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Juul spent big to court Black leaders, no more lead vests at the dentist, & fixing pulse oximeters faster

February 5, 2024
theresa-g-avatar-small - light bg
Reporter & Podcast Producer
Good morning! The next time you get X-rays taken at the dentist's office, you may not be offered a lead vest or apron. Find out why in today's newsletter.

health

Juul spent big $$$ courting Black leaders 

In 2018, the e-cigarette company Juul was facing a massive public relations crisis as news media documented kids' growing addiction to the device's powerful supply of nicotine. So executives tried something new — they began to court civil rights organizations with six- and seven-figure partnerships to promote their product, according to internal emails and documents released this week as part of a legal settlement with the state of North Carolina. It's not clear how much money the company ultimately spent on these partnerships, but one potential deal would have sent as much as $7 million to Rev. Al Sharpton's group, the National Action Network.

It's another example of companies today following Big Tobacco's playbook — this time, by "specifically targeting and marketing to the Black community, and seeing to buy influence within the Black community," said Yolanda Richardson, the president of the Campaign for Tobacco-Free Kids. Read more from STAT's Nicholas Florko on what the new documents reveal.


health

What's taking so long to fix pulse oximeters? 

The FDA should move more quickly to ensure pulse oximeters — the ubiquitous devices used to measure blood oxygen — work well in all patients; meanwhile, the agency also needs to better inform clinicians about the devices' shortcomings in patients with darker skin, and should recall versions that are particularly problematic. This is all according to patients, researchers, and consumer advocates who testified during a public advisory panel meeting on Friday, held virtually to consider how to improve the safety of pulse oximeters.

The meeting comes more than three years after a study published at the height of the Covid-19 pandemic found that the devices didn't detect low oxygen levels in some patients with darker skin. Without clear guidance from the FDA, many physicians are left unsure what to do when they get low blood oxygen readings while using the device on darker-skinned patients. "As someone who's intimately aware of this issue, I still don't know what to do for my patients," Tom Valley, a physician who was part of the group who conducted the pivotal 2020 study, told STAT's Usha McFarling. Read more.


health

You don't have to wear those funny vests at the dentist anymore

Since the 1920s, lead vests and aprons — if you've been to the dentist literally ever, you know the ones — have served as trusted shields against the harmful effects of X-rays for radiologists, technicians, and patients. But new safety guidelines from the American Dental Association call for discontinuing their use among patients, both because X-ray technology has evolved significantly over the years, and because there are better ways to reduce patients' exposure to radiation, such as using digital as opposed to conventional X-ray film.

Lead aprons and other lead shields provide "no additional benefit to the patient except for some psychological comfort," said Mahadevappa Mahesh, a professor of radiology and cardiology at Johns Hopkins University and a chair of the American College of Radiology Commission on Medical Physics. But safety practices can linger even after technological advances render them outdated — so it's reasonable to think that some patients and practitioners may be reluctant to let lead armor go. Read more from Annalisa Merelli.



global health

Cancer cases expected to surge 77% by 2050

Dr.-Aparna-Parikh-Mass-General-Mass General Cancer Center 

Sorry to bring bleak news on a Monday morning, but here it is: Cancer cases around the world are expected to surge 77% by 2050, a new report from WHO estimates. That attention-grabbing statistic, based on an analysis of 185 countries, cites a growing and aging population and  factors including tobacco, alcohol, obesity, and pollution. 

Aparna Parikh, an oncologist who directs the Global Cancer Care Center at the Mass General Cancer Center who was not involved with the report, spoke to STAT's Elizabeth Cooney about the global disparities revealed by the report, which also found significantly higher mortality rates in lower-income countries. 

Is there consensus on screening? 

Some of the nihilists in global health will say, well, if you don't have the systems in place to actually treat the cancer, why should we screen? If you can set up capacity for mammography, or clinical breast exams from a provider, or colonoscopy, which is more resource intensive, but then you don't have the downstream health systems to treat them, is that ethical?

Do you have an answer?

I think we need to focus on health system strengthening for screening and early detection. And it's not an option to not think about how we bolster those services when we see numbers like this.

Read more from their conversation. 


health tech

Making medical devices more accessible to the blind

Home medical devices are in a regulatory gray area when it comes to accessibility standards. No agency requires manufacturers to incorporate features for blind people, so advocates from the National Federation of the Blind have lobbied lawmakers for years to fix this. (Early insulin pumps had tactile buttons, but later ones typically have digital screens.) Now, federal lawmakers have introduced a bill that would require the Food and Drug Administration to develop rules mandating that device makers build accessible products. 

"Blind people cannot independently and safely manage our lives through the technology that's available in home medical devices," said Katie Keim, an advocate who was diagnosed with diabetes at 8 years old. The condition started affecting her vision 20 years later, and by the time she was 36, her sight was completely gone. Read more from STAT's Lizzy Lawrence on the status of the bill in Congress.


health

New guidelines on caring for patients with epilepsy

For the first time in over 13 years, the National Association of Epilepsy Centers has published updated guidelines on how its 260+ member clinics should provide better care to patients. Epilepsy is one of the most common neurologic chronic conditions in the world, and yet almost a third of those who live with it do not respond to medication. The guidelines were published Friday in Neurology, the medical journal of the American Academy of Neurology. Some new recommendations include:

  • Offering genetic testing and counseling: No consensus currently exists on the best genetic testing strategy for epilepsy, the authors note. But it is most useful for those with drug-resistant epilepsy, those who started having seizures earlier, and those with neurodevelopmental disabilities.
  • Employing care coordinators who facilitate multidisciplinary care: Patients with epilepsy are often dealing with much more than "just" epilepsy.  Especially when it comes to caring for young patients, centers need to coordinate with other medical providers, therapists, schools, and social workers, the authors advise.
  • Providing mental health screening: Up to 30% of adults with epilepsy also live with a serious mental health condition, according to the CDC. Better incorporation of mental health and psychosocial services into epilepsy care may improve people's treatment outcomes and overall quality of life, the authors write.


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  • Lots of cities have anti-crime laws. A Minnesota city used theirs against people with mental illness, AP

  • Chicago children's hospital network down as experts warn of rising cyber threats, STAT

Thanks for reading! More tomorrow — Theresa


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