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Morning Rounds Megan Thielking

Experts call for shift in thinking on vaccine use in pregnant women

Health care and bioethics experts are calling on the scientific community to allow pregnant and lactating women to receive vaccines against emerging infectious diseases. Like with many other drugs, vaccines against infectious diseases like Ebola aren't often tested or approved for use in pregnant women. An international coalition of experts says it's time for that to change — and this morning, released a report laying out steps to shake up the status quo. Among the recommendations: make it the default during an epidemic to offer vaccines to pregnant and lactating women and get their input on research and vaccine deployment decisions. 

Medical students lead a push against 'public charge' proposal

A group of medical students from across the country is mounting an effort to collect comments on the Trump administration’s “public charge” proposal. Under the proposal, an immigrant's use of Medicaid and SNAP would be considered a "negative factor" in green card and temporary visa applications. Critics — including medical groups such as the American Academy of Pediatrics — say it'll discourage families from seeking food assistance or health insurance. 

The proposal is open for comment until Dec. 10. and has already garnered more than 130,000 comments. The students behind Medicine for Migration are hoping to add even more. They're hosting public comment writing parties and teach-ins at medical and public health schools across the country today. Alec Feuerbach, a Mount Sinai medical student and one of the effort's leaders, says "it's our duty as health professionals to fight against such attacks and protect our patients."

Inside STAT: Memorial Sloan Kettering deals create a web of conflicts, ethics experts say

In 2016, Memorial Sloan Kettering signed a deal with one of New Jersey's biggest hospital systems, giving the cancer center access to a bigger pool of patients. Within a year, it launched another collaboration, this one with a data analytics startup founded by an executive of the New Jersey hospital system who helped strike the blockbuster 2016 deal. The company promises its software can take patient data and spit out insights about how best to treat certain cancers. Ethics experts tell STAT that by forging those partnerships, MSK has created a web of financial conflicts that raise doubts about whether the hospital can always put its patients’ interests first. STAT's Casey Ross and Ike Swetlitz have the story here.

New report makes the case for studying heroin-assisted treatment

A new RAND analysis suggests providing supervised access to medical-grade heroin to certain drug users can reduce the risk of harm. Here’s the rundown:

  • The study: The researchers scoured the evidence on heroin-assisted treatment, in which patients are prescribed heroin that's used under medical observation and are also offered methadone. 
  • The finding: They found that other countries have seen success in providing heroin-assisted treatment to people who continue using the drug after trying multiple traditional treatments, particularly when it comes to curbing criminal activity.
  • The recommendation: The researchers say it’s critical to improve access to approved treatments, but argue it’s also worth evaluating potential tools such as heroin-assisted treatment in the U.S. “This is not a silver bullet or first-line treatment,” RAND researcher Beau Kilmer said in a statement. “But there is evidence that it helps stabilize the lives of some people who use heroin.”

Scientists create a sensor to record light exposure

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The sensors can detect several kinds of radiation. (S.Y. Heo et. al / Science translational medicine)

Scientists have created miniature, flexible sensors designed to track a person’s sun exposure in real time. The sensors stick onto the skin and can relay information about light exposure wirelessly to a smartphone. Volunteers sported the sensors while walking, swimming, and having other kinds of fun in the sun for four days, and the devices were able to record UVA radiation exposure. The researchers are hopeful the devices could also one day be used to measure exposure on light therapy, like the blue light that’s used to treat babies with jaundice. The sensors also successfully measured light exposure in a test on babies being treated for the condition.

Medicare patients often experience harm in long-term care hospitals

Medicare patients in long-term care hospitals often experience serious problems that put their health in danger, according to a new report from the HHS Office of Inspector General. The analysis looked looked at records for Medicare beneficiaries who were admitted to long-term care hospitals in March 2014. Patient harm was common — 21 percent had experienced particularly severe adverse events, and another 25 percent experienced temporary problems that still required medical care. More than half of all cases of patient harm were likely preventable and were due to medical errors or substandard care. 

What to read around the web today

  • Airlines accused of discrimination for banning lab monkeys. Bloomberg
  • Opinion: Overzealous use of the CDC’s opioid prescribing guideline is harming pain patients. STAT
  • Federal legislation seeks ban on shackling of pregnant inmates. NPR
  • China backs bold plan to tear down journal paywalls. Nature
  • The Trump administration called this biotech VC firm a suspicious agent of China. It’s run by U.S. citizens. STAT Plus

Thanks for reading! More tomorrow,

Megan

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Thursday, December 6, 2018

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