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Wednesday, November 22, 2017
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Happy Wednesday, everyone, and welcome to Morning Rounds! A quick programming note: We'll be off tomorrow and Friday, but back with your daily dose of health news Monday morning.
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What does the future of the WHO look like?
It’s showtime for the World Health Organization’s new director general, Tedros Adhanom Ghebreyesus. Today, the leader — who goes by Tedros — will hash out the agency’s plan of action for the next five
years with the WHO’s executive board. Tedros goes into the meeting bruised by a recent
miscalculation: his move to appoint just-ousted Zimbabwean dictator Robert Mugabe as a WHO goodwill ambassador. The appointment was quickly rescinded and many in the global health world have
argued Tedros must be allowed to move on from the mistake.
But there are questions about a draft copy of the
general program of work posted online. The plan sets a “triple billion” target: Ensure 1 billion more people get health care coverage, 1 billion are safer because of improved capacity to detect and respond to health emergencies,
and 1 billion lives are improved through a focus on health priorities. In an
editorial, Lancet editor Richard Horton said the plan is “worryingly vague” on how those goals will be met, warning that for the battered WHO, “the risks of overpromising and under-delivering are great.”
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A parasite from Vietnam could be killing veterans
Test results suggest some Vietnam War veterans might’ve been infected by a slow-killing parasite called a liver fluke during their service in Southeast Asia, the Associated Press reports.
Earlier this year, the VA commissioned a small pilot study to look at the possible link between liver flukes and a rare form of cancer after an AP investigation found that more than 700 veterans with the cancer have been seen by the VA in the last 15 years.
The study found that more than 20 percent of the 50 samples submitted were positive or borderline-positive for liver fluke antibodies, though the results are still preliminary and more research is needed.
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Self-inflicted injuries rise among young girls
There’s a
troubling rise in the number of young girls showing up in the emergency room with self-inflicted injuries. New research in
JAMA finds that among girls ages 10 to 14, ER visits for self-inflicted injuries jumped nearly 19 percent each year between 2009 and 2015. That actually underestimates the prevalence of self-injury, because it only includes adolescents who were
taken to the ER, not those who were treated in other settings or didn’t receive medical care at all. The finding mirrors an increase in suicide rates among the same group in recent years. The study’s authors say their findings point to a dire need for evidence-based,
comprehensive strategies to prevent suicide and self-harm among young people.
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Lab Chat: How antibiotic-resistant bacteria swap secrets
red bacteria that have received the green resistance genes appear yellow and take over the culture because they are resistant to both antibiotics. (allison lopatkin / duke)
The growing threat of antibiotic resistance has sparked calls to use antibiotics more responsibly. The idea: If we reduce antibiotic use, we could reduce the resistance that’s been naturally selected for
over time. But new
research finds that isn’t always the case. Here’s what Allison Lopatkin of Duke told me about her work, published in
Nature Communications.
How did you study the spread of antibiotic resistance between bacteria?
We looked at something called horizontal gene transfer, the primary way that new bacteria acquire antibiotic resistance genes. One of the main methods of gene transfer is called conjugation. It’s literally just two cells that knock into one another and one
transfers the DNA. This DNA is often located on these really transferable elements called plasmids. We looked at, if we totally remove antibiotics, will the resistance gene on these plasmids disappear? Cells without plasmid often reproduce faster, because
there’s less of a burden on them.
What did you see happening?
Even though cells [with plasmids] are growing slower, the resistance doesn’t go anywhere. The plasmid can be transferred so fast that even for really, really, costly plasmids, we can remove antibiotics
entirely and the resistance will still exist. It’s continuously infecting new cells. That’s a really concerning conclusion. [But we] combined two compounds, one which inhibits gene transfer and one which promotes the rate of plasmid loss. We were able to reverse
resistance in four out of the nine plasmids we studied, and we could prevent the spread of resistance in the remaining five.
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Inside STAT: Upstart maker of opioids takes on mighty Purdue Pharma
Collegium Pharmaceutical, the startup taking on
Purdue Pharma, is having a moment. The Massachusetts company recently convinced a handful of top health insurers to generally cover only its product Xtampza — and not Purdue’s well-known OxyContin — for patients prescribed oxycodone. And earlier this month,
Collegium scored another win when the FDA allowed the company to update Xtampza’s label to describe data demonstrating that the capsules are harder than OxyContin to abuse when crushed. The company is still far from a leading force in the market, but it's
gaining traction with a strategy carefully calibrated for a time when there’s widespread concern about the opioid epidemic. STAT’s Rebecca Robbins has more
here.
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New report finds sugar industry buried evidence of health harms
A new
report adds to the growing pile of evidence that the sugar industry isn’t all that sweet. An analysis of internal documents revealed that nearly 50 years ago, the sugar industry buried scientific research that pointed
to sugar’s negative health effects. Back in the late 1960s, the Sugar Research Foundation funded animal research to study how sucrose affects cardiovascular health. But preliminary results suggested sugar consumption was tied to both bladder cancer and elevated
levels of triglyceride fats, which can increase a person’s risk for heart disease — so the group scrapped the study without publishing the evidence.
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Insulin pills don't prevent type 1 diabetes
There’s been excitement around the idea of using a daily insulin pill to prevent type 1 diabetes in people at an increased risk of the disease — but a new
study shows the pill doesn’t prevent or delay diabetes. Researchers recruited people who had normal glucose tolerance, but who had relatives with type 1 diabetes and had antibodies that put them at a higher risk of developing
the disease. Those patients took either a daily insulin pill or a placebo drug. There wasn’t a big difference in diabetes prevalence between the two groups, and the insulin pill also didn't significantly delay the development of diabetes. I track negative
results, which often don’t get reported, in this newsletter. See one? Send it my way at
[log in to unmask].
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What to read around the web today
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Millions of patients face pain and withdrawal as opioid prescriptions plummet.
Bloomberg
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As malaria resists treatment, experts warn of global crisis.
New York Times
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Coming out to your doctor in rural America.
Valley Public Radio
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Thanks for reading! See you next week,
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