Heroin usage, mortality rates increase, CDC data show | CDC: Infant deaths declining faster than stillbirths | CT scans can cause DNA damage, cell death, study finds
July 24, 2015
Family Medicine SmartBrief

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Heroin usage, mortality rates increase, CDC data show
Federal data show heroin use and overdose deaths significantly increased from 2002 to 2013, and CDC Director Tom Frieden, M.D., said the higher rates are driven by a prescription opioid epidemic and the cheapness and availability of heroin. Robert Rich, M.D., chair of the AAFP Commission on Health of the Public and Science, said the trend likely will continue. Family physicians should acknowledge that opioid drugs put patients at higher risk for substance abuse and use validated screening tools to periodically evaluate them, Rich said. AAFP News (7/23)
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How Physicians Can Use Technology To Bring A Mega Group To Life
In an increasingly complex business environment, U.S. Physicians are banding together into mega groups that gain leverage with payers without sacrificing independence. Innovative technology platforms are playing a major role in making it happen. One leading mega-group shares its story in this whitepaper.

Clinical News
CDC: Infant deaths declining faster than stillbirths
For the first time, there were more stillbirths than infant deaths in the U.S., according to a CDC report that found both were declining, but infant death rates were falling faster. The report also found disparities in fetal death rates. Teens, women over age 35, and women who are black, Hispanic, American Indian or of Alaska Native descent were among groups facing higher likelihood of fetal death. "The fact that blacks and other minorities have the highest rate is concerning, because research shows that these are not genetic differences but differences in access to care," said Edward McCabe, M.D., chief medical officer at the March of Dimes. HealthDay News (7/23)
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CT scans can cause DNA damage, cell death, study finds
A study published in the Journal of American College of Cardiology: Cardiovascular Imaging found that computed tomography scans are associated with DNA damage, although cells also initiate repair mechanisms, and sometimes cellular death. The findings come from 67 patients who had heart CT scans. The team found that scans using the lowest radiation dose did not adversely affect the cells of healthy patients, and they recommend clinicians minimize use of radiation when possible. HealthDay News (7/22)
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Study: Rivastigmine leads to improved gait, fewer falls in Parkinson's disease
Parkinson's patients without dementia saw better gait variability when walking and performing a simple cognitive test after receiving rivastigmine treatment, according to a study presented at the 19th International Congress of Parkinson's Disease and Movement Disorders. The placebo-controlled study had patients keep diaries to log falls because walking gait time is a marker for fall risk, and data showed the therapy also resulted in fewer falls. Medscape (free registration) (7/22)
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Experts question accuracy of blood glucose meters in low glycemic range
An assessment found considerable differences in the performance of blood glucose meters in the low glycemic range, which could explain why blood glucose measurement data is not accepted by the FDA as evidence for the efficacy of antidiabetic drugs for reducing hypoglycemia, researchers reported in Diabetes Care. They questioned whether these devices can be used in clinical trials to evaluate hypoglycemia risk. PhysiciansBriefing.com/HealthDay News (7/22)
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Study links sleep apnea to greater likelihood of panic disorder
A study in the Annals of Family Medicine found that patients with sleep apnea are more likely to develop panic disorder, with a hazard ratio of 2.17. The study compared 8,704 sleep apnea patients with 34,792 matched controls, finding 1.34% of those with sleep apnea developed panic disorder during the follow-up period, compared with 0.42% of the control group. PhysiciansBriefing.com (7/23)
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Making Work-Life Balance Work
For startups or established enterprises, juggling the demands of work and the rest of your day means knowing what's important, setting boundaries and getting creative. Click here to read Boomtown: Think Like a Startup

Practice Management
Medical group uses best-practice library to improve care, reduce costs
Physician-owned Crystal Run Healthcare in New York created a best-practice library using clinical guidelines and expert opinion to improve patient care, reduce costs and increase practice revenues, according to a Health Affairs blog. The practice's efforts to reduce variations in care began with a pilot program for diagnosing diabetes and then expanded to other departments, resulting in 15 additional diagnoses being chosen for the development of best-practice guidelines. Health Affairs Blog (7/23)
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Health Policy & Legislation
Bill calls for nutrition education for physicians, nurses
The Education and Training for Health Act of 2015 under consideration in the U.S. House calls for nurse practitioners and physicians who are federal employees to get annual continuing education in nutrition to help them talk with patients about how diet affects disease risk. Registered dietitian Cameron Wells writes that clinicians need help keeping updated on the best diets for weight loss, lowering cholesterol, reducing inflammation and controlling blood sugar. U.S. News & World Report (7/21)
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Inside the AAFP
FPs can help curb spending on services patients don't need
Fresh Perspectives
In health systems that view primary care physicians merely as a source of referrals to subspecialty care, patients are overutilizing services and wasting their money. Kyle Jones, M.D., has more in the latest Fresh Perspectives blog post.
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AAFP CareerLink - Connecting Family Physicians and Employers
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There is no passion to be found playing small -- in settling for a life that is less than the one you are capable of living."
-- Nelson Mandela,
political activist and president of South Africa
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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 http://aafp.org.
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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