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Morning Rounds Megan Thielking

Violence complicates a challenging Ebola response

The response to the Ebola outbreak in the Democratic Republic of the Congo is facing serious challenges amid ongoing violence in the affected areas. There have been 235 confirmed and probable cases in the outbreak, including 152 deaths. Here's what you need to know:

  • Rebels killed 15 civilians and abducted a dozen children in an attack this weekend in Beni, a city at the center of the Ebola outbreak. The news follows on the heels of an attack in Beni late last month that forced officials to suspend Ebola response efforts for several days, hampering the effort to stem the spread of the virus.

  • On Saturday, health officials announced that rebels killed two medical agents who were working with the Congolese army to support the Ebola response. “Health workers are not a target for armed groups,” health minister Dr. Oly Ilunga said in a statement.

  • Health officials also reported that a gang of young men exhumed the body of someone who had died from Ebola after hearing rumors that responders had taken the body. They came into contact with body fluids and agreed to be vaccinated.

Judge could decide today on whether to call for new Roundup trial

A San Francisco judge is slated to make a final decision today about whether to toss out part of a jury's $289 million award to a school groundskeeper who claimed Monsanto's Roundup weedkiller contributed to his cancer. Dewayne Johnson was one of hundreds of plaintiffs who have sued Monsanto over claims that Roundup — which contains the chemical glyphosate — could cause cancer and that the company didn't adequately warn consumers about that risk. But experts say the science on glyphosate and cancer risk is far from settled. Judge Suzanne Bolanos has suggested she may overturn the $250 million in punitive damages, cut down the remaining reward, and call for a new trial.

Cancer researchers report on experimental drugs and clinical trial barriers

Cancer researchers presented a slew of new findings at the European Society for Medical Oncology conference over the weekend. Here’s a breakdown of the big news:

  • Merck's cancer drug data: Merck released data that showed an early-stage, immune-boosting drug wasn’t able to kill cancer cells on its own. But when used in combination with the company's drug Keytruda, tumors got smaller in a handful of patients. More on that here.

  • Immunotherapy and breast cancer: For the first time, a new study of an existing immunotherapy drug — used in combination with chemotherapy — shows it holds promise against an aggressive type of breast cancer. But the benefit was modest, and experts raised questions about the drug’s cost and possible side effects.

  • Clinical trial barriers: A review of clinical trials found that there are still barriers that prevent teens and young adults with cancer from participating in research, including age minimums and caps in some studies.

Inside STAT: How doctors raced to stop a young girl's rare disease


Dr. Timothy Yu, left, with Mila and her mother Julia Vitarello. (KATHERINE C. COHEN / BOSTON CHILDREN’S HOSPITAL)

Mila was just six years old when she was diagnosed with Batten's disease, a rare neurodegenerative disorder that is always fatal. But her parents, Julia Vitarello and Alek Makovec, now have a glimmer of real hope. With the help of scientists, regulators, and Mila’s family, an experimental therapy — developed in record time — now holds the potential to stop her disease in its tracks roughly a year after she was diagnosed. Her case serves as a proof-of-concept case study in the effort to rapidly develop and deliver precision therapies that are tailored to a particular patient. STAT's Meghana Keshavan has the story here.

Severe mental health issues tied to higher ER use

Patients with a mental health condition are more likely to use the ER than the general population — and a new study of California hospital data from 2012 to 2014 teases out the role that the severity of a condition might play. The researchers found mild mental health diagnoses were associated with a 3 percent increase in ER use, while moderate and severe diagnoses were associated with 12 and 23 percent increases in ER use, respectively. And while the authors say their findings are likely relevant in other parts of the country, the study is particularly pertinent for California, where the state’s Medicaid program has made big changes to how it delivers mental health care.

City health officials call for more disease detectives

Health directors of big cities across the country say they need far more epidemiologists to deal with the challenges posed by public health emergencies, citing findings from a new survey of 27 city health departments. Epidemiologists are scientists tasked with tracking disease outbreaks. The survey — coordinated by the Big Cities Health Coalition and the Council of State and Territorial Epidemiologists — found that there are often far fewer epidemiologists for the size of a city than state staffing ratios recommend. “Some cities are woefully under-resourced,” the authors write. “Even in well-staffed departments, there is a perceived need for a significant increase in capacity.”

What to read around the web today

  • The Trump administration is considering narrowly defining gender as a biological, immutable condition. New York Times
  • Miscarrying at work: the physical toll of pregnancy discrimination. New York Times
  • For many, a struggle to find affordable mental health care. Boston Globe
  • Is China ready for a revolution in cancer therapy? Progress may hinge on access and screening. STAT Plus
  • Investors are betting $660 million that 'Viagra on demand' is the future of healthcare. Business Insider

Thanks for reading! More tomorrow,


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Monday, October 22, 2018


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