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Have you ever seen an award-winning journalist sing karaoke? After the Summit ended last week, a big group of STAT staffers belted and crooned together for hours and my heart has never been so full. It was all deeply off the record so I can’t tell you who sang what. But just know — we’ve got some multi-hyphenates in the newsroom!
RFK is alarming to health leaders — even the GOP ones
Robert F. Kennedy Jr. is counting on getting a top-ranking health job if Donald Trump wins the election. Some health leaders, even some former GOP health officials, fear that Kennedy’s history of vaccine skepticism could delegitimize Trump’s health care goals.
“Look, I would be lying if I said some of the rhetoric in some quarters didn’t make me a little bit nervous,” former Trump official Joe Grogan said at the STAT Summit last week. “But the flip side of that is: What, are we crazy? We don’t think that some companies do some things from time to time that are sleazy? That does happen.”
That’s the tightrope many former Trump officials and longtime Republicans find themselves walking. Though a number have deep concerns about Kennedy, several declined to speak publicly for fear of offending Trump or his lieutenants. Read more from STAT’s Sarah Owermohle on what industry and political leaders are worried about with the election just over two weeks away.
Delirium and pain management data from an anesthesiology conference
The annual meeting of the American Society of Anesthesiologists took place this weekend in Philadelphia. Here are some of the abstracts that caught my eye:
- Ibuprofen could prevent delirium after surgery: Among hundreds of thousands of patients in a medical records database who got surgery between 2014 and 2023, those who received NSAIDS had a lower risk for delirium in the week afterward than those who received acetaminophen. Non-salicylate NSAIDs like ibuprofen were associated with even lower risks than salicylate ones like aspirin.
- But could poor sleep raise delirium risk? A smaller study of 150 patients who got general anesthesia for non-cardiac surgeries found that those who reported poor sleep in the month before surgery were more likely to experience delirium in the three days afterward.
- Black patients less likely to get this standard pain management: Previous research has shown that pain management that uses a combination of drugs is more effective than using a single medication. But a study of nearly 3,000 patients in one ICU found that Black patients were 29% less likely to receive multimodal anesthesia than white patients.
An ‘epic’ fight and a revolving door at FDA
The FDA is in the middle of “an epic struggle” with the tobacco industry over vaping and other next-generation nicotine products, according to Robert Califf, the agency’s commissioner. “We are in a legal battle every single day,” Califf told an FDA oversight organization last year.
And their opponents are all too familiar. In the past 15 years, nearly two dozen FDA lawyers have left the agency and its Center for Tobacco Products to advise, litigate for, or work with the tobacco and vaping industry, according to new reporting from The Examination.
Tobacco industry products are linked to more than 8 million deaths a year worldwide. Reporting from STAT has found how tricky it can be to regulate these products, which can often be found in the FDA’s own backyard. With stakes this high, ex-FDA lawyers can be hugely helpful to tobacco companies who want to keep products on shelves, as they bring their institutional knowledge with them. Read more from The Examination on the FDA’s revolving door and how it impacts tobacco regulation.
The mounting evidence for a viral cause of dementia
The idea that viral infections can play a role in at least some dementia cases goes back decades. It’s still controversial in the Alzheimer’s field, but as more researchers and funders have begun to take the idea seriously, the connections between pathogens and dementia have been slowly strengthening. Just in the last couple years, two papers have contributed evidence that the shingles vaccine helps to protect people’s brains from dementia.
Part of this recent shift has to do with Covid-19. There’s been a growing appreciation for the role of viruses in neurodegenerative disease since the pandemic. Paul Harrison, a psychiatry professor at Oxford who authored one of the shingles papers, has also researched how rates of mood disorders, strokes, and dementia alarmingly increase following Covid infection.
“I’ve always been a vaccine believer, but the Covid vaccine reinforced to me that there may be long-term benefits to vaccination beyond simply stopping short-term effects,” he said.
Read more from STAT’s Megan Molteni on the growing body of evidence around viral infections and dementia. Then check out her Q&A with an ophthalmologist who is working to develop an antiviral to address shingles-induced blindness — a condition that ended her own career as a cornea surgeon.
Progress on the Marburg outbreak in Rwanda
There was good news over the weekend about Rwanda’s Marburg outbreak. Two patients who had been on ventilators were successfully taken off the machines, Health Minister Sabin Nsanzimana told a press conference on Sunday, adding this marks the first time that Marburg patients treated in Africa were intubated for care and then successfully extubated. The two are among three remaining patients in care. To date there have been 62 cases recorded, 15 of them fatal.
WHO Director-General Tedros Adhanom Ghebreyesus, who visited Kigali to learn about how the country has been dealing with the outbreak, spoke highly of Rwanda’s response. “I can see that the outbreak is being managed under strong leadership,” Tedros said. “But we’re dealing with one of the world’s most dangerous viruses, and continued vigilance is essential.”
Nsanzimana said contact tracing efforts point to the index case being a 27-year-old male who spent time in a cave known to be a bat habitat, noting the genetic sequence of viruses from this outbreak is closely related to viruses retrieved from bats in the region in 2014.
— Helen Branswell, senior writer focusing on infectious diseases
3 new recommendations to prevent a first stroke
You probably know strokes can be deadly, but did you realize that up to 80% of the 600,000 first strokes Americans suffer each year may be preventable? That startling figure appears with updated screening guidelines published this morning by the American Stroke Association in its journal Stroke. Health care providers already monitor people for high blood pressure, elevated cholesterol, high blood sugar, and obesity. These are all well known to raise the risk of blood flow to the brain being blocked by a blood clot or cut off when a blood vessel ruptures. But for the first time the guidelines also recommend:
- Considering GLP-1 drugs not only to manage type 2 diabetes but also to lower weight and reduce the risk of cardiovascular disease and stroke.
- Recognizing and addressing social determinants of health: Structural racism, lower access to health care, less availability of healthy food, and lack of walkable neighborhoods.
- Focusing on sex- and gender-specific factors that raise risk: Oral contraceptives, high blood pressure during pregnancy, premature birth, endometriosis, premature ovarian failure, early onset menopause, and taking estrogens for gender affirmation in transgender women and gender-diverse people.
— Liz Cooney, cardiovascular reporter
With pregnancy loss, at a loss for words
Rebecca Little has experienced pregnancy loss. But the word loss doesn’t feel quite right to her. “I felt isolated, devastated, and like there wasn’t a vocabulary for what happened — clinically, emotionally, or legally,” Little writes in a First Opinion essay.
Clinically, a pregnancy loss before 20 weeks is called “a spontaneous abortion.” Someone who has recurrent miscarriages is known in the medical world as a “habitual aborter.” But in a post-Roe world, these language issues aren’t just a matter of semantics. When “abortion” is restricted, pregnant people who urgently need care can be turned away from emergency rooms or receiving subpar treatment. Depending on the state you live in, a miscarriage could put you at risk for prosecution.
“The lack of language and divisive politics are leaving pregnant women even more adrift,” Little writes. Read more.
What we’re reading
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Psychedelics have a shaky-science problem, Atlantic
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The flu shot is different this year, thanks to COVID, NPR
- What the U.S. election could mean for Medicare, drug pricing, and AI, STAT
- More than 2,000 Kaiser mental health professionals could go on strike Monday, LA Times
- Perplexing results from Duchenne muscular dystrophy trial raise questions about gene therapies, STAT
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