Breaking News

Concerning trends for young people, what herpes patients want, & two takes on a union for medical residents

April 21, 2023
Reporter, Morning Rounds Writer
Good morning. We bring you concerning news about the health of young people, what people with herpes want the U.S. government to do, and hopeful results from Kenya on a single dose of HPV vaccine.

Health

Nearly 1 in 5 trans youth live in a state where needed care is banned

STAT's Theresa Gaffney brings this report: Queer youth across the country have seen more legislation targeting their rights in 2023 than ever before. Nearly 20% of trans youth now live in a state where medically necessary care has been banned, according to a new report from the Movement Advancement Project, a nonprofit think tank. Just over two years ago, there were no states that banned this care for trans youth — now, 16 states do. The bans typically target care such as gender-affirming hormones, puberty blockers, and surgery for youth, though an increasing number of proposed bills affect transgender adults as well. The exact details of each bill vary, but they contain similar language and goals, which demonstrates the "coordinated, extremist efforts" behind them, according to the report.

The stakes are high when it comes to gender-affirming care, especially for young people. In 2021, 45% of LGBTQ youth seriously contemplated suicide, according to the Trevor Project, including almost 60% of trans boys and almost 50% of trans girls. Research has shown that gender-affirming care can have immense mental health benefits for trans youth.


health

Suicide attempts by young people soared in pandemic's first full year

Continuing a troubling pandemic trend, suspected suicide attempts by U.S. children and adults aged 10 to 19 rose by 30% in 2021 compared with 2019, a new study from the CDC reports. The surge was highest for the youngest, with a jump of 73% for 10- to 12-year-olds and about 49% for 13- to 15-year-olds compared to 11% for 16- to 19-year-olds. For girls and women, the rate jumped about 37% compared to 5.6% for boys. 

The findings are based on data from U.S. poison control centers; most of the cases involved the over-the-counter pain relievers acetaminophen and ibuprofen. "We're seeing very young ages, ages that I didn't used to see attempting suicide by poisoning," study author Christopher P. Holstege told reporters yesterday. "And to see a 73% increase in the 10- to 12-year old age group, it was pretty stunning from our perspective." STAT's Ambar Castillo has more.


If you or someone you know may be considering suicide, contact the 988 Suicide & Crisis Lifeline: call or text 988 or chat 988lifeline.org. For TTY users: Use your preferred relay service or dial 711 then 988.

global Health

Single-dose HPV vaccine continues to show high efficacy

Cervical cancer comes close to a success story in oncology. Screening tests can detect it early enough to treat and HPV vaccines can prevent it. Countries like the U.K. have nearly eliminated cervical cancer in young women thanks to HPV vaccination, but that's not true for low- or middle-income countries, where 90% of new cases and deaths occurred in 2020. Originally delivered in three doses spread over months, that expensive and unwieldy schedule has prompted researchers to study single doses.

Last year WHO said one dose was sufficient after 18 months, and today researchers report at a conference that protection was still strong after three years among young women age 15 to 20 who participated in three trials in Kenya. Efficacy reached 98% against the two HPV strains responsible for 70% of cervical cancer cases and 96% against seven strains in the HPV9 vaccine. 



Closer Look

Herpes patients push government for action

151027_HerpesSimplex_BW
CDC

It's a disease with only a temporary treatment, no reliable test, little hope of a vaccine, but plenty of stigma. Herpes can be a lifelong infection, one affecting two-thirds of the world in oral or genital form. Its psychological toll is significant, it can raise the risk of acquiring HIV, and in rare cases it can be passed from mother to infant, causing neurological harm. Some studies link it to Alzheimer's.

Advocates are demanding more action and more information, beyond sites suggesting abstinence. HHS recently held listening sessions for people to say what they'd like the agency to do. "I have not been given any guidance," a Wyoming public health worker said. "I feel like I'm at a dead end. I give people a lot of printout information on it, and send them to their primary care providers where I know that they are also not well-informed." STAT's Jason Mast has more.


health

How new cancer cases vary among people from specific Asian groups

You've seen it here in this newsletter: Reports that analyze health by race and ethnicity often group together people who may be quite diverse in geographic origin, culture, and language. Breaking down populations by race, ethnicity, or gender has advanced from when studies didn't include more than white men (or provide a breakdown if they did), but yesterday the CDC's Morbidity and Mortality Weekly Report took a step further. The study describes new cancer cases among 25 Asian and Native Hawaiian and Pacific Islander populations, groups often combined under the term "Asian." Here's some of what they found from 2015 through 2019: 

  • The percentage of cancer cases in people younger than 40 was highest among Hmong, Micronesian, and Melanesian people. 
  • Lung cancer was the most common cancer among Chamoru, Micronesian, and Vietnamese people.
  • Colorectal cancer was the most common cancer among Cambodian, Hmong, Laotian, and Papua New Guinean people.

medicine

Opinion: Two medical residents, two different takes on unionization

There's a union drive in progress at Mass General Brigham, the Harvard-affiliated hospital system where trainees are seeking better pay and working conditions. "The care I was providing for patients was not always what I would want for my own family members," Minali Nigam, a third-year neurology resident, writes in a STAT First Opinion. "I was suffering from moral injury as health care systems forced me to provide inadequate and at times inequitable medical care. And I'm not alone."

In another First Opinion essay, David N. Bernstein, a third-year orthopedic surgery resident, writes, "Overworked, underpaid, and under-appreciated in an era of skyrocketing paperwork requirements and historic inflation, trainees sometimes struggle to make ends meet, care for themselves and loved ones, and even find joy in the day-to-day grind of learning to be an independent physician."

Yet they disagree on what to do next, after Mass General Brigham increased their benefits. Nigam believes residents need a union to care better for themselves and their patients, But Bernstein says it's time for a pause to examine what tradeoffs any union gains might mean.


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What we're reading

  • Patients were told their voices could disappear. They turned to AI to save them, Washington Post

  • Key senators make a big pivot on bipartisan insulin cost proposal, STAT
  • Biden promised a watchdog for opioid settlement billions, but feds are quiet so far, KFF Health News
  • Narcan manufacturer aims to price over-the-counter kit under $50, STAT
  • Powerful Senate duo drops a bipartisan PBM reform plan, STAT

Thanks for reading! More Monday,


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