CDC warns of quinolone-resistant Shigella strains | FDA warns against codeine, tramadol for youths, breast-feeding mothers | Study: Reduced CV events, mortality risks tied to metformin use in diabetes
April 21, 2017
Family Medicine SmartBrief
Top Story
CDC warns of quinolone-resistant Shigella strains
The CDC issued an alert warning clinicians about strains of Shigella that may have reduced susceptibility to ciprofloxacin. The agency's Health Alert Network health advisory provides background on the emerging strains, which often have a quinolone-resistant gene that can make them less susceptible to fluoroquinolone antibiotics, and gives recommendations for diagnosing, managing and reporting Shigella infections.
AAFP News (4/20) 
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CMS Open Payments: What You Need to Know
As part of CMS Open Payments, pharmaceutical and device manufacturers submitted data about their financial relationships with you - physicians and teaching hospitals. CMS encourages you to review that data before it is made available on a publicly accessible website. Learn more now!
Clinical News
FDA warns against codeine, tramadol for youths, breast-feeding mothers
The FDA issued a warning against the use of codeine and tramadol in children younger than 12, in adolescents ages 12 to 18 who are obese or have conditions that cause problems with breathing, such as sleep apnea and lung disease, and breast-feeding mothers, as well as a warning against tramadol use in children ages 18 and younger who underwent tonsil and adenoid removal, after a recent review showed serious breathing difficulties among youths who received the drugs. The FDA is requiring drugmakers to update warning labels on the drugs to reflect the new contraindications.
The New York Times (free-article access for SmartBrief readers) (4/20),  The Washington Post (tiered subscription model) (4/20),  National Public Radio (4/20) 
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Study: Reduced CV events, mortality risks tied to metformin use in diabetes
Danish researchers found patients with type 2 diabetes who achieved HbA1C levels of less than 6.5% after six months of metformin initiation had the lowest risk for cardiovascular events or death, while those who had an HbA1C of at least 8% had the highest risk. The findings in Diabetes Care, based on 24,752 adults with a mean age of 62.5, showed that large HbA1C reductions among those with a baseline HbA1C of more than 9% were associated with the greatest outcome risk reductions.
Healio (free registration)/Endocrine Today (4/20) 
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Breast cancer striking more Asian-American women
The breast cancer incidence rate is rising among women in six of seven Asian-American ethnic groups studied, according to a study in Breast Cancer Research and Treatment. The finding warrants additional attention and research to identify relevant risk factors for specific breast cancer subtypes, lead researcher Scarlett Lin Gomez said.
HealthDay News (4/14) 
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Researchers study prenatal antidepressant use, disabilities
Two studies published in the Journal of the American Medical Association found no link between taking antidepressants during pregnancy and a child's risk of developing autism or attention-deficit/hyperactivity disorder. One study reviewed medical records for 36,000 Canadian children, and another examined records for more than 1.5 million Swedish children.
HealthDay News (4/18) 
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Practice Management
Report examines EHR adoption rates among US states
Wyoming has the highest rate of EHR adoption across the US at 78.6%, followed by South Dakota, Utah, Iowa and North Dakota, according to a report from SK&A. The lowest EHR adoption rates were found in Maryland, Rhode Island, New Jersey, Louisiana and New York. (4/19) 
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Health Policy & Legislation
Amendment might bring AHCA back to House floor for a vote
Amendment might bring AHCA back to House floor for a vote.
(Stefan Zaklin/Getty Images)
An amendment to the American Health Care Act proposed by Rep. Tom MacArthur, R-N.J., would retain the Affordable Care Act's essential health benefits at the federal level but allow states to request approval to replace the EHBs with their own list. States could also let insurers charge higher premiums to people with preexisting conditions if they create high-risk pools for those patients, according to the amendment, which has been billed as a tool for resurrecting the legislation for a vote the White House would like to see happen next week.
The Washington Post (tiered subscription model) (4/20) 
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Professional Issues & Trends
Health care organizations lag in adapting to patient-as-payer reality
A McKinsey study in 2013 predicted that health care organizations would be receiving a higher percentage of their revenue from individual patients than traditional payers, but close to 50% of health care consumers responding to a Healthcare Financial Management Association survey expressed dissatisfaction with their clinician's billing processes. Implementing a consumer-centric approach in billing and payment collection may bolster health care organizations' return on investment and patient satisfaction while reducing patient debt, writes PatientPay founder Tom Furr.
Health Data Management (4/18) 
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Inside the AAFP
Motivational interviewing for obesity webcast | Watch today
AAFP CME webcast
Obesity among both U.S. children and adults continues to grow at an alarming rate, and family physicians are well positioned to engage in motivational interviewing with obese patients to improve outcomes. Watch the AAFP webcast Motivational Interviewing: A Patient-centered Approach to Obesity Management to learn the latest evidence-based recommendations and guidelines to help improve those outcomes. Earn 1.5 AAFP Prescribed credit by viewing the webcast, and earn up to 2 additional AAFP Prescribed credits when you complete the Translation to Practice (t2p) process. This CME activity is supported by an educational grant from Novo Nordisk Inc. and Takeda Pharmaceuticals U.S.A. Inc.
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Pick Your Pace: Avoid Medicare Part B penalties
Are you ready for the Merit-based Incentive Payment System (MIPS)? Pick Your Pace now to avoid a negative payment adjustment in 2019. The AAFP can help.
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AAFP CareerLink - Connecting Family Physicians and Employers
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I stand upon my desk to remind myself that we must constantly look at things in a different way.
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About AAFP
This news roundup is provided as a timely update to AAFP members and other health care professionals about family medicine topics in the news media. Links to articles are provided for the convenience of family physicians who may find them of use in discussions with patients or colleagues. Opinions expressed in Family Medicine SmartBrief are those of the identified authors and do not necessarily reflect the opinions or policies of the American Academy of Family Physicians. On occasion, media articles may include or imply incorrect information about the AAFP and its policies, positions or relationships. For clarification on AAFP positions and policies, we refer you to
External Resources are not a part of the AAFP website. AAFP is not responsible for the content of sites that are external to the AAFP. Linking to a website does not constitute an endorsement by AAFP of the sponsors of the site or the information presented on the site.

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