Thursday, July 7, 2016

Morning Rounds by Megan Thielking

Happy Thursday! Here's what you need to know about science and medicine today. 

Viral hepatitis surpasses AIDS and TB in death toll

Viral hepatitis kills as many people worldwide as tuberculosis, malaria, or HIV/AIDS, according to new numbers published in the Lancet. Researchers analyzed death data from 183 countries and found that the disease is taking a growing toll — viral hepatitis deaths grew from 890,000 deaths in 1990 to 1.45 million deaths in 2013.  About 96 percent of those deaths were due to hepatitis B or C, which can cause significant damage to the liver. Overall, the death rate has topped that of AIDS, which killed 1.3 million people in 2013, and tuberculosis, which killed 1.4 million people. And given that there are effective vaccines and treatments for viral hepatitis, the paper's authors say, there's a significant opportunity for public health officials to help get those numbers down.  

Many sunscreens don't meet dermatologists' guidelines

About 40 percent of sunscreens commonly purchased on Amazon don’t actually meet sunscreen guidelines set forth by the American Academy of Dermatology. Researchers parsed out the top 1 percent of nearly 6,500 sunscreens available by sales numbers on the site and found that many of those products weren’t up to snuff. The most common failings? A lack of water or sweat resistance. The study also found that many shoppers aren’t worried about saving a buck when it comes to sunscreen. The analysis found that shoppers purchased products offering similar levels of sun protection ranged from 68 cents an ounce to $24 an ounce.

After medical marijuana legalization, prescription drug use drops

Prescriptions for common issues fell from their standard, shown in red, after states adopted medical marijuana laws. (Health Affairs)

Medical marijuana laws could be saving the health care system big money, according to new research out in Health Affairs. Researchers looked at how prescribing patterns changed for common medical conditions that states had approved for treatment with medical marijuana, like nausea or seizures. Those conditions also had pharmacological drugs available as treatment options, too. Doctors doled out fewer prescriptions for those drugs after medical marijuana became legal — and that translated to a $165.2 million reduction in Medicare Part D spending in 2013. The paper’s authors say cost-saving benefits should be considered as states change marijuana laws. 

sponsor content by michigan health lab

Doctors unleash new weapon to fight pediatric neuroblastoma

More than half of children saw either partial or complete cancer remission in an international clinical trial — an "extraordinary success.” Learn how the treatment changed one life.

House bill would cut funds agency behind controversial drug price plan

The House funding bill released yesterday would provide a big boost for the NIH — a $1.3 billion increase — but the bill also might be bad news for the Center for Medicare and Medicaid Innovation. The bill would cut $7 billion in funding for the agency, which recently proposed a new plan for overhauling Medicare Part B drug payments that stirred quite a bit of controversy. That proposal had the pharma industry, some doctor and patient groups, and Republicans in Congress up in arms. The new bill would slash the bulk of the agency's funding. 

Inside STAT: An open letter to Olympic athletes worried about Zika

The 2016 Olympics in Rio pose a dilemma for athletes worried about contracting the Zika virus, which can be devastating to the developing brain if a fetus is exposed during pregnancy. Competitors ranging from American cyclist Tejay van Garderen to golfers Rory McIlroy and Lee-Anne Pace have said they won’t compete in Rio. STAT’s infectious disease reporter Helen Branswell, who’s been covering the virus closely, has some advice for athletes weighing the decision of whether to compete. Read her letter to potential competitors here.

What a decline in practicing psychiatrists means for mental health care

The number of practicing psychiatrists in the US is slowly declining, and experts are worried that’s limiting access to mental health services. New research in Health Affairs finds that the median number of psychiatrists per 100,000 residents in a hospital’s referral region fell 10.2 percent between 2003 and 2013. At the same time, the number of primary care docs practicing in the US went up. That suggests it’s worth looking at new strategies that integrate some mental health services into primary care, the paper’s authors say.

Lab Chat: Scientists aim to stop the fatal strike of sepsis

Sepsis — the body’s overwhelming response to an infection — kills 250,000 people each year in the US alone. Now, scientists have zoomed in to the cellular level to better understand what drives sepsis and to potentially come up with a new strategy to prevent or reverse it. Here’s what study author Dr. Judy Lieberman of Boston Children’s Hospital told me about the work, published in Nature.

What balance does the body have to strike in responding to an infection?

The inflammatory response can get out of control, especially if the bacterial infection is not immediately suppressed, and kill the patient. When the inflammatory response is too great or too sustained because the infection is not quickly controlled, the blood pressure falls and critical organs like the kidney and liver stop functioning. This is called sepsis, which is fatal in about a third of patients even with the best medical care.

What did you discover about how that happens?

We figured out how the infected cells that sound the immune alarm are killed — [a molecule called] gasdermin–D-NT forms pores in the cell’s membrane that makes it leaky and die. [It also] forms pores in bacterial membranes to directly kill the bacteria that set off the alarm. Before our work, most scientists thought that bacterial infection was only indirectly suppressed by recruiting [immune] cells to the infected tissue.

MRI contrast agents don't affect Parkinson's risk

There isn’t a connection between the contrast agents used in MRIs and the development of Parkinson’s disease, according to new data published in JAMA. Experts had expressed concern that gadolinium, used to obtain better images through MRIs, had neurotoxic effects in patients. Researchers pooled data from patients over age 66 who had an initial MRI between 2003 and 2013, 41 percent of whom were given gadolinium. There wasn’t any significant difference in the likelihood of developing Parkinson’s between patients who were given gadolinium and those who weren’t — so doctors are clear to keep using contrast agents as needed, the paper's authors say. 

What to read around the web today

More reads from STAT

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