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Presidential health from Reagan to Trump and Biden, update on vaccine advisers, & how a new drug for frostbite came to be

February 16, 2024
Reporter, Morning Rounds Writer
Good morning. Don't miss a veteran reporter's take on assessing the health of our presidents, which reminds me to tell you we'll be taking a break in observance of Presidents Day. Theresa Gaffney will be back with you on Tuesday.

aging

How old is too old? A doctor who has reported on the health of presidents since Reagan weighs inALTMAN_CLIPS_01

Alex Hogan/STAT

Now it seems almost unimaginable, but, back in the day, physician Lawrence K. Altman made a career reporting on the health of every president since Ronald Reagan. He tells us in a STAT First Opinion what has changed since 1980 and what to make of questions about the age and fitness of both Donald Trump and President Biden. He starts with a startling revelation: At 69, Ronald Reagan was about to become the oldest person to be elected president. After mentioning his mother had symptoms suggestive of dementia, he said he'd resign if his doctors found evidence of cognitive decline.

Then, listing the ages of presidents and candidates (Clinton, 46, to Biden, 81), Altman reminds us there is no direct correlation between a leader's health and performance in office. Still, "I have learned that the most reliable way to evaluate who is up for the physical and mental demands of the White House is through medical records and deep interviews with the candidates' doctors," he writes. "Short of that information, it's left to the candidates to convince voters they are fit to serve a full term." 

Read more, including his take on special counsel Robert K. Hur characterizing Biden as a "well-meaning, elderly man with a poor memory." 


reproductive health

Study confirms the safety of abortion medication prescribed via telehealth

While we await next month's arguments before the Supreme Court on access to the abortion medication mifepristone, a new study published yesterday in Nature Medicine weighs in on the safety of prescribing the pills remotely. After analyzing health records of more than 6,000 patients who received the standard combination of mifepristone and misoprostol, some via video calls and some through text messages, the researchers concluded both the success and adverse event rates were comparable to those assessed in studies of in-person prescriptions. 

The new study follows the retraction of two studies pointing to supposed dangers associated with abortion pills. Neither addressed telehealth prescribing, but "adding another study to the evidence base regarding the safety of medication abortion prescribed via telehealth is welcome from a policy perspective for groups seeking to make medication abortion more accessible," said Julia Rollison, a senior policy researcher at policy nonprofit RAND. STAT's Annalisa Merelli has more


public health

HHS fills vacancies on a key vaccine advisory panel 

You may recall an exclusive story from STAT's Helen Branswell last week telling us more than half of the slots on a key vaccine advisory panel were empty. The Advisory Committee on Immunization Practices, which advises the CDC on how vaccines should be used in this country, saw its membership dwindle when the Department of Health and Human Services didn't replace seven members whose terms had expired in 2023 or one who had resigned. The terms of four of the remaining seven members expire at the end of June. 

Yesterday, HHS said it is filling eight vacancies, including the chairmanship, that had reduced its normal roster to less than half for months. Helen Keipp Bredenberg Talbot, an infectious diseases researcher at Vanderbilt University, will be reappointed to the committee and serve as chair, a senior HHS official who asked not to be named told Helen. She has more, including the other members, here.



closer look

How deep space poses different health challenges

dorit donoviel

Sarah Gonzalez for STAT 

Dorit Donoviel has deep experience exploring the science of humans in space. Now she leads a consortium between Baylor College of Medicine, Caltech, and MIT that works with NASA to solve the health challenges that come with exploring deep space. That includes studying balance in microgravity, how astronauts might make drugs in space, and how to assess potential astronauts' mental fortitude in places like Antarctica. She talked with STAT's Nicholas St. Fleur about her work.

What are some of the health challenges in exploring deep space?

We've figured out how to keep humans healthy in what we call low Earth orbit, which is still within the protection of our atmosphere. What's different is that deep space means that we leave the protection of our atmosphere. That would include the moon, a space settlement outside of low-Earth orbit, or going to Mars. 

What are the risks?

Space radiation. Second, you'd be surprised, but it's actually mental health because you're in a confined space.

Read the full interview.


drug development

The long and winding road to a treatment for frostbite

Rubbing snow or cold water on frozen limbs during the Napoleonic wars. Dipping a rabbit's ear in liquid nitrogen. Quickly rewarming limbs in heated water in the "Alaska method." It's been a long and circuitous road to a new drug to treat frostbite, including the path from an Alps-climbing surgeon to a tiny California biotech. On Wednesday, the FDA approved iloprost, under the brand name Aurlumyn, as the first drug for the disabling and notoriously hard-to-study disease. 

The culmination of 30 years of research is not a cure, but the infusion could improve treatment for a damaging disease. "It's a tiny market, but to the patients that have these devastating injuries, it's a huge development," Peter Hackett, a wilderness medicine specialist at the University of Colorado, told STAT's Jason Mast. "We're talking about no fingers, versus all your fingers." Read more on the back story and prospect for the future.


obesity revolution

FDA warns sites selling what they say are chemicals found in weight-loss drugs

The websites say their chemicals are "for research use" and "not for human consumption," but these ingredients, found in popular diabetes and obesity drugs like Ozempic, Wegovy, and Zepbound, are marketed with dosing information and claims about their clinical benefits. That has drawn warning letters from the FDA to Synthetix Inc. DBA Helix Chemical Supply and US Chem Labs, with the agency saying the websites are selling unapproved and misbranded drug products. 

STAT's Elaine Chen has previously reported that, amid shortage of the popular drugs, some people have turned to these websites and others, ordering the chemicals in powder form, mixing them, and injecting themselves at home. That's extremely risky, doctors say. It's not clear where the websites get their chemicals, and people could be mixing wrong amounts of the chemicals or in an unsterile way. Elaine has more.


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What we're reading

  • Sick patients collapsed waiting for care at Mass. hospital with known safety violations, Boston Globe
  • Covid-19 vaccine confidence soured by officials' messaging, Republicans argue, STAT

  • Lyme disease cases rise, but largely due to a change in data collection, STAT

Thanks for reading! More on Tuesday,


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