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Marijuana, ancient skulls, syphilis, periods

May 30, 2024
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Morning Rounds Writer and Podcast Producer
ICYMI, yesterday was the 100th (!) episode of the First Opinion Podcast. We started the show in January 2021. Time, as they say, flies.

policy

Marijuana will soon be reclassified — what will it mean for research?

Bright green marijuana leaves on a black background.

Jenny Kane/AP

The Biden administration announced earlier this month that it intends to reclassify marijuana as a less dangerous drug and begin regulating it more like Schedule III drugs like anabolic steroids and ketamine. This would seem to open up new avenues for researchers who have been stymied by the federal government's decades-old declaration that the drug is just as dangerous as heroin and LSD. 

But experts told STAT's Nick Florko and Sarah Owermohle they have questions about what will come next for marijuana science. Will politics interfere with the process? What about the basic scientific information that we still don't know about the substance? And will weed finally get cheaper? Read more from Nick and Sarah on what marijuana's reclassification might change (or not) for scientific research.


chronic disease

The risky gap between pediatric and adult sickle cell care 

Fifty years ago, sickle cell disease mostly affected children, as STAT's Eric Boodman reports in his Coercive Care series, since those who had it often didn't survive into adulthood. Life expectancy has continued to rise, but with older age also comes increased risks, making the transition from pediatric to adult care a particularly important period. A study published yesterday in Blood Advances found that when the transition takes longer than six months, patients are twice as likely to be hospitalized compared to those who transition within two months.

Researchers looked at long-term data for more than 350 sickle cell patients from St. Jude Children's Research Hospital in Memphis who transitioned to adult care at partner facilities. Most had their first adult appointment about a month and a half after their last pediatric one. But across the country, many patients face gaps in insurance coverage, discomfort with change, and potential bias from institutions or clinicians. The researchers hope to continue studying and improving transitions at other facilities, they wrote.


clinical trials

NIH-funded trials miss racial, gender diversity enrollment goals

Clinical trials funded by NIH often enroll fewer Black patients and other underrepresented racial groups than they plan to, according to a study of 30 such trials sampled by the HHS Office of Inspector General. "One would assume that the academic NIH studies may perform better on diversity, but that doesn't appear to be the case," William Fitzsimmons, who is part of a group pushing to improve diversity, told STAT's John Wilkerson.

When researchers apply for NIH funding, they must explain how they plan to enroll patients who are representative of the population that would be affected by the condition for which treatments are being studied. These "inclusion plans" must include a numerical breakdown of targeted participant demographics by race, ethnicity, and gender. These are the goals that most trials missed, per the report. Read more from John on the findings.



ancient medicine

Ancient skulls indicate that Egyptians were trying to heal cancer 4,000 years ago

The skull of a man from about 4,000 years ago sits against a black background. A small measurement showing 2 cm sits next to the skull for scale. A small lesion about that size can be seen on the top of the skull.

Tondini, Isidro, Camarós, 2024 

We already know that ancient Egyptians had advanced medical skills when it came to infections, injuries like bone fractures, and even dental work. But after examining two skulls held in the U.K., researchers believe that they may also have recognized and attempted to treat cancer. "What we found is the first evidence of a surgical intervention directly related to cancer," study co-author Edgard Camarós Perez told Live Science

The skulls — one from a man in his 30s who could have died as early as 2687 BCE, the other a female over age 50 from at least 343 BCE — each have lesions consistent with cancerous tumors. Researchers found one big lesion and about 30 smaller ones on the man's skull (seen above). But there was something else on his skull that shocked them: cut marks around the lesions, likely made with something like a metal instrument, indicating surgical treatment. (Read STAT's cancer coverage for some slightly more modern approaches to treat cancer.)


menstruation

The new menstruation: Periods comes earlier and less regularly now

Menstruation is a major indicator of both reproductive and overall health. Two new studies published in JAMA Network Open shed (no pun intended) light on how periods have changed in recent decades and what ripple effects that may have on health.

One study, published yesterday, found that people in the U.S. have started getting their periods earlier and earlier over the last half-century, and it's taking longer for menstrual cycles to become regular. Between 1950 and 1969, people typically got their first period around age 12 and a half, but between 2000 and 2005, that average dropped to just under 12 years old. It's not just about unpleasant coming of age moments — early periods are linked to increased risk for cardiovascular disease, cancer, and early death. My colleague Nalis Merelli wrote about the study and why menstruation is changing.

The other study, from Tuesday, analyzed mortality risk among more than 67,000 people with diagnosed premenstrual disorders in Sweden as compared to those without the disorders. Broadly, people with disorders did not have an increased risk of death overall — except for those diagnosed before age 25, who did. But there was an increased risk of death by suicide for people with these disorders, regardless of age. These disorders are often mis- or underdiagnosed, so the authors see a need for careful follow-up and suicide prevention strategies for patients. 


first opinion

Stigma and the return of syphilis

Rates of syphilis in the U.S. have been climbing for decades, with the highest number of infections in more than 70 years recorded in 2022. It's unclear why syphilis seems to be spreading faster than other STIs, but it is clear what needs to be done to address it, write two experts in a new First Opinion essay. 

One critical solution will be addressing the powerful stigma around syphilis, the authors argue. Apparently, there isn't a single patient advocacy group that places the word "syphilis" in the organization's name. The history of sexually transmitted infection campaigns shows that blaming people affected by (or at risk for) syphilis has stymied both testing and treatment. Read more on how public health and medicine can stop the resurgence of syphilis


More around STAT
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What we're reading

  • The trouble with turmeric, The Vajenda

  • Scientists install 'window' in the skull to record brain activity using ultrasound, STAT
  • The textbooks were wrong about how your tongue works, New York Times
  • Akili, maker of a video game to treat ADHD, to be acquired for $34 million, STAT

Thanks for reading! More tomorrow,


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