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Friday, June 23, 2017

Morning Rounds by Megan Thielking

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What you need to know about the health bill today

The Congressional Budget Office is poring over the Senate health care bill, which landed in full yesterday after weeks of work behind closed doors. And with Senate Majority Leader Mitch McConnell pressing for a vote next week, Republicans who find themselves on the fence about voting for it or against it are being forced to weigh the decision while waiting for a CBO score. Here’s a rundown of the bill:

§  Several GOP senators are rumored to oppose the current version of the health bill, including Kentucky Sen. Rand Paul. Republicans can only afford to lose two votes from their party if they want to pass the bill.

§  The deep cuts to Medicaid in the bill are key to the vote’s outcome. The bill would phase out federal funds for the 31 states that expanded Medicaid starting in 2021, and would end the Medicaid expansion entirely in 2024.

§  Hospital groups aren't happy. Every major hospital association has spoken out against the draft, including the American Hospital Association, the Federation of American Hospitals, and America’s Essential Hospitals. AHA and FAH both called for the Senate to throw the bill in the trash and start from scratch. 

§  There’s also a rift over funding for addiction treatment and prevention. Republican senators Rob Portman (Ohio) and Shelley Moore Capito (W. Va.) had previously requested $45 billion over a decade for efforts to combat the opioid epidemic. But the bill would only allocate a one-time fund of $2 billion in 2018. The Senate bill also cuts the $15 billion in funding to expand access to mental health services that was included in the House version.

Do FDA standards to rein in dietary supplements work? 

The FDA put manufacturing standards in place between 2007 and 2010 to make sure dietary supplements are, in fact, what they claim to be. But a new study suggests that for one commonly used supplement, those standards don't seem to have done much to improve consistency. Researchers analyzed 26 different red yeast rice supplements with monacolin K, which mirrors the active ingredient in a prescription cholesterol medication. The amount varied wildly from one supplement to the next, with a 60-fold difference between two of the tested supplements. "There was no improvement in consistency or strength of red yeast rice supplements after the FDA's current good manufacturing standards were introduced," study author Pieter Cohen tells me. 

Refugee kids are more likely to get vaccinated for HPV

Refugee children in the U.S. are just as likely to be vaccinated as American children, according to a new analysis published by the CDC. Researchers measured HPV and hepatitis B immunization rates among young refugees in Massachusetts. They were pleasantly surprised by their findings: 90 percent had received the HBV vaccine and nearly 70 percent got the HPV vaccine. That means refugees were significantly more likely to be vaccinated against HPV than U.S. adolescents.

Researcher Rachel Berman says that’s thanks, in part, to health screenings and immunizations given to refugees through local clinics in the state. She also thinks refugee parents might've missed a controversy over the HPV vaccine (some parents have taken issue with the idea of vaccinating young adolescents against a sexually transmitted virus). She said there’s still more work to be done, though. “Maintaining quality care for refugees and for all children and adolescents and reducing stigma about the HPV vaccine will be important,” Berman says. 

Sponsor content by Shire

New Developments in ADHD Management

The U.S. FDA has approved a new option for Attention Deficit Hyperactivity Disorder (ADHD). Find out more about the latest news from Shire. Intended for U.S. audiences.

Inside STAT: A contested trial in India comes under fire

A long-debated study designed to find a cheap way of screening for cervical cancer in India has come under fire again. Critics have said the researchers used ineffective screening that endangered thousands of poor women in Mumbai. They've also argued the 18-year trial should've been stopped years earlier, because other studies had already shown the screening method worked, making it unethical to test the idea on a control group that went unscreened. A paper detailing that evidence was briefly published by the science journal BMJ Global Health, but was withdrawn from the website over concerns that the researchers accused of unethical behavior might sue. STAT’s Charles Piller has the story.

Cancer cells might ditch extra baggage to spread faster

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A BIG bowl of chromosomAL NOODLES, WITH RIBOSOMES IN GREEN. (Tamara Potapova)

Cancer cells looking to proliferate might be ditching copies of repetitive DNA sequences to spread. Researchers examined genome sequencing data from the cancer cells and healthy cells of 162 patients. They counted the copies of ribosomal DNA — which codes for the tiny particles that produce proteins to help cells function — and saw some cancer genomes had lost extra copies of ribosomal DNA. But getting rid of those extra sequences also seemed to make the cells more vulnerable to the DNA damage from chemotherapy, which the researchers suspect might be because the genome is less stable. Their conclusion: Counting ribosomal DNA copies might one day be a simple, easy way to predict how well particular chemotherapeutics might work.

The evidence for brain training to stop dementia is thin

A new report out from the National Academies of Science finds there just isn’t enough evidence to support running a public health campaign to encourage cognitive training and exercise as a way to stave off cognitive decline and dementia. There is some evidence to suggest that brain training and bumping up physical activity levels — along with better blood pressure management for people with hypertension — could help prevent dementia. But experts at the academies reviewed all of that evidence, and found that at this point, it’s still too inconclusive to carry out a health campaign.

What to read around the web today

§  NASA calls out Goop's $120 "bio-frequency healing" sticker packs. Gizmodo

§  The Senate bill to repeal and replace Obamacare, explained. Vox

§  Insurers battle families over costly drug for fatal disease. New York Times

More reads from STAT

§  A text message helped one of my patients stay in control of his health. Here’s how. 

§  Mylan board survives ouster attempt, but shareholders reject rich pay packages

The latest from STAT Plus

§  In a medical first, ‘long read’ DNA sequencing solves a diagnostic mystery. 

§  6 takeaways from BIO 2017

Thanks, as always, for reading. Hope you have a wonderful weekend! Back bright and early on Monday, 

Megan

 

 

 

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