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Abortion, shingles, extreme heat, and sudden cardiac arrest

August 14, 2024
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Morning Rounds Writer and Podcast Producer
Good morning! See how I write these newsletter items? Very demure, very mindful. (If you don't understand what I am referencing here, consider yourself blessedly more offline than me and many of my colleagues.) 

cardiovascular health

Can scientists improve the odds for surviving sudden cardiac arrest?

LUDOVIC MARIN/AFP via Getty Images

It's the "sudden" in sudden cardiac arrest that makes it so scary — a seemingly healthy person can simply collapse. If they're lucky, medical help is nearby and can restart their heart before it's too late. But for decades, only about 10% of people who experience sudden cardiac arrest outside of a hospital have been lucky enough to survive.

There's bystander CPR and automated external defibrillators. There are implantable cardioverter defibrillators that can shock a heart back to normal within eight to 10 seconds. And of course there are medications for people with heart failure. But none of it is enough. 

"It affects a thousand Americans a day," cardiologist Sumit Chugh told STAT's Liz Cooney. "But if you look in the community it's still rare. It's not like high blood pressure or diabetes. It's 50 people per 100,000 people." Read Liz's deep dive into the confounding condition and how scientists are working both to better understand the risk factors involved and to create better interventions like cell-based therapies.


abortion

Most reproductive-age women are worried about abortion access, survey says

One in seven reproductive-age women in the U.S. report that they've had an abortion, according to new data from KFF's nationally representative Women's Health Survey. Nearly 4,000 women ages 18 to 49 responded to the survey on abortion and reproductive health after the fall of Roe v. Wade. Here are a few takeaways that caught my eye:

  • Most reproductive-age women (74%) believe that abortion policies should not be determined at the state level. This is true across political affiliations, with 54% of Republican, 86% of Democrat, and 73% of independent women in agreement.
  • More than six in 10 survey respondents are concerned that either they or someone they're close to would not be able to get an abortion if needed to save one's life or preserve health.
  • The report also looked specifically at Florida and Arizona, where voters may soon see abortion on the ballot. In Florida, only one in five respondents were aware that medication abortion is still legal in the state until the sixth week of pregnancy. In Arizona, just over one in 10 were aware that medication abortion is legal and can be obtained online.
  • 17% of respondents in the U.S. reported changing their contraceptive practices as a result of Roe being overturned. This included starting or switching birth control, getting a sterilization procedure, or purchasing emergency pills to have on hand.

first opinion

How to restore America's confidence in vaccines

It was only two hours after receiving the second dose of the Covid vaccine that virologist Gregory A. Poland heard a sudden ringing in his ear while driving. "The shock of a sudden loud and high-pitched whistling nearly caused me to veer off the road," he writes in a First Opinion essay. He'd had intermittent tinnitus before, but never like this. It got even worse after his third dose later that year, and the noise has continued to this day. 

As someone who has studied vaccines for 40 years, Poland knows that all types of vaccines have saved millions upon millions of lives. But some number of people like him have also suffered unexpected effects on their health and well-being. Poland argues that understanding how this happens would not only be a first step toward reducing these rare risks, but it would help combat vaccine hesitancy. Read more.



first opinion

Is ultra-processed food the tobacco of the 21st century?

DAN KITWOOD/GETTY IMAGES 

Oncologist Nicholas DeVito says yes. Ultra-processed foods — which include packaged meals, snacks, candies, sodas and more — are more relevant to his work treating cancer than one might think. An estimated 40% of cancers in the U.S. are caused by risk factors that can be changed like using tobacco products, a sedentary lifestyle, and consuming ultra-processed food.

In a First Opinion essay, DeVito argues that, just like tobacco before it, ultra-processed foods have flooded onto our shelves due to a lack of regulation. And just like increased tobacco use over the 20th century was linked to lung cancer, these foods have emerged as a potential cause for gastrointestinal cancers. Read more.


climate change

Airport workers rally to protest dangerous heat conditions 

Airport workers in Charlotte, N.C. and Phoenix held rallies yesterday to demand better workplace protections from extreme heat, including easy access to water, cool break rooms, and training on heat illness. Last summer was the hottest the northern hemisphere has seen in 2,000 years, and this year is already predicted to break records again.

"Workers like me have been risking our lives every day in brutal conditions, and we're quite literally sick and tired," Cecilia Ortiz, a passenger service agent at Phoenix Sky Harbor International Airport, said in a press release.

Extreme heat can have serious detrimental health effects, especially when it comes to cardiovascular health. Earlier this summer, the Biden administration proposed a new rule for the country's first-ever federal regulations around heat safety at work. The rule would require employers to evaluate heat risk, develop prevention plans for excessive heat, and to ensure workers have access to cool water and paid rest breaks. 


dementia

Study: Getting shingles could increase risk of cognitive decline

It's likely that you and just about everybody you know have either had chickenpox before or received the vaccine. Shingles is a reactivation of the same virus that causes chickenpox, which stays in your body, and can cause painful rashes. But the infection might be more than an unpleasant experience. A study published yesterday in Alzheimer's Research & Therapy found that getting shingles was associated with about 20% higher long-term risk for subjective cognitive decline (when someone's memory gets worse or they are getting confused more often).

Researchers at Brigham and Women's Hospital analyzed survey data from almost 150,000 people to assess the connection. It's the first large study to look at shingles and the risk of subjective cognitive decline, the authors note. While previous research has shown mixed evidence on a link between shingles and dementia, the authors write that this may be due to study designs that used insurance claims or administrative diagnostic data, which only includes people who received medical attention for their shingles.

The authors don't know exactly how the virus might be linked to cognition. The study also found that men (not women) who had gotten shingles and carry the APOE4 gene, a risk factor for dementia, had an even higher risk.


cancer

The Biden Cancer Moonshot's next target is surgery

The president and first lady spoke in New Orleans at Tulane University in New Orleans yesterday, announcing $150 million dollars in ARPA-H awards to develop technologies that will improve cancer surgeries. Tulane University is one of the first eight grantees to receive one of these awards, and the funding will go towards the creation of methods that will allow surgeons to determine if a cancer surgery successfully removed all of a tumor in real time.

"There are no good technologies that can help determine during the surgery whether it has been successful, but rather days later when it is already too late to change the surgery," J. Quincy Brown, a biomedical engineer at Tulane University, said in the moonshot announcement in New Orleans. "We should at least be able to give surgeons and patients the peace of mind and positive health benefits of a successful surgery every time. That's the goal our team is working towards."

This program will also require the new technology to be deployed in rural hospitals at the end of the project, Brown added during his remarks. "So, we can't build a million-dollar device," he said.

— Angus Chen


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What we're reading

  • California bill would require state review of private equity deals in health care, KFF Health News

  • The politics of mifepristone in the 2024 election, STAT
  • Her son died of an overdose in his dorm room. Where was the Narcan? NPR
  • Illumina lays out plan to boost growth by helping scientists interpret sequencing data, STAT
  • Following national funding cuts, 'July was pure hell' for abortion funds, Rewire News Group

Thanks for reading! More tomorrow,


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