Treah Haggerty and Cara Sedney - researchers in the West Virginia University School of Medicine are studying how a new West Virginia law has changed the way health care providers prescribe opioids. Working with the state’s Board of Pharmacy, they’re examining prescription practices before and after the law took effect on June 7, 2018, and pinpointing differences. They’ll also interview health care providers, pharmacists, and patients. To see how the law has influenced opioid prescribing, Haggerty and Sedney will assess prescription data from the Board of Pharmacy.
News
Dec 13, 2019
According to an announcement by the House Ways and Means Committee, they will let let insurers and providers work out their differences without interference. If private market dynamics failed, a negotiated, structured process would then settle payment differences by taking into account payments made to similar providers for similar services in similar areas. The party that will lose, will pay a fee for reconciliation process.
Dec 13, 2019
Costa Rica’s President Carlos Alvarado issued a technical decree that will allow for therapeutic abortions in the Central American nation, despite opposition from religious and conservative political groups. The measure will allow for the first therapeutic abortions to be performed within six months at public hospitals. Private clinics will also be allowed to perform the procedure.
Journal Abstracts
Dec 11, 2019
Cornelia Knaak et al examined links between preoperative C-reactive protein (CRP) and the incidence of POD and postoperative NCD via performing an observational analysis including 314 patients registered in the SuDoCo trial. Participants had preoperative CRP levels measured the day before surgery. The primary outcomes included POD evaluated according to DSM-4 criteria from day 1 until day 7 following surgery, and postoperative NCD evaluated 3 months post-surgery. The investigators noted an independent link between preoperative CRP levels with POD but not with postoperative NCD after 3 months. Moreover, higher risk for POD was demonstrated by higher preoperative CRP levels—reinforcing the role of inflammation in POD development. Risk stratification of POD might thus be enabled by the evaluation of CRP prior to surgery
Dec 11, 2019
sought to define a new first-trimester sonographic sign, the ‘crash sign’, connected with fetal open spina bifida. Further, they examined its clinical utility in the first-trimester diagnosis of spina bifida. Patients referred to three fetal medicine centers in the first trimester (11 + 0 to 13 + 6 weeks) with suspected spina bifida were asked to undergo ultrasound for direct visualization of the spinal defect to confirm spina bifida by two experts and, when possible, by fetal postmortem examination. The crash sign is the posterior displacement of the mesencephalon and deformation against the occipital bone in the axial view. Forty-eight out of 53 confirmed cases of spina bifida exhibited the crash sign. Outcomes suggest the possible utility of the crash sign as a tool in the first-trimester detection of spina bifida. In a routine clinical screening ultrasound setting, evaluation of the crash sign appeared to be beneficial.
Dec 11, 2019
Variation in blood pressure may relate to dementia risk via autonomic disturbance or hemodynamic mechanisms, but the long-term associations are unclear. Yuan Ma et al aimed to determine whether blood pressure variation over a period of years, considering both magnitude and direction, is associated with the risk of dementia. The results of this study showed that a large blood pressure variation over a period of years was associated with an increased long-term risk of dementia. The association between blood pressure variation and dementia appears most pronounced when this variation occurred long before the diagnosis. An elevated long-term risk of dementia was observed with both a large rise and fall in blood pressure.
Recent Articles
Dec 13, 2019
Superior sagittal sinus (SSS) dural arteriovenous fistulas (DAVFs) are rare and present unique challenges to treatment. Complex, often bilateral, arterial supply and involvement of large volumes of eloquent cortical venous drainage may necessitate multimodality therapy such as endovascular, microsurgical, and stereotactic radiosurgery techniques. The authors present a complex SSS DAVF associated with an occluded/severely stenotic SSS. The patient underwent a successful endovascular transvenous approach with complete obliteration of the SSS. The authors discuss the management challenges faced on this case.
Dec 13, 2019
Watch Dr. Peter Harris, Ph.D. discuss Frontiers in Autsomal Dominant Polycystic Kidney Disease.
Dec 13, 2019
This is a case of a patient with infantile-onset Pompe disease with a normal paternal carrier genetic test, born prior to newborn screening for Pompe disease in the state of Michigan. The infant’s father was retested once the infant was diagnosed with Pompe disease postnatally and noted to have a mutation conducive to Pompe disease.
Clinical Research
Dec 12, 2019
The study will be conducted as a multicenter, prospective, single-arm clinical trial, evaluating the efficacy and safety of cochlear implantation in patients with asymmetric hearing loss. A repeated-measures analysis will be employed whereby patients will act as their own controls. Participants will be recruited from surgeons and audiologists in Otolaryngology departments at the participating sites. Participants who have not previously used a poor-ear hearing aid or BiCROS hearing aid will complete a 1-2 week trial and be evaluated at the end of the trial. If performance is better with the alternate therapy (bilateral hearing aids or BiCROS hearing aid) than the better ear alone performance and the participant prefers the alternate therapy, the participant will not continue in the study.
Dec 12, 2019
This is an open-label, phase II study of TGR-1202 in patients with relapsed or refractory (R/R) Grade 1, 2, or 3A follicular lymphoma (FL). FL is the most common subtype of indolent lymphoma. The prognosis of FL depends on the histologic grade, stage, treatment, and age of the patient. More recently, efforts have been made to find novel regimens for the treatment of relapsed FL that do not contain non-specific cytotoxic agents. One of the important goals of this phase II study is to discover novel genetic, biochemical, and immunological markers that are associated with the response and safety of TGR-1202 in patients with FL. TGR-1202 blocks PI3K, a signal that is required for cancer to grow.
Dec 12, 2019
This is a single-center prospective randomized investigation of patients undergoing surgical arthrodesis for single or multi-level cervical disease, resulting in cervical radiculopathy. Patients indicated for surgery for cervical degenerative disease (CDD) will be screened for yellow flags using validated tools to assess pain. Cognitive-behavioral therapy (CBT) will be used to modify yellow flags in spine patients. All patients at risk will be stratified by risk rating and randomly assigned to 2 groups; sham treatment (N=20) or CBT (N=20). The goal of this study is to unmask the relationship between psychological distress and clinical outcomes in patients undergoing surgical treatment for cervical degenerative disease resulting in combinations of neck pain and radiculopathy and to determine the effectiveness of a brief psychological intervention on a subset of patients who screen positive for psychological distress prior to their surgeries.
Publications
Dec 12, 2019
Lipids in Health and Disease is an open access, peer-reviewed, journal that publishes articles on all aspects of lipids: their biochemistry, pharmacology, toxicology, role in health and disease, and the synthesis of new lipid compounds. Lipids in Health and Disease is aimed at all scientists, health professionals and physicians interested in the area of lipids. Lipids are defined here in their broadest sense, to include: cholesterol, essential fatty acids, saturated fatty acids, phospholipids, inositol lipids, second messenger lipids, enzymes and synthetic machinery that is involved in the metabolism of various lipids in the cells and tissues, and also various aspects of lipid transport, etc. In addition, the journal also publishes research that investigates and defines the role of lipids in various physiological processes, pathology and disease. In particular, the journal aims to bridge the gap between the bench and the clinic by publishing articles that are particularly relevant to human diseases and the role of lipids in the management of various diseases.
Dec 12, 2019
The Journal of General Internal Medicine is the official journal of the Society of General Internal Medicine. It promotes improved patient care, research, and education in primary care, general internal medicine, and hospital medicine. Its articles focus on topics such as clinical medicine, epidemiology, prevention, health care delivery, curriculum development, and numerous other non-traditional themes, in addition to classic clinical research on problems in internal medicine.
Dec 12, 2019
The Journal of the Neurological Sciences provides a medium for the prompt publication of original articles in neurology and neuroscience from around the world. JNS places special emphasis on articles that: 1) provide guidance to clinicians around the world (Best Practices, Global Neurology); 2) report cutting-edge science related to neurology (Basic and Translational Sciences); 3) educate readers about relevant and practical clinical outcomes in neurology (Outcomes Research); and 4) summarize or editorialize the current state of the literature (Reviews, Commentaries, and Editorials).
JNS accepts most types of manuscripts for consideration including original research papers, short communications, reviews, book reviews, letters to the Editor, opinions and editorials. Topics considered will be from neurology-related fields that are of interest to practicing physicians around the world. Examples include neuromuscular diseases, demyelination, atrophies, dementia, neoplasms, infections, epilepsies, disturbances of consciousness, stroke and cerebral circulation, growth and development, plasticity and intermediary metabolism.
The fields covered may include neuroanatomy, neurochemistry, neuroendocrinology, neuroepidemiology, neurogenetics, neuroimmunology, neuroophthalmology, neuropathology, neuropharmacology, neurophysiology, neuropsychology, neuroradiology, neurosurgery, neurooncology, neurotoxicology, restorative neurology, and tropical neurology.
The Journal of the Neurological Sciences is the official journal of the World Federation of Neurology.
Videos
Dec 13, 2019
In this fast-paced case review, vRad Chief Medical Officer, Dr. Benjamin W. Strong, utilizes cinematic and still imagery to explore the findings and diagnosis of some of his favorite cases complied from vRad’s extensive teaching library. Some of the diagnosis that are included are Gastric bypass with small bowel obstruction, Gastric bypass with intussusception, Staple line dehiscence, Staple line dehiscence with ischemia etc.
Dec 13, 2019
Superior sagittal sinus (SSS) dural arteriovenous fistulas (DAVFs) are rare and present unique challenges to treatment. Complex, often bilateral, arterial supply and involvement of large volumes of eloquent cortical venous drainage may necessitate multimodality therapy such as endovascular, microsurgical, and stereotactic radiosurgery techniques. The authors present a complex SSS DAVF associated with an occluded/severely stenotic SSS. The patient underwent a successful endovascular transvenous approach with complete obliteration of the SSS. The authors discuss the management challenges faced on this case.
Dec 13, 2019
Watch Dr. Peter Harris, Ph.D. discuss Frontiers in Autsomal Dominant Polycystic Kidney Disease.
Dec 13, 2019
Dr Anurag Bajpai gives an interesting and a complete description of Hypophosphatemic Rickets with respect to its causation, symptoms, presentation, management. He has also discussed the updated management strategies with the help of cases.
Case Studies
Dec 13, 2019
The patient described in this case is quite unique in the sense that despite only partial tumour resection was obtained, the residual tumour was not progressive during several years of follow-up. Preoperative recognition of this disease entity is crucial to modify the treatment approach and improve patient outcome.
Dec 13, 2019
This is a case of a patient with infantile-onset Pompe disease with a normal paternal carrier genetic test, born prior to newborn screening for Pompe disease in the state of Michigan. The infant’s father was retested once the infant was diagnosed with Pompe disease postnatally and noted to have a mutation conducive to Pompe disease.
Dec 13, 2019
This is a case of a patient with infantile-onset Pompe disease with a normal paternal carrier genetic test, born prior to newborn screening for Pompe disease in the state of Michigan. The infant’s father was retested once the infant was diagnosed with Pompe disease postnatally and noted to have a mutation conducive to Pompe disease.
Dec 13, 2019
Brugada syndrome is a genetic condition that accentuates the risk of potentially lethal ventricular arrhythmias and sudden cardiac death in a structurally normal heart. This case report highlights a suspected coronary slow flow-associated Brugada type 1 electrocardiographic pattern, which subsequently normalized following the institution of guideline-directed medical therapy for acute coronary syndrome.