You are invited to attend ASIPP's 23rd Annual Meeting,
June 24-26
in NOLA!
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Topics will include COVID-19, ECONOMICS, BURNOUT, SOCIAL MEDIA, METABOLIC HEALTH, REGULATORY ISSUES, SCIENTIFIC ADVANCES
in IPM, and MUCH MORE!
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The ASIPP Annual Meeting will feature
THREE INNOVATION SUMMITS during the afternoon breakout sessions each day.
Learn about the
LATEST TECHNOLOGICAL ADVANCEMENTS
to help you in your practice.
Multiple technologies will be highlighted in the areas of SPINAL CORD STIMULATION,
PERIPHERAL NERVE STIMULATION, and
MINIMALLY INVASIVE TECHNOLOGIES.
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Howard Bauchner, MD, will step down as editor-in-chief of JAMA, the journal of the American Medical Association — one of the most widely circulated medical journals in the world — after fallout from a February podcast and tweet about structural racism in medicine.
The announcement comes just days after a group of doctors wrote AMA leadership criticizing a racial equity and justice plan the AMA released last month.
"I remain profoundly disappointed in myself for the lapses that led to the publishing of the tweet and podcast. Although I did not write or even see the tweet, or create the podcast, as editor in chief, I am ultimately responsible for them," Bauchner said in a statement. "I share and have always supported the AMA's commitment to dismantling structural racism in the institutions of American medicine, as evident by numerous publications in JAMA on this issue and related subjects, and look forward to personally contributing to that work going forward. To advance equity in medicine, my contributions will be best accomplished in other venues."
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Emergency physicians group characterized new policy as "direct violation" of current standard
UnitedHealthcare plans to take a closer look at emergency department (ED) claims beginning July 1.
In a June network bulletin posted to its website, the insurer said that it will assess ED facility commercial claims to determine if an event was emergent or non-emergent. Claims determined to be non-emergent will be subject to no coverage or limited coverage.
ED claims will be evaluated on many factors, UnitedHealthcare said, including the patient's presenting problem, the intensity of the diagnostic services performed, and other patient complicating factors.
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All eyes are on CMS, which could issue a Medicare National Coverage Determination
Biogen's Alzheimer's drug aducanumab (Aduhelm) may have been cleared by the FDA, but its uptake will be influenced by insurance coverage, particularly by Medicare.
The $56,000 annual price tag on the therapy is far higher than the $8,300 estimated by the Institute for Clinical Economic Review (ICER) to be cost-effective, setting the stage for potential insurance challenges.
"Only a hypothetical drug that halts dementia entirely would merit this pricing level," ICER said in a statement. "The evidence on aducanumab suggests that, at best, the drug is not nearly this effective."
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Large database helps inform differences in pediatric illness patterns
Certain underlying medical conditions, as well as complex chronic illnesses exacerbated the risk for severe COVID-19 in children, researchers found in a cross-sectional study.
The strongest risk factors for COVID-19 hospitalization included type I diabetes (adjusted risk ratio 4.60, 95% CI 3.91-5.42) and obesity (aRR 3.07, 95% CI 2.66-3.54), reported Lyudmyla Kompaniyets, PhD, and colleagues from the CDC.
Type I diabetes (aRR 2.38, 95% CI 2.06-2.76), cardiac and circulatory congenital anomalies (aRR 1.72, 95% CI 1.48-1.99), and epilepsy and/or convulsions (aRR, 1.71, 95% CI 1.41-2.08) were strong risk factors for developing severe COVID-19 illness, the authors wrote in JAMA Network Open.
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The 2020 lab report was used by the State Department in its own inquiry during Trump administration
A report on the origins of Covid-19 by a U.S. government national laboratory concluded that the hypothesis claiming the virus leaked from a Chinese lab in Wuhan is plausible and deserves further investigation, according to people familiar with the classified document.
The study was prepared in May 2020 by the Lawrence Livermore National Laboratory in California and was drawn on by the State Department when it conducted an inquiry into the pandemic’s origins during the final months of the Trump administration.
It is attracting fresh interest in Congress now that President Biden has ordered that U.S. intelligence agencies report to him within weeks on how the virus emerged. Mr. Biden said that U.S. intelligence has focused on two scenarios—whether the coronavirus came from human contact with an infected animal or from a laboratory accident.
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Life-related risk factors played a key role, study found
Symptoms of work-related post-traumatic stress disorder (PTSD) were three times higher for interns than the general population, according to a 2018 study.
There were 10.8% of intern physicians who screened positive for PTSD at the end of their first internship year compared with a 12-month prevalence of 3.6% in the general population, reported Mary Vance, MD, of the Uniformed Services University's Center for the Study of Traumatic Stress in Bethesda, Maryland, and colleagues.
Among 1,134 resident physicians surveyed, 56.4% reported exposure to trauma in the workplace, and 19% of that group screened positive for PTSD by the end of their residency, the authors wrote in JAMA Network Open.
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We can prepare today for an influx of patients knocking at our doors
So far, the response to this pandemic has been focused on addressing the acute manifestations of COVID-19 -- but that is only the tip of the iceberg. We must not ignore what's beneath the surface: the lingering health and mental health implications of long COVID.
Long after the initial infection should have resolved, a substantial number of people infected with SARS-CoV-2 continue to experience lingering health problems. Some patients even experience the emergence of new problems they did not have during the acute phase of the infection. The constellation of clinical abnormalities that characterize this phase of the disease is now generally referred to as long COVID (or more officially, post-acute sequelae of SARS-CoV-2, or PASC for short). People with long COVID have been dubbed long haulers. In addition to being at risk of long COVID, people who survive the acute phase of the COVID-19 infection are also at increased risk of death. The death and suffering among 30-day COVID-19 survivors will add to the already substantial toll of this pandemic.
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Open discussion in science is a necessity
First, an admission: this is not really a column about the origin of SARS-CoV-2. Others have written great ones, and I am not terribly interested in the question. Why? Right now, the two most widely discussed possibilities are the virus underwent zoonotic transmission (from some animal to a person), possibly at a wet market, and the other is that it escaped from the Wuhan Institute of Virology due to poor safety protocols in a biosafety level (BSL) 3 or 4 laboratory.
If it escaped due to a wet market, I would strongly suggest we clean up wet markets and improve safety in BSL laboratories because a future virus could come from either. And, if it was a lab leak, I would strongly suggest we clean up wet markets and improve safety in BSL 3 and 4 ... you get the idea. Both vulnerabilities must be fixed, no matter which was the culprit in this case, because either could be the culprit next time.
I want to talk about the real lesson of "lab leak," which in my mind is the way in which the idea moved from a taboo subject -- a conspiracy theory -- to a perfectly acceptable topic of discussion. In fact, last week, Facebook removed its ban on posts discussing the laboratory escape of the virus as a possibility. How could this happen? What was misinformation yesterday is something that needs investigating today? Other writers have discussed how prominent social media accounts took extreme positions that dissuaded the media from fairly considering the possibility of a lab leak, and on the heels of an election, turned the lab-leak idea into a political issue.
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Pain Medicine Case Reports (PMCR) and Editor-in-Chief Alaa Abd-Elsayed, MD, PhD would like to invite you to submit case reports and case series to the PMCR journal. Your article will be published free of charge.
Open access journals are freely available online for immediate worldwide open access to the full text of published articles. There is no subscription fee for open access journals. Open access journals are no different from traditional subscription-based journals: they undergo the same peer-review and quality control as any other scholarly journal.
Interested in becoming a member of the PMCR Editorial Board?
Editorial board members are asked to review 2-6 manuscripts per year. Please submit your most up-to-date CV to sgold@asipp.org for consideration.
For more information or to submit your articles, click here.
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| CASE REPORT |
Lia Alves Martins Mota Lustosa, MD, Felipe Chiodini Machado, MD, PhD, Glison Carone Neto, MD, Luisa Oliveira de Paiva, MD,
and Hazem Adel Ashmawi, MD, PhD
Abstract
BACKGROUND: Pain is a usual symptom in patients with POEMS syndrome. The pain occurs in the superior and inferior limbs and it is featured as numbness, weakness, and tingling that worsens with movement of the affected limb.
CASE REPORT: A 58 year-old-woman began to feel numbness, tingling, and burning in the lower members with progression to her upper extremities, hyperpigmentation, and cutaneous sclerosis. She was in treatment for chronic inflammatory demyelinating polyneuropathy (CIDP) but the symptoms worsened and she was admitted to the hospital. Her laboratory exams showed increases in pro-BNP (N-terminal prohormone of brain natriuretic peptide), platelets, B-2-microglobulin, monoclonal IgG lambda, thyroid stimulating hourmone (TSH), and decreases in T4 and cortisol levels. Computed tomography angiography showed moderate bilateral pleural effusion, pericardial effusion, hepatomegaly, and severe pulmonary hypertension. Thus, she was diagnosed with POEMS syndrome. She reported constant burning, paresthesia, and tingling in both hands with a Visual Analog Scale (VAS) score of 8 of 10, while taking daily doses of 1800 mg of gabapentin, 400 mg of carbamazepine, 4 g of dipyrone, and 100 mg of amantadine. Topical lidocaine 2% + amitriptyline 4% cream was prescribed twice a day. After 2 days of using the cream, the patient reported significant pain improvement, and after 7 days her VAS pain score was 1 of 10. Afterwards, the patient was discharged for ambulatory follow-up.
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| OBSERVATIONAL STUDY |
Amelie Poilliot, MSc, Daisuke Kurosawa, MD, Mireille Toranelli,
Ming Zhang, MMed, PhD, Johann Zwirner, MD,
Magdalena Müller-Gerbl, MD, and Niels Hammer, MD
Abstract
BACKGROUND: Sacroiliac joint arthrodesis is an ultima ratio treatment option for sacroiliac joint dysfunction. Fusion drastically reduces sacroiliac joint movement providing long-lasting pain-relief associated with tension-relief to the innervated sacroiliac joint structures involved in force closure.
OBJECTIVES: To display the bone mineralization distribution patterns of the subchondral bone plate in 3 distinct regions (superior, anterior, and inferior) of the sacral and iliac counterparts of the sacroiliac joint pre- and post-sacroiliac joint arthrodesis and compare patterns of sacroiliac joint dysfunction post-sacroiliac joint fusion with sacroiliac joint dysfunction pre- arthrodesis patterns and those from healthy controls.
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| OBSERVATIONAL STUDY |
Zhixiang Huang, MD, Guochao Li, MD, Weiming Deng, MD,
Meng Liu, MD, and Tianwang Li, MD, PhD
Abstract
BACKGROUND: Sacroiliac joint (SIJ) abnormality is a potential source of low back pain (LBP), therefore numerous patients receive various treatments because of the degenerative changes of SIJ. However, the outcome is unfavorable for patients because these morphologic alterations are common but not the origins of LBP. Previous studies revealed lumbar fusion and transitional vertebra increased the prevalence of degeneration of SIJ. Lumbar disc herniation (LDH) is one of the most common lumbar diseases, but there is no study regarding the relationship between LDH and SIJ degradation.
OBJECTIVES: The aim of this study was to investigate the severity of SIJ degeneration in patients with LBP with LDH. The relationship between degenerative changes of SIJ and LDH was also assessed.
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Great News!
The Annual Meeting of the
Ohio & Kentucky Societies of
Interventional Pain Physicians is back!
Designated for 15 AMA PRA Category 1 Credits™
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Since this malpractice insurance program officially launched in November 2018, ASIPP has signed up hundreds of providers with an average savings of 30%. This is professional liability insurance tailored to our specialty and will stand up for us and defend our practices.
Norcal Mutual is 'A' Rated by AM best and is license in all 50 states. To read a few important points to keep in mind about the program, including discounts, administrative defense, cyber coverage, aggressive claims handling, and complimentary award-winning risk management CME activities, click here.
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ASIPP® is now offering our members the benefit of a unique revenue cycle management/ billing service. We have received a tremendous amount of interest in the ASIPP® billing and coding program.
Click here to learn more about the negotiated rate for practices and more!
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ASIPP® has formed a partnership with Henry Schein and PedsPal, a national GPO that has a successful history of negotiating better prices on medical supplies and creating value-added services for the independent physician. Working with MedAssets, PedsPal provides excellent pricing on products like contrast media that alleviate some of the financial pressures you experience today.
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up-to-date news related to you, your practice, and your patients!
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