Senators take on e-cig rules, the battle over nutrition policy heats up, & fruit juice for kids

STAT

Monday, May 22, 2017

Morning Rounds by Megan Thielking

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Welcome to Monday morning, everyone. Here's what you need to know about health and medicine today. 

Nutrition experts gear up for a fight against Trump

Dozens of prominent nutrition researchers are urging the Trump administration’s top health officials not to delay the new requirements for nutrition labels. “Americans consume added sugars, especially sugar-sweetened beverages, in amounts that are linked to a higher risk of heart disease, type 2 diabetes, obesity, tooth decay, and nutrient-poor diets,” they warn in a letter to FDA Commissioner Scott Gottlieb and HHS Secretary Tom Price.  The new labels — set to go into effect starting in July 2018 — would require manufacturers to include information on the amount of added sugar in food and beverages. The food industry is pushing the FDA and commissioner Scott Gottlieb to delay those changes. The agency has already pushed off the implementation of a rule that would require calorie counts on restaurant menus.

Amid the federal back-and-forth, New York City is taking charge of its own nutrition policy. Starting today, chain restaurants and supermarkets in the city will have to post calorie counts on any prepared food for sale. Any business with at least 15 locations nationwide will have to comply with the new rule, part of an expansion of the city’s health code.

Brace yourselves for a new budget and a CBO score

It’s a big week for health and science in Washington. President Trump’s revised budget blueprint for fiscal year 2018 is expected to drop tomorrow. An early version of this budget proposal included a $6 billion cut to the NIH and a $15 billion cut to HHS. And on Wednesday, the Congressional Budget Office is expected to release its long-awaited report on the GOP’s health care bill. It’ll give an estimate of how many people will lose coverage and how the bill would impact the budget. The AHCA has been amended since CBO’s earlier analysis, which found that 24 million people would lose insurance under the plan.

Pediatricians warn against fruit juice for babies

The American Academy of Pediatrics is putting the squeeze on parents to stop giving children under age one fruit juice. The organization released the new recommendation this morning after evaluating the evidence on fruit juices. They say fruit juice offers no nutritional benefit to kids that young and packs excess sugar and calories. The group had previously recommended against fruit juice in kids under six months, but revisited that recommendation given rising rates of obesity and concerns about dental health.

Inside STAT: Deaf patients struggle to get interpreters

When John Paul Jebian showed up in the emergency room at Baptist Hospital of Miami with chest pain, he asked the staff for an American Sign Language interpreter. Instead of bringing an interpreter, they brought a video screen in to connect Jebian, who is deaf, with a remote interpreter trying to help him understand what doctors and nurses were saying. They struggled to set up the equipment while Jebian waited anxiously to find out whether he was having a heart attack. “I didn’t know if I had to have surgery. Everything was going past me. I didn’t know what was happening, when it was happening,” said Jebian. STAT reviewed  hospital inspection reports and court records and found dozens of cases around the country when deaf patients said they weren’t provided adequate interpretations. STAT contributor Leila Miller has the story.

Scientists engineer a synthetic protein to stop MERS

MERS stuck to an infected human cell. (NIAID)

Scientists studying Middle East Respiratory Syndrome are working on a new molecular tool to fight the virus. The first case of MERS cropped up in 2012, and the virus has since been detected in 27 countries, with most cases in Saudi Arabia. There isn’t a vaccine or treatment for the virus. One of the ways MERS is able to do its damage is by vacuuming up ubiquitin, a protein found in every cell that helps keep cells alive and functioning. Viral enzymes deactivate ubiquitin to stifle the immune system and allow the viruses to replicate.

Now, scientists have engineered a synthetic version of ubiquitin that can intervene — though only in a dish. The synthetic ubiquitin gets sucked up preferentially over the cell's own ubiquitin, thereby halting the virus's replication. In the lab, the engineered ubiquitin was able to do away with MERS from infected cells within one day. The scientists say they’re hopeful the engineered ubiquitin could be tested as a therapeutic for MERS.

Senators stick letter on e-cigs in Scott Gottlieb's mailbox

Scott Gottlieb’s mailbox is starting to fill up. A group of Senate Democrats have sent the FDA head a letter expressing serious concerns about the agency’s approach to tobacco regulation. The FDA announced last year it would start regulating e-cigarettes the same way it oversees tobacco. That rule was supposed to go into effect this month, but the agency has delayed the deadlines for the e-cig industry players to comply with the rule. “Such delays will have dangerous consequences and hamper the ability of the FDA to carry out its mandate to protect the public’s health,” the letter reads. The senators are urging Gottlieb and his colleagues at the FDA to stand up to industry pressure and implement the regulations.

Patient safety program reduced nursing home infections

A patient safety program has helped nursing homes cut rates of urinary tract infections among patients with catheters, according to new results published in JAMA Internal Medicine. The Agency for Healthcare Research and Quality gave funding to more than 400 nursing homes and long-term care facilities to implement a comprehensive safety program developed to reduce infections among patients with catheters. The program includes training for staff on how to care for and remove catheters and how to improve communication with residents and their families to coordinate better care. Nursing homes that implemented the program saw their UTI rates drop by an average 54 percent over the first year. The agency has released a new toolkit to make it easy for all long-term care facilities to put those practices in place. 

What to read around the web today

§  How a remote California tribe set out to save its river and stop a suicide epidemic. Los Angeles Times

§  The tsunami in Japan is threatening the developing brains of children in Cambodia. New York Times

§  Neurofeedback could fight your depression — or just empty your wallet. Bloomberg

More reads from STAT

§  Behind closed doors, WHO prepares to elect its next leader

§  Doctors have resisted guidelines to treat sepsis. A new study suggests those guidelines save lives

The latest from STAT Plus

§  PhRMA doubles down on R&D but falls short in bid to rein in bad actors. 

§  HHS pushes to increase industry fees paid to FDA

Thanks for reading! More tomorrow,

Megan

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