A report by the National Academies of Sciences, Engineering, and Medicine recommends enhanced methods of screening, treatment and prevention to help eliminate hepatitis B and C as a public health concern in the US by the year 2030 and save almost 90,000 lives. The report says a coordinated federal effort is needed, such as expansion of needle exchanges, free access to the hepatitis B vaccine and unrestricted treatment for patients with hepatitis C.
A US Preventive Services Task Force statement in the Journal of the American Medical Association found insufficient evidence to recommend or not recommend universal celiac disease screening for asymptomatic individuals. The statement should prompt researchers to provide data to better identify patients who should undergo screening and treatment for celiac disease, according to an accompanying editorial.
Researchers found an 89.2% reduction in waiting times for diabetic retinopathy screening -- from 158 days to 17 days -- after implementing telemedicine screening. The findings in JAMA Internal Medicine, based on 21,222 patients who underwent screening in 15 primary care clinics across Los Angeles County, Calif., revealed that annual screening rates for diabetic retinopathy also increased in a subset of clinics from 40.6% to 56.9% after the intervention.
A study in Diabetes Care showed that patients with type 2 diabetes and preserved renal function experienced renal metabolism changes that may be beneficial for long-term kidney function following treatment with SGLT2 inhibitor empagliflozin, while those without diabetes had similar, but smaller changes. Italian researchers used a cohort of 66 diabetes patients and 25 healthy adults with normal glucose tolerance or prediabetes and found an increase in fractional glucose excretion in the fasted and fed states over a range of body mass index and creatinine clearance rates after 28 days of chronic therapy.
Overweight or obese type 2 diabetes patients who engaged in light walking or light exercise had an improved fat-burning capacity and blood lipid profiles that were less inflammatory and had a greater capacity to fight inflammation, compared with patients who were sedentary, according to a study in The Journal of Clinical Endocrinology and Metabolism. Australian researchers evaluated the blood lipid profiles of 21 individuals and recommended "interrupting sitting every 30 minutes with a few minutes of light intensity activity, in addition to regularly taking part in a structured exercise program."
A study in Obesity Reviews showed that there are 79 rare genetic syndromes tied to obesity. Canadian researchers reviewed 161 scientific papers and found that 19 of the 79 syndromes identified had the genetics worked out completely, while 27 had been mapped to a chromosomal region, 11 had been partially clarified and 22 lacked identification of specific genes or chromosomal locations.
House Republicans, including members of the conservative Freedom Caucus who blocked progress of the American Health Care Act last week, said Tuesday they will continue working to unravel and replace portions of the Affordable Care Act. House Speaker Paul Ryan, R-Wis., also said Congress must take immediate action to stabilize markets because insurers must soon develop plans for 2018.
Reps. Greg Walden, R-Ore. and Tom Cole, R-Okla., this week said Congress must find a way to continue cost-sharing subsidies for plans sold under the Affordable Care Act, or market instability would become untenable. Insurers have expressed concern about continued uncertainty regarding the funds, now that Republicans who challenged the subsidies in court are in a position to eliminate them.
A study in Annals of Emergency Medicine found that costs at freestanding emergency departments in Texas are on average close to 10 times higher than costs for the same services at urgent care centers, but costs at hospital-based EDs were still higher. Use of freestanding EDs grew 236% between 2012 and 2015, while utilization of hospital EDs grew 10% and urgent care utilization grew 24%.
A CMS proposal would give insurers until June or July to file rate requests for the 2018 plan year, but that's not much time, given the uncertainty that remains after the American Health Care Act failed to gain adequate support to win a vote in the House last week. A lawsuit challenging cost-sharing reduction payments is one point of serious concern, but questions about enforcement of other provisions including the mandate to purchase health insurance are also complicating planning for next year.
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