Exclusive: The far-reaching consequences of a scientific language slip-up

José A. Alvarado Jr. for STAT

Makena, once the only available treatment to prevent preterm birth, has had its share of controversy. The drug was the subject of a years-long debate over its effectiveness that led the Food and Drug Administration to withdraw its approval of the product and demand it be pulled from the market after a confirmatory trial couldn’t replicate the results of a key study.

But one aspect of the drug’s legacy has gone untold. A widely cited study that supported Makena’s approval mixed up the names of two distinct molecules: 17P and progesterone. One pharmaceutical consultant who supported the drug’s development wrote that she had long been concerned the mixup would lead doctors to order the wrong compound from pharmacies. That’s exactly what happened to one mother, Tara Skopelitis.

Read more in an exclusive story from Nalis about the real-life ripple effects of this confused terminology.

chemicals

EPA sets new standards for 'forever chemicals' in drinking water

The federal government has been busy working on regulations for “forever chemicals,” also known as PFAS, my colleague Brittany Trang tells us. The chemicals, which have been linked to several cancers, chronic diseases, and birth defects, crop up in both the environment and in consumer products like burger wrappers, dental floss, and waterproof outdoor gear. Here’s the latest:

The Environmental Protection Agency recently finalized the first U.S. standards for PFAS in drinking water. Environmental health advocates lauded the near-zero standards, but there’s concern the rules may penalize wastewater systems that have to install expensive purification systems.
The EPA also classified two PFAS chemicals as “hazardous substances” under the Superfund law that requires polluters to clean up extremely contaminated sites. Many worried that this would unfairly include people who spread PFAS unintentionally, such as local fire departments and landfills, but the EPA in a separate letter clarified it instead intends to go after big fish like PFAS manufacturers and federal facilities, which could include military bases.

more reproductive health

Hospitals largely keep quiet on maternal health care post-Dobbs, a STAT survey finds

The Supreme Court’s decision to overturn Roe v. Wade has transformed access to abortions in the last year, leading to major shifts in maternal health care across the U.S. as clinicians attempt to provide care under restrictive laws. A new STAT survey shows that the public conversation around abortion has been stifled as well. STAT’s Olivia Goldhill reached out to 100 hospitals (two from each state) to discuss maternal healthcare post-Dobbs, and only six institutions made physicians available to speak about their work. Five were in states where abortion access remains protected.

“People want to speak up, but a lot of people are afraid for their jobs,” said Melissa Russo, maternal-fetal medicine specialist at Women & Infants Hospital of Rhode Island. “They could get in trouble just for talking to a reporter.” Read more from Olivia on how the discussion has changed.

closer look

Opinion: How to nurture resilience amid conflict during Sudan’s civil war

Getty Images

Heitham Mohammed Ibrahim Awadalla, a physician and director of Sudan’s Federal Ministry of Health, remembers when everything about his job changed one year ago, after civil war erupted in the country. Since then, an estimated 15,000 people have died, tens of thousands have been injured, and nearly 8 million people have been displaced. Most physicians, nurses, and other health professionals fled to safer states within Sudan or nearby countries.

The war has curtailed necessary work to keep cholera, dengue fever, and measles in check. Still, in a new First Opinion essay, he writes: “The ministry staff and the public health corps who remain at work have committed to the goal of saving lives, and that has kept the system functioning when many, including me, thought it would collapse.”

Read more for a first-hand account of how to continue protecting public health during a national crisis. And if you’d like to read more on the effects that war can have on health care, you can revisit a First Opinion essay by Johns Hopkins professor Leonard Rubenstein from last fall about why hospitals and other health care facilities in Gaza have suffered so much violence.

outbreaks

CDC, FDA investigate illnesses from bad botox

Injections of counterfeit or mishandled botulinum toxin, widely called Botox, have occurred in 11 states, leading to harmful reactions in 22 people, according to a notice posted Friday by the Centers for Disease Control and Prevention. Three more people in two states (Texas and California) were added to the tally since the previous CDC update on April 15.

Nobody has died, but 11 people have been hospitalized. People reported symptoms such as blurry or double vision, drooping eyelids, difficulty swallowing or breathing, fatigue, and general weakness. All reports came from women, most of whom were seeking the drug for cosmetic reasons. And all the injections were given by somebody who was unlicensed or untrained, or in a non-health care setting like at home or at a spa. The investigation is ongoing.

gun violence

Can hospital programs address the epidemic of gun violence?

Gun violence is considered an epidemic in this country, and a public health crisis that medical students are trained to respond to. It spreads like an infectious disease, except while many non-Covid contagions were suppressed during the pandemic, gun violence surged.

A new guide from Everytown for Gun Safety and the Health Alliance for Violence Intervention details a potential systematic way to help victims of gun violence: hospital-based violence intervention programs, or HVIPs. These programs connect survivors of gun violence with hospital staff who create individual plans for patients involving case management, counseling, crisis support, and other services outside of the hospital. In Baltimore, people who participated in an HVIP were six times less likely to be hospitalized for another violent injury two years after completing the program than those who didn’t, per the guide. But a literature review last year noted that, despite some evidence that HVIPs are beneficial, more and larger randomized controlled trials are needed.