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Morning Rounds Shraddha Chakradhar

I can’t believe we’re already a week into August! I, for one, have been spending some of my time making ice cream for the STAT crew. But before I go ponder the next flavors I’ll make, here’s today’s news.

Major medical and public health groups call for action on gun violence

A group of seven medical and public health organizations, including the American College of Physicians and the American Medical Association, is urging immediate action on the issue of gun-related injuries and deaths. “The magnitude and frequency of mass attacks are unacceptable to our organizations,” the group shared in a statement. It said lawmakers should enact measures including comprehensive background checks for all firearm purchases — including at gun shows — while also pushing for more research into the causes behind gun violence. The group is also calling for closing a loophole that currently allows those with a history of domestic violence against spouses or parents but not domestic partners or other family members to purchase guns. The organizations emphasize that although a majority of people with mental illness are not violent, screening and treatment for mental health could be a preventive measure against violence using guns. 

Lower-impact hits in football can still cause brain damage

Hits that don’t bring on concussions in football players can still cause brain damage, a new study finds. The potential neurological effects of concussions are well-known, but the new work suggests that even one season of small hits could lead to reduced white matter in the brain, which can lead to cognitive and motor problems. Researchers measured more than 19,000 hits sustained by 38 college players during one season from practices and games. MRIs from the start and end of the season revealed an overall reduction in white matter in the players, even though only two of these players suffered concussions. The extent of the damage corresponded with the number of hits sustained. The researchers say MRIs of the midbrain could help physicians diagnose “clinically silent” brain injuries and prevent long-term damage from play-related hits.

Insurance plans in the ACA marketplace don’t often provide abortion coverage

A new report from the advocacy organization National Health Law Program finds that abortion care is not covered under many insurance plans offered through the Affordable Care Act marketplace even in states where the procedure isn’t restricted in some way. Here’s more: 

  • Abortion coverage: 17 of the 24 states where abortion coverage isn’t prohibited have insurers on the ACA marketplace who offer insurance coverage for the procedure, but most states only have one or two such insurers. 

  • Definitions: Many plans didn’t explicitly define abortion coverage under the list of services offered, which the report authors say could have confused patients about whether they could seek out the procedure. 

  • A caveat: The report only looked at plans in 2017 and 2018, and several states have enacted abortion laws since.

Inside STAT: Startups look to viruses and bacteria for the next generation of skin care


(Illustration: Molly Ferguson for STAT; Photo: Adobe)

The skin care market might seem oversaturated, but better products for acne and other conditions are still lacking. And while it may seem like getting rid of bacteria and germs that promote skin conditions is the obvious answer, a handful of companies are now trying to do the opposite: leveraging the microbes that reside with us to better treat skin conditions. But are these startups biotech companies or beauty companies? The distinction could mean the difference between whether their products are regulated as drugs or whether they can go straight to consumers. From pore-strip-derived bacteria to bacteria-killing viruses, STAT’s Megan Thielking has the skinny on all things skin microbiome here.

Researchers call for an end to conversion therapy

Physicians and historians writing in a new perspective article are calling for an end to conversion therapy, the controversial practice of trying to change the orientation of gay and gender-nonconforming individuals. The practice is currently banned in 18 U.S. states, Puerto Rico, and Washington, D.C., but the authors say that there is still room for improvement. Those who have undergone conversion therapy have reported higher rates of attempted suicide and depression, the authors write, and several medical organizations have stated their opposition. Beyond states ending the practice, the researchers say that more needs to be done to educate people on supporting and accepting gender-nonconforming and gay individuals. Clinicians should also be aware of the ethical and medical risks of the practice, the authors write.

Women in India don’t access health care as much as men

Women in India face aren’t accessing health care as much as men, according to a new analysis. Researchers looked at more than 2.3 million visits in 2016 at a major hospital in the capital city of New Delhi and found that female patients made up 37% of the visits. Women younger than 30 and older than 60 were also almost half as likely to visit the hospital compared to men in the same age groups. The authors conclude that “there is extensive gender discrimination in healthcare access,” and write that although the differences could be due to differences in how men and women are afflicted with disease, this is unlikely because the data included all the departments of a multispecialty hospital and “any gender predilection would get balanced across specialties.” The scientists say the findings should prompt government action to address the disparity. 

What to read around the web today

  • Apple and Eli Lilly are studying whether data from iPhones and Apple Watches can detect signs of dementia. CNBC
  • Medical schools are pushed to train doctors for climate change. The Wall Street Journal
  • He went to jail as a fake doctor. Now he’s a real one: The saga of Adam Litwin, MD. Los Angeles Times
  • Is pot safe when pregnant? Study seeks answer, draws critics. The Associated Press
  • CMS finalizes long-sought rules for Medicare CAR-T coverage. STAT

Thanks for reading! More tomorrow,

Shraddha

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Thursday, August 8, 2019

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