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Morning Rounds Shraddha Chakradhar

Trump to announce strategies to overhaul kidney care

President Trump this morning is expected to announce new measures that could overhaul treatment for kidney disease. Although the details haven’t yet been made public, Politico reports that the initiatives will include plans for better access to kidney transplants and kidney dialysis at home. The government spends more than $100 billion a year on kidney care, and the new strategy — which the current administration has been signaling for months — could be a way to cut costs and help patients. Only 12% of people with end-stage kidney disease start dialysis at home, but this option may be more convenient. Many in the Trump administration have a personal tie to kidney disease, according to Politico, including HHS Secretary Alex Azar, whose father required weekly dialysis before getting a kidney transplant.

Largest AFM outbreak prompts a call for better case reporting

Acute flaccid myelitis, a mysterious polio-like condition that’s been linked to viruses, is on the rise. According to new CDC statistics, there were 232 new cases of AFM last year, making it the largest wave of cases since the first surge in 2014. The disease most commonly affects young children and can cause muscle weakness as well as respiratory illness. In the wake of these numbers, CDC officials called for better monitoring and reporting of AFM, saying that a delay in contacting the agency was hindering progress toward a cure. The CDC is often only notified of a case after a child has gone home from the hospital, but even so, many hospitals don't have pediatric neurologists or infectious diseases specialists who would be able to identify the disease and report it. 

CDC made a synthetic Ebola virus to test treatments. It worked


Fluorescent microscope image showing an Ebola strain growing in cells in a CDC lab. Green cells are those infected with Ebola and red are uninfected cells. (LANCET INFECTIOUS DISEASES)

Two treatments being developed for Ebola seem effective against the strain currently in the Democratic Republic of the Congo, according to new research. This outbreak — the second largest in history — has resulted in more than 2,400 cases of the disease, and more than 1,600 deaths. What’s interesting is that scientists tested these drugs against a reverse-engineered synthetic version of virus. Why? Because there are no available samples of the natural strain, known as the Ituri strain, although the reasons for this are unclear. “They did a great job here in a short period of time, but man, that takes a lot of resources and a lot of money and a lot of energy to make a cloned virus by reverse genetics,” Tom Geisbert, of the University of Texas Medical Branch in Galveston, told STAT’s Helen Branswell

Inside STAT: 5 burning questions about deploying voice recognition technology in health care 

Nearly a quarter of U.S. households have a device with a built-in voice assistant — like Apple’s Siri or Amazon’s Alexa — and even health care is getting in on the trend. Physicians are increasingly using voice recognition technology to help with transcribing notes. And many companies are developing software that could help doctors with other tasks such as filling out electronic health records using speech recognition software. But before such technology can become a clinical reality, there are still several outstanding questions, including whether it’s accurate enough to be useful and whether privacy concerns have been sufficiently addressed. Beyond that, are patients even receptive to the use of such software? STAT’s Ruth Hailu looks into these questions — and shares answers from experts — here.

Black children less likely than other youths to receive CPR outside hospitals

Black children in the poorest neighborhoods are less likely than white children to be given CPR by bystanders outside a hospital setting, a new study finds. In general, black children were 41% less likely to be given CPR if they had a heart attack than children of other races. Hispanic kids were 22% less likely to be helped, and children of other ethnicities were about 6% less likely to be given CPR. Researchers also ranked neighborhoods based on the racial makeup of the population, unemployment levels, and other factors and found that black children in the worst-scoring neighborhoods were almost half as likely to receive CPR than white children. One way to reduce these disparities could be to better educate those in the poorest neighborhoods on how to perform CPR, the authors write. 

WHO adds immunotherapies to its latest essential medicines list

The WHO just released its latest list of essential medicines — drugs that the agency recommends should be affordable and easily available — and the immunotherapies Opdivo and Keytruda are notable additions. The drugs are listed only for their use against advanced melanoma, where patient survival has increased by up to 50% as a result of the treatments. The list did not include the use of these drugs for lung and other cancers. The WHO also said that despite other new cancer drugs being approved in recent years, not all of them have shown enough efficacy to warrant a place on the list. Other additions of note: an abortion pill that was moved up in priority, provided a nation's laws allow it; a dozen new tests for cancer, as earlier detection can improve the chances of survival; and tests for infectious diseases including Zika and dengue.

What to read around the web today

  • Once I was warned not to be a ‘mommy doctor.’ Was I becoming a ‘mommy writer’? STAT
  • Stanford calling for retractions of work by deceased star cancer researcher. Retraction Watch
  • #MeTooSTEM founder out at Vanderbilt. Science
  • California first state to offer health benefits to adult undocumented immigrants. NPR
  • Appeals court seems skeptical about constitutionality of Obamacare mandate. The New York Times

Thanks for reading! More tomorrow,

Shraddha

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Wednesday, July 10, 2019

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