About 1,306,285 results

Workplace Efficiency: How to Get More Time Back

Oct 4th, 2022 - One of the biggest complaints that healthcare professionals continuously have is with workplace efficiency and administrative burdens. Many clinicians, including physician assistants, are happy with their career choices but find that the paperwork is burdensome. It's not just a little bit burdensome either, in fact, many healthcare providers report spending several hours a day outside of clinic...

How Anthem Gets Away With Nonpayment and Denials

Oct 4th, 2022 - This discussion was recorded on August 31, 2022. This transcript has been edited for clarity. Editor's Note: All views expressed are those of the authors and do not represent the opinions of any affiliates. Medscape reached out to Anthem with an opportunity to respond to claims made regarding payment denials mentioned in this interview. Since the alleged claims are currently the subject of liti...

Physician Bias Against Disabilities; Cannabis Substitutes for Opioids; Don't Thumb Your Nose at Nasal Vaccines

Oct 4th, 2022 - Physician Bias Against Disabilities Some clinicians are refusing to take people with disabilities on as patients, according to a new study. Though small, the research sheds an alarming light on why people with disabilities have worse outcomes, including undetected cancer, obesity, and cardiovascular disease. Many simply cannot get a doctor to see them. Broken system: There is physician bias at ...

AstraZeneca Pays 660% Premium for Gene Therapy Firm LogicBio

Oct 4th, 2022 - (Reuters) - Shares of LogicBio Therapeutics skyrocketed on Monday after Britain's AstraZeneca's said it would buy the U.S.-based gene therapy developer at a rare 660% premium for $68 million. LoigBio's shares, which have traded below $1 since February, were up 637% at $2 before the bell, close to AstraZeneca's offer price of $2.07 per share. LogicBio is developing gene editing therapies to trea...

US Supreme Court Turns Away Biogen Bid to Reinstate MS Drug Patent

Oct 4th, 2022 - WASHINGTON (Reuters) - The U.S. Supreme Court on Monday declined to hear Biogen Inc's bid to win reinstatement of a patent on the company's blockbuster multiple sclerosis drug Tecfidera in a dispute with Viatris Inc subsidiary Mylan Pharmaceuticals Inc. The justices turned away Biogen's appeal of a lower court's decision to invalidate the patent in a ruling that helped clear the way for Mylan's...

The Catch-22 of the Nursing Shortage

Oct 4th, 2022 - According to the US Bureau of Labor Statistics, more than 200,000 registered nurse (RN) positions are projected to be vacant annually over the next decade. This prediction was made prior to the pandemic, which saw a multitude of nurses transition out of bedside care through retirement or just leave the field. The need for staff nurses is a topic of great concern, but what is the solution? The p...

Breakthrough COVID Studies Lend Support to Use of New Boosters in Immunosuppressed Patients

Oct 4th, 2022 - People with immune-mediated inflammatory diseases who are taking immunosuppressants don't mount as strong of an immune defense against the Omicron variant as they did against the original SARS-CoV-2 wild-type virus, according to two studies published in Annals of the Rheumatic Diseases. One of the studies further showed that vaccinated individuals taking immunosuppressants have poorer cross-neu...

In the Aftermath of Medical Errors: Podcast Dives Deep

Oct 4th, 2022 - In William Bynum's second year as a medical resident, he was pressed into a high-stakes emergency service to deliver a baby, despite feeling that he was the only person in the delivery room who didn't know what he was doing. He was at the end of a 24-hour shift and had to use a vacuum device to pull the baby out as quickly as possible to save its life. Bynum succeeded. But in the process, he le...

Time for Universal Germline Genetic Testing in Breast Cancer

Oct 4th, 2022 - A new study provides additional support for universal germline genetic testing for women with breast cancer. The study found that adhering to current restrictive guidelines on germline testing misses a substantial number of women with pathogenic or likely pathogenetic (P/LP) variants, knowledge of which would alter patient management. The study used the multigene cancer panel from Invitae, whic...

Comparing Prevention and Neurostimulation for Dementia

Oct 4th, 2022 - New data from the United States bolster the case for dementia prevention. At the same time, noninvasive stimulation procedures are still not being used to treat Alzheimer's disease (AD) in day-to-day clinical practice. Since it will still be a long time until effective antidementia medication is successfully developed, dementia researchers and health officials have emphasized the prevention of ...

Will Real Meat Grown in a Lab Be Good for Us?

Oct 4th, 2022 - The idea is nearly a hundred years in the making. None other than Winston Churchill envisioned an alternative to traditional meat production when he wrote in 1931, "We shall escape the absurdity of growing a whole chicken in order to eat the breast or wing, by growing these parts separately under a suitable medium." Churchill's poultry example would prove prophetic because the first restaurant ...

Dive Right in! Cold Water Swims Bring Many Health Benefits

Oct 4th, 2022 - Every Sunday from November to April Dennis Thomas starts his day by hitting the beach at Coney Island for a dip in the frigid Atlantic Ocean — no matter how low the mercury plummets. Thomas, president of the Coney Island Polar Bear Club, says these winter swims offer more than just a bracing rush of adrenaline. He believes they're the reason that, at age 67, he is fiddle-fit physically, tack-sh...

Long-Acting Naltrexone Effective in Alcohol Use Disorder

Oct 4th, 2022 - Starting treatment for alcohol use disorder (AUD) with extended-release naltrexone injections in the emergency department (ED) produced a dramatic reduction in alcohol consumption, according to findings presented at the American College of Emergency Physicians (ACEP) 2022 Scientific Assembly. The results show the feasibility of such a program and underscore the importance of the ED in combating...

Team Effort: A Multidisciplinary Approach to Severe Asthma Control

Oct 4th, 2022 - This transcript has been edited for clarity. Michael Wechsler, MD: Hello, and welcome to Medscape's InDiscussion series on moderate to severe asthma. I'm Dr Mike Wechsler, professor of medicine at National Jewish Health in Denver, Colorado. This is episode four of the first season. First, let me introduce my guest, Dr David Jackson. Today, we'll be discussing the topic of multidisciplinary appr...

Non–Clear Cell Renal Cell Carcinoma: A Conversation About Subtypes, Clinical Trials, Treatment Options, and Outcomes

Oct 4th, 2022 - This transcript has been edited for clarity. Sumanta Pal, MD: Hi. My name is Dr Monty Pal. I'm a medical oncologist at the City of Hope Comprehensive Cancer Center. I'm here today for Medscape's InDiscussion series on renal cell carcinoma. We've done several of these, and today we're going to be tackling a topic that is very near and dear to my heart, and that's non–clear cell kidney cancer. I'...

Street Medicine Reaches People Where They Live

Oct 4th, 2022 - One summer evening, on his regular rounds through the streets of Syracuse, NY, David Lehmann, MD, PharmD, came across an unsheltered man in dirty clothes who seemed to be making his bed each night on the pavement where he stood. An exam in the privacy of the medical van revealed a painful, infected boil on the man's backside. After some coaxing, Lehmann lanced the infected sore, gave medicine a...

Newer Drugs Not Cost-Effective for First-Line Diabetes Therapy

Oct 4th, 2022 - To be cost-effective compared with metformin for initial therapy for type 2 diabetes, prices for a sodium-glucose cotransporter-2 (SGLT2) inhibitor or a glucagon-like peptide-1 (GLP-1) agonist would have to fall by at least 70% and at least 90%, respectively, according to estimates. The study, modeled on US patients, by Jin G. Choi, MD, and colleagues, was published online October 3 in the Anna...

Folic Acid Tied to a Reduction in Suicide Attempts

Oct 4th, 2022 - Prescription folic acid, a synthetic form of vitamin B9, may provide a safe and effective approach for decreasing suicidal ideation, new research suggests. After adjusting for multiple factors, results from a large pharmaco-epidemiological study showed taking folic acid was associated with a 44% reduction in suicide events. Dr Robert Gibbons "These results are really putting folic acid squarely...

Monkeypox Features Include Mucocutaneous Involvement in Almost All Cases

Oct 4th, 2022 - MILAN – In the current spread of monkeypox among countries outside of Africa, this zoonotic orthopox DNA virus is sexually transmitted in more than 90% of cases, mostly among men having sex with men (MSM), and can produce severe skin and systemic symptoms but is rarely fatal, according to a breaking news presentation at the annual congress of the European Academy of Dermatology and Venereology....

Online Tool Predicts Complications From Hysterectomy

Oct 4th, 2022 - An online prediction tool provides personalized risk estimates to help clinicians and patients choose between laparoscopic and abdominal surgery for hysterectomy for benign disease. The tool, which integrates 11 routinely available predictors, had "acceptable" predictive ability and "moderate" discrimination. Krupa Madhvani "The overall numbers of hysterectomies are declining, and there are als...

Bariatric Surgery May Up Risk for Epilepsy

Oct 4th, 2022 - Bariatric surgery may raise the risk of developing epilepsy, new research suggests. Analyzing health records, investigators compared almost 17,000 patients who had undergone bariatric surgery with more than 620,000 individuals with obesity who had not undergone the surgery. During a minimum 3-year follow-up period, the surgery group had a 45% higher risk of developing epilepsy than the nonsurge...

Antifibrotic shows mixed results in RA-ILD
Pam Harrison, MDedge News

Oct 3rd, 2022 - The antifibrotic pirfenidone (Esbriet) did not change the decline in forced vital capacity percentage (FVC%) from baseline of 10% or more or the risk of death compared with placebo in patients with rheumatoid arthritis-associated interstitial lung disease (RA-ILD). However, the drug appeared to slow the rate of decline in lung function, a phase 2 study indicated.

Instagram: Cosmetic procedures discussed without cosmetic experts
Richard Franki

Oct 3rd, 2022 - Instagram’s lack of high-quality educational content on nonsurgical cosmetic procedures puts the onus on dermatologists and plastic surgeons to increase their social media presence, according to analysis of related posts on the photo-sharing service. “Given that there is little to no oversight on social networking sites, unqualified sources can widely disseminate misinformation resulting in mis.

What’s the true role of Demodex mites in the development of papulopustular rosacea?
Doug Brunk

Oct 3rd, 2022 - Mounting evidence suggests that a higher density of Demodex mites on the skin may play a role in the development of papules and pustules associated with rosacea, a narrative review proposes. According to the author, Fabienne Forton, MD, PhD, a dermatologist based in Brussels, recent studies suggest that Demodex induces two opposite actions on host immunity: A defensive immune response aimed at.

High Risk of Long COVID Neurologic Sequelae in Veterans
Jan Dyer

Oct 3rd, 2022 - We now know that the effects of COVID-19 don’t always end when the infection seems over. Long COVID—the postacute sequelae—can encompass a wide range of extrapulmonary organ dysfunctions.

Sotatercept May Have Long Term Benefit in Pulmonary Arterial Hypertension
Pulmonology Advisor

Oct 3rd, 2022 - Long-term use of sotatercept may allow patients with pulmonary arterial hypertension (PAH) to maintain significantly reduced pulmonary vascular resistance, according to results of an 18- to 24- month open-label extension trial published in The European Respiratory Journal. The previously conducted 24-week, placebo-controlled, phase 2 PULSAR clinical trial (ClinicalTrials.gov Identifier: NCT0349...

Asthma Outcomes Improved With Use of Mindfulness-Based Stress Reduction
Pulmonology Advisor

Oct 3rd, 2022 - Training patients with asthma in mindfulness-based stress reduction (MBSR) improves clinically relevant outcomes and may therefore enhance asthma management, especially among those with comorbid psychopathology, according to study findings published in Brain, Behavior, and Immunity – Health. Asthma exacerbation risk is elevated in individuals with psychological distress and comorbid psychopatho...

Vaccine-Associated Aluminum Linked to Persistent Asthma in Young Children
Clinical Advisor

Oct 3rd, 2022 - HealthDay News — There is an association between vaccine-associated aluminum and persistent asthma among children with and without eczema, according to a study published online in Academic Pediatrics. Matthew F. Daley, MD, from Kaiser Permanente Colorado in Aurora, and colleagues conducted a retrospective cohort study in the Vaccine Safety Datalink to examine the association between cumulative ...

Self-Reported Lung-Related Comorbidities Have No Impact on LCS Outcomes
Pulmonology Advisor

Oct 3rd, 2022 - Patients undergoing lung cancer screening (LCS) who self-reported lung-related comorbidities did not have differing outcomes compared with those not reporting conditions. These findings were published in JAMA Network Open. Current guideline recommendations indicate people aged 50 to 80 years who had a 20 pack-year smoking history should undergo annual LCS. These recommendations do not specify w...

The dubious value of online reviews
Allan M. Block, MD

Oct 3rd, 2022 - I hear other doctors talk about online reviews, both good and bad. I recently read a piece where a practice gave doctors a bonus for getting 5-star reviews, though it doesn’t say if they were penalized for getting bad reviews.

Psychiatric Risks Subside Before Neurologic Risks After COVID-19
Pulmonology Advisor

Oct 3rd, 2022 - Following COVID-19 infection, the risk for developing neurological disorders remains high after 2 years, while the risk for psychiatric disorders subsides earlier. These are the findings of a study published in Lancet Psychiatry. Researchers analyzed outcome data in a multinational, retrospective cohort study. They obtained data from the TriNetX electronic health records network between January...

Risk-adapted screening strategy could reduce colonoscopy use
Carolyn Crist

Oct 3rd, 2022 - The Asia-Pacific Colorectal Screening (APCS) scoring system, combined with a stool DNA test, could improve the detection of advanced colorectal neoplasms and limit colonoscopy use, according to a new study published in Clinical Gastroenterology and Hepatology. Although a colonoscopy can detect both colorectal cancer and precancerous lesions, using it as the primary screening tool can cause barr.

Holding Methotrexate in RA/PsA After Second Dose of COVID-19 Vaccine Improves Antibody Response
Rheumatology Advisor

Oct 3rd, 2022 - In patients with rheumatoid arthritis (RA)/psoriatic arthritis (PsA), holding vs continuing methotrexate (MTX) after the second dose of the ChAdOx1 nCov-19 (Oxford-AstraZeneca) vaccine results in a higher antibody response, according to the results of a study published in The Lancet Rheumatology. The researchers sought to evaluate the impact of holding MTX for 2 weeks after each dose of the COV...

Cancer as a full contact sport
Sarah F. D’Ambruoso, NP

Oct 3rd, 2022 - John worked as a handyman and lived on a small sailboat in a marina. When he was diagnosed with metastatic kidney cancer at age 48, he quickly fell through the cracks.

APP Leaders Discuss What Keeps Them Up at Night
Clinical Advisor

Oct 3rd, 2022 - Presidents from 5 advanced practice provider (APP) associations shined a light on strategies to increase the health care workforce, key bills that may change the practice landscape, how to create greater diversity among practitioners, and what keeps them up at night at an online panel discussion held in honor of the second annual National APP Week. The presidents all noted access to care issues...

Tocilizumab Normalizes Serum Amyloid Levels in Familial Mediterranean Fever
Rheumatology Advisor

Oct 3rd, 2022 - Tocilizumab vs placebo was found to normalize serum amyloid A (SAA) levels and decrease disease activity in patients with Familial Mediterranean Fever (FMF), according to findings published in the Journal of Clinical Medicine. FMF is an autoinflammatory disease that causes chronic inflammation without the presence of autoantibodies or antigen-specific T-lymphocytes. Symptoms include recurrent f...

Bupivacaine Now Available for Analgesia After Shoulder Surgery
Rheumatology Advisor

Oct 3rd, 2022 - Posimir® (bupivacaine solution) is now available for postsurgical analgesia for up to 72 hours following arthroscopic subacromial decompression. Posimir is a novel formulation of bupivacaine, an amide local anesthetic, designed to be administered into the subacromial space under direct arthroscopic visualization. The depot product uses a sucrose-based biodegradable matrix (sucrose acetate isobu...

Monkeypox Outbreak Can Still Be Contained, Says Columbia Epidemiologist
Rheumatology Advisor

Oct 3rd, 2022 - Health officials worldwide can still take steps to contain the monkeypox outbreak, says Dr Alissa Davis, Associate Professor at the Columbia School of Social Work, but it will require addressing the challenges of stigma, misinformation, and health inequity. “Overall case numbers of monkeypox are growing, although the number of new infections has recently been trending downward,” says Davis, an ...

Monkeypox features include mucocutaneous involvement in almost all cases
Ted Bosworth

Oct 3rd, 2022 - MILAN – In the current spread of monkeypox among countries outside of Africa, this zoonotic orthopox DNA virus is sexually transmitted in more than 90% of cases, mostly among men having sex with men (MSM), and can produce severe skin and systemic symptoms but is rarely fatal, according to a breaking news presentation at the annual congress of the European Academy of Dermatology and Venereology.

ACR Updates Guidelines for Glucocorticoid-Induced Osteoporosis
Clinical Advisor

Oct 3rd, 2022 - The American College of Rheumatology (ACR) updated their 2017 ACR guidelines for preventing and treating glucocorticoid-induced osteoporosis (GIOP). The full manuscript will be published in Arthritis & Rheumatology and Arthritis Care and Research in early 2023. Since the publication of the 2017 ACR guidelines for GIOP, treatments, including abaloparatide (PTHrP) and romosozumab, have been avail...

High Procedural Success With Novel LAA Occluder for Preventing Stroke in AF
Cardiology Advisor

Oct 3rd, 2022 - Left atrial appendage (LAA) closure with use of a novel, disc-like occluder (the Leftear device [Pulse Scientific]) has demonstrated a high rate of procedural success, and satisfactory safety and efficacy for stroke prevention among patients with nonvalvular atrial fibrillation (NVAF). These findings were published in the journal JACC: Asia. Researchers sought to explore the effectiveness and s...

Study Confirms Benefits of Lecanemab in Early Alzheimer Disease
Clinical Advisor

Oct 3rd, 2022 - Topline results were announced from a large global phase 3 confirmatory study of lecanemab for the treatment of early Alzheimer disease. Lecanemab is a humanized monoclonal antibody that works by selectively binding to, neutralizing, and eliminating soluble toxic amyloid beta aggregates. The investigational agent was by the Food and Drug Administration (FDA) in July 2022 for the treatment of mi...

Six-Lead ECG Device Highly Accurate for Atrial Fibrillation Detection
Cardiology Advisor

Oct 3rd, 2022 - The Kardia Mobile 6-lead electrocardiogram (ECG) device is superior for detecting atrial fibrillation (AF) when compared with a pair of single-lead smartwatches according to cardiologists’ interpretation. These findings were published in the American Heart Journal. A prospective, nonrandomized study compared ECG-based devices for AF detection at a nonacademic, regional hospital in Blaricum, the...

Air pollution linked to increased IBS incidence
Tara Haelle

Oct 3rd, 2022 - Increased levels of air pollution were linked to a slight uptick in new diagnoses of irritable bowel syndrome (IBS) in California residents, according to an ecologic study published in Clinical Gastroenterology and Hepatology. “These data provide support for the role of environmental pollutants, especially air pollutants, in the development of IBS,” Philip N.

In Patients With Alopecia Areata, Shared Decision Making Increases Satisfaction
Dermatology Advisor

Oct 3rd, 2022 - Patients with alopecia areata (AA) prefer to make treatment decisions with their dermatologist with use of shared decision making (SDM), researchers reported in a study published in JAMA Dermatology. The findings are based on a cross-sectional study that used an online survey to assess patient preferences in SDM during AA treatment decision making and to determine which aspects of their involve...

Atopic Dermatitis Not Linked to VTE or JAK Inhibitors
Dermatology Advisor

Oct 3rd, 2022 - Atopic dermatitis (AD) is not associated with an increased risk for venous thromboembolism events, and neither are JAK inhibitors when used to treat AD, according to data from a systematic review and meta-analysis published in JAMA Dermatology. Investigators conducted a comprehensive literature search on electronic databases for cohort studies analyzing the association of AD with incident venou...

Children and Adolescents Present Differently With Eosinophilic Esophagitis
Dermatology Advisor

Oct 3rd, 2022 - Young children and adolescent patients present differently with eosinophilic esophagitis (EoE), according to study results published in the Journal of Pediatric Gastroenterology and Nutrition. For the study, researchers sourced data from the European Pediatric Eosinophilic Esophagitis Registry (pEEr) registry, which was initiated in 2015 by the Eosinophilic Gastrointestinal Disorders Working Gr...

Worldwide trial seeks to revolutionize pediatric leukemia care
Randy Dotinga

Oct 3rd, 2022 - While great strides have been made in children’s leukemia care during the past 50 years, statistics have remained grim. For acute myeloid leukemia (AML), the most common type, 5-year survival rates were just 69% for children younger than 15 between 2009 and 2015.

CAR T-cell therapy neurotoxicity linked to NfL elevations
Nancy A. Melville

Oct 3rd, 2022 - Patients undergoing chimeric antigen receptor (CAR) T-cell therapy who develop potentially serious neurotoxicity from the therapy show elevated plasma levels of neurofilament light chain (NfL) prior to the treatment, suggesting a possibly important predictor of risk for the side effect. “This is the first study to show NfL levels are elevated even before CAR T treatment is given,” first author.

Novel Haploidentical Bone Marrow Transplantation Approach Effective in Relapsed/Refractory Severe Aplastic Anemia
Cardiology Advisor

Oct 3rd, 2022 - According to research published in Lancet Haematology, a novel approach to haploidentical bone marrow transplantation results in excellent overall survival (OS) with minimal graft vs host disease (GVHD) in patients with relapsed or refractory severe aplastic anemia and may now be considered a standard salvage treatment for the disorder. The researchers reported the outcomes of BMT CTN 1502, a s...

Hepatitis C in Patients With HIV Increases Age-Related Cardiovascular Disease Risk
Cardiology Advisor

Oct 3rd, 2022 - The association between increasing age and risk for type 1 myocardial infarction (MI) in patients with HIV is more significant among those with vs without hepatitis C virus (HCV) coinfection, suggesting that HCV status should be considered when evaluating cardiovascular disease (CVD) risk in this patient population. These study findings were published in The Journal of the American Heart Associ...

Positive psychiatry: An introduction
Erick Messias, MD, PhD, MPH, Dilip V. Jeste, MD

Oct 3rd, 2022 - Historically, psychology and psychiatry have mostly focused on negative emotions and pathological states. However, during the last few decades, new developments in both disciplines have created novel vistas for a more comprehensive understanding of human behavior.

Using the tools of positive psychiatry to improve clinical practice
Samantha Boardman, MD, Rosemary Odem et. al.

Oct 3rd, 2022 - FIRST OF 4 PARTS What does wellness mean to you? A 2018 survey posed this question to more than 6,000 people living with depression and bipolar disorder. In addition to better treatment and greater understanding of their illnesses, other priorities emerged: a longing for better days, a sense of purpose, and a longing to function well and be happy.

The accelerating societal entropy undermines mental health
Henry A. Nasrallah, MD

Oct 3rd, 2022 - According to the second law of thermodynamics, it is inevitable that entropy will continue to increase over time. 1 Entropy is a measure of disorder, which can eventuate in chaos and lead to profound uncertainty, with serious psychological consequences.

More on varenicline
Ian R. Tofler, MBBS

Oct 3rd, 2022 - Murray et al have written a timely, thoughtful, and useful article (“Smoking cessation: Varenicline and the risk of neuropsychiatric adverse events,” Current Psychiatry, July 2022, p. 41-45) about the role of the nicotinic acetylcholine receptor partial agonist varenicline for helping patients stop smoking, which is still the main preventable cause of morbidity and premature death.

Faulty fences: Blood-brain barrier dysfunction in schizophrenia
Delaney A. Schrenk, BS, Henry A. Nasrallah, MD

Oct 3rd, 2022 - The blood-brain barrier (BBB) is an essential barrier of closely spaced cells that regulates entry into the CNS. What passes should be highly regulated to protect the brain from potentially harmful peripheral cells or molecules from the rest of the body.

Generalized anxiety disorder: 8 studies of psychosocial interventions
Sy Atezaz Saeed, MD, MS, Daniel John Majarwitz, MD

Oct 3rd, 2022 - SECOND OF 2 PARTS For patients with generalized anxiety disorder (GAD), the intensity, duration, and frequency of an individual’s anxiety and worry are out of proportion to the actual likelihood or impact of an anticipated event, and they often find it difficult to prevent worrisome thoughts from interfering with daily life. 1 Successful treatment for GAD is patient-specific and requires clinici.

Using SNRIs to prevent migraines in patients with depression
Huda H. Ismail, PharmD, Kelly Powell, PharmD et. al.

Oct 3rd, 2022 - Ms. D, age 45, has major depressive disorder (MDD), generalized anxiety disorder (GAD), migraines, and hypertension.

Medical record documentation: What to do, and what to avoid
Kaustubh G. Joshi, MD

Oct 3rd, 2022 - Medical record documentation serves as a reminder of previous discussions with patients and what happened during their visits, a reimbursement justification for services, a communication tool to coordinate care with current and future clinicians, and a basis for defense in legal or regulatory matters. 1,2 Documentation should be thorough, accurate, timely, and objective, with the ultimate goal o.

Lithium, valproate, and suicide risk: Analysis of 98,831 cases
Dan Giurca, MD

Oct 3rd, 2022 - The current academic psychiatry paradigm reinforces that lithium reduces suicide risk, more so than other medications, including valproate. However, data from multiple sources contradict this “evidence-based” belief.

Postop analgesia in Saudi Arabia and the United States: A resident’s perspective
Hashem N. Akbar, MD

Oct 3rd, 2022 - I had the opportunity to experience first-hand acute postoperative pain management in both the United States and Saudi Arabia. In this article, I discuss some of the differences in how postop pain is managed in each location, potential reasons for these differences, how they may impact patients over time, and the psychiatrist’s role in raising awareness about the hazards of overprescribing anal.

The State of the Art in NAFLD/NASH Identification and Management

Oct 3rd, 2022 - This transcript has been edited for clarity. Seth J. Baum, MD, FACC, FAHA, FNLA, FASPC: Hi. My name is Seth Baum. I'm a preventive cardiologist and clinical lipidologist, the chief scientific officer for Flourish Research, and a past president of the American Society for Preventive Cardiology. I'm joined today by Dr Jay Shubrook, who is an expert in diabetes, nonalcoholic steatohepatitis (NASH)...

Major Depressive Disorder: Transforming the Theoretical into the Clinical

Oct 3rd, 2022 - Bradley Neil Gaynes, MD, MPH, remembers two mentors who provided the framework for a notion of translational medicine in the context of the treatment of major depressive disorder (MDD). Although each explored different aspects of depression, they were united in their common cause to transport the most recent research results into the clinical realm in order to bring applicable and effective tre...

Comorbidities in Patients With Major Depressive Disorder: Seeing Beyond the 'Tip of the Iceberg'

Oct 3rd, 2022 - Leslie Citrome, MD, MPH, discusses the importance of considering comorbidities in patients with major depressive disorder (MDD), which requires asking the right questions and recognizing the symptoms. Dr Citrome gives two examples that taught him to have a healthy respect for comorbidities in patients with MDD. The examples concerned a patient whose comorbid anxiety and posttraumatic stress dis...

Major Depressive Disorder: Fulfilling the Promise of Therapeutics

Oct 3rd, 2022 - Bradley Neil Gaynes, MD, MPH, considers the assorted modes of treatment for major depressive disorder (MDD). By way of offering counsel to aspiring clinicians, Dr Gaynes observes the range of established MDD therapies, from the pharmacologic to the psychotherapeutic, noting that each will have greater or lesser applicability according to the specific patient/clinician dynamic. Dr Gaynes goes on...

Fast Five Quiz: Monkeypox

Oct 3rd, 2022 - Caused by the same family of viruses (Poxviridae) as the variola virus, monkeypox was discovered in 1958 after outbreaks occurred among research monkeys. It was first identified in humans in 1970. Before the 2022 outbreak, nearly all cases seen outside Africa were linked to the continent via travel or animal export. However, data suggest that men who have sex with men (MSM) account for a sizeab...

Intracranial Atherosclerotic Disease Clinical Practice Guidelines (ESO, 2022)

Oct 3rd, 2022 - Guidelines for the management of patients with intracranial atherosclerotic disease (ICAD) were published in September 2022 by the European Stroke Organisation (ESO) in European Stroke Journal.[1] Oral anticoagulation is not recommended over aspirin in patients with an ischemic stroke or transient ischemic attack due to high-grade stenosis related to intracranial atherosclerotic disease (ICAD)....

Standing Up for Our Patients' Rights and Our Right to Care For Them

Oct 3rd, 2022 - As a family medicine physician specializing in HIV for over two decades, standing up for my patients' rights and speaking out against discrimination in healthcare have become an unavoidable and integral part of caring for my patients. When the Trump Administration in 2019 launched an initiative to end the HIV epidemic in the United States by 2030 featuring HIV preexposure prophylaxis (PrEP) as ...

Why Private Practice Will Always Survive; What Makes Some Infections Asymptomatic?; Cancer's Emotional Toll

Oct 3rd, 2022 - Why Private Practice Will Always Survive Employed physicians are often torn. Many relish the steady salary and ability to focus on being a physician rather than handle administrative duties but bemoan their employers' rules and their lack of input into key decisions. Seven physicians talked to Medscape Medical News about why they chose private practice. Greater control: Some physicians chose pr...

Cholera Outbreaks Surging Worldwide, Fatality Rates Rising: WHO

Oct 3rd, 2022 - GENEVA (Reuters) - Cholera cases have surged this year, especially in places of poverty and conflict, with outbreaks reported in 26 countries and fatality rates rising sharply, a World Health Organization official said on Friday. In a typical year, fewer than 20 countries report outbreaks of the disease which is spread by the ingestion of contaminated food or water and can cause acute diarrhoea...

Intercept's NASH Drug Fails Late-stage Trial, Shares Tumble

Oct 3rd, 2022 - (Reuters) - Intercept Pharmaceuticals Inc said on Friday its treatment for patients with advanced liver scarring due to non-alcoholic steatohepatitis (NASH) failed to meet the main goal of a late-stage study, sending its shares down as much as 21%. Non-alcoholic steatohepatitis is a serious progressive liver disease that is one of the fastest-growing causes of liver transplant and does not have...

Amylyx Prices Newly Approved ALS Drug at $158,000 Per Year

Oct 3rd, 2022 - (Reuters) - Amylyx Pharmaceuticals Inc on Friday set the list price of its newly approved drug to treat amyotrophic lateral sclerosis (ALS) at about $158,000 per year in the United States, a discount to its most recently approved competitor. The drug Relyvrio was approved by the U.S. Food and Drug Administration on Thursday, making it the third ALS treatment to get the regulator's nod after Jap...

France Raises Bird Flu Alert Level After Resurgence of Virus

Oct 3rd, 2022 - PARIS (Reuters) - France will tighten measures to contain bird flu after a resurgence of the virus that swept through poultry flocks last winter, said the agriculture ministry, adding that the nationwide alert level on bird flu had been raised to 'moderate' from 'low'. France experienced its worst-ever bird flu crisis between November and May, with over 19 million animals being culled to stem a...

Ebola Kills Doctor in Uganda, First Health Worker Killed in Latest Outbreak

Oct 3rd, 2022 - KAMPALA (Reuters) - A Tanzanian doctor working in Uganda who contracted Ebola has died, the first health worker killed by the disease in the latest outbreak in the country, Uganda's health minister said on Saturday. "I regret to announce that we have lost our first doctor, Dr. Mohammed Ali, a Tanzanian national, 37-year-old Male," the health minister, Jane Ruth Aceng, tweeted. She said Ali had ...

Moderna Refused China Request to Reveal Vaccine Technology

Oct 3rd, 2022 - (Reuters) - Moderna Inc has refused to hand over to China the core intellectual property behind the development of its COVID-19 vaccine, leading to a collapse in negotiations on its sale there, the Financial Times reported on Saturday, citing people familiar with the matter. The Cambridge, Massachusetts-based pharmaceutical company turned down China’s request to hand over the recipe for its mRN...

Balanced Fat Intake Links With Less Type 2 Diabetes

Oct 3rd, 2022 - Researchers published the study covered in this summary on Preprints with The Lancet as a preprint that has not yet been peer reviewed. Key Takeaways Adults in China who consumed a "balanced," moderate-ratio (middle three quintiles) of animal-to-vegetable cooking oil had a lower rate of developing type 2 diabetes during a median follow-up of 8.6 years compared with those who consumed the lowest...

Ruxolitinib Repigments Many Vitiligo Affected Body Areas

Oct 3rd, 2022 - Ruxolitinib (Opzelura) cream can help repigment the skin in many body areas affected with vitiligo, researchers reported at the European Academy of Dermatology and Venereology (EADV) 2022 Annual Meeting. Those difficult areas include the hands and feet, said Thierry Passeron, MD, PhD, of Université Côte d'Azur and Centre Hospitalier Universitaire de Nice in France. Indeed, a 50% or greater impr...

Gardasil 9 HPV Vaccine Advised for MSM Living With HIV

Oct 3rd, 2022 - Men who have sex with men (MSM) living with HIV, especially those who are young or who've had gonorrhea should get the human papillomavirus (HPV) 9-valent vaccine (Gardasil 9), findings of a newly published study in JAIDS suggests. According to the World Health Organization, only 30% of the target population worldwide has received the HPV vaccine. Despite increased risk for HPV anal infection (...

Will AI Affect the Burden of Patient Surveillance After Polyp Removal?

Oct 3rd, 2022 - While the use of artificial intelligence (AI) during colonoscopy may contribute to improved cancer prevention, it may also add to patient burden in terms of increased colonoscopy frequency and, in turn, healthcare costs, a new study suggests. The study found that colonoscopy plus AI (vs colonoscopy alone) increased the proportion of patients requiring intensive postpolypectomy colonoscopy surve...

FDA Approves Futibatinib (Lytgobi) for Certain Biliary Tract Cancers

Oct 3rd, 2022 - The US Food and Drug Administration (FDA) has granted an accelerated approval for a new drug, futibatinib (Lytgobi), to be used for patients with a certain type of biliary tract cancer. Futibatinib was granted priority review and breakthrough designation, the agency said in its announcement. Futibatinib is indicated for use in adult patients with previously treated, unresectable, locally advanc...

Schools Are Significant Sites of COVID Transmission

Oct 3rd, 2022 - The school setting is an important site of SARS-CoV-2 transmission, new data suggest. An analysis of surveillance data for almost 1000 exposures to SARS-CoV-2 found that students accounted for a higher proportion of infected individuals who caused onward transmission than did the public overall (46.2% vs 25%). “Our analysis suggests that younger age groups were deeply involved in the spread of ...

Is Medical Cannabis the Answer to the Opioid Crisis?

Oct 3rd, 2022 - Medical cannabis may be an important alternative to opioids for pain management, new research suggests. In a large survey, patients with a variety of ailments, including pain and mental health problems, reported less pain and better functioning, after using medical cannabis — and most were able to stop or cut back on their opioid use. "Some patients wish to move away from opioid-based pain medi...

Distensibility Index: A 'Game Changer' in Pediatric Eosinophilic Esophagitis?

Oct 3rd, 2022 - Measuring esophageal distensibility can help define the severity of early scarring in the esophagus of children with eosinophilic esophagitis (EoE), a new study indicates. "Using the distensibility index (DI), a gastroenterologist can provide a quantitative measure of fibrostenotic severity, locate the narrowing, and determine the appropriate balloon size for dilation," Joshua Wechsler, MD, med...

High-Dose Folic Acid During Pregnancy Tied to Cancer Risk in Kids

Oct 3rd, 2022 - Prenatal exposure to high-dose folic acid is associated with a greater than twofold increased risk for cancer in children of mothers with epilepsy, new data from a Scandinavian registry of more than 3 million pregnancies suggests. The increased risk for cancer did not change after considering other factors that could explain the risk, such as use of antiseizure medication (ASM). There was no in...

Physician Bias May Prevent Quality Care for Patients With Disabilities

Oct 3rd, 2022 - Dr Tara Lagu For Tara Lagu, MD, MPH, the realization that the healthcare system was broken for patients with disabilities came when a woman she had been treating seemed to keep ignoring Lagu's request to see a urologist. When Lagu asked the patient's two attentive daughters about the delay, their response surprised her. The women said they couldn't find a urologist who was willing to see a pati...

Are Nasal Sprays the Future for the COVID Vaccine?

Oct 3rd, 2022 - Are nasal sprays the future of COVID-19 vaccines? That’s certainly the hope of many researchers working on new kinds of inoculation. Nasal vaccines were recently approved in China and India for use as a booster dose. The Chinese vaccine is inhaled through the mouth and nose, whereas the Indian vaccine is delivered through nasal drops. These vaccines are just two of more than 100 oral or nasal v...

Optimized HF Meds May Lessen MR Severity, Perhaps Avoiding MV Repair

Oct 3rd, 2022 - Among the benefits of fully optimized medical therapy in heart failure with reduced ejection fraction (HFrEF) may be, indirectly, lessened severity of associated mitral regurgitation (MR) that might render invasive mitral valve (MV) repair unnecessary for some patients. That's one implication, at least, from an analysis of HFrEF patients who showed significantly less moderate-to-severe MR a yea...

Two Thirds of US Adults Not Getting COVID-19 Booster Soon, Survey Shows

Oct 3rd, 2022 - Editor's note: Find the latest COVID-19 news and guidance in Medscape's Coronavirus Resource Center. Americans are not showing great enthusiasm for the new bivalent COVID-19 booster vaccine — if they've even heard about it, a Kaiser Family Foundation survey says. About two-third of respondents say they're not getting the booster vaccine anytime soon, if at all. Twelve percent said they "definit...

Ancient DNA Discoveries Lead to Nobel Prize in Medicine and Help Explain How Humans Evolved

Oct 3rd, 2022 - The Nobel Committee announced today it was awarding Professor Svante Pääbo the Nobel Prize in Physiology or Medicine for 2022 for his "pioneering research" into ancient DNA. It all started with a 40,000-year-old bone. That Neanderthal bone contained enough DNA that Pääbo could start decades of research showing us modern humans, Homo sapiens, are genetically distinct from other now-extinct homin...

The Private Market Is No Place for COVID-19 Countermeasures

Oct 3rd, 2022 - Editor's note: Find the latest COVID-19 news and guidance in Medscape's Coronavirus Resource Center. Throughout the Covid-19 pandemic, the U.S. federal government has supervised the purchasing and distribution of vaccines, tests, and treatments. Many Americans saw for the first time what publicly funded healthcare could do as citizens were able to access prevention and treatment without for-pro...

Brazil Records Two Cases of Invasive Meningococcal X Disease

Oct 3rd, 2022 - In the city of São Paulo, Brazil, two children, one a 7-month-old boy and one a 6-year-old boy, were hospitalized with invasive meningococcal disease (IMD) caused by the rare bacteria Neisseria meningitidis serogroup X (MenX). The unconnected cases occurred in November 2021 and January 2022 and were described in a research letter published in Emerging Infectious Diseases, the journal of the US ...

Med Groups Urge Feds to Protect Physicians From Anti-Trans Violence

Oct 3rd, 2022 - Several leading medical groups Monday called on US Attorney General Merrick Garland to investigate and prosecute those responsible for a recent spate of threats and attacks against hospitals and physicians who are providing gender-affirming care. In an October 3 letter, the American Academy of Pediatrics (AAP), the American Medical Association (AMA), and the Children's Hospital Association deta...

US Suicide Rate Rose in 2021 After 2 Years of Decline

Oct 3rd, 2022 - The number of people in the United States who died by suicide increased 4% in 2021 compared to the previous year, the National Center for Health Statistics reported. The agency said 47,646 people died by suicide in 2021 compared to 45,979 in 2020. The number of suicides had fallen the two previous years. Before that, the national suicide rate increased 35% from 1999 to 2018, when it hit a peak ...

COVID Attacks DNA in Heart, Unlike Flu, Study Says

Oct 3rd, 2022 - Editor's note: Find the latest COVID-19 news and guidance in Medscape's Coronavirus Resource Center. COVID-19 causes DNA damage to the heart, affecting the body in a completely different way than the flu does, according to a recent study published in Immunology. The study looked at the hearts of patients who died from COVID-19, the flu, and other causes. The findings could provide clues about w...

Don't Make Kids With Head Lice Leave School, Report Says

Oct 3rd, 2022 - The American Academy of Pediatrics says children with head lice don't need to be sent home from school. Head lice infestations aren't really a health hazard because of low transmission rates, a new report from the academy says, and sending students home "may stigmatize children suspected of having head lice." The group says schools should instead offer education programs to help families unders...

Athletes With Mild HCM Can Likely Continue Competitive Sports

Oct 3rd, 2022 - Athletes with mild hypertrophic cardiomyopathy (HCM) at low risk of sudden cardiac death (SCD) can safely continue to exercise at competitive levels, a retrospective study suggests. During a mean follow-up of 4.5 years, athletes who continued to engage in high-intensity competitive sports after a mild HCM diagnosis were free of cardiac symptoms, and there were no deaths, incidents of sustained ...

Severe Sleep Apnea Diagnosis Panics Reporter Until He Finds a Simple, No-Cost Solution

Oct 3rd, 2022 - I woke up in a strange bedroom with 24 electrodes glued all over my body and a plastic mask attached to a hose covering my face. The lab technician who watched me all night via video feed told me that I had "wicked sleep apnea" and that it was "central sleep apnea" — a type that originates in the brain and fails to tell the muscles to inhale. As a journalist — and one terrified by the diagnosis...

Docs May Be Disciplined for Spreading COVID Lies

Oct 3rd, 2022 - Editor's note: Find the latest COVID-19 news and guidance in Medscape's Coronavirus Resource Center. SACRAMENTO, Calif. (AP) — Doctors who spread coronavirus lies could be disciplined for unprofessional conduct in California under a law signed Friday by Gov. Gavin Newsom. The bill, AB2098, introduced by Democratic Assembly Member Evan Low, declares that a physician or surgeon commits profession...

QB's Head Injury Spurs Scrutiny of NFL Concussion Protocol

Oct 3rd, 2022 - A high-profile NFL injury has put the spotlight back on football's persistent concussions, which are linked to head trauma and a variety of long-lasting symptoms, and can be worsened by rushing back to physical activity. Miami Dolphins quarterback Tua Tagovailoa, who appeared to suffer head trauma in a prior game Sunday afternoon that was later described as a back injury, was diagnosed with a c...

When Emails Asking to Withdraw Manuscripts Started Repeating Themselves, an Editor Got Suspicious

Oct 3rd, 2022 - In late 2021, editors at Laboratory Investigation noticed something strange. The journal was receiving far more emails than usual asking to withdraw manuscripts that were already being peer reviewed. And some of the emails were strikingly similar, even using the same unusual language.  A total of five identical emails said that the authors had new results to add to the manuscript:  We feel that...