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Friday, January 12, 2018





[Morning Rounds by Megan Thielking]





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Happy Friday, everyone! Here's what you need to know to get ahead of the day's news in science and medicine.





Trump is getting a physical today



President Trump is heading in for a physical today. His exam comes as public debate continues to escalate over whether Trump is suffering cognitive decline that could impact his ability to carry out the work of the presidency. And while the White House says psychiatric tests won’t be part of the president’s physical, standard cognitive tests could detect mental deterioration that can cause memory problems, STAT’s Sharon Begley reports<https://statnews.us11.list-manage.com/track/click?u=f8609630ae206654824f897b6&id=e53c6c02c8&e=4aad33fd68>. One way neuropsychologists evaluate cognitive function: language. The apparent decline<https://statnews.us11.list-manage.com/track/click?u=f8609630ae206654824f897b6&id=d33e6dfea5&e=4aad33fd68> in Trump’s unscripted speech was one of the first behaviors that spurred debate about whether he was suffering cognitive decline or mild cognitive impairment. The White House says it’ll release a “readout” of the exams, but it’s not yet clear how much information that will contain.





FDA takes a tougher stance on cough and cold drugs



The FDA is taking a stronger stance on prescription cough and cold medicines that contain opioids. The agency just announced it’ll require drug makers to change the safety labels on cough and cold products that contain hydrocodone or codeine. Going forward, they’ll only be labeled for use in adults 18 years or older. It's the second such update in a year — last April, the FDA announced<https://statnews.us11.list-manage.com/track/click?u=f8609630ae206654824f897b6&id=fabf0f7a0f&e=4aad33fd68> it'd require codeine products to carry a label saying they shouldn't be used in kids under 12 because of the health risks they can pose. Now, the labels will also carry a longer warning that cautions patients about the risk of opioid misuse, addiction, overdose, and death, along with a warning about breathing problems that can come from codeine or hydrocodone exposure.





Lab Chat: Finding drivers of drug resistance in malaria



[87396691-e5ca-4560-8a09-e04a5b7a5bdb.png]



peering in on a parasite that causes malaria. (CDC)



Hundreds of thousands of people die from malaria every year — and as drug-resistant strains of the parasite grow more common, there’s an urgent need for new treatment options. So researchers analyzed parasites that cause malaria to better understand that resistance and find potential workarounds. Here’s what Elizabeth Winzeler of the University of California, San Diego, told me about the work, published in Science<https://statnews.us11.list-manage.com/track/click?u=f8609630ae206654824f897b6&id=62439a47f7&e=4aad33fd68>.



What were you looking for?



We were looking generally for resistance genes that contribute to the parasite’s ability to escape antibiotics. We grew parasites in the presence of something that’s toxic to the parasite. And after they acquired tolerance to this compound, we then sequenced the genomes of the parasites. We were able to identify drug resistance genes that popped up over and over again. We found known ones, but also new ones.



What’s the next step in your work?



We need to do more research to find whether these [genes] are associated with clinical resistance. I think they most likely are. It also gives us a number of tools to design better drugs. The objective is to create new classes of medicines where resistance may not be such a problem.





Inside STAT<https://statnews.us11.list-manage.com/track/click?u=f8609630ae206654824f897b6&id=a264e38a41&e=4aad33fd68>: A grass-roots push to get a new kind of doctor in the House



Since 1960, nearly 50 doctors have traded in their white coats to serve in Congress. Those doctors-turned-legislators have been overwhelmingly male and overwhelmingly Republican. This year, Dr. Ramsey Ellis, a progressive hand surgeon, is trying to change that. She’s working with a private group of more than 8,000 Democratic female doctors nationwide to support eight congressional candidates with the same qualifications: all women, all Democrats, and all doctors. “Women are missing from public debate and physicians are missing,” Ellis, a former grass-roots organizer for Hillary Clinton, told STAT. “Given that a sixth of the American economy is health care, I think it’s time that [women] physicians step into the arena.” STAT’s Erin Mershon has the story — read here<https://statnews.us11.list-manage.com/track/click?u=f8609630ae206654824f897b6&id=792603c9ab&e=4aad33fd68>.





BRCA gene doesn't change survival odds post-treatment, study finds



The BRCA mutations place women at a higher risk of developing breast cancer, but new research<https://statnews.us11.list-manage.com/track/click?u=f8609630ae206654824f897b6&id=2dd8a5bdde&e=4aad33fd68> suggests it doesn’t impact their chances of survival once treated. Back in 2000, researchers recruited more than 2,700 young women with breast cancer, tested them for BRCA, and then followed their outcomes. Ten years later, there wasn’t any difference in survival rates between women with a BRCA mutation and women without a mutation. The caveat: Treatment for women with BRCA mutations has changed since the treatment period of the study, which might increase survival rates over time. But still, experts say<https://statnews.us11.list-manage.com/track/click?u=f8609630ae206654824f897b6&id=d3e0fef1f4&e=4aad33fd68>, it’s an interesting finding that warrants more research on care for young breast cancer patients.





What could changes to Medicaid's rules mean?



The Centers for Medicare and Medicaid Services are moving to allow states more latitude in their Medicaid programs, including the ability to require that non-disabled adults work, volunteer, go to school, or get job training in order to qualify. The changes could make a sizable impact: A recent Kaiser Family Foundation analysis<https://statnews.us11.list-manage.com/track/click?u=f8609630ae206654824f897b6&id=4311284230&e=4aad33fd68> found that of the nearly 25 million Medicaid enrollees between ages 19 and 64 in 2016, 60 percent were working. Of those who weren’t working, 30 percent said it was due to illness or disability, 30 percent were taking care of their families or home, 15 percent were in school, and the rest were retired or looking for work.





What to read around the web today

§  When people with anorexia grow up. New York Times<https://statnews.us11.list-manage.com/track/click?u=f8609630ae206654824f897b6&id=a3d27ea935&e=4aad33fd68>

§  Ohio takes steps to resolve opioid litigation. Wall Street Journal<https://statnews.us11.list-manage.com/track/click?u=f8609630ae206654824f897b6&id=7ec95b725f&e=4aad33fd68>

§  Trump’s tweets cause sales of anti-radiation drug to skyrocket. Kaiser Health News<https://statnews.us11.list-manage.com/track/click?u=f8609630ae206654824f897b6&id=85c0a14c55&e=4aad33fd68>





More reads from STAT

§  The toll of racism on maternal health<https://statnews.us11.list-manage.com/track/click?u=f8609630ae206654824f897b6&id=06cfbaf16f&e=4aad33fd68>.

§  Why prescription drugs in Canada<https://statnews.us11.list-manage.com/track/click?u=f8609630ae206654824f897b6&id=6eda77b75b&e=4aad33fd68> could soon become less safe.





The latest from STAT Plus

§  U.K. doctor groups overseen by the government fail to disclose pharma payments<https://statnews.us11.list-manage.com/track/click?u=f8609630ae206654824f897b6&id=1aa89cba04&e=4aad33fd68>.

§  The week of #JPM18<https://statnews.us11.list-manage.com/track/click?u=f8609630ae206654824f897b6&id=886ee1990f&e=4aad33fd68>: the Michaels, transparency, and Trump as non-factor.









Thanks so much for reading! Have a wonderful weekend,

[Megan]















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