Tuesday, May 3, 2016

Morning Rounds by Megan Thielking

Happy Tuesday, everyone! Welcome to the Morning Rounds, where I get you ahead of the day's top stories in science and medicine. 

Johnson & Johnson order to pay up in talc lawsuit

A St. Louis jury has ordered Johnson & Johnson to pay $55 million to a woman who used the company's talcum powder for decades and then was diagnosed with ovarian cancer. Talc is associated with possible cancer risks, which the woman's lawyers said Johnson & Johnson didn't properly disclose to consumers. In February, the company was ordered to pay $72 million to another woman in a similar lawsuit, and there are 1,200 similar cases pending, Reuters reports

Nonprofit hospitals top the list of profitable hospitals

Seven of the ten most profitable hospitals in the US are, ironically, nonprofit hospitals, finds a new analysis out this morning. The authors of the paper say there are three big contributors to a hospital's profitability: whether it’s the dominant provider of health care in the area, whether it’s affiliated with a hospital chain, and how much it charges for care. The top ten hospitals billed an average of $5.20 for every $1 of cost they incurred. “Higher charge is associated with higher hospital profit,” study author Ge Bai of Johns Hopkins explained to me. If you’re curious, the most profitable hospital in the country is the nonprofit Gundersen Lutheran Medical Center in the small town of La Crosse, Wisconsin.

These shoes shock your feet to stop you from tripping

The insoles could improve your score on Dance Dance Revolution, too. (Wyss Institute)
This’ll put some pep in your step — new vibrating shoe insoles could reduce the risk of injury during hiking or trekking over difficult terrain. The vibrations aren’t perceptible to humans, but in tests on humans, they augmented sensory nerve performance in the feet, which improves a person’s balance and control while walking  An added bonus: the shoes also might be able to up your basketball skills. In another study of the insoles, participants wearing the inserts who completed a jump test designed to measure agility — shown here — finished a tenth of a second quicker than participants not wearing them.

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Inside STAT: The Detroit native overhauling the city's health department

A few years ago, Detroit’s health department, along with the rest of its economy, was in shambles. So when 31-year-old Detroit native Dr. Abdul El-Sayed took the job, he had one mandate: Rebuild. Now, El-Sayed is trying to do everything from improving the struggling animal control office to testing kids for lead exposure. “The hard thing about a turnaround is, there’s no launch date, right? You already launched a long time ago,” El-Sayed told STAT’s David Nather. “You have to keep — and improve, even — the quality of city services even as you are fundamentally [shifting] the gears inside the machine.” It’s no easy task: Four out of every 10 residents in the city live below the poverty line, and infant mortality is higher in Detroit than in any other major American city. More on El-Sayed’s work here.

Bladder surgery for kids doesn't work like docs said

A promising surgery to restore bladder function in children with spinal defects doesn’t seem to help the problem at all, according to the first controlled clinical trial of the procedure. The Xiao procedure has been used in kids with spina bifida, a spinal cord defect that can cause bladder problems among other issues. It’s used in tandem with another procedure, spinal cord detethering. Researchers at Johns Hopkins ran a randomized, double-blind, placebo-controlled trial of the procedure on 20 patients, some of whom underwent the procedure along with spinal cord detethering and some of whom just had the detethering surgery. The Xiao procedure didn’t improve bladder control in any of the patients, according to the study. Negative trial findings are often underreported; I’ll keep tracking them in Morning Rounds.

Investing in social programs could reduce health care costs

Social determinants like education, income, and housing support can significantly influence individual and population health, and some states are making bigger investments in those programs to improve public health. That investment seems to pay off, according to a new analysis of data from 2000-2009 published in Health Affairs.

The study found that people living in states that spent more on educational programs, housing support, and places like parks and community centers had much better health outcomes than people living in states that spent less. “If we could invest in income support and education, we could offset in health care spending,” the paper’s author, Yale public health researcher Elizabeth Bradley, told me.

Lab Chat: Capturing the vast diversity of bacteria in our bodies

The earth is teeming with microbes. New research in PNAS says there might be a trillion different species of bacteria on the planet, of which only .001 percent have been identified so far. Here’s what Indiana University biologist Jay T. Lennon told me about the new estimates and what they mean for the booming field of microbiome research.

What don’t we know about how many microbes are in humans?

There’s a lot of interest in trying to understand the types of microbes that are associated with the human microbiome and if they can ward off other pathogenic infections or do things like improve digestion. But we don’t really fully understand the diversity in those habitats and certainly not among individuals. We tried to to develop scaling laws, trying to find some way to capture the abundance of microbes. Our study used human microbiome data, but it wasn’t the primary focus. But it can give us some expectations of how many types of bacterial species we’d see in a normal gut microbiome.

How much diversity would you expect to see?

There’s a pattern we see no matter where we study, whether it’s the human gut or soil or the ocean. Systems tend to be dominated by just a few species of microbes, and then there are more rare species of microbes. It’s like crows and robins that you can see all day, but other types of birds are very rare and you encounter very infrequently. Those rarities are shared by microbial communities, and estimating them is a challenge.

HHS taking names for vaccine committee

The Department of Health and Human Services is taking nominations for its national vaccine committee, which makes recommendations aimed at keeping vaccines safe and effective. Their latest project: Examining the role vaccines could play in curbing the growing threat of antibiotic resistance. More on what it takes to throw a hat in the ring here.

What to read around the web today

  • South Dakota wrongly put thousands in nursing homes, government says. New York Times
  • The secret culprit in the Theranos mess. Vanity Fair
  • Rising health care costs weigh on voters. NPR

More reads from STAT

  • Shkreli's old company is sued for breach of sales contract for Daraprim. 
  • Reagan Alzheimer's movie raises the question — can illness be funny? 
  • We're one step closer to a polio-free world

Thanks so much for reading! Back tomorrow with more stories, 


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