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Thursday, May 4, 2017





[Morning Rounds by Megan Thielking]





Follow STAT on Facebook<http://statnews.us11.list-manage.com/track/click?u=f8609630ae206654824f897b6&id=a327119772&e=4aad33fd68> and Twitter<http://statnews.us11.list-manage.com/track/click?u=f8609630ae206654824f897b6&id=2656c5f299&e=4aad33fd68>, and visit us at statnews.com<http://statnews.us11.list-manage2.com/track/click?u=f8609630ae206654824f897b6&id=6e3cc53b02&e=4aad33fd68>







Good morning, and welcome to Thursday. STAT reporter Andrew Joseph here filling in for Megan. To the health and medicine news we go:





Today: House votes on Obamacare replacement



Today’s the day. The House is expected to vote on a Republican plan to repeal and replace the Affordable Care Act, a major moment in the years-long campaign against Obamacare. House Republicans spent Wednesday juggling new proposals — including an $8 billion boost to help cover people with pre-existing conditions — and trying to squeeze support from wavering members, with President Trump doing some personal cajoling himself. But questions remain about the bill’s provisions on pre-existing conditions, and what the Senate will think of it. Not to forget: If passed, the measure wouldn’t just affect people on Obamacare plans. It would have broad implications for Medicaid and even for people on employer plans. The bill as it stands has not been analyzed by the Congressional Budget Office.





A new tool to wean babies off opioids



Treating infants exposed to opioids in utero with buprenorphine may help them recover from their withdrawal symptoms — part of a condition called neonatal abstinence syndrome — faster than the current frontline treatment, according to results of a clinical trial published<http://statnews.us11.list-manage.com/track/click?u=f8609630ae206654824f897b6&id=b64fa4663d&e=4aad33fd68> in the New England Journal of Medicine. For the 33 infants given buprenorphine, the median treatment was 15 days, compared to 28 days for the 30 infants given morphine. Similarly, infants in the first group stayed in the hospital for a median of 21 days, compared to 33 days for the latter group. Researchers say it’s not clear why buprenorphine appears to work faster. As of now, an estimated 80 percent of babies with NAS are treated with morphine.





Recognizing those who fought Ebola outbreak



Today, WHO Director-General Margaret Chan is in Conakry, Guinea, with leaders from that country, Liberia, and Sierra Leone. They’ll be recognizing those who helped bring the West African Ebola outbreak under control and those who have been at work developing a vaccine for Ebola.





Inside STAT:<http://statnews.us11.list-manage.com/track/click?u=f8609630ae206654824f897b6&id=b7985d7347&e=4aad33fd68> A peek inside a zebrafish lab



[https://gallery.mailchimp.com/f8609630ae206654824f897b6/images/9bffb2c8-9f5f-4eac-b00b-ee4d73799cff.gif]



(Hyacinth empinado/STAT)



Dr. Leonard Zon’s lab at Harvard, open since 1993, is home to 150,000 zebrafish, with rows and rows of tanks filled with genetically modified swimmers. The work done here has led to the development of several drugs in clinical trials — and over those decades zebrafish have become cemented as a model animal for biomedicine worldwide. Take a peek inside his lab and learn why the fish are such good models for understanding human disease. STAT’s Hyacinth Empinado has the video<http://statnews.us11.list-manage1.com/track/click?u=f8609630ae206654824f897b6&id=8b742c7a1f&e=4aad33fd68>.





Lab Chat: A new role for the thalamus



A series<http://statnews.us11.list-manage1.com/track/click?u=f8609630ae206654824f897b6&id=d1bf90809c&e=4aad33fd68> of new studies<http://statnews.us11.list-manage.com/track/click?u=f8609630ae206654824f897b6&id=2095dafb08&e=4aad33fd68> in mice hints that the thalamus may have a more sophisticated role in the brain than previously believed. The thalamus is typically thought of a waypoint where information from the senses passes through to reach the cortex. Now, it appears that the thalamus plays a conductor role as well, directing which neural circuits in the cortex should activate so that correct decisions are made. Here’s what an author of one of the papers, Dr. Michael Halassa of NYU Langone Medical Center, told me about the work.



What did you learn about the thalamus?



The classical view is that it relays information to the cortex. We’re studying the part of the thalamus that connects with the frontal part of the cortex, which is associated with decision-making and memory. There, the brain can maintain working memory over time, like if you want to remember a phone number for a few seconds. What we’ve known is that connectivity in the frontal cortex is important for that. Neurons there have to talk with each other to remember that number. It turns out they cannot do that without an input from the thalamus.



What do those inputs do?



They're providing these instructions saying which neurons in the cortex should be talking to each other. This kind of thalamic function solves a very big problem in neuroscience. Our behavior is changing on a very rapid time scale, which involves changes in connectivity. It is so quick that mechanisms of plasticity — like learning and memory — are too slow to account for that. This is a new way to think about rapid reconfiguration of cortical connectivity.





A new tool to measure infants' pain



Researchers have developed a new tool that could one day help pediatricians gauge how much pain their youngest patients are in. Doctors now have to rely on facial expressions and heart rates to attempt to measure pain in babies, and finding the right dose of a pain medication remains a challenge when the patients can't articulate what hurts and what doesn’t. For a study<http://statnews.us11.list-manage1.com/track/click?u=f8609630ae206654824f897b6&id=d6eff4aca6&e=4aad33fd68> published in Science Translational Medicine, researchers examined the EEG brain activity from 72 infants undergoing medically necessary painful procedures. They found a consistent pain signal was generated, one that was different than those generated after other stimuli such as flashing light or gentle touches. The technology still needs to be refined, but the researchers plan to use it as part of a clinical trial<http://statnews.us11.list-manage.com/track/click?u=f8609630ae206654824f897b6&id=667d61555a&e=4aad33fd68> to test the efficacy of morphine in infants. Read more here<http://statnews.us11.list-manage.com/track/click?u=f8609630ae206654824f897b6&id=00418dff50&e=4aad33fd68>.





Majority of American homes now landline-free



For the first time, a majority of American homes only have cell phones, according to new data<http://statnews.us11.list-manage1.com/track/click?u=f8609630ae206654824f897b6&id=c256e8e1a5&e=4aad33fd68> from the National Center for Health Statistics. Health officials track such data so they can make sure they are capturing an accurate representation of the country when conducting phone surveys; even in 2009, some health surveys were still calling only landlines, leaving many people out. “The wireless-only population are more likely to engage in risky behaviors,” said Stephen Blumberg, an author of the report. “They’re more likely to smoke, to drink heavily, to be uninsured, to not wear seatbelts. Without including them, the reported numbers of people doing those things appeared smaller than they really were.”





What to read around the web today

§  Louisiana proposes using century-old law to reduce drug prices. Kaiser Health News<http://statnews.us11.list-manage.com/track/click?u=f8609630ae206654824f897b6&id=5cfb8cf3e5&e=4aad33fd68>

§  Opioid crisis straining medical examiners. Wall Street Journal<http://statnews.us11.list-manage2.com/track/click?u=f8609630ae206654824f897b6&id=475c0ab7ae&e=4aad33fd68>

§  Most of Iowa could be without an insurer selling individual policies. Des Moines Register<http://statnews.us11.list-manage.com/track/click?u=f8609630ae206654824f897b6&id=1a29de55e7&e=4aad33fd68>





More reads from STAT

§  Research to cut<http://statnews.us11.list-manage.com/track/click?u=f8609630ae206654824f897b6&id=46756a917e&e=4aad33fd68> unnecessary prostate cancer treatment is 'on fire'

§  Quiz: How well do you know the health care debate<http://statnews.us11.list-manage.com/track/click?u=f8609630ae206654824f897b6&id=d46ff921e7&e=4aad33fd68>?

§  Don't call it a 'war on superbugs<http://statnews.us11.list-manage1.com/track/click?u=f8609630ae206654824f897b6&id=5c8a51afa8&e=4aad33fd68>'





The latest from STAT Plus

§  A college application<http://statnews.us11.list-manage.com/track/click?u=f8609630ae206654824f897b6&id=dc0f6c1c7c&e=4aad33fd68> for drugs and other pricing ideas

§  Former FDA chief takes aim<http://statnews.us11.list-manage.com/track/click?u=f8609630ae206654824f897b6&id=9155ba616d&e=4aad33fd68> at drug ads, prices, and supplements

§  Mylan CEO payment will 'not sit well <http://statnews.us11.list-manage1.com/track/click?u=f8609630ae206654824f897b6&id=3825d7b33c&e=4aad33fd68> with investors'









Thanks for reading! Back tomorrow to round out the week,

[Megan]