Maine Medicine Weekly Update - 04/08/2019 (Plain Text Version)
In this issue:
This Week's Public Health Updates from the AMA
Click through for a brief update on recent public health issues, provided by the American Medical Association's electronic publication, Morning Rounds.
The AP (4/8, Stobbe) reports a new study found that children who displayed symptoms of sniffling and a sore throat during telemedicine visits “were far more likely to be prescribed antibiotics than those who went to a doctor’s office or clinic,” and many “of those prescriptions disregarded medical guidelines.” Researchers assessed “more than 340,000 insured children who had acute respiratory illness medical visits in 2015 and 2016,” finding that the children “received prescriptions for antibiotics more than half the time during telemedicine visits, compared with 42% at urgent care clinics and 31% at doctors’ offices.” The findings were published in the journal Pediatrics.
CNN (4/5, Howard) reported that a study suggests Medicaid expansion under the Affordable Care Act “was linked with fewer cardiovascular-related deaths in counties where expansion took place.” The research was presented at the American Heart Association’s Scientific Sessions.
Reuters (4/5, Rapaport) reported researchers found that “many women who suffer from menstrual symptoms like pain and heavy bleeding don’t tell their families or doctors about it even when it interferes with their ability to keep up with daily routines.” The findings were published in the American Journal of Obstetrics and Gynecology.
Reuters (4/5, Crist) reported researchers who assessed “nearly 2.4 million hospital discharges to skilled nursing facilities under fee-for-service Medicare in 2012-2014” found that when Medicare patients are discharged from a hospital to an SNF, “the time it takes for a doctor or advanced-level practitioner to see them for a first evaluation can vary widely.” They found that nearly “half of first medical assessments happened within a day of admission to the nursing home, and 71 percent occurred within four days.” However, “about 15 percent of assessments happened four to 14 days after the patient arrived, nearly 4 percent were more than 14 days later and 10 percent of patients were never seen at all.” The findings were published in Health Affairs.
The AP (4/5, Ortutay) reports, “internet companies are trying to contain vaccine-related misinformation they have long helped spread. So far, their efforts at quarantine are falling short.” Searches of social media “turn up all sorts of bogus warnings about vaccines, including the soundly debunked notions that they cause autism or that mercury preservatives and other substances in them can poison and even kill people.” Experts worry the spread of bad information is contributing to the return of deadly diseases such as measles.
The New York Times (4/6, A1, Richtel, Jacobs) reported that Candida auris, a fungus that “preys on people with weakened immune systems,...is quietly spreading across the globe.” The article explains that in the past five years, the fungus “has hit a neonatal unit in Venezuela, swept through a hospital in Spain, forced a prestigious British medical center to shut down its intensive care unit, and taken root in India, Pakistan and South Africa.” The Centers for Disease Control and Prevention has added the fungus to its list of “urgent threats,” and is leading an international effort to stop the fungus from spreading. Tom Chiller, M.D., the head of the CDC’s fungal branch, said, “It is a creature from the black lagoon. It bubbled up and now it is everywhere.”
Kaiser Health News (4/5, Ostrov) reported that physicians in California have “broad authority to grant medical exemptions to vaccination,” and some are “wielding that power liberally and sometimes for cash: signing dozens – even hundreds – of exemptions for children in far-off communities.” While the state’s SB 277 passed in 2016, improved overall youth vaccination rates by 92.9 percent in 2015-2016 and 95.1 percent in 2017-2018, parents “have found end runs around the new law requiring vaccinations.” This, Kaiser Health writes, “has led to a kind of gray market in which parents share names of ‘vaccine-friendly’ doctors by word of mouth or in closed Facebook groups. And some of those doctors are granting children blanket exemptions – for all time and all vaccines – citing a range of conditions not supported by federal guidelines.”