first opinion
ERs: 'Where the United States' social problems come home to roost'
Photo by Scott Olson/Getty Images
Emergency physician Uché Blackstock has seen firsthand how access to health care in the U.S. has long depended on a person's ability to pay, with patients of color making up a disproportionate number of the under- or uninsured. Since the middle of the 20th century, hospital emergency rooms have been where people without coverage could go. Even though hospitals might have no longer been segregated by race as of the 1960s, ERs were still where people of color would go for care.
In an excerpt from her book "Legacy," Blackstock traces the simultaneous transformation of emergency rooms "staffed by a motley crew of interns and residents" into a specialty after Black citizens in Cincinnati marched on the hospital in protest against the long waiting times and subpar treatment they were receiving there. She chose emergency medicine as her specialty, but writes that she "came to view it as the place where the United States' social problems come home to roost — just as they did in the 1960s." Read more.
health tech
Generative AI brings new threats to hospital security
Uh oh. The same AI tools — think ChatGPT — that can help hospitals by flagging crucial medical details and easing the burden of repetitive tasks can just as easily be harnessed by malicious hackers to exploit an industry known for outdated cyber protections, security experts say. And while health leaders tell STAT they're assessing risks, recruiting cybersecurity teams, and updating training materials to warn staff about increasingly sophisticated phishing and hacking attempts, regulators and cyber companies are urging hospitals to upgrade their security to prepare.
"The risks keep growing, and we don't necessarily have a way to combat them," said Samantha Jacques, a medical device cybersecurity expert at McLaren Health Care, a Michigan health system, and a member of the cyber committee within the Health Sector Coordinating Council, an industry group tasked by the federal government to coordinate threat response. Mohana Ravindranath has more on mounting cyber threats.
health
A clue to SIDS in a baby's brainstem
Sudden unexpected infant death and sudden infant death syndrome both lack an obvious explanation. Recently STAT's Eric Boodman told us about a study linking seizures to unexplained toddlers' deaths, based on heartbreaking video from baby monitors. New research published yesterday in JAMA Neurology names brainstem encephalitis as another potential cause. A viral infection was detected by metagenomic next-generation sequencing 1 of 6 infants who had signs of neuroinflammation, in a cohort study of 71 SIDS cases. The researchers think that an infection in the brainstem could have led to the 11-day-old baby's death by interfering with autonomic functions, interrupting her breathing.
The virus in question is known to cause mild respiratory and GI infections, but sometimes it reaches the brain or the heart. A companion editorial notes how often caretakers feel extreme guilt and blame for how their babies were placed when sleeping, and while the study can't rule out sleep position, the authors urge more studies of neuroinflammation and sequencing of pathogens.
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