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Morning Rounds Shraddha Chakradhar

House subcommittee issues subpoena warning to Juul

Turn over the requested marketing documents or be subpoenaed — that’s the warning that a House Oversight and Reform subcommittee issued to e-cigarette maker Juul yesterday. The subcommittee on economic and consumer policy requested documents related to the company’s marketing tactics — including funding for campaigns against teen vaping — back in June, and iterated these requests at a July hearing with Juul executives. Yesterday’s warning letter claimed Juul had only produced a small portion of the documents, despite receiving several requests over the past three months. The subcommittee issued a deadline of Oct. 1 to produce all the documents or risk legal action. 

The increased scrutiny of Juul and other e-cigarette manufacturers comes as more vaping-related illnesses are being reported: Canada is now investigating its first such case. Also this week, Michigan and New York became the first states to ban the sale of flavored e-cigarettes. 

Nearly 3 million pregnant women and newborns die yearly, WHO finds

A new WHO report finds that although fewer pregnant women and newborns are dying prematurely, some 2.8 million of them die every year. Between 2000-2017, the ratio of maternal deaths per 100,000 births dropped by 38% worldwide. At the same time, nearly 300,000 women died during or after pregnancy in 2017, and most of these deaths were in low-income settings and were preventable. When it comes to child mortality, the overall rate for children under 5 decreased by nearly 60% since 1990, although the share of neonatal deaths within this group increased. According to the report, the current pace of progress will mean that many countries won’t meet the UN’s 2030 goals for maternal and childhood mortality — more than 1 million women will die if the targets aren’t met, as will some 10 million children under the age of 5. 

1 in 20 young Canadians are hospitalized every day for substance use

A new report that looked at Canadian youths aged 10-24 finds that some 65 of them are hospitalized every day for substance use issues. Here’s more: 

  • Overall trends: Between 2017-2018, there were more than 23,500 hospitalizations among youth — or 1 in 20 of those ages 10-24 — because of substance use. 

  • Age and sex: Substance use-related hospital stays increased with age. More girls ages 12-16 were hospitalized than boys in the age group, but the opposite was true when it came to young adults aged 19 and older. 

  • Substances: Cannabis was the most common substance for which the youths were hospitalized, accounting for some 40% of hospitalizations. Alcohol was the second most common substance, making up about a quarter of hospital stays.

Inside STAT: Democrats still have questions about Nancy Pelosi’s drug pricing plan


House Speaker Nancy Pelosi (D-Calif.) (TOM BRENNER/GETTY IMAGES)

For many months, House Speaker Nancy Pelosi’s plan to lower drug prices has been kept under wraps. So when the big reveal came this week, it was preceded by big expectations. Among the plan's features: a $2,000 cap for out-of-pocket expenses for Medicare beneficiaries, and the availability of Medicare-negotiated prices for those on the commercial insurance market. However, for some, Pelosi’s plan — and the lack of details shared thus far — left more to be desired. Even members of the House committees who are expected to consider the legislation as early as next week didn't have much information. “I think we would benefit from seeing some more details,” Rep. Joe Kennedy (D- Mass.) tells STAT’s Lev Facher. Read more here

Microbiome affected by birth method, sleep cycles

A newly published study adds to the growing body of evidence that how babies are delivered — vaginal or by C-section — could influence their microbiome. Specifically, researchers found that babies born via C-section were missing beneficial strains of Bacteroides bacteria from their mother, but instead had high levels of infectious bacteria often found in hospitals, including Enterococcus and Klebsiella species. 

At the same time, a different study reports that sleep cycles could affect the gut microbiome. Researchers found that disruptions in sleep patterns — measured by the presence or absence of light — led to a reduced number of a type of immune cell that maintains gut health. This in turn led to changes in the makeup of the gut microbiome, which could make people more susceptible to infection. 

Current medical education may not sufficiently train doctors on nutrition

A review of 24 studies from all around the world finds that nutritional education is not well-incorporated into the medical school curriculum. The findings could mean that doctors in training are not sufficiently trained to help patients with nutrition-related care, which often affects other aspects of health. The studies included in the review asked recent medical school graduates about their nutrition knowledge and attitudes about receiving related information at school, and many students reported that they didn’t get enough such information during their education. In at least one study, fewer than half the students who were tested on their nutrition knowledge received a passing grade. One limitation: Many of the studies included in the review had small sample sizes, which could undermine how broadly applicable the findings are. 

What to read around the web today

  • A remote Bahamas medical clinic lost staff, power, and water. It stayed open anyway. BuzzFeed News
  • Will combo pill catch on in US to prevent heart attacks? The Associated Press
  • India announces widespread ban of e-cigarettes. NPR
  • America’s abortion rate has dropped to its lowest ever. The New York Times
  • Cancer cells have ‘unsettling’ ability to hijack the brain’s nerves, Nature

Thanks for reading! I'm off for the next few days, but my colleagues will still be bringing you this daily newsletter. I'll be back on Wednesday!

Shraddha

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Thursday, September 19, 2019

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