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  • July 18, 2016 9:13 AM | Deleted user

    A new study led by Assistant Medical Professor Philip Smith of The City College of New York's Sophie Davis Biomedical Education/CUNY School of Medicine, and conducted in collaboration with researchers at Yale University and Yeshiva University, found important differences between women and men in their ability to quit smoking when taking medications commonly prescribed to help smokers quit.

    The study, "Sex Differences in Smoking Cessation Pharmacotherapy Comparative Efficacy: A Network Meta-analysis," which reviewed and analyzed evidence from over 14,000 cigarette smokers participating in 28 clinical trials for nicotine patch, varenicline and bupropion, found that across the trials women who were given varenicline were much more likely to quit smoking than women who were given nicotine patch or bupropion. By contrast, among men there were no differences in the likelihood of successfully quitting smoking when given varenicline, bupropion or nicotine patch.

    While the study found that all three medications helped both women and men quit when compared to placebo, the difference was in the relative benefit of the three medications. Clinical trial data consistently show that taking medications can help smokers quit. Some may help more than others, and for women the best choice may be varenicline.

    "Before our study, research had shown that among the choices for medications for smokers who wanted to quit, varenicline was the clear winner when it came to promoting quitting," said Smith. "Our study shows this is clearly the case for women. The story seems less clear among men, who showed less of a difference when taking any of the three medications."

    Roughly one in six adults in the United States smokes cigarettes, which contributes to over 550,000 deaths per year in the U.S. Currently, three types of medications approved by the U.S. Food and Drug Administration can be prescribed to help smokers quit: nicotine replacement therapies, which include the nicotine patch and nicotine gum; varenicline, which is manufactured by Pfizer and sold as Chantix in the United States; and bupropion, which is manufactured by GlaxoSmithKline and sold as Wellbutrin or Zyban.

    The study appears in the journal Nicotine & Tobacco Research.

    Story Source: The above post is reprinted from materials provided by City College of New York. Note: Materials may be edited for content and length.

    Journal Reference:

    Sherry A. McKee, Philip H. Smith, Mira Kaufman, Carolyn M. Mazure, Andrea H. Weinberger. Sex Differences in Varenicline Efficacy for Smoking Cessation: A Meta-Analysis. Nicotine & Tobacco Research, 2016; 18 (5): 1002 DOI: 10.1093/ntr/ntv207

    City College of New York. "Study finds differing treatment options for women smokers." ScienceDaily. ScienceDaily, 13 July 2016. <www.sciencedaily.com/releases/2016/07/160713105742.htm>.


  • July 18, 2016 8:52 AM | Deleted user

    AAPA

    In a landmark partnership, the Centers for Disease Control and Prevention and AAPA will present a free webinar on Zika and pregnancy on July 28 from 2-3 p.m. EDT. The presentation qualifies as Category 1 CME.

    The World Health Organization declared Zika virus a public health emergency of international concern after local transmission was reported in many other countries and territories. With the likelihood that the Zika virus will continue to spread to new international and domestic areas, this webinar is an opportunity for PAs to be prepared to handle Zika by knowing the facts. Pre-register (at no cost) and view the detailed agenda here

  • July 18, 2016 8:51 AM | Deleted user

    AAPA is looking for 10-15 PAs in various specialties who are willing to be interviewed and provide their thoughts and attitudes on the development of clinical apps that would be used via smartphones. The goal of the project is to learn what features and characteristics make medical apps effective and user-friendly for healthcare professionals and to gather information on using an "App Store" approach to enhancing electronic health records (EHR) functionality.

    Interviews will be conducted via phone by KLAS marketing research firm and will take no more than 15 minutes. During the interview you will also have an opportunity to provide ideas and suggest questions that will be part of a larger survey that will go out to PAs, physicians, advanced practice nurses in the future.

    The project is funded by a grant from the Office of the National Coordinator for Health Information Technology (ONC). ONC is the principal federal entity charged with coordination of nationwide efforts to implement and support the adoption of advanced health information technology within the healthcare arena.

    We would appreciate hearing from interested PAs by Friday, July 22.

    For additional information or to volunteer contact Michael Powe, AAPA's Vice President of Reimbursement & Professional Advocacy at michael@aapa.org.

  • July 18, 2016 8:50 AM | Deleted user

    July 13, 2016

    Over the past year, AAPA aggressively lobbied for PAs to be part of the solution to the nation’s opioid epidemic. As a result of our efforts, PAs will soon be eligible to become waivered to prescribe buprenorphine for the treatment of opioid addiction. On July 8, the U.S. House of Representatives overwhelmingly supported passage of the House-Senate Conference report to S524, the Comprehensive Addiction and Recovery Act (CARA) of 2016 and the U.S. Senate followed suit on July 13. The legislation amends federal law (the Drug Addiction Treatment Act of 2000 orDATA 2000) to permit PAs to become waivered to prescribe buprenorphine for the treatment of opioid addiction.  It will now be sent to the president for his expected signature.

    “As a PA with a background in addiction medicine and community health clinics, I am pleased Congress is bringing more resources to bear to tackle the opioid addiction crisis in this country," said AAPA President Josanne Pagel. “The inclusion of PAs in CARA is crucial to our ability to provide proven treatment options to more Americans suffering from addiction.”

    Although CARA was crafted in a bipartisan manner, funding was a contentious issue leading up to the bill’s passage and shaped many of the bill’s final provisions. This was because the Congressional Budget Office gave the bill a high cost estimate for the Medication-Assisted Treatment (MAT) Program, Section 303, of the bill. This unexpectedly high cost ultimately determined the conditions in which DATA 2000 was amended to permit PAs and nurse practitioners (NPs) to become waivered to prescribe buprenorphine for the treatment of opioid addiction. The final version of the Section 303 MAT Program:

    • Authorizes PAs and NPs to become waivered to prescribe buprenorphine in MAT for a five-year period, expiring in 2021;
    • Allows newly-waivered PAs, NPs, and physicians to prescribe buprenorphine to 30 patients, with the option to treat up to 100 patients after one year if certain conditions are met;
    • Requires PAs and NPs to obtain 24 hours in education related to the treatment of opioid addiction as a condition to be waivered; the law includes AAPA in the list of professional associations who may provide the educational requirements; additionally, the law provides the secretary of the Department of Health and Human Services (HHS) the flexibility to adjust the 24-hour educational requirement for clinicians with demonstrated experience in treating patients struggling with addiction;
    • Defers to state law regarding whether a PA or NP works with a physician through a supervisory or collaborative relationship; however, the legislation requires that a physician who supervises or collaborates with a PA or NP must also be waivered to prescribe buprenorphine to treat addiction; given the small number of waivered-physicians, particularly in rural and other medically underserved communities, AAPA is concerned this requirement will limit the number of PAs and NPs who will become waivered; fortunately, there is also a provision in the bill that provides flexibility to the HHS Secretary to review and remove the requirement.

    According to Tillie Fowler, AAPA’s senior vice president for advocacy and government relations, “Although Section 303 of CARA does not include all of AAPA’s policy recommendations; we believe it is a significant step forward in utilizing PAs to expand access to treatment for the millions of Americans who are struggling with opioid addiction. And AAPA will push to extend this authorization for PAs beyond its current 2021 expiration date.”

    In addition to MAT, CARA contains numerous programs and provisions designed to:

    • Support and provide grants for education, prevention, treatment, and recovery efforts to confront the opioid epidemic and assist individuals and communities suffering from addiction to opioids and heroin;
    • Provide grants to expand access to naloxone and prescription drug monitoring programs and to support veterans and law enforcement.

    Enactment of CARA is a significant win in AAPA’s continued efforts to ensure PAs have the ability to be part of the solution to the nation’s opioid epidemic. The Academy presented multiple statements and letters to Congress on the need to permit PAs to prescribe buprenorphine for the treatment of opioid addiction; extensively lobbied committee staff and members, as well as House and Senate leadership; and held joint lobbying visits with the American Association of Nurse Practitioners. AAPA will continue its work through the development of regulations to implement the MAT Program.

    - See more at: https://www.aapa.org/twocolumn.aspx?id=6442451389#sthash.Ev0XpXcU.hDmrNspU.dpuf


  • July 18, 2016 8:49 AM | Deleted user

    Medscape 


    Overall, adverse event rates are comparable between the two vaccines, although injection-site AEs are more common with the 9-valent human papillomavirus vaccine (9vHPV) (Gardasil 9, Merck & Co., Inc.) than with the quadrivalent HPV (qHPV) vaccine (Gardasil, Merck & Co., Inc.), and they increase with subsequent doses for both vaccines, a new analysis concludes. 


    Read more

  • July 18, 2016 8:48 AM | Deleted user

    Media Statement

    Embargoed until: Friday, July 15, 2016, 11 AM, EDT
    Contact: Media Relations,
    (404) 639-3286

    The New York City report of female-to-male sexual transmission of Zika virus infection is the first documented case of sexual transmission of Zika from a woman to her sex partner and adds to the growing body of knowledge about the sexual transmission of Zika. All previously reported cases of sexually transmitted Zika virus infection have been spread from men to their sex partners.

    CDC recommends that all pregnant women who have a sex partner who has traveled to or resides in an area with Zika use barrier methods every time they have sex or they should not have sex during the pregnancy. Although no cases of woman-to-woman Zika transmission have been reported, these recommendations now also apply to female sex partners of pregnant women.

    CDC is currently updating recommendations for sexually active people in which the couple is not pregnant or concerned about pregnancy and for people who want to reduce personal risk of Zika infection through sex.

    ###
    U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES


  • July 14, 2016 8:19 AM | Deleted user

    High energy sound waves could treat a potentially deadly complication that affects some twin pregnancies, says new research.

    The early-stage feasibility study involving sheep suggests High Intensity Focused Ultrasound - a technique already used for treating some cancers - could help a condition called Twin-Twin Transfusion Syndrome (TTTS). It was conducted by researchers from Imperial College London and the University of Cambridge, with technology being developed at The Institute of Cancer Research, London.

    Twin-Twin Transfusion Syndrome occurs in around one in seven identical twin pregnancies, and leads to one baby growing much larger than the other due to abnormal blood vessels in the placenta.

    Some identical twins share a placenta, which provides the babies with equal amounts of oxygen and nutrients, carried in the blood. However in TTTS the shared placenta contains abnormal blood vessels that cause more blood to flow to one baby, leaving the other deprived of oxygen and nutrients.

    This affects the twins' growth, and can result in complications such as premature birth, handicap or even death of one or both babies.

    Severe cases can be treated by using a laser to destroy the abnormal blood vessels, so that each baby has a separate supply of oxygen and nutrients.

    However, this involves making a small hole in the womb and carries a risk of infection or miscarriage, explained Dr Christoph Lees, senior author from the Department of Surgery and Cancer at Imperial: "Twin-Twin Transfusion Syndrome can have tragic consequences, and in severe cases results in one tiny twin, while the other is very large - and begins to squash its sibling in the womb. Unfortunately, the little baby often does very badly - and in some cases the condition results in the loss of both twins.

    Sound waves may hold potential to treat twin pregnancy complications

    Color Doppler and B-mode ultrasound imaging of placental vascular ablation. (A) Pretreatment color Doppler imaging of a placentome. (B) Posttreatment color Doppler imaging of the same placentome demonstrating no flow within the targeted vessel. (C) B-mode harmonic ultrasound imaging of hyperechoic region within the high-intensity focused ultrasound (HIFU) focal zone. Credit: Shaw et al. / Science Translational Medicine (2016)

    "Yet at the moment the only option we have for these serious cases - laser treatment - carries risk of premature birth or miscarriage. Furthermore, the laser can sometimes not reach some abnormal vessels deep in the placenta."

    In the new study, published in the journal Science Translational Medicine, the team showed that High Energy Focused Ultrasound (HIFU) can selectively target and destroy placental blood vessels - potentially enabling it to split the placenta in two without the need for an invasive procedure. The technique creates a beam of high energy sound waves that generate heat, and kill cells. It is already used to treat prostate cancer and fibroids.

    To establish whether the procedure could destroy placental blood vessels, the team used the technique on 11 anesthetised pregnant sheep - five had the HIFU procedure while six had a placebo procedure.

    Although the sheep did not carry twins, the blood vessels in the sheep placenta have a similar structure to blood vessels in the human placenta, enabling the researchers to assess whether the HIFU could separate the placenta in TTTS. Furthermore, the fetuses of sheep and humans are a similar size.

    The results showed the technique was successful, and could destroy blood vessels without damage to the fetus. The researchers used the HIFU probe against the wall of the uterus, through an incision in the abdomen - and carried out further experiments to show the procedure works through the skin.

    Dr Lees added: "Although this is very early-stage research, it shows the procedure can successfully destroy blood vessels in the placenta - and could potentially stop abnormal blood flow between twin babies. We now hope to continue developing this HIFU procedure, translate these findings to humans, and work towards human trials."

    The team added that because the non-invasive technique could potentially be performed at an earlier stage in the pregnancy, this could further reduce chance of complications. The laser procedure is usually performed at around five months into the pregnancy, once the womb is big enough to accommodate the laser being inserted. However, the current study suggests the procedure may work even earlier, at around three-four months into the pregnancy.

    More information: "Noninvasive high-intensity focused ultrasound treatment of twin-twin transfusion syndrome: A preliminary in vivo study," Science Translational Medicine,stm.sciencemag.org/lookup/doi/10.1126/scitranslmed.aaf2135 

    Provided by Imperial College London

    "Sound waves may hold potential to treat twin pregnancy complications" July 13, 2016 http://medicalxpress.com/news/2016-07-potential-twin-pregnancy-complications.html


  • July 14, 2016 7:32 AM | Deleted user

    The 20th Biennial International Perinatal Bereavement Conference is coming up this fall — September 28 – October 1st in Phoenix, Arizona — and its sponsor wants to help you get there. The Pregnancy Loss and Infant Death Alliance (PLIDA) will be awarding 24 scholarships to professional care providers, parent advocates, and researchers to attend the event.

    The conference focuses on care for families who have experienced a perinatal death, as well as research on related topics. This scholarship would be ideal for PAs who work or research in the fields of family practice, obstetrics, maternal fetal medicine, or neonatology.

    The scholarship will cover the cost of the conference, but applicants should note that all other expenses (e.g., food, travel, lodging) are not included. Any member of PLIDA who can show financial need is invited to apply.

    The deadline to apply is August 5. For more information, visit the conference website.


  • July 12, 2016 12:28 PM | Deleted user

    AAPA


    In a landmark partnership, the Centers for Disease Control and Prevention (CDC) and AAPA will present a free webinar on Zika and pregnancy on July 28 from 2-3 p.m. EDT. The presentation qualifies as Category 1 CME.

    The World Health Organization declared Zika virus a public health emergency of international concern after local transmission was reported in many other countries and territories. With the likelihood that the Zika virus will continue to spread to new international and domestic areas, this webinar is an opportunity for PAs to be prepared to handle Zika by knowing the facts.

    At the end of the webinar, you will be able to:

    • List the ways pregnant women become infected with the Zika virus;
    • Describe CDC recommendations for testing of pregnant women with possible exposure;
    • Describe CDC recommendations for testing of couples interested in conceiving who reside in an active Zika virus transmission area;
    • Describe the implications of Zika virus infection;
    • And identify the cases that meet criteria for inclusion in the U.S. Zika Pregnancy Registry.
    Don't miss this special opportunity, eligible for free CME for PAs.

    Zika Virus — Implications for Pregnant Women
    Date: Thursday, July 28
    Time: 2–3 p.m. EDT
    Sign up: Pre-register (at no cost) and view the detailed agenda.


  • July 08, 2016 8:19 AM | Deleted user

    THURSDAY, July 7, 2016 (HealthDay News) -- Cancers linked to the sexually transmitted human papillomavirus (HPV) keep rising in the United States, even though most cases are preventable, health officials reported Thursday.

    Cervical cancer, and mouth and throat cancers in men, accounted for most of the nearly 39,000 HPV-associated cancers diagnosed annually from 2008 to 2012, according to the U.S. Centers for Disease Control and Prevention.

    HPV vaccination and cervical cancer screening could keep more than 28,000 of these cancers from developing, the agency estimated.

    "Most cervical cancers are preventable with regular screening for precancerous lesions among women aged 21 to 65 years, linked with follow-up for abnormal test results," the CDC researchers wrote in the report.

    But cancer experts said that public perception may have to change first, especially with respect to HPV vaccination.

    "In order to increase HPV vaccination rates, we must change the perception of the HPV vaccine from something that prevents a sexually transmitted disease to a vaccine that prevents cancer," said Electra Paskett. She is co-director of the Cancer Control Research Program at the Ohio State University Comprehensive Cancer in Columbus.

    "Every parent should ask the question: If there was a vaccine I could give my child that would prevent them from developing six different cancers, would I give it to them? The answer would be a resounding yes -- and we would have a dramatic decrease in HPV-related cancers across the globe," Paskett added.

    At current rates, these sexually linked cancers are developing in almost 12 of every 100,000 persons, the CDC said. In the previous five-year period, fewer than 33,500 of these HPV-linked cancers were diagnosed annually.

    Using data from national cancer registries, CDC analysts looked for certain cancer types -- cervical, head and neck, and anal, among them -- that have links to HPV. They found an average of 38,793 such cancers annually from 2008 to 2012.

    When looked at closely, researchers confirmed the HPV connection in 79 percent -- or 30,700 -- of cases. This included about 19,200 cancer diagnoses in females and 11,600 diagnoses in males.

    The agency estimates that as many as 28,500 of these were preventable with recommended HPV vaccination.

    In men, the head and neck cancers mainly involved the tongue, tonsils and pharynx -- or "oropharyngeal" cancers, the agency reported. They're often symptom-free, but may include persistent sore throat, earaches and pain when swallowing, according to the CDC.

    Breaking down the figures, whites had higher rates of oral and throat cancers than blacks and Hispanics, the report found.

    However, Hispanics and blacks were more likely to have cervical cancer than whites. The state with the highest cervical cancer rate was West Virginia; Vermont's rate was the lowest, according to the report.

    "Full vaccination coverage of the U.S. population could prevent future HPV-attributable cancers and potentially reduce racial and ethnic disparities in HPV-associated cancer incidence," according to report author Dr. Laura Viens and colleagues.

    The findings were published in the July 8 issue of the Morbidity and Mortality Weekly Report.

    The CDC recommends routine HPV vaccination at ages 11 to 12 for boys and girls, and through age 26 for females and age 21 for males if they were not previously vaccinated.

    Anyone who has ever had sex -- genital or otherwise -- can get HPV, scientists say.

    Oral cancers in particular are HPV-related, said Dr. Jill Rabin of Northwell Health in New Hyde Park, N.Y.

    "This is important since oral-genital contact may be quite prevalent and teens may not consider this as 'true' sexual activity," Rabin said. Oral-genital sex also places teens at risk for penile, rectal and vulvar-vaginal cancers, she said.

    "The reason the vaccine is given to girls (aged 9 to 26) and boys (aged 9 to 21) is that the younger the person is vaccinated, the better they will respond in making antibodies which help fight and prevent the HPV," Rabin explained.

    "We give the vaccine now, in other words, to protect against exposure to HPV later, when they are older," she said.

    More information

    The U.S. National Cancer Institute has more on HPV vaccination.

    SOURCES: Electra Paskett, Ph.D., co-director, Cancer Control Research Program, Ohio State University Comprehensive Cancer Center -- Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, Columbus, Ohio; Jill Rabin, M.D., co-chief, division of ambulatory care, women's health programs-PCAP Services, Northwell Health, New Hyde Park, N.Y.; July 8, 2016, Morbidity and Mortality Weekly Report

    -- Margaret Farley Steele

    Last Updated: Jul 7, 2016

    Copyright © 2016 HealthDay. All rights reserved.


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