Maine Medicine Weekly Update - 12/02/2019  (Plain Text Version)

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In this issue:
•  5 things Doctors Need to Know About 2020 Medicare Fee Schedule
•  AMA Comments to CMS 2020 Physician Fee Schedule and QPP Proposed Rule
•  15 Physicians Fired From Chicago-area Health System, Replaced by APRNs
•  MaineCare "Provider" Application Fees to Rise
•  US Life Expectancy Continues to Decline; Maine has 4th Greatest Rate
•  Maine Native, Med Student, Featured in NPR Story on Opioids
•  This Week's Public Health Updates from the AMA
•  IMD Exclusion for SUD and SMI/SED 1115 Waiver Application
•  Safe Sleep Research Project - Provider Survey to improve recommendations for parents
• 2020 Open Enrollment Ends on December 15
•  From The Alzheimer's Association: Making a Plan of Care for Patients with Cognitive Decline and Dementia
•  MMA Legislative Calls Will Start Again in January; Organizational Meeting 12/10 at 6 p.m., MMA HQ
•  Maine Legislature's List of Bill Titles for 2020 Session: Initial Approval List
•  Upcoming Specialty Society Meetings
•  MMA partners with the Maine Suicide Prevention Program and the Maine CDC/Sweetser to offer training for clinicians.
•  10th Annual Maine Patient Safety Academy - March 30, 2020
•  Northern Light Sebasticook Valley Hospital seeks a BC/BE General Surgeon
•  Family Medicine Physician
•  Family Medicine Opportunity in Beautiful Western Maine
•  BC/BE Family Medicine or Internal Medicine Physician
•  Physician Director of Primary Care
•  Full-time, Part-time and Leadership Opportunities for Physicians
•  Opportunities at the VA for Volunteer Physicians
•  Volunteer Opportunity with Partners for World Health


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. [This article is updated weekly.]


Americans weigh more this decade, but fewer adults say they want to lose weight, poll data reveal

CNN (11/28, Andrew) reported, “Americans weigh more this decade than they did last decade, but fewer adults say they want to lose weight.” A new poll found that “28% of Americans said they weighed 200 pounds or more between 2010 and 2019 – a four-point jump from...2001 to 2009.” Even so, “fewer Americans now consider themselves overweight or obese.”

Newsweek (11/27, Moyler) reported, “The data came from Gallup’s Health and Healthcare survey, which the organization said was conducted in November of each year.” The 2019 survey responses “were collected between November 1 and November 14 from a random selection of 1,015 adults living in all 50 states and Washington, D.C.” These findings “appeared to directly contradict those of a study” recently published in JAMA Network Open. That particular “study, which involved 48,026 people between the ages of 40 and 64, indicated that the number of Americans trying to lose weight was on the rise.”

MRI screening may benefit women with dense breasts, study suggests

The New York Times (11/27, Rabin) reported a study of over 40,000 women with extremely dense breasts “found that MRIs detected tumors missed by mammograms, cutting interval cancers by half or more.” The research “provides strong evidence that getting supplemental MRIs are more effective in finding tumors in” women with dense breasts “than mammograms alone.” The study also “found that those who had MRIs were less likely to find a cancerous lump in between routine screenings.” The findings were published in the New England Journal of Medicine.

Study: Gabapentin and baclofen may be linked to increased suicide attempts

Newsweek (12/2, Gander) reports “suicide attempts linked to some non-opioid medications replacing [opioid prescriptions] have risen,” in the face of falling opioid prescriptions, research indicates. In a study examining gabapentin and baclofen, “over the period the drugs were studied, suicides attempts after people took just gabapentin rose by 80.5 percent, and by 43 percent for baclofen.” The study was published in Clinical Toxicology.

U.S. deaths from alcohol-related liver disease at highest levels since 1999, study indicates

According to Reuters (11/29, Mathias), CDC data revealed that “U.S. deaths from alcohol-related liver disease (ALD) are at their highest levels since 1999 and have risen every year since 2006 in nearly every racial, ethnic and age group.” After analyzing “causes of death for people aged 25 and older in the two decades since 1997,” investigators “found that 2017 had the highest rates of death from ALD, at 13.1 per 100,000 deaths in men and 5.6 per 100,000 in women,” which “compares to 1999 ALD mortality rates of 10.6 per 100,000 in men and 3.3 per 100,000 in women.” In particular, “mortality rates and recent increases in ALD diagnoses were...pronounced among middle-aged adults, Native Americans and non-Hispanic whites,” the study found. The findings were published online in the American Journal of Gastroenterology.

Research indicates one in ten cancer patients die from cardiovascular disease, not cancer

CNBC (11/26, Mitra) reports research suggests patients with cancer “have a higher risk of dying from heart disease and stroke with 10% of all cancer patients dying from cardiovascular problems, not cancer.” The risk may be even higher for certain cancers, including thyroid, breast, prostate, and endometrial cancer. The research indicates “roughly half of those patients die from cardiovascular disease.” For uterine, prostate, and breast cancer, “cardiovascular disease deaths have actually surpassed the deaths from the cancer that the patients have,” according to the study author. Moreover, “in 2012, 61% of all the cancer patients who died from cardiovascular diseases had been diagnosed with breast, prostate or bladder cancer.” The findings were published in the European Heart Journal.

Medscape (11/26, Castellino, Subscription Publication) reports the researchers “compared the U.S. general population to 3,234,256 U.S. cancer survivors from the SEER database for the period 1973 to 2012.” Meanwhile, “the period covered in the analysis does not reflect key developments that have occurred regarding immunotherapies, the authors note.” The study also revealed “increased age at cancer diagnosis is associated with increased risk for death from CVD,” while “the younger a cancer survivor is diagnosed, the higher is the risk for heart disease.”

Drug-resistant MRSA may be spread through household items, study suggests

Newsweek (11/26, Gander) reports drug-resistant Methicillin-resistant Staphylococcus aureus (MRSA) “can be spread via household items such as refrigerator door handles, the TV remote, toothbrushes and towels,” a new study warns. The research involved home visits of 150 children treated for MRSA infections, and “bedsheets of the child with the initial infection were found to be most often contaminated with MRSA.” The study was published in the journal Lancet Infectious Diseases.

Reuters (11/27) reports, “People who transmitted MRSA to other individuals or animals were 25% more likely to share bath towels than people who didn’t spread staph, the study found.” The research also found that “pets were often transmission recipients, but rarely the sole transmission source of MRSA.” Additionally, “new strains of MRSA were 14% less likely to show up in households where people frequently washed their hands,” the study suggested.

Study: Number of deaths during mass shootings may be lower if large-capacity gun magazines are banned

Reuters (11/26, Crist) reports that “a ban on gun magazines that hold a large number of bullets could lower the number of deaths during mass shootings in the U.S.,” according to a recent study. The study found “the average number of deaths was 12 in shootings involving large-capacity magazines, compared to an average of 7 deaths per shooting without large-capacity magazines.” The research also indicated that “high-fatality mass shootings were twice as likely to happen in states where high-capacity magazines weren’t banned.” The study was published in the American Journal of Public Health.

Researchers find vitamin E acetate in newer vaping products and those used by people with vaping-related lung injuries but not in older products

USA Today (11/26, Alltucker) reports researchers at the Minnesota Department of Health analyzed vaping products containing THC that were seized by law enforcement and found that all of those that were seized this year contained vitamin E acetate, while none of those seized last year contained the chemical. The researchers also analyzed products “from people with vaping-related lung injuries,” and found vitamin E acetate “in samples provided by 11 of 12” patients with vaping-related lung injuries.

The AP (11/26, Stobbe) reports the findings offer “more evidence” that vitamin E acetate “is a culprit in a national outbreak of vaping illnesses.” Dr. Ruth Lynfield, a Minnesota state health official, said, “The findings further support a potential role for vitamin E acetate in causing lung injury associated with vaping products.”

STAT (11/26, Thielking) reports the study was published in the CDC’s Morbidity and Mortality Weekly Report and the results might offer an explanation of why the vaping-related illnesses “appeared seemingly suddenly this year.”

Fertility rate continued four-year decline, reaching record low in 2018, CDC data show

The New York Times (11/27, Tavernise) reports that the rate of births dropped again in 2018 for the fourth consecutive year, according to new data from the National Center for Health Statistics, “extending a lengthy decline as women wait until they are older to have children.” In addition, “there were 59.1 births for every 1,000 women of childbearing age in the country last year, a record low.” The rate was down 2% from 2017, and “has fallen by about 15 percent since 2007.”

NBC News (11/27, Edwards) reports that the data also indicated a downward trend for babies being born to smoking mothers, with 6.5% of the women who gave birth in 2018 reporting having used “a tobacco product, a 6 percent decline from 2017.”

U.S. News & World Report (11/27, Galvin) reports the “data also indicates that, among other measures, a greater share of women started prenatal care early in pregnancy and gave birth vaginally in 2018 – even as disparities persisted for many birth-related outcomes.”