Medical déjà vu: Hepatitis cases in children evoke another mystery

What could two mystifying infections in children, one cropping up eight years ago and one now worrying parents and pediatricians, have in common? If you’re drawing a blank (as I did), STAT’s Helen Branswell tells us about the medical déjà vu that infectious disease doctors in the U.S. felt when liver specialists in the U.K. spotted unexplained hepatitis cases in very young children. Since 2014, acute flaccid myelitis, or AFM, a rare, polio-like condition in children, has surged every two years, pre-pandemic. The two illnesses appear to come from known bugs — EV-D68 for AFM and adenovirus 41 for hepatitis — behaving in unknown ways, if they are the culprits. “You have to follow the data wherever it leads,” Kevin Messacar of Children’s Hospital Colorado told Helen. “I think you’re seeing that with the hepatitis outbreak. I think you saw that with AFM.”

Senate bill could change how FDA regulates dietary supplements

Today could be the day Senate lawmakers unspool draft legislation to reform the FDA’s regulation of dietary supplements, cosmetic products, and certain lab-based tests, sources confirmed to STAT’s Nicholas Florko Friday. For years the agency has been called to task for not using its full enforcement powers to protect the public from dangerous dietary supplements, which can be legally sold without proof of safety or efficacy. The new draft policies would be included in FDA user fee reauthorization legislation. Two caveats: The Senate committee has not released the text of the package, which could evolve, and a separate House version of the user fee legislation does not include the proposals. Nick has more in STAT+, including on cosmetics and tests, here; meanwhile, I recommend this 2017 tale of a Harvard researcher’s tangle with a supplement maker who tried to silence him.

What living 50 miles away from an abortion clinic can mean

A new study in JAMA Network Open analyzing how far away an abortion clinic was and how likely a patient considering abortion was to still be pregnant a month later comes to a conclusion that may seem obvious, but it's one that may be tested more widely in the days ahead. Among 856 people surveyed between August 2017 and May 2018, living 50 miles away from a clinic meant they were twice as likely as someone within 5 miles away to still be pregnant four weeks after — either continuing to seek an abortion or continuing the pregnancy. The cohort study takes on added meaning as more states restrict abortion and Roe v. Wade may be overturned. “This finding suggests that travel distance to abortion facilities may be an important barrier to abortion access in the U.S.,” the authors conclude.

Closer look: Early-stage startups are prime targets for biotech shopping spree, analysis shows

(MOLLY FERGUSON FOR STAT)

There’s a major stock market downturn going on, you may have noticed when looking away from Covid news. The plunge in biotech stocks has been particularly dizzying, which means mergers and acquisitions are on the horizon. A new analysis from STAT’s Kate Sheridan spanning 2000 to 2021 predicts that early-stage startups will be more tempting targets to pharma companies than normal, based on the last buying wave. She has much more detail and charts here, but these quotes on the coming shopping spree struck me:

Acquiring an early-stage business can mean “a little less egg-on-the-face risk.” — Nina Kjellson, a partner at venture capital firm Canaan.
On not waiting to fill a need: “You don't go to the grocery store when you're hungry.” — Michael Gilman, CEO of Arrakis Therapeutics.
Companies are acting as though they’re “dating before marrying.” — Arie Belldegrun, biotech investor.

Arterial stiffness may better flag type 2 diabetes risk than blood pressure

High blood pressure is a well-known risk for developing type 2 diabetes, but a new paper in Hypertension suggests there may be a better warning signal. Arterial stiffness measured by an ankle cuff better predicted type 2 diabetes than high blood pressure, and together they were the strongest indicator of risk, a study of more than 11,000 people in China showed. People who have arterial stiffness often also have high blood pressure, insulin resistance, and type 2 diabetes, but the researchers were able to tease out that people with normal blood pressure and arterial stiffness had an increased risk of type 2 diabetes while that wasn’t true for high blood pressure and no arterial stiffness. The researchers note that combined high blood pressure and arterial stiffness were more likely in people with high BMI, higher heart rate, smoking, and alcohol use.

Family relationships: from protecting to flourishing

Here’s research that goes beyond family connectedness not just as a way to avoid poor outcomes for adolescents but to allow them to flourish. Appearing today in Pediatrics, the pre-pandemic study tracked more than 37,000 11- to 13-year-olds in 26 countries to see if safe, stable, and nurturing family relationships led to the ability to develop and maintain safe, stable, and nurturing relationships with others — and went further. “Flourishing” was defined as having self-acceptance, purpose in life, positive relations with others, personal growth, autonomy, and managing daily responsibilities. And family connectedness did matter, the adolescents said, even after factoring in family financial worries or such serious problems as not having enough food. “Children’s perceptions that they are safe and seen by an adult may be as important as children’s reports of what they do with adults,” the authors write.

People with excited delirium are said to display “superhuman strength,” and the controversial term often comes up in relation to people who have died in police custody. But most medical authorities do not think excited delirium is real. In this episode of "Color Code," Isabella Cueto, a Sharon Begley science reporting fellow at STAT, traveled to Miami to learn more about the historical roots of the term "excited delirium" in the medical examiner’s office there. Listen here.

What to read around the web today

How Australia saved thousands of lives while Covid killed a million Americans. New York Times
How public health failed America. The Atlantic
Opinion: The case of RaDonda Vaught highlights a double standard for nurses and physicians. STAT
MIT, Harvard scientists find AI can recognize race from X-rays — and nobody knows how. Boston Globe
Real estate firms own nearly 1 in 10 health care properties. STAT+