researchers and 88 organizations. “We need to really do a better job using the information that is generated in practice or routine care to make information available to women that are pregnant and their health care providers. There’s just not good enough evidence,” says Dr. Miriam Sturkenboom, the scientific coordinator of ConcePTION.

Epilepsy treatment can cost $5 a year. Millions don’t get it

Think of epilepsy as an electrical storm in the brain. This abnormal brain activity causes seizures, unusual behavior or sensations, or a loss of awareness. Most of the 50 million people who have it can live seizure-free if they take inexpensive, effective medicines. But 80% of people with epilepsy live in low- and middle-income countries, where three-quarters of them lack treatment, according to a new WHO global report on epilepsy. That’s despite effective anti-seizure medicines that can cost as little as $5 per year. “A lack of action to address the epilepsy treatment gap has dire consequences for people’s lives and well-being, and impacts social and economic development,” WHO’s Dr. Ren Minghui says in the report, which urges integrating epilepsy treatment into primary care.

One last thing ...

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(Alex Hogan/STAT)

Welcome to summer! That means sun, fun, and STAT’s annual list of great health and science books to check out. 

What to read around the web today

  • Horns are growing on young people’s skulls. Phone use is to blame, research suggestsWashington Post
  • About the idea that you’re growing horns from looking down at your phone … New York Times
  • Latest suicide data show the depth of U.S. mental health crisist. Bloomberg
  • While addiction crisis raged, many surgeons overprescribed opioids, analysis show. Kaiser Health News/STAT
  • Pulling back the curtain on Alzheimer's, through its lighter and darker moments. NPR

Thanks for reading! Shraddha will be back Monday.

Shraddha

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Friday, June 21, 2019

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