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September 2013 Briefing - Gastroenterology

September 2013 Briefing - Gastroenterology

Here are what the editors at HealthDay consider to be the most important developments in Gastroenterology for September 2013. This roundup includes the latest research news from journal articles, as well as the FDA approvals and regulatory changes that are the most likely to affect clinical practice.

Lower National Health Spending Due to Slow Economy

MONDAY, Sept. 30 (HealthDay News) -- National health care expenditures remain sluggish but are expected to grow at a rate of approximately 6.2 percent per year after 2014, with federal, state, and local governments accounting for half, according to research published online Sept. 18 in Health Affairs.

Abstract (http://content.healthaffairs.org/content/early/2013/09/13/hlthaff.2013.0721 )Full Text (subscription or payment may be required) (http://content.healthaffairs.org/content/early/2013/09/13/hlthaff.2013.0721.full.pdf+html )

Medicare, Medicaid Will Still Run If Government Shuts Down

MONDAY, Sept. 30 (HealthDay News) -- According to U.S. officials, veterans and Medicare and Medicaid recipients will continue to receive health care benefits even if the federal government shuts down on Tuesday.

More Information (http://www.hhs.gov/ )

Only One-Third of Voters Think Congress Should Delay ACA

MONDAY, Sept. 30 (HealthDay News) -- With a government shutdown impending, only one-third of voters think that Congress should delay, defund, or repeal the health care laws set to take effect imminently, according to a report from The Morning Consult.

More Information (http://themorningconsult.com/topline-results-september-2013-tracking-poll/ )

DOL Clarifies Employer Health Insurance Notification Duty

MONDAY, Sept. 30 (HealthDay News) -- The U.S. Department of Labor has provided clarification in the form of a frequently-asked-questions (FAQ) document, relating to employer obligations to provide employees with written notice about the Affordable Care Act's health insurance marketplaces by Oct. 1, 2013.

More Information (http://www.dol.gov/ebsa/faqs/faq-noticeofcoverageoptions.html )

Practical Tips Offered for Medical Employee Satisfaction

FRIDAY, Sept. 27 (HealthDay News) -- Managing staff is a learned skill, and one for which physicians are often ill-equipped. An article published Sept. 25 in Medical Economics lays out some practical tips and advice for motivating staff to excel.

Full Text (http://medicaleconomics.modernmedicine.com/medical-economics/news/how-physicians-can-increase-employee-satisfaction-their-medical-practice?page=0,0 )

Health Worker Roles Impacted When 'Undervalued' by Patients

FRIDAY, Sept. 27 (HealthDay News) -- Job satisfaction among nurse practitioners and other professionals can suffer when clientele lack a clear understanding of what they do, according to research published in the Aug. 1 issue of the Academy of Management Journal.

Abstract (http://amj.aom.org/content/56/4/1050.abstract )Full Text (subscription or payment may be required) (http://amj.aom.org/content/56/4/1050.full )

HEALTH REFORM: ACA Impact on Medicare Recipients Unclear

FRIDAY, Sept. 27 (HealthDay News) -- The Affordable Care Act (ACA) will help millions of uninsured Americans access affordable health care coverage, but it's unclear what effect the law will have on people covered by Medicare.

More Information (https://www.healthcare.gov/ )

No Association Seen Between Celiac Disease, Autism Disorders

FRIDAY, Sept. 27 (HealthDay News) -- There is no association between celiac disease and autism spectrum disorders (ASDs), although there may be an increased risk of ASDs in patients with normal lining of the gastrointestinal tract but a positive antibody test, according to a study published online Sept. 25 in JAMA Psychiatry.

Abstract (http://archpsyc.jamanetwork.com/article.aspx?articleid=1743008#Abstract )Full Text (subscription or payment may be required) (http://archpsyc.jamanetwork.com/article.aspx?articleid=1743008 )

Sutures Not Superior to Staples for Closure in GI Surgery

FRIDAY, Sept. 27 (HealthDay News) -- Compared with standard procedure using staples, skin closure with subcuticular sutures does not reduce the incidence of wound complications after open gastrointestinal (GI) surgery, according to research published in the Sept. 28 issue of The Lancet, a theme issue on surgery.

Abstract (http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)61780-8/abstract )Full Text (subscription or payment may be required) (http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)61780-8/fulltext )Editorial (subscription or payment may be required) (http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)61166-6/fulltext )

HEALTH REFORM: Medicaid Expansion Will Up Coverage

THURSDAY, Sept. 26 (HealthDay News) -- Two aspects of the Affordable Care Act (ACA) have the potential to extend health insurance coverage to those who do not qualify for government-sponsored health care but cannot afford to purchase private plans.

More Information (https://www.healthcare.gov/ )

CDC: Flu Shot Coverage of Health Care Personnel Increasing

THURSDAY, Sept. 26 (HealthDay News) -- Influenza vaccination coverage has increased among health care personnel but varies by occupation type and occupational setting, according to a report published in the Sept. 27 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

Full Text (http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6238a2.htm?s_cid=mm6238a2_w )

Bariatric Surgery in T1DM Teens Doesn't Aid Glycemic Control

THURSDAY, Sept. 26 (HealthDay News) -- Despite significant weight loss, improvements in cardiovascular risk factors, and quality of life, bariatric surgery does not necessarily lead to improved glycemic control in adolescents with type 1 diabetes mellitus (T1DM), according to a case report published online Sept. 23 in Pediatrics.

Abstract (http://pediatrics.aappublications.org/content/early/2013/09/18/peds.2012-3640.abstract )Full Text (subscription or payment may be required) (http://pediatrics.aappublications.org/content/early/2013/09/18/peds.2012-3640.full.pdf+html )

C. difficile Transmitted Through Genetically Diverse Sources

WEDNESDAY, Sept. 25 (HealthDay News) -- About half of Clostridium difficile cases are genetically distinct from previous cases, suggesting that symptomatic patients are not the only source of transmission, according to a study published in the Sept. 26 issue of the New England Journal of Medicine.

Full Text (subscription or payment may be required) (http://www.nejm.org/doi/full/10.1056/NEJMoa1216064?query=featured_home )Editorial (subscription or payment may be required) (http://www.nejm.org/doi/full/10.1056/NEJMe1310454?query=featured_home )

HEALTH REFORM: Exchanges Offer Options for the Uninsured

WEDNESDAY, Sept. 25 (HealthDay News) -- Millions of part-time, seasonal, self-employed workers and other individuals currently without health insurance may find a solution to their vulnerable status when the new health care exchanges go into effect on Oct. 1.

More Information (https://www.healthcare.gov/ )

More Options, Lower Premiums With Insurance Exchanges

WEDNESDAY, Sept. 25 (HealthDay News) -- Consumers are likely to find insurance options more plentiful and more affordable than expected in the new Health Insurance Marketplace that goes into effect Oct. 1, according to a report released Sept. 25 by the U.S. Department of Health and Human Services.

More Information (http://www.hhs.gov/news/press/2013pres/09/20130925a.html )

Long-Term Metabolic Effects Seen With Bariatric Surgery

WEDNESDAY, Sept. 25 (HealthDay News) -- In obese patients, bariatric surgery can aid in achieving sustainable remission and improvement of type 2 diabetes mellitus (T2DM), according to a study published in the October issue of the Annals of Surgery.

Abstract (http://journals.lww.com/annalsofsurgery/Abstract/2013/10000/Can_Diabetes_Be_Surgically_Cured__Long_Term.14.aspx )Full Text (subscription or payment may be required) (http://journals.lww.com/annalsofsurgery/Abstract/2013/10000/Can_Diabetes_Be_Surgically_Cured__Long_Term.14.aspx )

ACP Provides Overview of Health Insurance Marketplaces

WEDNESDAY, Sept. 25 (HealthDay News) -- The opportunities and challenges presented by health care reform are discussed in an article published online Sept. 24 in the Annals of Internal Medicine.

Full Text (http://annals.org/article.aspx?articleid=1741855 )

HEALTH REFORM: Health Care Reform a Mixed Bag for Workers

TUESDAY, Sept. 24 (HealthDay News) -- Much discussion of the Affordable Care Act revolves around the dramatic changes in store for America's uninsured, but the health care reform law will also have an impact on individuals with employer-based coverage.

More Information (https://www.healthcare.gov/ )

FDA Gives Final Guidance on Mobile Medical App Oversight

TUESDAY, Sept. 24 (HealthDay News) -- The U.S. Food and Drug Administration issued final guidance for mobile application (app) developers, and is focusing its oversight on medical apps that will be used as accessories to regulated medical devices, or that transform a mobile device into a regulated medical device.

More Information (http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm369431.htm )

Marriage Shown to Provide Cancer Survival Benefit

TUESDAY, Sept. 24 (HealthDay News) -- Unmarried patients are at significantly higher risk of presentation with metastatic cancer, undertreatment, and cancer-related death, according to a study published online Sept. 23 in the Journal of Clinical Oncology.

Abstract (http://jco.ascopubs.org/content/early/2013/09/18/JCO.2013.49.6489.abstract )Full Text (http://jco.ascopubs.org/content/early/2013/09/18/JCO.2013.49.6489.full.pdf+html )Editorial (http://jco.ascopubs.org/content/early/2013/09/18/JCO.2013.51.5080.full.pdf+html )

FDA Issues Final Rule for Device Identification System

MONDAY, Sept. 23 (HealthDay News) -- The U.S. Food and Drug Administration has released a final rule for the unique device identification system (UDI) that, when implemented, will improve patient safety by providing a consistent way to identify approved medical devices.

More Information (http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm369276.htm )

HEALTH REFORM: Young People Likely to Be Key to Success

MONDAY, Sept. 23 (HealthDay News) -- Young, healthy adults are considered key to the success of health insurance reform, but many are not even aware of state insurance exchanges.

More Information (https://www.healthcare.gov/ )

HEALTH REFORM: Health Care Exchanges Going Into Effect

MONDAY, Sept. 23 (HealthDay News) -- As of Oct. 1, consumers looking for health insurance will be able to turn to state-based health care exchanges, a centerpiece of the Affordable Care Act intended to help the uninsured and small businesses find affordable coverage.

More Information (https://www.healthcare.gov/ )

Majority of U.S. Consumers Want Full Access to EMR

MONDAY, Sept. 23 (HealthDay News) -- Most U.S. consumers want to have full access to their electronic medical records (EMR), and 41 percent would be willing to switch doctors to gain access, according to a survey published by Accenture.

More Information (http://newsroom.accenture.com/news/more-than-40-percent-of-us-consumers-willing-to-switch-physicians-to-gain-online-access-to-electronic-medical-records-according-to-accenture-survey.htm?c=hls_fy13prtwt_10000108&n=smc_0713#sf17115649g )

Lawyers File Most Isotretinoin Adverse Drug Reports

FRIDAY, Sept. 20 (HealthDay News) -- Attorneys have submitted a disproportionate number of isotretinoin-associated inflammatory bowel disease (IBD) cases to the U.S. Food and Drug Administration, according to a study published in the September issue of the Journal of the American Academy of Dermatology.

Abstract (http://www.jaad.org/article/S0190-9622(13)00423-4/abstract )Full Text (subscription or payment may be required) (http://www.jaad.org/article/S0190-9622(13)00423-4/fulltext )

Little Correlation Between Care Quality, Patient Experience

FRIDAY, Sept. 20 (HealthDay News) -- There is little correlation between quality of care assessed by clinical measures versus by patient experience, according to research published in the September/October issue of the Annals of Family Medicine.

Abstract (http://www.annfammed.org/content/11/5/467.abstract?sid=de84fee1-68b9-4629-9da0-445437383dab )Full Text (http://www.annfammed.org/content/11/5/467.full )

New Medicaid Enrollees Under ACA May Be Healthier

THURSDAY, Sept. 19 (HealthDay News) -- Adults potentially eligible for Medicaid under the Patient Protection and Affordable Care Act (ACA) are expected to have equal or better health status than current beneficiaries, according to research published in the September/October issue of the Annals of Family Medicine.

Abstract (http://www.annfammed.org/content/11/5/406.full )Full Text (http://www.annfammed.org/content/11/5/406.full )Editorial 1 (http://www.annfammed.org/content/11/5/402.full )Editorial 2 (http://www.annfammed.org/content/11/5/400.full )

Pros and Cons of Shortening Medical School Discussed

THURSDAY, Sept. 19 (HealthDay News) -- The pros and cons of shortening medical school to three years are discussed in two perspective pieces published in the Sept. 19 issue of the New England Journal of Medicine.

Full Text - Abramson (http://www.nejm.org/doi/full/10.1056/NEJMp1304681 )Full Text - Goldfarb and Morrison (http://www.nejm.org/doi/full/10.1056/NEJMp1306457 )

Millions Are Harmed by Unsafe Medical Care Each Year

THURSDAY, Sept. 19 (HealthDay News) -- Adverse events caused by inferior medical care are a major source of morbidity and mortality globally, according to research published in the October issue of BMJ Quality & Safety.

Abstract (http://qualitysafety.bmj.com/content/22/10/809.abstract )Full Text (http://qualitysafety.bmj.com/content/22/10/809.full )Editorial (http://qualitysafety.bmj.com/content/22/10/798.full )

Colorectal Cancer Screening Offers Lasting Benefits

WEDNESDAY, Sept. 18 (HealthDay News) -- Lower endoscopy and fecal occult-blood testing screening correlate with lasting reductions in colorectal cancer mortality, according to two studies published in the Sept. 19 issue of the New England Journal of Medicine.

Full Text - Nishihara (subscription or payment may be required) (http://www.nejm.org/doi/full/10.1056/NEJMoa1301969?query=featured_home )Full Text - Shaukat (subscription or payment may be required) (http://www.nejm.org/doi/full/10.1056/NEJMoa1300720?query=featured_home )Editorial (subscription or payment may be required) (http://www.nejm.org/doi/full/10.1056/NEJMe1308253?query=featured_home )

Enhanced Care Program Set Up at Six Mayo Clinic Hospitals

WEDNESDAY, Sept. 18 (HealthDay News) -- A new program has been developed and implemented at six Mayo Clinic Health System hospitals to improve care and shorten hospital stays using remote monitoring, according to a press release issued by the Mayo Clinic.

More Information (http://www.mayoclinic.org/news2013-rst/7666.html )

EHR Systems Meeting Meaningful Use Criteria Beneficial

WEDNESDAY, Sept. 18 (HealthDay News) -- Most electronic health record (EHR) systems meet meaningful use criteria, and these systems are associated with time-saving and other benefits, according to a September data brief published by the U.S. Centers for Disease Control and Prevention's National Center for Health Statistics.

More Information (http://www.cdc.gov/nchs/data/databriefs/db129.htm )

Payment for Routine Office Visits Varies Substantially

WEDNESDAY, Sept. 18 (HealthDay News) -- There is substantial variation in private insurance payment to physicians for routine office visits, according to research published in the September issue of Health Affairs.

Abstract (http://content.healthaffairs.org/content/32/9/1583.abstract )Full Text (subscription or payment may be required) (http://content.healthaffairs.org/content/32/9/1583.full )

More Than 1.6 Million Americans Expected to Get Cancer in 2013

TUESDAY, Sept. 17 (HealthDay News) -- Although significant progress has been made in treating cancer, more than 1.6 million Americans are projected to receive a cancer diagnosis in 2013, according to the third American Association for Cancer Research's Cancer Progress Report 2013.

More Information (http://cancerprogressreport.org/2013/pages/toc.aspx )

Factors Affecting Spontaneous Clearance of Hep C Identified

MONDAY, Sept. 16 (HealthDay News) -- For individuals with acute hepatitis C virus (HCV) infection, female gender, IL28B CC genotype, and HCV genotype 1 are independently linked to spontaneous clearance, according to research published online Aug. 2 in Hepatology.

Abstract (http://onlinelibrary.wiley.com/doi/10.1002/hep.26639/abstract )Full Text (subscription or payment may be required) (http://onlinelibrary.wiley.com/doi/10.1002/hep.26639/pdf )

Score Predicts Diabetes Remission After Gastric Bypass

FRIDAY, Sept. 13 (HealthDay News) -- A novel score based on four preoperative variables can predict the likelihood of type 2 diabetes remission following Roux-en-Y gastric bypass (RYGB) surgery, according to a study published online Sept. 13 in The Lancet Diabetes & Endocrinology.

Abstract (http://www.thelancet.com/journals/landia/article/PIIS2213-8587(13)70070-6/abstract )Full Text (subscription or payment may be required) (http://www.thelancet.com/journals/landia/article/PIIS2213-8587(13)70070-6/fulltext )Editorial (subscription or payment may be required) (http://www.thelancet.com/journals/landia/article/PIIS2213-8587(13)70108-6/fulltext )

Mindfulness Training Beneficial for Clinicians, Patients

THURSDAY, Sept. 12 (HealthDay News) -- Mindfulness training is associated with improvements in physician burnout; and, clinicians who rate themselves as more mindful engage in more patient-centered communication, according to two studies published in the September/October issue of the Annals of Family Medicine.

Abstract - Fortney (http://www.annfammed.org/content/11/5/412.abstract )Full Text (http://www.annfammed.org/content/11/5/412.full )Abstract - Beach (http://www.annfammed.org/content/11/5/421.abstract )Full Text (http://www.annfammed.org/content/11/5/421.full )

Combo Therapy Not Superior for Severe Alcoholic Hepatitis

WEDNESDAY, Sept. 11 (HealthDay News) -- Combination therapy with pentoxifylline and prednisolone, compared with prednisolone alone, does not result in a higher rate of six-month survival in patients with alcoholic hepatitis, according to research published in the Sept. 11 issue of the Journal of the American Medical Association.

Abstract (http://jama.jamanetwork.com/article.aspx?articleid=1737041#Abstract )Full Text (subscription or payment may be required) (http://jama.jamanetwork.com/article.aspx?articleid=1737041 )Editorial (subscription or payment may be required) (http://jama.jamanetwork.com/article.aspx?articleid=1737025 )

Swallow Preservation Protocol Effective in Compliant Patients

WEDNESDAY, Sept. 11 (HealthDay News) -- Head and neck cancer patients who are compliant with a swallow preservation protocol (SPP) are more likely to maintain their diet, according to a study published online Aug. 27 in Otolaryngology-Head and Neck Surgery.

Abstract (http://oto.sagepub.com/content/early/2013/08/27/0194599813502310.abstract )Full Text (subscription or payment may be required) (http://oto.sagepub.com/content/early/2013/08/27/0194599813502310.full )

About Half of Health Care Providers Are 'Digital Omnivores'

TUESDAY, Sept. 10 (HealthDay News) -- About half of health care providers are "digital omnivores," meaning they use a tablet, smartphone, and laptop/desktop computer routinely in a professional capacity, according to a report published by Epocrates.

More Information (http://www.epocrates.com/oldsite/statistics/2013%20Epocrates%20Mobile%20Trends%20Report_FINAL.pdf )

'Meaningful Use' Achievement Not Uniform Across Hospitals

MONDAY, Sept. 9 (HealthDay News) -- In regard to the adoption of electronic health records (EHRs), achievement of "meaningful use" criteria is not uniform across all hospitals, according to a study published in the August issue of Health Affairs.

Abstract (http://content.healthaffairs.org/content/32/8/1355?=right )Full Text (subscription or payment may be required) (http://content.healthaffairs.org/content/32/8/1355.full )

Most Physicians Report Being Satisfied With Career Choice

MONDAY, Sept. 9 (HealthDay News) -- Most physicians report being satisfied with their career choice, although 40 percent would rethink their path given the chance to choose again, according to the 2013 Great American Physician Survey published in Physicians Practice.

More Information (http://www.physicianspractice.com )

Study Assesses Benefits of HBV Vaccine Program in Taiwan

WEDNESDAY, Sept. 4 (HealthDay News) -- Implementation of a national hepatitis B virus (HBV) immunization program in Taiwan correlated with reductions in infant fulminant hepatitis (IFH), chronic liver disease (CLD), and hepatocellular carcinoma (HCC) mortality, and with HCC incidence, according to a research letter published in the Sept. 4 issue of the Journal of the American Medical Association.

Full Text (subscription or payment may be required) (http://jama.jamanetwork.com/article.aspx?articleid=1734688 )

Docs' Confidence in Diagnosis Unrelated to Diagnostic Accuracy

TUESDAY, Sept. 3 (HealthDay News) -- Physicians' confidence in their diagnostic accuracy is not associated with actual diagnostic accuracy or with case difficulty, according to a study published online Aug. 26 in JAMA Internal Medicine.

Abstract (http://archinte.jamanetwork.com/article.aspx?articleid=1731967#Abstract )Full Text (subscription or payment may be required) (http://archinte.jamanetwork.com/article.aspx?articleid=1731967 )Editorial (subscription or payment may be required) (http://archinte.jamanetwork.com/article.aspx?articleid=1731959 )

Male-Female Physician Earnings Gap Has Persisted for 20 Years

TUESDAY, Sept. 3 (HealthDay News) -- For physicians, the male-female earnings gap has not changed significantly since 1987, according to a research letter published online Sept. 2 in JAMA Internal Medicine.

Full Text (subscription or payment may be required) (http://archinte.jamanetwork.com/article.aspx?articleid=1733450 )Editorial (subscription or payment may be required) (http://archinte.jamanetwork.com/article.aspx?articleid=1733448 )

Employer-Based Health Insurance Premiums Rose Modestly in 2013

MONDAY, Sept. 2 (HealthDay News) -- Employer-sponsored health insurance premiums rose only modestly in 2013, according to research published in the August issue of Health Affairs.

Abstract (http://content.healthaffairs.org/content/early/2013/08/16/hlthaff.2013.0644 )Full Text (subscription or payment may be required) (http://content.healthaffairs.org/content/early/2013/08/16/hlthaff.2013.0644.full )

Workaholics Have Poorer Physical and Mental Health

MONDAY, Sept. 2 (HealthDay News) -- Workaholics, defined as those who work more than 50 hours per week, have reduced physical and mental well-being, according to researchers from Kansas State University.

Press Release (http://www.k-state.edu/media/newsreleases/aug13/workaholics82213.html )