Wednesday, June 22, 2016

Morning Rounds by Megan Thielking

Happy Wednesday! Welcome to the Morning Rounds. 

Speaker Paul Ryan to roll out Obamacare alternative

Speaker of the House Paul Ryan is rolling out the long-awaited GOP alternative to Obamacare today. The 37-page white paper doesn't get into the nitty-gritty of costs, but promises to drastically cut health care premiums for consumers, preserve Medicare, and reform Medicaid. It does not, however, lay out what will happen to the millions of people who now have health coverage thanks to Obamacare. 

And elsewhere in the House, Democrats are trying to keep the pressure on Republicans to fund the Zika response, as the House-Senate negotiations continue. Some key Democrats have announced they'll file what's called a "discharge petition" to force a vote on the $1.9 billion package President Obama originally requested, STAT's Dylan Scott reports. Democrats would need 218 signatures to get the bill onto the House floor for a vote — which they won't be able to get — but it's a means of laying into Republicans for not moving faster on the measure. 

Americans spend over $30 billion each year on complementary health

Americans spend $30.2 billion a year on complementary health care, and nearly half of that spending goes toward visits with alternative health practitioners, according to new CDC data out this morning. Visits to complementary practitioners totaled $14.7 billion in 2012, while natural product supplements raked in $12.8 billion. Those numbers are comparable to out-of-pocket spending on traditional doctor’s visits and prescription drugs, according to the CDC.

The biggest spenders on natural products: people with family incomes between $50,000 and $99,999. And total spending on complementary health care went up as income increased. The full findings are here.

Inside STAT: How hospitals are responding to the opioid crisis

Hospitals nationwide are trying to strike a careful balance between treating patients' pain while preventing opioid abuse and addiction. One place that's rolling out new opioid guidelines: Massachusetts General Hospital. In a recent piece for STAT, Seth Mnookin detailed his experience at MGH after undergoing surgery for kidney stones. Mnookin was open about his history of addiction with hospital staff, but wasn't given proper counseling on how to manage the prescription painkillers he was given upon discharge. Now, members of MGH's Opioid Task Force weigh in on how they're working to navigate the tricky waters of opioid abuse in a new STAT First Opinion — read here

sponsor content by cvs health

Making high-quality medical care more affordable and convenient

CVS Health is making high-quality medical care more affordable and preventing unnecessary use of higher-cost sites of care, such as emergency rooms. Nearly half of visits to MinuteClinic occur during evenings and weekends, when often the only other access to care is more costly emergency settings. Providing opportunities for individuals to enter the system in more cost-effective ways creates savings in the health care system and helps people on their path to better health.

An app a day to keep heart risks at bay

Doctors deciding whether to recommend low-dose aspirin to their patients have a new tool in their arsenal: an app that makes a virtual pros and cons list. The app, created by cardiologists, calculates a patient’s risk of cardiovascular disease — which aspirin could help lower — as well as the patient’s risk of gastrointestinal or other internal bleeding, which aspirin can increase the risk of. The free app, called Aspirin-Guide, also provides current clinical guidelines for low-dose aspirin use to prevent a first heart attack or stroke in high-risk patients.

How the sex life of the screwworm fly affects the Zika response

Scientists who studied the sex life of the screwworm fly decades ago are being honored posthumously with a Golden Goose Award for their work. It's an honor bestowed upon researchers whose project was deemed silly when conducted, but later turned out to be quite important. This year’s award goes to Edward F. Knipling and Raymond C. Bushland for their work on sterilizing insects. Their discoveries on insect control are now part of the conversation on how to battle insects like the Aedes aegypti mosquito that can transmit Zika virus.

Alpacas do their part in drug development 

Scientists looking to create antiviral drugs have turned to an interesting source: alpacas. They injected alpacas with inactivated versions of two stomach viruses, one of them a flu strain. The animals' bodies created antibodies that could potentially attack those viruses. Then, to figure out which ones actually stopped the virus from replicating in human cells, scientists pitted the antibodies against live versions of the viruses to see which ones stopped viruses from infecting cells. The researchers say that screening technique could work to identify inhibitors of any kind of pathogens. Read the research here

How high-fat diets affect the body's fat tissue

Fat cells are surprisingly beautiful. (Vanessa Schmidt/MDC)

Between two kinds of fat — the fat we eat and the fat around our waistlines — a protein called SORLA is a crucial middleman. To learn more about how SORLA levels affect weight gain, scientists studied mice with unnaturally high levels of the protein. They found that the animals quickly gained weight when they ate high-calorie food, while mice with a deactivated SORLA gene didn’t gain nearly as much weight. Then scientists turned to samples of adipose tissue from 362 overweight people and found that the higher the level of SORLA, the more sensitive adipose cells were to insulin. It seems, therefore, that a high-fat diet can make adipose tissue overly sensitive to insulin, interrupting a person’s metabolism and causing them to gain excess weight. 

What to read around the web today

  • In Zika-struck Puerto Rico, trouble delivering donated contraceptives. Reuters
  • Can doctors learn to perform abortions without doing one? NPR
  • How many calories we burn when we sit, stand, or walk. New York Times

More reads from STAT

  • At 31, she runs one of the hottest biotech companies in the industry. 
  • The growing diet divide between the rich and the poor in America. 
  • Federal panel approves first use of CRISPR in humans. 

Thanks so much for reading! Back bright and early tomorrow, 


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