HEALINE

Weekly Summary -- April 12, 2019

Friday, Apr. 12, 2019 (Pharmacist's Briefing) -- Here are what Pharmacist's Briefing editors consider the most important developments for the week of April 12, 2019

Hospital Privacy Curtains Could Be Breeding Ground for Germs

FRIDAY, April 12, 2019 (Pharmacist's Briefing) -- Privacy curtains in hospital rooms might offer patients some personal dignity, but they can also harbor dangerous, drug-resistant bacteria.

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Could Treating Gut Bacteria Help Ease Autism Symptoms?

FRIDAY, April 12, 2019 (Pharmacist's Briefing) -- Scientists suspect that your gut microbiome -- the mix of bacteria that inhabit your intestines -- affects your health in many ways, but a surprising new finding suggests that a healthy microbiome may even ease the symptoms of autism.

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Caregiving May Not Be as Taxing to Your Health as Feared

FRIDAY, April 12, 2019 (Pharmacist's Briefing) -- Being a family caregiver may not be as hazardous to your health as most people think, researchers say.

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Chemo Drug Shortages Have Little Effect on Cancer Care: Study

THURSDAY, April 11, 2019 (Pharmacist's Briefing) -- Cancer drug shortages don't appear to have a significant impact on chemotherapy treatment in the United States, according to a new study.

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Many Misdiagnosed With MS

THURSDAY, April 11, 2019 (Pharmacist's Briefing) -- Almost one in five multiple sclerosis patients may be misdiagnosed with the autoimmune disease, according to a new study.

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Many Cancer Patients Take Alternative Meds But Don't Tell Their Doctors

THURSDAY, April 11, 2019 (Pharmacist's Briefing) -- One out of every three U.S. cancer patients uses alternative or complementary therapies, but many keep that info from their doctors, a new study finds.

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Sunscreen's Secret Bonus: It Could Help Keep You Cool

THURSDAY, April 11, 2019 (Pharmacist's Briefing) -- Sunscreen may do double duty when you're outside on a summer day, keeping you cool as it protects your skin from the sun's harmful rays.

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Could Very Low 'Bad' Cholesterol Bring Stroke Danger?

WEDNESDAY, April 10, 2019 (Pharmacist's Briefing) -- Despite years of being told that the lower your LDL cholesterol the better, is it possible that levels that are too low might harm you?

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More Alzheimer's Drug Trial Failures: Are Researchers on the Wrong Track?

WEDNESDAY, April 10, 2019 (Pharmacist's Briefing) -- Amyloid beta has long been a prime suspect in Alzheimer's disease, since abnormal levels of the protein form disruptive plaques between patients' brain cells.

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Herbals in Pregnancy May Endanger Mom, Baby

WEDNESDAY, April 10, 2019 (Pharmacist's Briefing) -- During pregnancy, even harmless-sounding "natural" supplements should be avoided, a new research review suggests.

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New 'Cancer Vaccine' Attacks Tumors From Within

TUESDAY, April 9, 2019 (Pharmacist's Briefing) -- A new method of brewing a cancer vaccine inside a patient's tumor could harness the power of the immune system to destroy the disease, researchers report.

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Nurse Practitioners Often Restricted From Prescribing Opioid Treatments

TUESDAY, April 9, 2019 (Pharmacist's Briefing) -- In a finding that suggests that not all weapons are being deployed in the opioid war, new research shows that nurse practitioners often face tough restrictions for prescribing a medication that treats opioid addiction.

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Pros, Cons to Multiple Meds for Nursing Home Residents

TUESDAY, April 9, 2019 (Pharmacist's Briefing) -- There's an upside and a downside to prescribing nursing home residents a long list of medicines, new research confirms.

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Those Whitening Strips May Damage Your Teeth

TUESDAY, April 9, 2019 (Pharmacist's Briefing) -- Having a pearly white smile may come with a significant cost -- the health of your teeth.

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Insurers' Denials of Opioid Coverage Spurs CDC to Clarify Guidelines

TUESDAY, April 9, 2019 (Pharmacist's Briefing) -- People with severe pain from cancer or sickle cell anemia should not be denied coverage for opioid painkillers, a new clarification on federal guidelines states.

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Dietary Supplements Do Nothing for You: Study

MONDAY, April 8, 2019 (Pharmacist's Briefing) -- If you're popping dietary supplements in the hope of living longer, a large new study suggests you'd be better off investing that money in nutritious foods.

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More Evidence HPV Vaccine Cuts Cervical Cancer Rate

MONDAY, April 8, 2019 (Pharmacist's Briefing) -- Scotland is already seeing a payoff for vaccinating adolescent girls for human papillomavirus (HPV).

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For One Man, Too Much Vitamin D Was Disastrous

MONDAY, April 8, 2019 (Pharmacist's Briefing) -- Vitamin D is the healthy "sunshine" vitamin, but it can have a dark side, one Canadian man discovered.

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Morbidity Low With Focal Laser Ablation of Prostate Cancer

FRIDAY, April 12, 2019 (Pharmacist's Briefing) -- Focal laser ablation (FLA) of low- to intermediate-risk prostate cancer is associated with low morbidity and good oncologic outcomes, according to a study published in the March issue of the Journal of Vascular and Interventional Radiology.

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Prevalence of Extragenital STDs High in Men Who Have Sex With Men

FRIDAY, April 12, 2019 (Pharmacist's Briefing) -- Extragenital (rectal and pharyngeal) chlamydia and gonorrhea are prevalent among men who have sex with men (MSM), according to research published in the April 12 issue of the U.S. Centers for Disease Control and Prevention Morbidity and Mortality Weekly Report.

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Fibrosis, Steatosis of the Liver Observed in Some Young Adults

FRIDAY, April 12, 2019 (Pharmacist's Briefing) -- A considerable proportion of young adults have fibrosis and steatosis of the liver, according to a study presented at The International Liver Congress 2019, held from April 10 to 19 in Vienna.

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Pruritus Prevalent and Disruptive in Nondialysis Chronic Kidney Disease

FRIDAY, April 12, 2019 (Pharmacist's Briefing) -- Almost one in four patients with nondialysis chronic kidney disease (CKD) has moderate-to-extreme pruritus, which is associated with poorer quality of life, according to a study published online April 11 in the Clinical Journal of the American Society of Nephrology.

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Inflammatory Arthritis Linked to Sexual Dysfunction

THURSDAY, April 11, 2019 (Pharmacist's Briefing) -- Sexual dysfunction appears to be highly prevalent in both men and women with inflammatory arthritis (IA), according to a review published online April 3 in Arthritis Care & Research.

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Four Million New Peds Asthma Cases Attributed to NO2 Annually

THURSDAY, April 11, 2019 (Pharmacist's Briefing) -- An estimated 4.0 million new pediatric asthma cases could be attributed to ambient nitrogen dioxide (NO2) pollution annually, according to a study published online April 10 in The Lancet Planetary Health.

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Nonalcoholic Fatty Liver Disease Burden Up Among HIV-Infected

THURSDAY, April 11, 2019 (Pharmacist's Briefing) -- Nonalcoholic fatty liver disease (NAFLD) is becoming an increasingly important cause of liver disease (LD) and liver mortality among patients with HIV, according to a study presented at The International Liver Congress 2019, held from April 10 to 19 in Vienna.

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Cytomegalovirus Linked to Faster Progression of Cystic Fibrosis

THURSDAY, April 11, 2019 (Pharmacist's Briefing) -- For patients with cystic fibrosis (CF), cytomegalovirus (CMV) is associated with faster disease progression, according to a research letter published online April 7 in the European Respiratory Journal.

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Same Services More Expensive in Outpatient Than Office Settings

WEDNESDAY, April 10, 2019 (Pharmacist's Briefing) -- The same services are more expensive when performed in outpatient versus office settings, according to a blog post from the Health Care Cost Institute.

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Many NPs Unable to Prescribe Meds to Treat Opioid Addiction

TUESDAY, April 9, 2019 (Pharmacist's Briefing) -- Greater practice restrictions are associated with a lower percentage of nurse practitioners (NPs) with waivers to prescribe buprenorphine, but no association is seen for physician assistants (PAs), according to a study published in the April 9 issue of the Journal of the American Medical Association.

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Continued Smoking Among Cancer Patients Ups Costs by $3.4B

TUESDAY, April 9, 2019 (Pharmacist's Briefing) -- Continued smoking among patients with cancer and the associated increase in attributable first-line cancer treatment failure is tied to significant incremental costs for subsequent cancer treatments, according to a study published online April 5 in JAMA Network Open.

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New, Revised Topics Released in ACR Appropriateness Criteria

TUESDAY, April 9, 2019 (Pharmacist's Briefing) -- The latest edition of the American College of Radiology (ACR) Appropriateness Criteria has been released and includes 188 diagnostic imaging and interventional radiology topics, with 908 clinical variants covering more than 1,670 clinical scenarios.

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Older Patients With Crohn Disease May Benefit From Early Combo Tx

MONDAY, April 8, 2019 (Pharmacist's Briefing) -- A post hoc analysis of data from a randomized trial shows no difference between older and younger patients for the safety and efficacy of early combined immunosuppression therapy compared with conventional management for Crohn disease, according to a study published online March 19 in Alimentary Pharmacology and Therapeutics.

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Guidance Statements Issued for Breast Cancer Screening

MONDAY, April 8, 2019 (Pharmacist's Briefing) -- Four evidence-based guidance statements on breast cancer screening have been developed by the American College of Physicians and published online April 9 in the Annals of Internal Medicine.

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Model Can Predict Sepsis Risk for Emergency Medical Admissions

MONDAY, April 8, 2019 (Pharmacist's Briefing) -- A computer-aided National Early Warning Score (cNEWS) model accurately predicts sepsis for emergency medical admissions, according to a study published online April 8 in CMAJ, the journal of the Canadian Medical Association.

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Seniors Less Likely to Receive or Have Timely PCI for Acute MI

MONDAY, April 8, 2019 (Pharmacist's Briefing) -- Seniors with acute myocardial infarction (AMI) are less likely to undergo percutaneous coronary intervention (PCI) or receive PCI in a timely manner, according to a study presented at the American Heart Association Quality of Care and Outcomes Research 2019 Scientific Sessions, held from April 5 to 6 in Arlington, Virginia.

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In Pregnancy, Buprenorphine Use Up, Methadone Use Down

FRIDAY, April 12, 2019 (Pharmacist's Briefing) -- From 2009 to 2015, the prevalence of methadone use decreased and buprenorphine use increased among Medicaid-enrolled pregnant women with opioid use disorder, and the 4Ps Plus and Substance Use Risk Profile-Pregnancy (SURP-P) scale are sensitive for identifying illicit drug use, according to two studies published online April 5 in Obstetrics & Gynecology.

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Colchicine May Improve Obesity-Induced Inflammation

FRIDAY, April 12, 2019 (Pharmacist's Briefing) -- Colchicine is safe and effective at improving obesity-associated inflammatory measures among adults with obesity and metabolic syndrome (MetS) without diabetes, according to a pilot study published online March 14 in Diabetes, Obesity and Metabolism.

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Stress-Related Disorders Associated With Increased CVD Risk

THURSDAY, April 11, 2019 (Pharmacist's Briefing) -- Stress-related disorders are associated with cardiovascular disease, according to a study published online April 10 in The BMJ.

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Very Low LDL-C, Triglycerides Tied to Hemorrhagic Stroke Risk in Women

THURSDAY, April 11, 2019 (Pharmacist's Briefing) -- Women with very low low-density lipoprotein cholesterol (LDL-C) or low triglycerides have an increased risk for hemorrhagic stroke, according to a study published online April 10 in Neurology.

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Peripheral Nerve Block May Cut Opioid Use After Amputation

WEDNESDAY, April 10, 2019 (Pharmacist's Briefing) -- Peripheral nerve blockade with regular local anesthetic and liposomal bupivacaine is associated with lower oral morphine equivalent (OME) use at 72 hours after major lower extremity amputation (MLEA), according to a study being presented at the Annual Regional Anesthesiology and Acute Pain Medicine Meeting, held from April 11 to 13 in Las Vegas.

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STI Incidence Up After Receipt of HIV Preexposure Prophylaxis

WEDNESDAY, April 10, 2019 (Pharmacist's Briefing) -- For gay and bisexual men, receipt of HIV preexposure prophylaxis (PrEP) is associated with an increase in sexually transmitted infections (STIs), according to a study published in the April 9 issue of the Journal of the American Medical Association.

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Functional Impairment in Middle Age Linked to Adverse Outcomes

TUESDAY, April 9, 2019 (Pharmacist's Briefing) -- Functional impairment in middle age is associated with an increased risk for hospitalization and nursing home admission, according to a study published online April 8 in JAMA Internal Medicine.

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High Response Seen for All Hep C Tx Models in Injection Drug Users

TUESDAY, April 9, 2019 (Pharmacist's Briefing) -- For people with hepatitis C virus (HCV) who inject drugs (PWID) and receive opioid agonist therapy (OAT), receipt of HCV treatment is associated with high sustained virologic response (SVR), according to a study published online April 9 in the Annals of Internal Medicine.

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Chloroprocaine Offers Adequate Anesthesia for Knee Arthroscopy

TUESDAY, April 9, 2019 (Pharmacist's Briefing) -- Chloroprocaine results in adequate anesthesia with quick recovery of sensory/motor functions for knee arthroscopy in the ambulatory setting, according to a study presented at the Annual Regional Anesthesiology and Acute Pain Medicine Meeting, held from April 11 to 13 in Las Vegas.

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Dietary Supplement Use Not Linked to Mortality Benefits

TUESDAY, April 9, 2019 (Pharmacist's Briefing) -- For U.S. adults, dietary supplements are not associated with mortality benefits, according to a study published online April 9 in the Annals of Internal Medicine.

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More Secondary Prevention Meds May Reduce Deaths After AMI

TUESDAY, April 9, 2019 (Pharmacist's Briefing) -- For older nursing home residents, use of three or four secondary preventive medications following acute myocardial infarction (AMI) is associated with reduced mortality, according to a study published in the April issue of Circulation: Cardiovascular Quality and Outcomes.

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Early T2DM Diagnosis Linked to Increased Cardiovascular Risk

MONDAY, April 8, 2019 (Pharmacist's Briefing) -- The cardiovascular risks associated with type 2 diabetes mellitus (T2DM) are greater for patients diagnosed before age 40 years, according to a study published online April 8 in Circulation.

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Preventive Drugs Often Used in Last Year of a Cancer Patient's Life

MONDAY, April 8, 2019 (Pharmacist's Briefing) -- Preventive drugs are frequently used in the last year of life among older adults with cancer, according to a study published online March 25 in Cancer.

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CDC Clarifies Guideline on Opioid Prescribing for Chronic Pain

FRIDAY, April 12, 2019 (Pharmacist's Briefing) -- The U.S. Centers for Disease Control and Prevention has clarified that the new guideline on prescribing opioids for chronic pain is not meant to limit access to appropriate pain management, according to a letter issued to the American Society of Clinical Oncology, the American Society of Hematology, and the National Comprehensive Cancer Network.

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Complementary, Alternative Medicine Use High in Cancer Patients

FRIDAY, April 12, 2019 (Pharmacist's Briefing) -- One-third of patients with cancer and cancer survivors report using complementary and alternative medicine (CAM), and many do not disclose use to physicians, according to a research letter published online April 11 in JAMA Oncology.

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Drug Shortages

Updated: April 11, 2019

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FDA: Patients Should Not Abruptly Stop Taking a Prescribed Opioid

WEDNESDAY, April 10, 2019 (Pharmacist's Briefing) -- Because of the danger of "serious harm" to patients, the U.S. Food and Drug Administration is advising doctors not to suddenly stop patients from taking opioid painkillers, or drastically lower the dose.

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CDC: Measles Cases Reach 465 This Year in the United States

WEDNESDAY, April 10, 2019 (Pharmacist's Briefing) -- The number of reported measles cases in the United States hit 465 as of April 4, the U.S. Centers for Disease Control and Prevention said. That is 78 more than in the previous week's update, CNN reported.

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Verubecestat, Atabecestat Not Beneficial for Preventing Alzheimer Disease

WEDNESDAY, April 10, 2019 (Pharmacist's Briefing) -- Use of the orally administered β-site amyloid precursor protein-cleaving enzyme 1 inhibitors, verubecestat and atabecestat, does not prevent clinical progression to Alzheimer disease, according to two studies published in the April 11 issue of the New England Journal of Medicine.

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Review Links Adverse Events to Use of Herbal Meds in Pregnancy

WEDNESDAY, April 10, 2019 (Pharmacist's Briefing) -- The use of herbal medicinal products during pregnancy and the postnatal period is associated with increased risk of adverse events, according to a review published online April 9 in Obstetrics & Gynecology.

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FDA Approves Osteoporosis Treatment for High-Risk Postmenopausal Women

TUESDAY, April 9, 2019 (Pharmacist's Briefing) -- Evenity (romosozumab-aqqg) was approved for the treatment of osteoporosis in postmenopausal women with a high risk for fracture, the U.S. Food and Drug Administration announced.

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Cardiovascular Mortality Lower With Medicaid Expansion

TUESDAY, April 9, 2019 (Pharmacist's Briefing) -- Cardiovascular mortality rates among middle-aged adults are lower in counties in states that expanded Medicaid, according to a study presented at the American Heart Association Quality of Care and Outcomes Research 2019 Scientific Sessions, held from April 5 to 6 in Arlington, Virginia.

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First Two-Drug Regimen Approved for HIV-1 Treatment

TUESDAY, April 9, 2019 (Pharmacist's Briefing) -- The U.S. Food and Drug Administration has announced the approval of Dovato (dolutegravir and lamivudine), the first approved two-drug, fixed-dose, complete regimen for adults with HIV-1 who have not been previously treated with antiretroviral medication.

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Drug Recalls

Updated: April 9, 2019

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FDA Warns Against Use of Preowned or Unauthorized Test Strips

MONDAY, April 8, 2019 (Pharmacist's Briefing) -- The U.S. Food and Drug Administration is warning patients not to use preowned test strips or test strips not authorized for sale in the United States because of possible infection or inaccurate results that could cause serious harm.

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Draft Recommendation Promotes Screening Women for Anxiety

MONDAY, April 8, 2019 (Pharmacist's Briefing) -- Adolescent and adult women, including those who are pregnant and postpartum, should be assessed for anxiety as a routine preventive health service, according to a draft recommendation statement published online April 1 by the Women's Preventive Services Initiative (WPSI).

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Telemedicine Leads to More Antibiotic Rx for Pediatric Respiratory Infection

MONDAY, April 8, 2019 (Pharmacist's Briefing) -- For children with acute respiratory infections (ARIs), antibiotic prescribing is higher and guideline-concordant antibiotic management is lower with direct-to-consumer (DTC) telemedicine visits compared with other settings, according to a study published online April 8 in Pediatrics.

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