IL-6 Blocker Wins in Vasculitis

https://goo.gl/8WBTZb

Among a cohort of 251 patients with biopsy or imaging-confirmed giant-cell arteritis who underwent a 26-week prednisone taper, 56% of those who received subcutaneous tocilizumab once weekly were in sustained remission at week 52, as were 53% of those who were given the interleukin-6 receptor alpha inhibitor every other week, according to John H. Stone, MD, of Massachusetts General Hospital in Boston, and colleagues.

In contrast, only 14% of patients given placebo with a 26-week prednisone taper had sustained remission after 1 year, as did 18% of those given placebo with a 52-week prednisone taper (P<0.001 for both tocilizumab groups versus placebo), the researchers reported in the New England Journal of Medicine.

However, longer-term follow-up is needed to more fully assess the safety of tocilizumab.


Lower Readmissions Not Linked to Post-Discharge Mortality Risk

https://goo.gl/oNMh8R

A review of more than six million hospitalizations shows no linkage between reduced 30-day readmissions and increased post-discharge mortality, according to a new study in JAMA.

Yale New Haven Health researchers, led by Kumar Dharmarajan, MD, wanted to see if the Affordable Care Act's Hospital Readmissions Reduction Program had the unintended consequence of increasing mortality rates. Researchers and advocacy groups have raised concerns that hospitals might not readmit patients out of fear of financial penalties associated with HRRP, thus increasing post-discharge mortality.

Those concerns, apparently, are unfounded, the study showed.


Nursing Facilities, Staffing, July 2017 Residents and Facility Deficiencies, 2009 Through 2015

https://goo.gl/xkFLGx

Nursing facilities are one part of the long-term care delivery system that also includes home and community based services, but their relatively high cost has led them to be the focus of much attention from policymakers. Medicaid plays a major role in financing nursing facility care in the United States, and recent policy proposals to limit federal financing for Medicaid may lead to cuts in eligibility or scope of coverage for long-term care services. In addition, new regulations, effective November 2016, aim to address longstanding challenges in quality and safety in nursing facilities. 

As the demand for long term care continues to increase and new policy proposals and regulations unfold, the characteristics, capacity, and care quality of facilities remain subjects of concern among consumers and policy makers. This report provides information on recent trends in nursing facilities in the United States, drawing on data from the federal On-line Survey, Certification, and Reporting system (OSCAR) and Certification and Survey Provider Enhanced Reports (CASPER), to provide information on nursing facility characteristics, resident characteristics, facility staffing, and deficiencies by state from 2009 through 2015. 

Additional detail on the survey and methods underlying the data in this report are provided in the Appendix at the end of the report. This information enables policymakers and the public to monitor and understand recent changes in nursing facility care in the United States and helps highlight areas of ongoing concern for ongoing policymaking


'Just What We Dreamed.' New Vertex Drugs Show Dramatic Benefit Against Cystic Fibrosis

https://goo.gl/8RmHVF

Three different three-drug regimens all provided dramatic results against cystic fibrosis, a fatal disease of the lungs and digestive system that afflicts 75,000 people worldwide. The results are a step forward both for the drugs’ maker, Vertex Pharmaceuticals of Boston, Mass., and a long-awaited victory in the quest to use genes to develop new drugs.

“This is just what we dreamed would someday happen,” says Francis Collins, the director of the National Institutes of Health, who led the discovery of the cystic fibrosis gene two decades ago. “This is a remarkably happy moment to see how far this has come and how incredibly encouraging this news is.”


A toddler's brain damage has been reversed over a year after near drowning

https://goo.gl/wc9q6y

Physicians used a series of oxygen treatments, like hyperbaric oxygen therapy, to significantly reverse the 2-year-old's brain damage after she was in the water for 15 minutes.

To "wake up" her brain, doctors gave Carlson oxygen at a pressure higher than the general atmospheric pressure — increasing the amount of oxygen in her blood and repairing her damaged tissue in a sealed, pressurized hyperbaric chamber.

"The startling regrowth of tissue in this case occurred because we were able to intervene early in a growing child, before long-term tissue degeneration," hyperbaric specialist Paul Harch from LSU Health New Orleans said in the case report published by Medical Gas Research.


Don’t EVER Use Turmeric If You’re On Any of The Following Medications

https://goo.gl/FKtSV2

It’s a well-known fact that turmeric is one of the most effective health-boosting substances available today. Its active ingredient, curcumin, is a natural compound with anti-inflammatory, antioxidant, as well as heart disease-and-cancer-fighting properties (123).

Other studies have indicated that taking medicinal doses of turmeric may even protect your brain. This is because turmeric boosts Brain-Derived Neurotrophic Factor (BDNF), a growth hormone that prevents depression, Alzheimer’s disease, and dementia (45).

Compared to other pharmaceutical treatments, turmeric has a generally low risk of adverse effects (6). It almost sounds too good to be true. So is it?  Can you take turmeric with medications?


Large Study Confirms Elevated Risk of Diabetes When Prescribed Antipsychotics

https://goo.gl/g9q6JW

A large longitudinal cohort study out of Denmark, recently published in the American Journal of Psychiatry, corroborates previous evidence that antipsychotics increase the risk of developing diabetes in people diagnosed with schizophrenia.

Numerous medications have been associated with elevated risk of diabetes. Antidepressants, for example, are understood to reduce pancreatic insulin secretion, which is believed to increase the risk of developing diabetes. This elevated risk has also been demonstrated in children and youth exposed to antipsychotics.

The authors of the present study point out that the prevalence of diabetes mellitus is 4-5 times higher in people diagnosed with schizophrenia. Similar to the theory surrounding antidepressants, it is believed that impaired glucose tolerance and increased insulin resistance can explain some of the elevated rates of diabetes within individuals diagnosed with schizophrenia who are prescribed antipsychotics. Moreover, abnormal glucose tolerance has been shown to be more prevalent among individuals diagnosed with schizophrenia than those without.


Implementing MTM for COPD

https://goo.gl/W5HDDH

Chronic obstructive pulmonary disease (COPD) is a preventable disease in which persistent respiratory symptoms and airflow limitations worsen with time. COPD is the fourth leading cause of death in the world. The treatment of COPD includes various inhaled therapies as well as preventive measures, such as smoking cessation and immunizations. Patient education is crucial to the management of COPD. Medication therapy management (MTM) can play a role in helping patients learn how to manage COPD and decrease complications. Successful MTM interventions can improve patient care and provide a positive impact on the star measures of both pharmacies and healthcare plans.

Medication therapy management (MTM) services have demonstrated impact in a number of areas, including cardiovascular diseases, mental health, and transitions of care.1 MTM services are defined as a service or group of services that optimize therapeutic outcomes for individual patient and include activities such as immunizations, disease state coaching, and medication therapy reviews.2 The purpose of this article is to provide the pharmacist with a brief overview of chronic obstructive pulmonary disease (COPD) and identify areas within an MTM encounter the community pharmacist can capitalize on to improve management of this disease state.


How Telehealth Platforms Will Reshape U.S. Healthcare Delivery

https://goo.gl/vFW0F2

Telehealth in the United States is entering a new phase of accelerating growth. Indicators of this next phase include: FDA approval of remote diagnostic tools; the rapid evolution of telehealth platforms focused on managing chronic conditions as well as achieving specific patient outcomes; the expansion of telehealth services offered by private and government operated healthcare systems (such as the Veterans Administration); and a new direct-to-consumer initiative by Samsung and American Well.

However, the telehealth industry is still young. In many ways, today’s telehealth industry is comparable to the Internet services industry, when the reigning speed of Internet access was 56.6 kbps. As far higher broadband speeds became the norm, entire industries were upended. Similarly, as the telehealth industry matures, healthcare delivery across our nation will experience disruptive shifts.

This article explores how telehealth will change the delivery of healthcare in the United States, and its impact on the organization of many activities now provided by local hospitals and health systems throughout the nation.


Elderly Dehydration: Prevention & Treatment

https://goo.gl/Bk10nQ

Watching for signs of illness in a loved one can be challenging. Some illnesses show up quite clearly, while others have a more subtle effect on daily living. Dehydration, depending on the severity, sometimes creates only small telltale signs while having a big effect on the body, especially in the elderly.

Dehydration occurs when a person loses more water than they take in. Adequate fluid allows the body to regulate temperature through sweating, maintain blood pressure and eliminate bodily waste. If severe enough, dehydration can lead to confusion, weakness, urinary tract infectionspneumoniabedsores in bed-ridden patients or even death. Generally speaking, humans can't survive more than four days without water.

CAUSES OF SENIOR DEHYDRATION

Elderly dehydration is especially common for a number of reasons:

  • Medications
    It's not uncommon for seniors to be on several medications at any given time. Some of these may be diuretic, while others may cause patients to sweat more.
  • Decreased Thirst
    A person's sense of thirst becomes less acute as they age. In addition, frail seniors may have a harder time getting up to get a drink when they're thirsty, or they may rely on caregivers who can't sense that they need fluids.
  • Decreased Kidney Function
    As we age our bodies lose kidney function and are less able to conserve fluid (this is progressive from around the age of 50, but becomes more acute and noticeable over the age of 70). 
  • Illness
    Vomiting and/or diarrhea can quickly cause elderly dehydration.