Starting Saturday, private health insurers will be required to cover up to eight home COVID-19 tests per month for those on their plans
Starting Saturday, private health insurers will be required to cover up to eight home COVID-19 tests per month for people on their plans. The Biden administration announced the change Monday as it looks to lower costs and make testing for the virus more convenient amid rising frustrations.
Under the new policy, first detailed to the AP, Americans will be able to either purchase home testing kits for free under their insurance or submit receipts for the tests for reimbursement, up to the monthly per-person limit. A family of four, for instance, could be reimbursed for up to 32 tests per month. PCR tests and rapid tests ordered or administered by a health provider will continue to be fully covered by insurance with no limit.
President Joe Biden faced criticism over the holiday season for a shortage of at-home rapid tests as Americans traveled to see family amid the surge in cases from the more transmissible omicron variant. Now the administration is working to make COVID-19 home tests more accessible, both by increasing supply and bringing down costs.
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Key Points
Question
What is the association between immunization with a third (booster) dose of BNT162b2 vaccine (Pfizer-BioNTech) and the incidence of SARS-CoV-2 infection among immunocompetent health care workers?
Findings
In this cohort study of 1928 health care workers in Israel who were previously vaccinated with a 2-dose series of BNT162b2, administration of a booster dose compared with not receiving one was significantly associated with lower risk of SARS-CoV-2 infection during a median of 39 days of follow-up (adjusted hazard ratio, 0.07).
Meaning
Among health care workers previously vaccinated with a 2-dose series of BNT162b2, administration of a booster dose compared with not receiving one was significantly associated with a lower rate of SARS-CoV-2 infection in short-term follow-up.
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ASIPP is conducting a survey on the practice patterns of perioperative management covering antiplatelet and anticoagulant therapy in Interventional Pain Management. We last surveyed this topic 10 years ago. We would like to compare the 2011 data to 2021 to see the changes to the practice pattern. Your help is needed to accomplish this!
We recently mailed to you the survey titled Practice Patterns of Perioperative Management of Antiplatelet and Anticoagulant in Interventional Pain Management. If you did not complete the survey, please take a few minutes to complete it mail it back to us in the prepaid return address envelope.
If you did not receive the survey, you may download the survey by clicking here. Please complete and e-mail it back to drm@asipp.org or fax to 270.554.5394.
This survey is most important to ASIPP and its members. It will demonstrate how our members practicing Perioperative Management utilize antiplatelet and anticoagulant therapy in pain management procedures. The more members that participate will increase the impact of the survey.
Please complete the survey and mail, e-mail, or fax back as soon as possible.
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Study examines which factors did, and didn't, play a role in risk
A significant proportion of all fully vaccinated adults who died of COVID-19 had at least four risk factors associated with severe outcomes, researchers found.
In addition to older age (65 and up) and being immunosuppressed, having chronic kidney, cardiac, pulmonary, neurologic, or liver diseases, as well as diabetes, were all associated with higher odds of severe COVID outcomes, and 77.8% of fully vaccinated adults who died had at least four of these risk factors, reported Sameer Kadri, MD, of the NIH Clinical Center in Bethesda, Maryland, and colleagues in the Morbidity and Mortality Weekly Report.
However, there were no increased odds of severe outcomes associated with sex, race/ethnicity, time since primary vaccination, or whether the infection occurred during the Delta variant wave.
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Medical experts who belonged to President Biden's transition team are calling for a new national COVID-19 strategy that accepts "the new normal" of living with the virus for the foreseeable future.
Since wiping out the virus doesn't appear to be realistic, the former advisers urged the setting of benchmarks that would trigger the enforcement or relaxation of public health restrictions, the health experts wrote in the journal JAMA. The benchmarks might include a certain number of COVID-related hospitalizations or deaths.
"The goal for the 'new normal' with COVID-19 does not include eradication or elimination … the 'zero COVID' strategy," they wrote. "Neither COVID-19 vaccination nor infection appear to confer lifelong immunity. Current vaccines do not offer sterilizing immunity against SARS-CoV-2 infection."
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Misusing prescriptions linked to substance use disorder symptoms by midlife
Prescription drug misuse (PDM) at any age posed a risk for developing substance use disorder symptoms in adulthood -- with some patterns posing bigger threats -- a new study suggested.
In a sample of nearly 27,000 individuals followed throughout adulthood, 45.7% reported past-year PDM at least once during the 32-year study period with 40% reporting poly-PDM (misuse of more than one prescription drug class in the same time period), Sean Esteban McCabe, PhD, of the University of Michigan School of Nursing in Ann Arbor, and colleagues wrote in JAMA Network Open.
After first surveying respondents at age 18 (study start 1976-1986) and following up with them through age 50 (2008-2018), researchers were able to determine unique PDM trajectory patterns falling into three main categories: early peak trajectories (around age 18), later peak trajectories (around age 40), and a high-risk trajectory (high frequency misuse at many ages).
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Dr. Walensky Said Deaths May Rise Dramatically Given the Sheer Number of Cases
"Given the number of cases we're seeing, death rates might very possibly rise dramatically."
With COVID cases at an all-time high, with more than a million cases expected per day, Americans are understandably concerned but unsure how worried they should be. According to reports, Omicron is "less severe" than Delta and accounted for 94% of cases. However, we all know someone who has been infected with COVID, and some of them are pretty sick. So, how are you going to stay safe? Dr. Rochelle Walensky, the Director of the Centers for Disease Control and Prevention, appeared on Fox News Sunday with presenter Bret Baier yesterday to face some tough questions on what you should do right now. Read on for five life-saving answers.
"What we're seeing with the Omicron variant is that it tends to be milder person by person, but given the large numbers, we're seeing more and more cases come into the hospital—in some hospitals that we've talked to, up to 40% of the patients who are coming in with COVID are coming in with something else and have had the COVID variant detected, not because they're sick with COVID.
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- Check your email and then log in as directed.
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If you have problems logging into your account, click here.
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One of the "worst things" a colleague can do is to say nothing
As part of an investigation into substance use among nurses amid the pandemic, MedPage Today asked experts and peer support advocates how to identify a nurse who might be struggling with alcohol or drugs and how best to help connect them to care.
Deborah Koivula, RN, BSN, CARN, the Eastern Regional Coordinator for the Statewide Peer Assistance for Nurses (SPAN) program in New York, said there are a number of signs to look for that can indicate a substance use disorder, although those signs can differ based upon the work environment and the type of substance involved.
Physical signs of substance use can include bloodshot eyes, shaking hands, or changes in a nurse's alertness -- such as appearing sleepy or tired, Koivula said.
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Call for
Abstracts & Poster Presentations
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Proposals accepted through March 1st
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A $50 submission fee is required upon completion of the form. |
Questions can be directed to
Savannah Gold at 270.554.9412 ext 4219 or
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After reading the 2022 Abstracts & Poster Presentations guidelines, please complete the form along with the presenter's CV by clicking here.
- Top 3 will present during the general session on the final day.
- Top 10 will present during the abstract breakout session.
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Rapid review and publication in the Pain Physician journal will be extended to the Top 10 authors accepted for meeting presentations.
Click here for Abstract and Poster Presentation
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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 |
Michael Gyorfi, MD, and Alaa Abd-Elsayed, MD
Abstract
BACKGROUND: Sural neuralgia is persistent pain in the distribution of the sural nerve that provides sensation to the lateral posterior corner of the leg, lateral foot, and fifth toe. Sural neuralgia is a rare condition, but can be challenging to treat and cause significant limitations. Posterior tibial neuralgia, also known as tarsal tunnel syndrome, is an injury or stretch affecting the tibial nerve at the medial border of the ankle and heel. We present one case of sural neuralgia complicated by superimposed posterior tibial neuralgia resistant to conservative management that were effectively treated with a peripheral nerve stimulator placement.
CASE REPORT: A 60-year-old man developed sural and posterior tibial neuralgias after a motorcycle accident resulting in severe injury of his left lower extremity. He underwent surgery for his open left distal tibia fracture. The patient continued to have pain which was not alleviated with physical therapy and conservative management. Six years after the initial injury and failing conservative management, he underwent successful sural and posterior tibial nerve blocks followed by placement of a peripheral nerve stimulator with improvement in pain and daily function.
CONCLUSIONS: Peripheral nerve stimulators may be a safe and effective treatment for both sural and posterior tibial neuralgias that do not respond to conservative therapy. However, large scale studies are needed to elucidate its effectiveness and safety profile.
KEY WORDS: Peripheral nerve stimulator, posterior tibial neuralgia, sural neuralgia
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| PROSPECTIVE TRIAL |
Derya Guner, MD, Ibrahim Asik, MD, G. Enver Ozgencil, MD, Elif Peker, MD, and M. Ilhan Erden, MD
Abstract
BACKGROUND: Chronic low back pain is observed frequently after lumbar spinal surgery. Epidural fibrosis has been implicated in the etiology of persistent pain after back surgery. The incidence of epidural fibrosis increases as the number and extent of spinal surgery increases. Epidural fibrosis can be detected by conventional radiologic methods [e.g., lumbosacral magnetic resonance imaging (MRI) with gadolinium], but these methods are insufficient to reveal the presence of epidural adhesions. Imaging of the epidural cavity using an epiduroscope is one of the best methods for visualizing the spinal cavity without damaging anatomic structures.
OBJECTIVES: To evaluate the correlation between the type and number of surgery and the degree of epidural fibrosis and to compare epidural fibrosis in epiduroscopic and MRI findings in patients with failed back surgery syndrome (FBSS).
STUDY DESIGN: A prospective trial.
SETTING: A university hospital.
METHODS: This study included 61 patients with persistent low back pain and/or radicular pain for at least 6 months, despite lumbar surgery and conservative treatment, and who accepted epiduroscopic imaging. All patients were evaluated in a physical examination using a visual analog scale (VAS) per the elapsed time after surgery. The patients were divided into 3 groups according to the number and type of surgeries. Epidural fibrosis was rated using MRI with gadolinium and epiduroscopy.
RESULTS: When the relationship between admission symptoms and epidural fibrosis was evaluated, MRI findings of fibrosis were found to be significantly higher in all patients with both lumbar and radicular pain symptoms at the confidence level of 95% (P = 0.001). The degree of fibrosis detected using epiduroscopy was grade 1 and 2 in almost all patients who presented with low back pain only, only radicular pain, or only distal paresthesia (P = 0.001). In the correlation analysis between the duration of the postoperative period (4.13 ± 2.97 years) and the degree of fibrosis detected using MRI and epiduroscopy, a statistically significant relationship was found at the confidence level of 95% (P < 0.05). As the number and extent of spinal surgeries increased, the incidence of MRI fibrosis increased, which is compatible with the literature (P = 0.001) There was a statistically significant relationship between the degree of fibrosis as detected using MRI and epiduroscopy at the confidence level of 95% (P < 0.05). Differently, we observed that 6 patients had grade 1 fibrosis as diagnosed using epiduroscopy, whereas none had fibrosis on MRI.
LIMITATIONS: We did not have a control group. Further studies are required to demonstrate the relevance of these 2 imaging techniques (epiduroscopy and MRI) in terms of detecting epidural fibrosis in patients with FBSS.
CONCLUSIONS: Epiduroscopic imaging seems to be more sensitive than MRI in detecting grade I epidural fibrosis in patients with FBSS. Thus, the possibility of low-grade epidural fibrosis as a source of pain after back surgery, should be kept in mind in normally reported MRIs. Treatment should be planned accordingly.
KEY WORDS: Back surgery, epidural fibrosis, epiduroscopy, failed back surgery syndrome, low back pain
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| RETROSPECTIVE STUDY |
Ge Luo, MD, Zhiqiang Zhang, MD, Jianjun Zhu, MD, Keyue Xie, MD, Huadong Ni, PhD, Jiachun Tao, MD, and Ming Yao, MD, PhD
Abstract
BACKGROUND: Pulsed radiofrequency (PRF) on the dorsal root ganglion (DRG) is a common minimally invasive surgery for herpes zoster (HZ)-related pain, including acute zoster pain and postherpetic neuralgia (PHN); however, some patients still have no obvious pain relief, a high recurrence rate, and short-term recurrence. Radiofrequency thermocoagulation (RF-TC) has a higher temperature; however, it is still unknown whether the degree of complete damage will affect the recurrence rate and if there is any difference compared with the effect of PRF.
OBJECTIVES: This study mainly aimed to explore whether there was a difference in the recurrence rate following CT-guided PRF and RF-TC for HZ-related pain. This is also a preliminary exploration of RF-TC for treatment of HZ-related pain.
STUDY DESIGN: A retrospective cohort study.
SETTING: The study was carried out in the Affiliated Hospital of Jiaxing University in Jiaxing, China.
METHODS: We included a total of 134 patients who underwent CT-guided PRF or RF-TC for HZ-related pain in the pain department. Medical records related to relapse, numerical rating scale scores (NRSs), Pittsburgh sleep quality index (PSQI), adverse events, and satisfaction were reviewed. The Kaplan-Meier analysis was used to estimate the cumulative survival rates of the surgical procedures. After controlling for related confounders, the relationship of surgical procedure and recurrence rate was analyzed by interval-censored multivariable Cox regression. A time-independent receiver operating characteristic (ROC) curve analysis confirmed the signature’s predictive capacity. A nomogram was used to predict postoperative recurrence. Multiple imputations was used to deal with the randomly missing data. Repeated-measures analysis of variance (ANOVA) was applied to analyze NRSs and PSQI at each time interval, and multiple comparisons were made.
RESULTS: In 134 patients with HZ-related pain, the ratio of patients receiving PRF to those receiving RF-TC was 1:1. Interval-censored multivariable Cox regression analysis demonstrated that lesion space (1-2% / ref: adjusted hazard ratio (HR), 2.075; 95% confidence intervals (CI), 1.002-4.210; > 2% / ref: adjusted HR, 3.406; 95% CI, 1.670 - 6.950), pain grade (adjusted HR, 2.249; 95% CI, 1.221 - 4.143) and surgical procedure (adjusted HR, 2.392; 95% CI, 1.308 - 4.375) were significantly associated with a higher risk of the primary outcome. There were 20 cases of recurrence in RF-TC group, while there were 30 cases in PRF group. The short-term (within 3 months) postoperative recurrence rate was 14.93% in the RF-TC group and 37.31% in the PRF group. The differences in PSQI and NRSs between 2 groups were also statistically significant.
LIMITATIONS: The study uses a small sample size from a single center. The model built is not validated internally or externally. The conclusions of randomized controlled trials will be more convincing. Subgroup analysis of the disease course was not performed.
CONCLUSION: In the treatment of HZ-related pain, the use of PRF is significantly associated with a high short-term recurrence rate. However, compared with RF-TC, PRF results in milder numbness and less intraoperative pain. RF-TC may be a feasible procedure if patients can accept pain relief at the cost of long periods of numbness, whether RF-TC has the value of clinical promotion still needs to be further explored.
KEY WORDS: Herpes zoster, postherpetic neuralgia, pulsed radiofrequency, thermocoagulation.
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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 licensed 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® 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 independent physicians. 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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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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