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INSTITUTE OF MEDICINE OF CHICAGO

  • 7 Jun 2023 5:28 PM | Deborah Hodges (Administrator)

    There is no way around this: More patients need organ transplants than there are organs available to transplant. It is cold, hard arithmetic. No amount of negotiating with an insurance company or engaging in prior authorization can change that. [Medscape]

    As a kidney doctor, this issue is close to my heart. There are around 100,000 people on the kidney transplant waiting list in the US, with 3000 new patients being added per month. There are only 25,000 kidney transplants per year. And each year, around 5000 people die while waiting for a transplant.

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  • 6 Jun 2023 5:40 PM | Deborah Hodges (Administrator)

    Today, the U.S. Food and Drug Administration granted marketing authorization for the Cue COVID-19 Molecular Test. The product is a molecular nucleic acid amplification test (NAAT) that is intended to detect genetic material from SARS-CoV-2 virus present in nasal swabs from adults with signs and symptoms of upper respiratory infection. This test is the first at-home over-the-counter (OTC) test for COVID-19 to be granted marketing authorization using a traditional premarket review pathway and the first ever at-home test authorized using a traditional premarket review pathway for any respiratory illness.  [Food and Drug Administration]

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  • 5 Jun 2023 5:26 PM | Deborah Hodges (Administrator)

    “Despite various investments and political action, maternal death rates have climbed in recent years, especially for Black women. California passed a law in 2021 to confront racial disparities in maternal and infant health, but advocates say there needs to be mechanisms for transparency and accountability and deeper investment. [Public Health Institute] 

    Dana Sherrod is co-founder and director of the California Coalition for Black Birth Justice and an expert in advancing health and racial equity at hospitals and government agencies. 

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  • 2 Jun 2023 4:50 PM | Deborah Hodges (Administrator)

    The field of transplant medicine is rapidly developing technologies to address the severe organ shortage. With the transplant system and organ procurement organizations under increasing congressional scrutiny to improve efficient use of organs, there are growing efforts to optimize use of transplantable organs coming from donors who have been declared dead by circulatory criteria. Unlike organs obtained from living or brain-dead donors, those procured from donations after circulatory death are often compromised by hypoxic-ischemic injury because they cannot be removed until the donor has been declared dead, which in the US is typically after the donor has been pulseless for 5 minutes. [JAMA Network]

    Although multiple techniques have been developed to minimize or partially reverse the ischemic injury associated with donation after circulatory death, none has been as promising as normothermic regional perfusion. Although enthusiastically endorsed by many as an approach to procuring more and higher-quality organs, normothermic regional perfusion has also drawn criticism, including concerns that it may violate the “dead donor rule,” a fundamental ethical principle of organ procurement that prohibits procedures that may result in patients dying either by or for the procurement of their organs.

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  • 1 Jun 2023 8:53 AM | Deborah Hodges (Administrator)

    About 10% of people infected with Omicron reported having long COVID, a lower percentage than estimated for people infected with earlier strains of the coronavirus, says a study published in The Journal of the American Medical Association. [Medscape]

    The research team looked at data from 8,646 adults infected with COVID-19 at different times of the pandemic and 1,118 who did not have COVID. 

    "Based on a subset of 2,231 patients in this analysis who had a first COVID-19 infection on or after Dec. 1, 2021, when the Omicron variant was circulating, about 10% experienced long-term symptoms or long COVID after six months," the National Institutes of Health said in a news release. 

    People who were unvaccinated or got COVID before Omicron were more likely to have long COVID and had more severe cases, the NIH said.

    Previous studies have come up with higher figures than 10% for people who have long COVID. 

    For instance, in June 2022 the CDC said 1 in 5 Americans who had COVID reported having long COVID. And a University of Oxford study published in September 2021 found more than a third of patients had long COVID symptoms.

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  • 31 May 2023 11:41 AM | Deborah Hodges (Administrator)

    A global collaboration, known as the International Pathogen Surveillance Network, will harness pathogen genomics to improve disease surveillance and identify and respond to disease-causing agents before they become pandemics or epidemics, the World Health Organization (WHO) announced. The Network will connect members of different countries to improve sample collection and analysis and facilitate public health decision-making, among other goals.

    Pathogen genomics—which involves analyzing the genomes of viruses, bacteria, and other contagions to understand their infectivity, deadliness, and transmission—has played a key role in the world’s ability to respond to diseases, from COVID-19 to HIV, according to the WHO. [JAMA] 

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  • 31 May 2023 11:31 AM | Deborah Hodges (Administrator)

    Question  How many children receive intensive care in the US annually? [JAMA Network]

    Findings  In this cohort study of all hospital discharges of children in 21 states, there was an increase in the proportion of admissions involving intensive care from 2001 to 2019. Meaning  The findings indicate increasing medical complexity and illness severity and longer hospital stays among critically ill children in the US.

    Design, Setting, and Participants  This population-based retrospective cohort study used data from the Healthcare Cost and Utilization Project’s state inpatient databases from a total of 21 US states in 2001, 2004, 2010, 2016, and 2019. Hospitalized children aged 0 to 17 years, excluding newborns (during birth hospitalization), were included. Patients admitted to rehabilitation institutions or psychiatric hospitals were also excluded. Data were analyzed from July 2021 to December 2022.

    Original Investigation - Caring for the Critically Ill Patient

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  • 30 May 2023 1:49 PM | Deborah Hodges (Administrator)

    Illinois’ health associations generally support a roughly $50.6 billion spending plan approved by the General Assembly over the weekend. [Health News Illinois] 

    A sticking point for lawmakers last week was how much to increase wages for those who work with individuals with developmental disabilities. The initial budget draft included a $2 per hour increase, but the final approved package raises that to $2.50 an hour.

    The Illinois Association of Rehabilitation Facilities was opposed to the initial proposal and thanked lawmakers for the additional funds.

    “The extra dollars will help our members address a crisis in staffing that is reducing services available to those with disabilities in Illinois,” they said in a statement. “We have to stay ahead of the growing state minimum wage to recruit and retain workers, and this increase will help do that.”

    Illinois Health and Hospital Association CEO A.J. Wilhelmi said the package has a welcome focus on healthcare services and “advances much-needed, long-term financial assistance for hospitals.”

    “This state investment secures critical, ongoing relief in response to the financial challenges and workforce pressures Illinois hospitals are navigating in the wake of the COVID-19 pandemic,” he said, referring to a provision that includes 10 percent increases to hospital Medicaid base rates. "This legislative action will help preserve access to care for all Illinois residents — particularly our most vulnerable populations — and protect the long-term viability of Illinois hospitals.”

    The Illinois Primary Health Care Association highlighted an additional $50 million their members are expected to receive to support Medicaid rates, as well as budget provisions that add $3 million for scholarship and student loan repayment programs for healthcare workers from underrepresented backgrounds and expand billable behavioral health provider types.

    “During a difficult budget climate, we greatly appreciate the Legislature’s vote of confidence and willingness to continue investing in the community health centers — a model that has proven to keep people healthy, thereby improving patient health outcomes and lowering Medicaid costs,” they said in a statement.

    The House approved the package early Saturday morning along party lines. Gov. JB Pritzker said he intends to sign it into law.

    “I look forward to signing this budget making childcare and education more accessible, healthcare more affordable and our state’s business and economic position even stronger,” he said.

    Other provisions in the plan include $550 million to fund a program that provides Medicaid-like coverage to certain undocumented individuals. The proposal does not expand eligibility for the program, a step advocates had sought this spring.

    The Medicaid omnibus approved Friday gives the Department of Healthcare and Family Services emergency rulemaking to implement provisions intended to reign in the costs of the program, which is estimated to hit $1.1 billion in the coming year.

    The budget would also:

     

    ·    Provide an additional $38 million for 23 safety-net hospitals that serve low-income communities.

    ·    Provide $18 million to establish a reproductive health navigation hotline, training and consultation programs.

    ·    Create a council to advise HFS on how to support veteran suicide prevention.

    ·    Grant the Office of Firearm Violence Prevention the ability to award violence prevention organizations grants for violence prevention services related to behavioral health, including clinical interventions, crisis interventions and group counseling supports.

    ·    Establish the Opioid Remediation Services Capital Investment Grant Program.

     

    Rep. Jehan Gordon-Booth, a Democrat from Peoria and lead House budget negotiator, said the package is a “fiscally and socially responsible plan” that will, in part, help more individuals access healthcare services.

     

    “I am appreciative of the months of negotiation and hard work from both sides of the aisle to develop this responsible and compassionate plan, and look forward to the strong, positive impact it will have on uplifting families across our state,” she said.

     

    Rep. Norine Hammond, the Republican’s chief budgeteer from Macomb, said the budget “does not reflect our shared priorities.”

     

    “Despite their statements to the contrary, the budget passed by the majority Democrats is not balanced,” she said. “It relies on a series of fiscal fabrications and schemes, such as only funding half-a-year’s-worth of Medicaid costs and shifting $700 million from local government funds into the State’s General Revenue Fund.”


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  • 26 May 2023 7:44 AM | Deborah Hodges (Administrator)

    Question  What symptoms are differentially present in SARS-CoV-2–infected individuals 6 months or more after infection compared with uninfected individuals, and what symptom-based criteria can be used to identify postacute sequelae of SARS-CoV-2 infection (PASC) cases? [JAMA etwork]

    Findings  In this analysis of data from 9764 participants in the RECOVER adult cohort, a prospective longitudinal cohort study, 37 symptoms across multiple pathophysiological domains were identified as present more often in SARS-CoV-2–infected participants at 6 months or more after infection compared with uninfected participants. A preliminary rule for identifying PASC was derived based on a composite symptom score.

    Meaning  A framework for identifying PASC cases based on symptoms is a first step to defining PASC as a new condition. These findings require iterative refinement that further incorporates clinical features to arrive at actionable definitions of PASC.

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  • 25 May 2023 4:54 PM | Deborah Hodges (Administrator)

    After a three-year period of continuous Medicaid/CHIP enrollment under the COVID-19 public health emergency, states could begin terminating coverage for ineligible residents in April. With redeterminations underway, health policy experts say too many people in some states are losing health coverage for the wrong reasons. [Becker's Payer Issues]

    "Too many people are falling through the cracks in the system," Alison Yager, executive director of the Florida Health Justice Project, told Vox on May 19. "This should be of grave concern to all those charged with protecting the health of our residents."

    ...HHS has estimated that 15 million people total will lose Medicaid coverage during redeterminations.

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