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Who is in charge of watching the milk?

May 14, 2024
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Morning Rounds Writer and Podcast Producer
"Estrogen is up," my period tracking app of choice told me today. "Nothing to worry about." How wrong it was! Thanks to a study you can read about below, I am not only worried about the app sharing my data, but I'm annoyed that I can't seem to keep track of my period without it.

h5n1 bird flu

A federal regulatory turf battle: USDA vs FDA

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Hyacinth Empinado/STAT

Food regulation in the U.S. is sort of like a riddle. It's the job of the U.S. Department of Agriculture to regulate liquid egg whites, for example. But if you're grabbing a dozen eggs in a carton just a shelf down, it's the Food and Drug Administration that's in charge. Unfortunately, the stakes of this riddle just got higher: With H5N1 bird flu spreading among dairy cattle, experts say that the longtime fractured nature of the U.S. food regulation system could hamper the federal response. 

Three of my STAT colleagues in D.C. spoke with more than 20 former agency officials and independent experts, many of whom described the relationship between USDA and FDA as being punctuated by tense turf battles. In the past, the fragmented responsibilities between the FDA and sub-agencies within the USDA led to inefficient investigations and stunted surveillance testing in cases involving E. coli, salmonella, and tuberculosis. Read more on how much the historic tension between agencies is raising concerns now about bird flu.


brain injury

How do you know when to take somebody off life support?

In most cases of severe traumatic brain injury, the decision to withdraw life support is made within 72 hours of the accident. But new research published on Monday in the Journal of Neurotrauma suggests waiting longer may be beneficial. The study matched patients who died after their life support was ended with patients with similar characteristics who were kept on support, finding that about a third of them regained some level of independence within six months.

"Even though an injury can look quite devastating hours or a few days after it happens, in many cases we have some evidence to suggest that even with the most devastating injuries people may make a recovery that is meaningful to them months or years later," said Yelena Bodien, the study's corresponding author. This doesn't mean that life support should always be continued — nearly 60% of the matched ultimately patients died — but that waiting a little longer, and incorporating the insight of rehabilitation specialists alongside critical care physicians, may help make more informed choices. Read more from STAT's Nalis Merelli.


reproductive health

Period-tracking apps may be sneaking around with data

When Roe v. Wade was overturned in 2022, attention turned to period-tracking apps. The top concern was that personal data could be shared to prove somebody had an abortion, and then prosecute them for it. "Delete your period tracking apps," wrote one First Opinion author that summer. "Now."

A study presented this week at an Association of Computing Machinery conference seems to validate some of those worries. Researchers from King's College London analyzed 20 popular reproductive health apps available in Google Play. They found inconsistencies in their privacy policies, flawed consent and data deletion mechanisms, and covert data collection.

Eight out of the 20 apps claimed in data safety forms that they do not share users' personal data. But researchers found that all eight described some level of third-party sharing in their privacy policies. Thirteen apps said that user data may be given to law enforcement if requested or subpoenaed, but didn't explain when that might happen or the user's rights. Only one app explicitly stated that user data — shared anonymously — would not be handed over. 



first opinion

The future of portable MRIs and, maybe, a new type of health care worker

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Alain Jocard/AFD via Getty Images 

Most of us have never had our brains scanned. But a new generation of more affordable and highly portable MRI (pMRI) devices are rapidly reshaping neuroimaging research and clinical care. There could be a future out there in which people get regular brain "check-ups" from portable MRIs, write three authors of today's First Opinion essay. 

To address the rise in neuroimaging, these authors suggest the creation of a new field: neuroimaging counseling. Like genetic counselors before them, neuroimaging counselors would be trained to help explain brain scan findings to patients. The clinical interpretation of scans would remain in the domains of radiology, neurology, and neurosurgery. But communicating those readings, addressing follow-up questions, and facilitating dialogue about the emotional weight of abnormal brain imaging results could be supported by counselors. Read more on what this new type of health care worker could do.


chronic disease

New study provides a clue for better potential lupus treatments

STAT's chronic disease reporter Isa Cueto has described lupus as "a confounding and severe autoimmune disease." It affects up to 1.5 million people in the U.S., causing problems in organs including the kidneys, spleen, heart, and brain. Some treatments for the disease are designed to suppress immune system proteins called interferons. But they don't always work.

To learn more about why that might be, researchers looked at hundreds of samples from just under 200 patients to analyze the activity level of three interferon types — I, II, and III. In a study published Monday in Cell Reports Medicine, they report that some symptoms are correlated with overactivity in specific types. Skin-related symptoms were correlated with overactivity of interferon I, while kidney inflammation were related to elevated activity in all three types. Other symptoms couldn't be pinned down: Blood clots and low platelet counts didn't have any particular association.

Isa told me that this research seemed promising because experts would love to get clearer categories of systemic lupus in order to treat it in a more targeted way. Read more of her reporting on lupus and other chronic diseases


cardiovascular health

A genetic risk factor for heart failure in Black Americans 

When a protein called transthyretin folds up the wrong way, it can build up in the heart's muscle layer and sometimes cause heart failure. The most common gene variant causing that misfolding, V142I, originated in western Africa, and occurs in 3% to 4% of people in the U.S. who self-identify as Black or African-American. In a study published yesterday in JAMA, researchers found that Black individuals carrying the V142I variant were at much higher risk of heart failure and death. 

Heart failure affects African Americans at nearly twice the rate that it affects white people in the U.S. And while this genetic variant doesn't explain away those racial disparities, it could inform the care and genetic screening offered to Black patients at risk of heart disease. Read more from STAT's Debbie Balthazar on the implications of the findings for genetic counseling and heart disease.


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What we're reading

  • A British nurse was found guilty of killing seven babies. Did she do it? New Yorker

  • Cue Health's Covid-19 tests could give false results, FDA warns, STAT
  • FDA said it never inspected the dental lab that made controversial AGGA device, KFF Health News
  • Element Biosciences, an Illumina rival, on its genomics ambitions — and why it hasn't gone public, STAT

Thanks for reading! More tomorrow,


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