Sharon Smith

In patients with knee osteoarthritis, telehealth-delivered exercise and diet programs are superior to electronic health information for reducing pain and improving function, a randomized trial shows. Reuters Health Information source https://www.medscape.com/viewarticle/963789?src=rss

Cardiopulmonary exercise testing can help define the cause of unexplained dyspnea in patients with post-acute sequelae of COVID-19, report clinicians in New York. Reuters Health Information source https://www.medscape.com/viewarticle/963782?src=rss

Parathyroidectomy is associated with a lower risk of fracture compared with nonsurgical management among older adults with primary hyperparathyroidism, a new study indicates. Reuters Health Information source https://www.medscape.com/viewarticle/963760?src=rss

The Omicron variant of the coronavirus carries a very high global risk of surges, the WHO has warned, as more countries reported cases, prompting border closures and reviving worries about the economic recovery. Reuters Health Information source https://www.medscape.com/viewarticle/963738?src=rss

Enforcement began Monday in Los Angeles for one of the strictest vaccine mandates in the country. Associated Press source https://www.medscape.com/viewarticle/963823?src=rss

Existing COVID-19 vaccines should be highly effective at preventing severe disease and hospitalization from the newly identified Omicron variant, a top South African infectious disease expert said on Monday. Reuters Health Information source https://www.medscape.com/viewarticle/963736?src=rss

The heavily mutated Omicron coronavirus variant is likely to spread internationally and poses a very high risk of infection surges that could have 'severe consequences' in some places, the WHO said on Monday. Reuters Health Information source https://www.medscape.com/viewarticle/963735?src=rss

Are you a healthcare provider looking for a way to share your knowledge, advance your career, boost your income, or change your career altogether? If so, medical writing may be a great field for you. Over the past decade, medical writing has become recognized as a profession, with several universities now offering medical and science writing programs and other organizations, such as the American Medical Writer’s Association , offering certificate and certification programs; however, special degrees or certificates are generally not needed for physicians to find a place in the field. What follows is an overview of 5 of the larger medical writing niches physicians can consider. Journals: Although journal submissions are rarely compensated, having articles published in journals can be a great way to carve a name for yourself in your specialty. This may be especially important if you have recently obtained your medical degree or are practicing in an academic setting where “publish or...

Over 460,00 healthcare workers have left the field since February 2020. There is a huge shortage of entry-level staff and it has become more difficult to secure dependable, qualified staff. In October, the Bureau of Labor Statistics at the US Department of Labor reported an unemployment rate of 4.6%. While health care added 37,000 jobs in October, most of the gain occurred in home healthcare services (+16,000) and nursing care facilities (+12,000). The  Association of American Medical Colleges has already confirmed  that America will face a critical shortage of clinical providers by 2032 of nearly 122,000 physicians as demand for physicians continues to grow faster than supply. The number of physician assistants and advanced practice registered nurses is projected to continue to increase. Since healthcare jobs are in high demand, what can you do to find the right staff for your practice? Amy Hinton, a consultant at Provider Services Nationwide , which hires staff for p...

Gov. Kathy Hochul said the state won't be "defenseless" if everyone wears masks indoors, gets vaccinated, gets tested, washes their hands, and stays home when sick. Associated Press source https://www.medscape.com/viewarticle/963824?src=rss

The antibiotic-free formulation shows potential as a targeted treatment for antimicrobial-resistant bacteria in chronic wounds such as diabetic foot ulcers, as well as a potential therapy for SARS-CoV-2. Medscape Medical News source https://www.medscape.com/viewarticle/963813?src=rss

Nurses' unions representing more than 2.5 million healthcare workers in 28 countries filed a UN complaint citing inequity in the creation and distribution of COVID vaccines in disadvantaged countries. Medscape Medical News source https://www.medscape.com/viewarticle/963812?src=rss

The COVID-19 pandemic dominated our lives ― and our vocabulary ― in 2021. WebMD Health News source https://www.medscape.com/viewarticle/963810?src=rss

Patients with gout have significantly greater intercritical inflammation and lumbosacral spine monosodium urate crystal (MSU) deposition when compared with those without the condition, and trend toward greater deposition among patients with tophi. Preliminary results from a study using stringent Dual-Energy CT (DECT) threshold settings suggests MSU differences are not artifact. Physician’s Weekly spoke with Dr. Michael Toprover (Department of Medicine, NYU Grossman School of Medicine), who presented these new findings 1 at the annual American College of Rheumatology Convergence of 2021 , which was held from 3 to 10 November .   More than 100 cases of axial gout have been reported in the last 70 years, usually presenting as acute back pain, cord compression, and/or neurologic symptoms. Diagnosis relies on invasive procedures. Furthermore, little is known about the extent of MSU deposition in the spine of gout patients, including asymptomatic patients or those with non-specific...

Pegloticase is effective for lowering serum urate patients with uncontrolled or refractory gout, although more than half of patients experience anti-drug antibody development which limits its efficacy. 1  Administering pegloticase in conjunction with an immunomodulating therapy has been shown to improve sustained urate reduction while on treatment. 2  Very little data is available pertaining to who might be the best candidate for this approach, as well as which immunomodulation agent should be used. The data presented by Dr Broadwell reflected the experience from two community rheumatology practices where immunomodulating therapy is routinely prescribed in patients undergoing pegloticase treatment. Rheumatologist Dr Aaron Broadwell (Shreveport, Louisiana) presented the results of the study during the annual American College of Rheumatology Convergence of 2021 , 3 which was more or less simultaneous with the a related systematic review presented at the Kidney Week of the Ame...

All medical practices can benefit from funding and business loan options. However, many physicians are unsure of which options are best suited to increase their practice’s working capital. While some might benefit most from Small Business Administration (SBA) loans, others might be better off with new funding sources. SBA loans exist in a variety of forms, including the 7(a) Guaranteed Loan Program, express loans, microloans, and 504 Local Development Company Program Loans. Physicians benefit from SBA loans in many ways, such as longest terms, often lowest rates, and up to $5 million in loan amounts—the greatest amount offered from any funding option. Unfortunately, their desirability makes SBA loans the most challenging to procure, as the quest for an SBA loan is burdened with laborious paperwork requirements and an extremely time-consuming application process. Physicians seeking an SBA loan must be prepared to offer collateral or a personal guarantee, as well as business and persona...

The job market has never been more competitive, and small and large businesses alike are struggling to attract and keep competent employees. Even when a medical office offers a strong salary, attractive benefits, and flexible hours, staff turnover is still something the team must prepare for. Compile clear job descriptions. According to SHRM , making sure that each hire is a good fit is a key to reducing turnover. One way to ensure this is by having a detailed job description for every position in the office. This may be easier said than done because small offices are notorious for blending and crossing over tasks. Ask each of your current employees to write up a description of their job including things that aren’t really their job, but they do anyway. Make sure that they know that everyone is performing this exercise and it is for streamlining and understanding their workload burden. Edit these descriptions and have them ready should any give their notice. Outline a notice policy....

Patients saw improvements in knee pain, function with exercise/diet duo An exercise and diet program administered via telehealth improved pain and function in people with knee osteoarthritis (OA) who also had overweight or obesity, researchers in Australia reported. In a randomized study that looked at two six-month, telehealth-delivered exercise programs—paired with or without a dietary intervention—patients with knee OA saw improvements in two primary outcomes versus controls, who only got electronic OA information: Changes in knee pain on a numerical rating scale (NRS of 0 to 10 with 10 indicating worse pain): between-group mean difference of −1.5 for diet and exercise (95% CI −2.1 to −0.8); −0.8 (95% CI −1.5 to −0.2) for exercise alone at six months. Changes in physical function on the Western Ontario and McMaster Universities Osteoarthritis Index scale (WOMAC of 0 to 68): between-group mean difference −9.8 for diet and exercise (95% CI −12.5 to −7.0); −7.0 for exercise alone...

Findings may help identify patients at increased risk High-grade exercise-induced premature ventricular contractions (PVCs) were both more common and had greater prognostic significance when they occurred during recovery after exercise rather than during exertion, a retrospective study found. Among adults who had no known cardiac disease and no indication for cardiac exercise stress testing, high-grade exercise-induced PVCs were seen in 1.8% during exercise, 2.4% during recovery, and 0.8% during both exercise and recovery, reported Miran Jaffa, PhD, of the American University of Beirut in Lebanon, and co-authors. High-grade PVCs that occurred during recovery but not exercise were associated with cardiovascular (CV) death risk over a mean 20.2 year follow-up (HR 1.82; 95% CI 1.19-2.79; P =0.006), Jaffa and colleagues wrote in the Journal of the American College of Cardiology . Results remained significant when adjusted for exercise duration, heart rate recovery, achieving target h...

Drug designed to improve location of cancerous tissue during surgery The FDA approved an intravenous imaging drug , pafolacianine (Cytalux), to assist surgeons in detecting ovarian cancer lesions during surgery in adult patients with ovarian cancer. “The FDA’s approval of [pafolacianine] can help enhance the ability of surgeons to identify deadly ovarian tumors that may otherwise go undetected,” said Alex Gorovets, MD, deputy director of the Office of Specialty Medicine in the FDA’s Center for Drug Evaluation and Research, in a statement. “By supplementing current methods of detecting ovarian cancer during surgery, [pafolacianine] offers health care professionals an additional imaging approach for patients with ovarian cancer.” Pafolacianine works by binding to the folate receptors in a patient’s cancer cells. One binding occurs, the drug illuminates the cells under fluorescent light, helping surgeons to identify cancerous tissue. “Currently, surgeons rely on preoperative imaging...

No structural, functional benefit seen in phase III trial Erythropoietin added to methylprednisolone did not improve structural or functional outcomes in visual pathways after optic neuritis, the phase III TONE trial found. Mean 26-week peripapillary retinal nerve fiber layer (pRNFL) atrophy, a structural measure, was 15.93 μm for erythropoietin add-on and 14.65 μm for placebo add-on (adjusted mean treatment difference 1.02 μm, 95% CI –5.51 to 7.55; P =0.76), reported Wolf Lagrèze, MD, of the University of Freiburg in Germany, and co-authors, in Lancet Neurology . Mean low contrast letter acuity score, a functional measure, was 49.60 for erythropoietin and 49.06 for placebo (adjusted mean treatment difference –4.03, 95% CI –13.06 to 5.01). “We obtained clear results indicating that erythropoietin confers neither structural nor functional benefits in the visual system,” Lagrèze and colleagues wrote. “Treatment estimates did not approach clinically relevant effect sizes, were not ...

Study details benefits of surgery for persons with hyperparathroidism Parathyroidectomy was linked with “robust fracture risk reduction” in older adults with primary hyperparathroidism (PHPT), researchers reported. In a population-based, longitudinal cohort study of all Medicare beneficiaries with PHPT, the unadjusted incidence of fracture was 10.2% in patients treated with parathyroidectomy at a mean follow-up period of 58.5 months versus an unadjusted incidence of 13.7% in patients observed non-operatively for a mean follow-up of 52.5 months, according to Carolyn D. Seib MD, MAS, of Stanford University School of Medicine in California, and co-authors. On multivariable analysis, parathyroidectomy was associated with lower adjusted rates of any fracture, hip fracture, and adjusted absolute fracture risk reduction at various time points versus non-operative management, they stated in JAMA Internal Medicine . Seib’s group concluded that “among older adults with PHPT… operative manag...

WEDNESDAY, Nov. 24, 2021 (HealthDay News) — Significant gender disparities have been observed in work and family experiences and mental health symptoms between female and male physician parents during the COVID-19 pandemic, according to a study published online Nov. 12 in JAMA Network Open . Elena Frank, Ph.D., from the University of Michigan in Ann Arbor, and colleagues assessed gender differences in work-family factors and mental health among physician parents during the COVID-19 pandemic. Analysis included 215 U.S. physicians enrolled in the Intern Health Study since their first year of residency training and who completed the August 2020 survey. The researchers found that among physician parents, women were more likely than men to be responsible for childcare or schooling (24.6 versus 0.8 percent) and household tasks (31.4 versus 7.2 percent) during the pandemic. Women were also more likely to work primarily from home (40.9 versus 22.0 percent) and reduce their work hours (19.4 v...

WEDNESDAY, Nov. 24, 2021 (HealthDay News) — Six inflammatory proteins are upregulated in plasma several years before diagnosis of ulcerative colitis, according to a report published in the November issue of Gastroenterology . Daniel Bergemalm, M.D., Ph.D., from the Örebro University Hospital in Sweden, and colleagues characterized preclinical systemic inflammation in ulcerative colitis in plasma samples biobanked from 72 individuals who developed ulcerative colitis later in life and 140 matched healthy controls. Ninety-two proteins related to inflammation were measured. The biological relevance of findings was validated in an inception cohort of 101 ulcerative colitis patients and 50 healthy controls. The influence of genetic and environmental factors on these markers was examined in a cohort of 41 healthy twin siblings of patients with ulcerative colitis and 37 matched healthy controls. The researchers found that six proteins were upregulated in preclinical ulcerative colitis versus...

WEDNESDAY, Nov. 24, 2021 (HealthDay News) — CVS Health, Walmart, and Walgreens contributed to opioid overdoses and deaths in two Ohio counties, a federal jury in Cleveland found Tuesday. The first jury verdict in an opioids case came in the closely watched test case and may prove encouraging to plaintiffs in thousands of lawsuits across the United States using the same legal strategy — that the companies contributed to a “public nuisance,” The New York Times reported. That argument was rejected this month by judges in California and Oklahoma in cases against opioid manufacturers. The Ohio case is the first time the retail side of the drug industry has been held accountable in the U.S. opioid crisis, The Times reported. CVS Health, Walmart, and Walgreens are three of the nation’s largest pharmacy chains. Following the verdict, the trial judge will decide how much each of the pharmacy chains will have to pay Lake and Trumbull counties in northeastern Ohio, The Times reported. The c...

WEDNESDAY, Nov. 24, 2021 (HealthDay News) — Kraft Heinz Co. announced that it is recalling certain lots of Country Time Lemonade, Tang, Arizona Tea, and Kool-Aid powdered drinks because they may contain small pieces of metal or glass. The company also said that certain lots of Country Time Lemonade with “Best When Used By” date of Sept. 15, 2023 and Tang powdered drinks with “Best When Used By” dates of Aug. 20-21, 2023, have been recalled in Canada for the same issue. The problem with the glass and metal pieces occurred during production, the company said. The recalled products, which include “Best When Used By” dates between May 10, 2023, and Nov. 1, 2023, should be thrown away or returned to the place of purchase for a refund. Consumers can contact Kraft Heinz from 9 a.m. to 6 p.m., Monday through Friday at the following phone numbers to see if a product they purchased is part of the recall: U.S. Consumer Relations at 1-855-713-9237 or Canada Consumer Relations at 1-855-268-1775....

WEDNESDAY, Nov. 24, 2021 (HealthDay News) — Enterovirus D68 (EV-D68) detections were lower than anticipated in 2020, according to research published in the Nov. 24 issue of the U.S. Centers for Disease Control and Prevention Morbidity and Mortality Weekly Report . Noting that the number of EV-D68 detections followed a biennial pattern during 2014 to 2018 in the United States, Melisa M. Shah, M.D., from the CDC in Atlanta, and colleagues assessed recent levels of EV-D68. EV-D68 detections in respiratory specimens collected from patients aged <18 years with acute respiratory illness (ARI) evaluated within the New Vaccine Surveillance Network were summarized. Provisional descriptions of EV-D68 detections during July to November 2018, 2019, and 2020 were provided and the demographic and clinical characteristics of the patients were described. The researchers note that 382 EV-D68 detections in respiratory specimens from patients aged <18 years were reported in 2018; this number decr...

Age still a factor but not as great as it once was Age apparently matters when patients with symptomatic aortic stenosis are evaluated for surgical repair of the valve, as a sub-analysis by French researchers found that the oldest patients in the EURObservational Research Program Valvular Heart Disease II Survey (EORP VHD) were likely to be classified in a “not to intervene” group. But age is not the great barrier it once was, and there are other factors that are drivers of decisions about who should or should not receive intervention—less severe heart failure (New York Heart Association Class I or II) and a higher age adjusted Charlson comorbidity index, as well as lower transaortic mean gradient, all weighed against the decision to intervene with surgical repair, Marc Eugène, MD and Bernard Iung, MD of the Cardiology Department, Bichat Hospital, and the Université de Paris, and colleagues wrote in the Journal of the American College of Cardiology. The researchers planned to compa...

Will the heavily mutated Omicron variant take center stage in the Covid-19 pandemic? A new, heavily mutated SARS-CoV-2 variant of concern, first identified in South Africa, triggered another round of travel bans across the globe and raised concerns that a new, more-transmissible Covid-19 wave is on the horizon. The new Omicron variant (B.1.1.529) was first reported to the World Health Organization (WHO) on Nov. 24 after the viral strain began cropping up in South Africa, coinciding with a recent steep increase in Covid infections in the region. Just two days later, WHO officially declared it a variant of concern (VOC) . “This variant has a large number of mutations, some of which are concerning,” WHO explained in a press release. “Preliminary evidence suggests an increased risk of reinfection with this variant, as compared to other VOCs. The number of cases of this variant appears to be increasing in almost all provinces in South Africa. Current SARS-CoV-2 PCR diagnostics continue ...