Opioid Epidemic Causes an Alarming Rise in Philadelphia HIV Cases	Trump Expected to Sign Massive Opioid Bill
Acute Flaccid Myelitis Cases on the Rise	Rabies Concerns
Temple Study Shows Positive Results for Minimally Invasive Treatment of Severe Emphysema	The Leading Candidate for the Next Hi-Tech Dinosaur - the Fax Machine
PCMS Member Honored by Latino Connection	Calendar of Events

The Philadelphia Department of Public Health (PDPH) has released a health advisory that reports a 48% increase in new HIV diagnoses among people who inject drugs. In the 12 months ending on August 31, 2018, PDPH identified 46 new cases of HIV, compared with 31 cases in the previous 12 months.

PDPH reports that "the HIV epidemic in Philadelphia is highly concentrated in men who have sex with men (MSM), and it is unusual for PDPH to identify new diagnoses of HIV in people who inject drugs." But the health department adds that "these recent changes have the potential to foster HIV transmission in a local population that has not recently experienced high rates of HIV." PDPH recommends testing of high-risk persons.

You can find the complete PDPH advisory by going to https://hip.phila.gov.

The U.S. House and Senate have overwhelmingly approved a bipartisan bill to combat the nation's opioid crisis. The 660-page package, which contains many provisions the AMA lobbied for, calls for bolstering programs to treat addiction, more closely monitoring prescriptions, and updating information on alternative treatments to addictive drugs.

The bill passed the Senate by a 98 to one vote. The House approved the bill 398 to eight. Drug overdoses killed more than 72,000 Americans last year, including nearly 30,000 from opioid overdose.

The legislation would require the Centers for Medicare and Medicaid Services to implement programs for prevention and treatment, including drug management for at-risk beneficiaries to avoid over-prescribing opioids, medical assistance for incarcerated juveniles, and limits on e-prescribing prescription drugs that are controlled substances.

Click here to view the bill.

Click here to view the AMA response.

The Centers for Disease Control and Prevention (CDC) received an increased number of suspected acute flaccid myelitis (AFM) cases from January through August of this year. The 43 suspected cases were spread over 20 states. In 2014 and 2016 similar increases in AFM cases were found during the same period of the year.

AFM usually shows itself as a prodromal respiratory or gastrointestinal illness for one week with neck and back pain, followed by weakness of one or more limbs. The patient also can have slurred speech, difficulty swallowing, eyelid or facial droop, poor tone and diminished reflexes. Most patients recover, but severe neurologic complications can result in death.

PDPH advises collecting specimens from patients as early as possible after symptom onset, preferably on the day limb weakness develops. For information on what specimens to collect, click here.

For more PDPH AFM resources, click here.

PDPH used World Rabies Day this year, to remind physicians that they should act quickly and decisively when a patient has been bitten by an animal.

A Delaware state resident died from a rabies bite in August. The woman was diagnosed too late to receive the life-saving rabies vaccine. Human cases of rabies are rare, but once symptoms appear, the disease is almost always fatal.

PDPH urges you to report all animal bites, scratches and exposures to PDPH by phone or fax. For information on the criteria for rule-out human rabies testing and other information on the disease, download the PDPH notification.

World Rabies Day is held annually on September 28, the anniversary of the death of Louis Pasteur, the French chemist and microbiologist who developed the first rabies vaccine.

Dr. Gerard Criner, MD, FACP, FACCP, chair and professor of Thoracic Medicine and Surgery at the Lewis Katz School of Medicine at Temple University, has announced the 12-month results of the EMPROVE multicenter, randomized and controlled study for the Spiration Valve System (SVS), a minimally invasive treatment for severe emphysema.

Dr. Criner said that "the EMPROVE study shows that treatment of severe emphysema with the Spiration Valve System resulted in statistical and clinically meaningful improvements in FEV1, target lobe volume reduction, dyspnea and quality of life parameters, with a good safety profile." The study looked at 172 patients in 31 centers in the U.S. and Canada.

The Spiration Valve is an umbrella-shaped, one-way valve that is placed in the lungs through a flexible bronchoscope that provides surgeons and pulmonologists with a novel method of limiting distal airflow to the damaged or diseased lung.

The study was sponsored by Olympus Respiratory America, part of Olympus Corporation, the developer of the Spiration Valve System. Neither Dr. Criner nor any member of his immediate family has financial interest in Olympus Respiratory America or Olympus Corporation.

For more information, click here.

CMS Administrator Seema Verma is calling on developers at the Office of the National Coordinator (ONC) for Health Information Technology's Interoperability Forum to help make doctors' offices "a fax-free zone by 2020." And the ONC's Office of Technology declared October 12, "No Fax Friday."

These critics say the fax machine should go the way of the rotary phone, because it can't compete with sending patients' information digitally - by far the quickest and most efficient way to get patient test results and other information. Although fax machines have worked well for many physicians, others in the health-care industry find them cumbersome. They say sending patient data and other health information digitally would result in more complete patient records and allow machine-learning tools to analyze much of that information.

Those who want to end the era of the fax, say providers would cut costs by doing less repeat work, since a fax requires them to read the same thing on screens that they've already read on paper. They'd also lose the big risk of sending the information to the wrong recipient. Along with federal regulators fax opponents also include large health systems.

PCMS member, Dr. Natalia Ortiz, has been named one of Pennsylvania's 100 Most Influential Latino Leaders. Latino Connection Executive Director George Fernandez wrote to Dr. Ortiz, that "we recognize and esteem you for your leadership in the medical community as well as your continuous efforts in particular at Temple Health-Temple University Hospital."

Dr. Ortiz will receive her honor on October 12 at WITF, the public television station in Harrisburg, along with other recipients in the fields of health care, education, community relations, government and politics.

October

18 - Medical Marijuana Education Workshop Date: Thursday, October 18 Time: 5:30 PM - 8:00 PM Place: IPEX/University of the Sciences in Philadelphia, 4601 Woodland Avenue, Philadelphia, PA 19104 Cure Pennsylvania Medical Marijuana Dispensary is presenting a free educational workshop for physicians and patients who are interested in learning about Pennsylvania's Medical Marijuana Program. Click Here to Register

18 - Contract Review Program Date: Thursday, October 18 Time: 6:00 PM - 7:30 PM Place: The Philadelphia County Medical Society, 2100 Spring Garden Street, Philadelphia, PA 19130 All Residents/Fellows and their guests are invited to attend this free educational program on employment contracts (Physicians and medical students are also welcome to attend). Come learn about the basics of an employment contract, how to negotiate your contract, how to resolve disputes, and more. Click Here to Register

26 - House of Delegates 2018 Date: October 26-28 Place: Hershey Lodge, Hershey, PA Join your colleagues for a lively, informative weekend of continuing education, leadership development, advocacy, and networking at the Pennsylvania Medical Society's House of Delegates Meeting and Annual Education Conference. Click Here to Register

November

1 - Medical Cannabis Certification 4-Hour Live Webinar Date: Thursday, Nov 1 Time: 5:00 PM - 9:15 PM The Substance Use Disorders Institute is offering its Medical Cannabis Certification Course as a live, interactive webinar. The Substance Use Disorders Institute is an approved educational provider for the PA DOH Office of Medical Marijuana. PCMS Members save $50 on their registration. Click Here to Register

8 - Chronic Pain, the Opioid Epidemic, and Changing Prescribing Guidelines Date: Thursday, November 8 Time: 6:00 PM - 8:30 PM Place: The Philadelphia County Medical Society, 2100 Spring Garden Street, Philadelphia 19130 All physicians are invited to attend this free educational program on chronic pain and the opioid epidemic. Connect with colleagues and learn more about approaching these major issues. This program satisfies the requirement of pain management education for medical license renewal. Click Here to Register

14 - Myalgic Encephalomyelitis / Chronic Fatigue Program Date: Wednesday, November 14 Time: 6:00 PM - 8:30 PM Place: The Philadelphia County Medical Society, 2100 Spring Garden Street, Philadelphia 19130 The Philadelphia County Medical Society will be hosting an evening program on Myalgic Encephalomyelitis / Chronic Fatigue Syndrome, featuring a screening of the documentary Unrest followed by a panel discussion. Click Here to Register