Posts from 2016

Commensal Organisms Can Protect Against Pathogenic Bacteria


Recent studies published in Science Immunology and Science have shown how a commensal intestinal bacterium produces an enzyme that can help protect against pathogenic bacteria. 

“In our studies, we characterize both epithelial and commensal microbial contributions to a protective mechanism in the mammalian intestine that reduces early pathogen invasion and tissue damage,” write Virginia Pedicord, PhD, from Rockefeller University, New York, New York. “Our results suggest that the commensal bacterium [Enterococcus] faecium triggers enhanced epithelial barrier function and pathogen tolerance through its expression of a unique secreted peptidoglycan hydrolase, SagA [secreted antigen A].” 

The microbiome plays an important role in human health, and changes in its composition can help to promote either resistance to, or infection by, pathogenic bacteria. However, the specific factors in modulating host susceptibility to infection, as well as the mechanisms involved, have remained poorly understood. Researchers from Rockefeller University therefore conducted experiments to study the probiotic potential of the bacterium Enterococcus faecium, using Caenorhabditis elegansworms and mice infected with Salmonella bacteria.

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Lyme Disease Reminder!

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The Virginia General Assembly, in its 2013 Session, passed legislation that became law on July 1, 2013. Currently in the Code of Virginia at Section 54.1-2963.2, this law requires certain communication with patients who are tested for Lyme Disease. The obligation to provide the information is for all licensees of the Board of Medicine or an in-office designee that orders a laboratory test for Lyme. Below is the law in its entirety. 

CME Required for Certain Practitioners

Law was passed this year that authorizes the Board of Medicine to require certain prescribers to obtain 2 hours of continuing education on topics related to pain management, the responsible prescribing of opioids and other controlled substances, and the diagnosis and management of addiction. The licensees selected to obtain this focused continuing education will be determined by data from the Prescription Monitoring Program (PMP). In October, members of the Board will define the thresholds that will be used to identify these licensees. The thresholds will be reviewed by the Board’s Executive Committee on December 2, 2016. Notifications will be sent prior to January 1, 2017 to the licensees that are required to obtain this continuing education in the next biennium. Here is the bill that passed the House, the Senate, and was signed by Governor McAuliffe. To read more...

Opioid Educational Opportunities

One Care of Southwest Virginia, Inc. is teaming up with the Virginia Department of Health to offer free Category I CME programs around the state on pain management, proper prescribing of controlled substances, and substance abuse. Please consider taking advantage of one of these opportunities to enhance your knowledge, sharpen your practice skills, and provide safe and effective care to your patients. 

Opioid Addiction

Opioid Addiction Drug Underutilized in Medicare Patients

WEDNESDAY, July 20, 2016 (MedScape) -- Only a fraction of Medicare patients who have opioid use disorder receive opioid agonist therapy (OAT) with buprenorphine-naloxone (multiple brands), say US researchers, who found that nonspecialist physicians are the least likely to prescribe the drug.

The Medicare population of 55 million patients has one of the largest and fastest growing rates of opioid use disorder in the United States. More than 6 in 1000 Medicare patients are diagnosed with the disorder; this translates to more than 300,000 affected individuals. Moreover, 211,200 Medicare patients require hospitalization for opioid overuse every year.

Because Medicare Part D, which covers prescription drugs, does not pay for methadone maintenance, buprenorphine-naloxone is the only OAT that is covered for Medicare patients. It is the most effective pharmacotherapy for opioid addiction that is available for Medicare patients with opioid use disorder.

However, an analysis of claims data revealed that only about 81,000 Medicare patients are receiving buprenorphine-naloxone therapy and that the drug is prescribed by just 1 in 40 family physicians who prescribe an opioid painkiller. Moreover, it is rarely used by pain specialists.