Mdedge Daily News

Doctors are pushing back on a CMS policy change aimed at controlling spending on prescription drugs administered in the office. Also today, low-dose CT scan fails to improve small cell lung cancer survival, a French study warns a rise in penicillin-resistant pneumococcal meningitis, and opioids are driving down the life expectancy in the U.S. and are one of the reasons that more Americans aren’t living into their golden years.

A diverse diet is not necessarily a healthy one, according to a new advisory from the American Heart Association. Also today, treating sleep disorders in chronic opioid users, next-gen sputum PCR panel boosts CAP diagnostics, and there is no increased risk in autism spectrum disorder with prenatal Tdap.

The FDA approves the Natural Cycles mobile app as a form of contraception. Also today, on-demand PrEP has similar efficacy as daily PrEP for HIV prevention, continuation and complication rates are similar for implants and IUDs, and the CMS pushes ACOs to take on more risk.

Exposure to second-hand smoke, including living with a smoker, sends teens to the ED more than their counterparts. Also today, adults with ADHD are using stimulants and opioids concurrently, a rural health initiative helps raise vaccination rates, and the different rungs of treating itch in eczema. 

Inducing labor at 39 weeks receded the rate of c-section for first-time mothers who were at low-risk. Also today, religiosity of parents is tied to a reduced risk of suicide in their daughters, rising use of PrEP in the U.S. is linked with droping HIV infections, and CUBE-C initiative aims to educate about atopic dermatitis. Listen to the MDedge Daily News for today’s top news.

Researchers interviewed injection drug users and identified 5 themes that capture how having HCV impacts their care. Also today, the FDA proposes broader outcomes for opioid user disorder treatment drug approvals, there’s a new state on top of WalletHub’s healthcare rankings, and there is new guidance for men who want to start a family on how to protect against Zika.

The CMS says that the need to reduce time spend coding is driving its new proposal to flatten the 2019 payment for E&M visits that are coded levels 2-5. Also today, low disease activity in SLE compares favorably with clinical remission, medical associations want withdrawal of Title X changes, and telomere length is linked to COPD exacerbations and mortality.

The FDA has issued a safety alert warning against long-term use of azithromycin to prevent bronchiolitis obliterans syndrome in patients with blood or lymph node cancers. Also today, four syndromes suggest life-threatening PVL-positive Staphylococcus aureus infection, asthma medication ratio identifies high-risk pediatric patients, and new MS criteria may create more false positives.

Weight gain is linked to progression of fibrosis in patients with nonalcoholic fatty liver disease. Also today, e-cigarette prices are down while sales are up, HPV positivity is associated with good outcomes for esophageal cancer, and PhRMA leads the way for health-care-sector lobbying.

Over the last decade, opioid use has not significantly declined, despite efforts to educate physicians about the risk of abuse. Also today, the Fitbit Flex is feasible and provides nuanced step-count data in patients with MS, even moderate alcohol use could worsen outcomes in nonalcoholic fatty liver disease, and a new study supports meningococcal B vaccine in children with rare diseases.

Changes to how doctors are paid for drugs that are administered in-office could be on the way depending on the outcomes of two recent regulatory proposals from the Centers for Medicare and Medicaid Services. Also today, who are high-need, high-cost patients?, RA seroconversion is not associated with sustained drug-free remission, and a new myeloma frailty index based on biological cage.

Successful phase 3 data for new headache medications (rimegepant, ubrogepant, lasmiditan) are finally raining in after a lengthy drought. Also today, interferon status and family history predict autoimmune connective tissue disease, steroid injection before rotator cuff repair predicts revision, and the CMS resumes risk adjustment payments for 2017.

The FDA says that cancer risk associated with NDMA contained in impure valsartan is definitely real, but it is very low. Also today, drinking during pregnancy could impact cognition, sexual function counseling should start early, and those with HIV a develop more frailty.

Almost half of the individuals diagnosed with melanoma in a free skin cancer screening program would otherwise not have gone to a doctor to have their skin examined. Also today, a new CMS proposal for hospital outpatient setting, heart failure is linked to HIV, and trial design is an issue in a promising Alzheimer’s study.

An experimental agent slowed cognitive decline and cleared Alzheimer’s plaques. Can meteorology predict migraines? Why closing a patent foramen ovale is the right approach to prevent recurring ischemic stroke. And claims that cannabis relieves noncancer pain go up in smoke.

Hypertension medications slashed mild cognitive impairment risk by 19% in the SPRINT MIND study. Updated HIV guidelines recommend immediate treatment, three-drug therapy. Early antidepressant therapy after a heart attack delivers benefits years later. And HIV infection could double a patient’s risk of stroke.

Are omega-3 fatty acids' heart benefits just another fish tale? Why sustaining weight loss requires more than a bariatric procedure. How pregnancies and a longer span of reproductive years shape dementia risk. And physicians sound off on possible dramatic changes to how Medicare pays them.

Fibromyalgia should be seen as one disorder, not two. How dementia prevalence differs among sexual minorities. Why you should talk with parents about the risks of food additives. And breast cancer patients don’t get the financial counseling they want from their clinicians.

Epinephrine provided a slight 30-day survival benefit, but those patients experienced more severe brain damage. Also today, nerve growth factor inhibitor shows phase-3 efficacy in osteoarthritis, National Academies issues a 5-step plan to address infections linked to opioid use disorder, and there may be beneficial class effects of SGLT2 inhibitors, including dapagliflozin.

Medicare’s bundled pay plan didn’t deliver any cost savings per episode or care outcomes for the top five medical conditions under the program. Also today, deaths in the US from liver disease surged from 1999 to 2016, bivalent HPV vaccine brings no significant increase in any of 38 different potential adverse outcomes, and almost one-quarter of preoperative patients were already using opioids.