October 31, 2023
Reporter, Morning Rounds Writer
Happy Halloween to all. For reasons unclear to me, my street is trick-or-treat central in a city of spookily decorated three-deckers and scary transit stories. We’re talking a record 900 pieces of candy handed out one year by one neighbor (not me). Speaking of sweet stuff, read what came up at an FDA hearing on drugs that look like candy.


When drugs look (and taste) like candy 


M&Ms, Reese’s, gummy bears, and cotton candy. Sounds like a fun day at the FDA, especially on the day before Halloween, no? Regulators were debating the potential benefits and pitfalls of “candy-like” nonprescription drug products such as vitamin gummies, particularly for children who often cannot, or do not want to, swallow actual pills. A dentist did speak passionately about the potential benefits of sedating kids for dental work with medicated gummy bears, STAT’s Nicholas Florko tells us, but the rest of the meeting’s speakers stressed the potential pitfalls of these products, particularly accidental overdose. 

Don’t tell the kids, but some suggested less-fun ways to medicate those who can’t swallow pills, ranging from intranasal to rectal administration. “Why does it have to be candy-like?” asked Rachel Meyers, a clinical professor at Rutgers University. “I think we have to get away from this idea that all kids can’t swallow oral solids.” Read more.

health Tech

White House orders up a plan to vet AI in health care

Threading the needle between providing protection and encouraging innovation, President Biden has ordered federal health agencies to come up with a plan for regulating artificial intelligence tools that hospitals, insurance companies, and other health businesses are already using. Under the directive, part of a broader order covering AI in government, a safety program would be created to receive reports of AI-related harms and unsafe practices while other agencies would fund research to support AI in drug discovery and other domains.

The order calls for efforts to fight discrimination and harmful practices, but it may be late to the game,  trailing standards in Europe and the practices of some U.S. businesses, STAT’s Casey Ross notes. Earlier this year, he and Bob Herman reported that the nation’s largest health insurers are using an algorithm to issue payment denials to Medicare beneficiaries struggling to recover from serious illnesses and injuries. Read more.


Bone mineral density returned to normal levels long-term after puberty blockers, study says

Transgender youth who use puberty blockers followed by gender-affirming hormones do not have reduced bone mineral density in the long term, according to a new study published yesterday in JAMA Pediatrics, STAT's Theresa Gaffney tells us. The study helps address at least one question regarding the long-term health impacts that may or may not arise as a result of the treatment, which halts the physical developments of puberty and has been FDA-approved for cisgender children going through precocious puberty since 1993. In a study of 75 transgender people at one Amsterdam health center from 1972 through 2018, researchers found that bone mineral density measurements were largely restored to pretreatment levels by the time participants reached adulthood.

Participants who received puberty blockers continued with gender-affirming hormones for at least nine and an average of about 11 years, with a median age of 28 at follow-up. Bone mineral density was measured in the lower back vertebrae, hip, and femoral neck (which connects bones at the top of the thigh near the hip). In participants assigned female at birth, measures of bone mineral density returned to normal levels for the participants’ affirmed gender in all locations. For those assigned male at birth, measures returned to normal in all except the lumbar spine. The authors note that to strengthen bone density, trans people assigned male at birth should be encouraged to play sports, avoid smoking, and ensure adequate calcium and vitamin D.

closer look

3D-printing tourniquets to meet the need in Gaza

20220408_122627Courtesy The Glia Project

Gaza is a hub for the Glia Project. Founded in 2016 by emergency physician Tarek Loubani, it 3D-prints open-source medical equipment for low-resource areas. Based in Canada, it was inspired by Loubani’s work there in 2012 during clashes between Israel and Palestinian groups, but the continuing dearth of medical devices keeps it on the group’s radar. Now the focus has intensified in Gaza amid the catastrophic conflict between Hamas and Israel.

Glia’s engineers in Gaza are unable to print tourniquets after Israeli air attacks damaged their office, so the team is preparing to ship them in when more aid is allowed into Gaza through Egypt. “The current conditions make it impossible to do our work but as soon as we have a chance we will produce as many [tourniquets] as we can,” Hanan Abu Qassem, administrative director of Glia’s Gaza office, told STAT’s Lizzy Lawrence. Read more.


If we have health questions, most of us go online

Screen Shot 2023-10-30 at 2.14.03 PMNational Center for Health Statistics, National Health Interview Survey, 2022

We've heard so much about telehealth since the pandemic precipitated a surge in virtual medical care that we may have forgotten about the internet’s function simply as a source of information. A new CDC report focuses on three ways U.S. adults go online for health: to search for medical information (chart above), to communicate with a doctor (but not get care), and to view test results. Based on a survey conducted late last year, the researchers say nearly 6 out of 10 adults who had internet access used it in at least one of these ways to gain information about their health. There were some differences:

  • Gender: Women were more likely to use the internet for health reasons than men
  • Age: Adults age 30 to 44 used it the most, with rates declining as age increased
  • Race and ethnicity: Asian and white adults used the internet more compared with Black and Hispanic adults

heart disease

Unnecessary stents can cost Medicare $800 million a year, new analysis estimates

Coronary stents can be lifesaving in an emergency, opening up blocked coronary arteries so blood can reach an oxygen-starved heart. But that’s not the only time stents are inserted. If someone’s heart disease is stable, medication can offer the same benefit to patients at a fraction of the cost. A report out today from the Lown Institute says unnecessary use of coronary stents could cost Medicare an estimated $800 million a year. Looking at more than 1,700 hospitals and outpatient centers, the think tank determined more than 1 in 5 procedures from 2019 through 2021 met criteria for overuse.

Those criteria for overuse included patients diagnosed with ischemic heart disease at least six months prior to the procedure and excluded patients with a diagnosis of unstable angina or heart attack within the past two weeks. Patients who visited the emergency department over the past two weeks were also excluded.

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