policy
Indian Health Service care ensnared in HHS red tape
Rodrigo Abd/AP
In late February, President Trump signed an executive order that included a call for a new process to review contracts and grants in order to "promote efficiency." But at the Indian Health Services, former and current employees say that the new procedure, which involves getting final approval from a top HHS official for every contract and requisition, is an onerous process that can take weeks or longer. IHS clinicians told STAT's Angus Chen that the approval process has become a bottleneck, leading to delays in care and losses in medical services and personnel.
That has included impacts to emergency department staffing, general surgery, labor and delivery, inpatient beds, imaging, and temporarily, some infectious disease testing, IHS employees said. In at least one instance, a patient had to be admitted overnight as a safety precaution, due to staff shortages. Read more from Angus on the impact these new administrative delays can have on patients.
science
Amniotic fluid as stem cells?
From vaginal fluid to beating heart cells — sounds like science fiction but it isn't. A study published yesterday in Stem Cells Translational Medicine shows that amniotic fluid collected during vaginal birth can act as a readily available and non-invasive source of stem cells to model heart disease.
Human stem cells are a hot commodity. They can model disease, acting as a way to study human cell behavior in a dish. Additionally, stem cells can be used for regenerative therapies, as they have the ability to differentiate into cells that can repair areas of damage in the body. Normally, stem cells obtained from amniotic fluid have to be collected during the second-trimester of pregnancy, in an invasive procedure called amniocentesis, or during C-section. During the amniocentesis procedure, clinicians use an ultrasound to help guide a large needle to the uterus to remove a small amount of amniotic fluid.
Jeffery Jacot, associate professor of pediatrics and bioengineering at the University of Colorado, and his team show that by collecting amniotic fluid during vaginal birth, they are able to obtain stem cells with the same capabilities as those obtained during amniocentesis. Scientists were able to manipulate the stem cells towards different cell lineages, which has the potential to be used for treatment in infants born with congenital heart defects. — Marissa Russo
first opinion
Should med school prereqs include microbiology?
Bacterial structures. Viral replication. Antimicrobial mechanisms. If you haven't studied microbiology before entering medical school, these concepts could be completely foreign to you, making it even harder to fully understand the foundations of infection-related pathology and treatment.
In a new First Opinion essay, a learning specialist and an industry scientist argue that microbiology should become a prerequisite for medical education, in addition to biology, chemistry, and physics. And before you say anything, they know what you're thinking. "It's easy to assume microbiology matters only for infectious disease specialists," the authors note. "But that couldn't be further from the truth." Read more on why they believe microbiology is a foundational topic, and not just a niche one.
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