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  • October 21, 2016 9:41 AM | Deleted user
    Resveratrol also decreases fasting insulin level and increases Insulin Sensitivity Index

    THURSDAY, Oct. 20, 2016 (HealthDay News) -- For patients with polycystic ovary syndrome (PCOS), resveratrol is associated with significant reductions in ovarian and adrenal androgens, according to a study published online Oct. 18 in the Journal of Clinical Endocrinology & Metabolism.

    Beata Banaszewska, M.D., Ph.D., from the Poznan University of Medical Sciences in Poland, and colleagues evaluated endocrine and metabolic effects of resveratrol on PCOS in a randomized placebo-controlled trial conducted over a three-month period. Thirty-four patients were enrolled in the trial and 30 completed the trial.

    The researchers observed a significant 23.1 percent decrease in total testosterone with resveratrol (P = 0.1). Resveratrol also induced a 22.2 percent decrease in dehydroepiandrosterone sulfate, a 31.8 percent decrease in fasting insulin level, and a 66.3 percent increase in the Insulin Sensitivity Index (P = 0.01, 0.007, and 0.04, respectively). There were no significant alterations in the levels of gonadotropins, lipid profiles, and markers of inflammation and endothelial function.

    "Resveratrol significantly reduced ovarian and adrenal androgens," the authors write. "This effect may be, at least in part, related to an improvement of insulin sensitivity and a decline of insulin level."

    RevGenetics provided resveratrol for this study. The Adamed Group partially supported the study and produced the placebo pills.

    Full Text

    Copyright © 2016 HealthDay. All rights reserved.

  • October 21, 2016 9:39 AM | Deleted user

    Two doses of a vaccine that protects against cervical and several other types of cancer are enough for 11-to 12-year-olds, rather than the previous three-shot regimen, the U.S. Centers for Disease Control and Prevention said on Wednesday.

    Vaccines against the human papillomavirus, or HPV, Merck & Co Inc's Gardasil and GlaxoSmithKline Plc's Cervarix, have been available for years, but acceptance by the public has been slow.

    "Safe, effective, and long-lasting protection against HPV cancers with two visits instead of three means more Americans will be protected from cancer," CDC Director Tom Frieden said in a statement. "This recommendation will make it simpler for parents to get their children protected in time."

    The CDC now recommends that 11- to 12-year-olds receive two doses of HPV vaccine at least six months apart. Adolescents aged 13 and 14 can also receive the two-dose schedule, but teens and young adults who start the series later, at ages 15 through 26 years, will continue to need three doses, the agency said.

    HPV is among the most common sexually transmitted diseases. Most infections do not cause symptoms and go away on their own, but the virus is still a leading cause of cancer deaths among women worldwide. Since the virus can also cause genital warts and cancers of the anus and mouth/throat, the vaccine is recommended for both sexes.

    In the United States, the HPV vaccine is recommended for children aged 11 or 12, with the goal of protecting them against the virus before they become sexually active, and also for teens and young adults who may not have previously been vaccinated.

    (Reporting by Deena Beasley; Editing by Peter Cooney)

  • October 21, 2016 9:37 AM | Deleted user

    Last year, more STDs were reported in the United States than ever before, a troubling rise that federal health officials say is partly a result of budget cuts in state and local health departments.

    Annual surveillance data from state and local levels showed an increase in all three nationally reportable STDs, the CDC announced. In total, there were 1,946,233 cases of chlamydia, gonorrhea and syphilis reported in 2015 around the country — a record high.

    Jonathan Mermin

    The burden was particularly high in young people and gay and bisexual men.

    “We have reached a decisive moment for the nation,” Jonathan Mermin, MD, MPH, director of the CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, said in a news release. “STD rates are rising, and many of the country’s systems for preventing STDs have eroded. We must mobilize, rebuild and expand services — or the human and economic burden will continue to grow.”

    STDs cost the U.S. health care system nearly $16 billion each year, according to the CDC. Many cases of chlamydia, gonorrhea and syphilis are undiagnosed and unreported. Further, several STDs such as HPV and herpes simplex are not routinely reported at a national level, meaning the annual CDC captures only a fraction of the actual STDs cases around the country each year.

    According to the CDC, in 2015:

    • Patients aged between 15 and 24 years accounted for nearly two-thirds of the more than 1.5 million cases of chlamydia and half of the nearly 400,000 cases of gonorrhea.
    • Men who have sex with men accounted for the majority of new gonorrhea and primary and secondary syphilis cases, and may face a higher risk of antibiotic resistant gonorrhea.
    • The rate of syphilis diagnosis among women rose more than 27% since 2014, and there was a 6% increase in congenital syphilis to 487 cases.

    All three reportable diseases are curable with antibiotics and widespread access to screening and treatment can limit their spread. But budget cuts in over half of state and local STD programs have resulted in more than 20 health departments closing, the CDC said.

    The rates of all three reportable diseases increased by at least 6%, including a 19% rise in primary and secondary syphilis.

    “STD prevention resources across the nation are stretched thin, and we’re beginning to see people slip through the public health safety net,” Mermin said. “Turning the STD epidemics around requires bolstering prevention efforts and addressing new challenges — but the payoff is substantial in terms of improving health, reducing disparities and saving billions of dollars.” – by Gerard Gallagher


    CDC. Sexually transmitted disease surveillance. 2015. Accessed Oct. 19, 2016.

    Disclosures: Mermin reports no relevant financial disclosures.

    Read the full article here.

  • October 20, 2016 9:27 AM | Deleted user
    Concentrations suggest higher fetal exposure to metabolites than the drug

    WEDNESDAY, Oct. 19, 2016 (HealthDay News) -- In pregnant women taking the antidepressant bupropion, the drug and its active metabolites cross the placenta to the fetal circulation, according to a study published in the October issue of the American Journal of Obstetrics & Gynecology.

    Valentina M. Fokina, from the University of Texas Medical Branch in Galveston, and colleagues investigated the transfer of bupropion and its major pharmacologically active metabolites (hydroxybupropion and threohydrobupropion) across the placenta in 22 women taking bupropion during pregnancy. Samples included maternal blood (22 subjects), umbilical cord venous blood (22 subjects), and amniotic fluid (nine subjects).

    The researchers found that the levels of hydroxybupropion and threohydrobupropion in umbilical cord venous plasma were lower than the corresponding concentrations found in maternal plasma. For the majority of the maternal-cord blood pairs, concentrations of bupropion in umbilical cord plasma were lower than in maternal plasma. Bupropion and its metabolites were detectable in amniotic fluid; however, the concentrations of threohydrobupropion were higher than those in the corresponding umbilical cord venous plasma.

    "The biological consequences of fetal exposure to maternally administered bupropion and/or its active metabolites via placental transfer and recirculation of the amniotic fluid are yet to be determined," the authors write.

    Full Text (subscription or payment may be required)

    Copyright © 2016 HealthDay. All rights reserved.

  • October 20, 2016 9:25 AM | Deleted user
    Younger patients, having proximal stones, needing IV narcotics more likely to return

    WEDNESDAY, Oct. 19, 2016 (HealthDay News) -- Among patients with ureteral stones, those who are younger, have proximal stones, and require intravenous narcotics for pain control are more likely to return to the emergency department within 30 days, according to a study published in the November issue of The Journal of Urology.

    Vishnu Ganesan, from the Cleveland Clinic, and colleagues reviewed the 2010 to 2013 records for 1,510 emergency department patients at a single institution with a diagnosis of urolithiasis and an associated computed tomography scan. Images were reviewed to confirm stone size, location, and degree of hydronephrosis.

    The researchers found that 164 patients (11 percent) revisited the emergency department within 30 days. The presence of a proximal ureteral stone, age less than 30 years, and the need for intravenous narcotics in the emergency department remained independently associated with an emergency department revisit, according to multivariable analysis.

    "Consideration should be given for early follow-up or intervention for these patients to prevent costly emergency department returns," the authors write.

    Full Text (subscription or payment may be required)

    Copyright © 2016 HealthDay. All rights reserved.

  • October 20, 2016 9:24 AM | Deleted user

    After bariatric surgery, women with polycystic ovary syndrome (PCOS) not only lost weight but also experienced decreases in both ovarian volume and markers of androgen excess, according to data presented at the American Society for Reproductive Medicine (ASRM) 2016 Scientific Congress & Expo.

    Researchers conducted a retrospective chart review of 33 women with PCOS who underwent bariatric surgery at the Cleveland Clinic Foundation from 2009 to 2015. Information on pre- and postoperative weight, testosterone levels, dehydroepiandrosterone (DHEAS), HbA1c, fasting glucose, BMI, weight, and ovarian volume were gleaned from medical records.

    Weight and BMI were significantly lower after bariatric surgery than before the procedure (95.7 kg vs 126.3 kg and 37.4 vs 47.5, respectively; P <.0001 for both). Similar results were seen for ovarian volume (7.7 mL vs 14.0 mL; P =.036), as well as a trend toward decreases in total testosterone (38.4 ng/dL vs 56.1 ng/dL), free testosterone (4.5 pg/mL vs 10.3 pg/mL), and DHEAS (132.9 mcg/dL vs 196.3 mcg/dL).

    “These results suggest that weight loss associated with bariatric surgery may result in resolution of the key characteristics associated with PCOS including androgen excess and ovarian enlargement,” the researchers concluded.

    “Women with PCOS experience a large set of painful, discouraging, and uncomfortable manifestations of the syndrome,” Owen K. Davis, MD, president of ASRM, said in a press release. “The study showing reduction in symptoms after bariatric surgery is encouraging, but such surgery is an extreme remedy and only appropriate for a few.”



    1. Christ J, Falcone T. Abstract O-82. Changes in ovarian morphology associated with bariatric surgery among women with polycystic ovary syndrome (PCOS). Presented at: ASRM 2016 Scientific Congress & Expo; October 15-19, 2016; Salt Lake City, UT.
    2. Polycystic ovary syndrome increases risk of eating disorders, PCOS symptoms diminish after bariatric surgery [press release]. Washington, DC: ASRM Office of Public Affairs; October 17, 2016.
      . Accessed October 17, 2016.

  • October 20, 2016 9:22 AM | Deleted user

    The PA Foundation IMPACT Grant Program provides funding to encourage and support PA and PA student involvement in programs that improve health, consistent with the mission, values and vision of the PA Foundation. Through the program, the Foundation seeks to support patient-focused, community-based health projects that demonstrate an impact on patient health outcomes.

    2016 Timing and Availability of Funds

    The PA Foundation will offer two grant cycles in 2016, one opening in February and the other in October.
    The second cycle will open October 15.

    Add the cycle open date to your calendar.

    October 2016 Grant Cycle – Mental Health Focus

    The PA Foundation seeks to support patient-focused, community-based health projects in the area of mental health that demonstrate an impact on patient health outcomes.

    Read the qualifications and requirements document.

    Who Can Apply?

    All grant applications must be submitted by one or more PAs or PA students who are members in good standing of AAPA. Applications must be made in conjunction with a 501(c)(3) sponsoring organization, such as a nonprofit hospital or nonprofit community organization, an accredited PA Program, or an AAPA Constituent Organization. Depending upon the specific project and the potential liability it may involve, the PA Foundation reserves the right to condition approval of an application on affiliation with a sponsoring organization. In the evaluation process, preference will be given to those applicants who have not already been awarded a grant from the PA Foundation within the preceding 12 months (including both IMPACT Grants and Global Outreach Grants).

    October 2016 Evaluation Criteria

    Preference will be given to:

    1. Projects/programs focused on mental health patient education, screening/referral, and patient outcomes.
    2. Projects/programs that test new PA-led models of care in mental health, which may include screening/referral methods, and/or thatintegrate mental health education into clinical visits.
    3. Projects/programs focused on reducing stigma associated with mental health disorders.

    Proposals will be evaluated based on the following criteria:

    1. Clarity of the goals and activities of the project and alignment with designated mental health focus
    2. Demonstration of PA leadership and involvement
    3. Impact on the health of the target population

    Please note that grant funds may not be used to pay salaries or to reimburse organizations for salaries. Grant funding will not be provided to cover any indirect/administrative costs.

    2016 IMPACT Grants Requirements & Application

    Please read the grant requirements before applying for the IMPACT Grants.

    A written proposal (maximum 3 pages) addressing the following questions is required:

    1. How does this project address the mental health crisis, particularly in the areas of screening/referral, patient education, and stigma reduction?
    2. What are the characteristics of the patient population this project will serve?
    3. What points of data do you anticipate collecting during this project to measure impact?
    4. Show how other PAs or PA students will be involved in this program/project. How many will be involved and what are their roles?
    5. Indicate how PA value and/or PA utilization is critical in attaining the project objectives.
    6. Briefly summarize how the IMPACT Grant funding will improve or enhance population health of the community.
    7. What impact will this grant funding have on the success of this program/project?

    In addition to the written proposal, the following supporting materials are also required:

    1. Detailed project budget
    2. Letter of support signed by an official of the sponsoring organization

    Open date: October 15, 2016
    Deadline: November 18, 2016


    Special Funding Opportunity

    This grant cycle also includes a special opportunity to apply for an award in the area of substance use disorders (SUD), with a focus on enhancing knowledge of SUD treatment research and promoting adoption of evidence-based SUD treatment practices.

    Learn more and apply>>

    IMPACT Grant Recipients

    Learn more>>


    Questions? Contact Caroline Pierce at or 571-319-4510.

  • October 18, 2016 9:10 AM | Deleted user

    Did you know that APAOG has a member only forum? 

    Access the forum here and post your practice questions, help a colleague with a problem or stay up to date on the latest happenings through APAOG! 

    Be sure to click 'subscribe' to stay up to date.

  • October 18, 2016 8:34 AM | Deleted user

    Journal of Clinical Outcomes Management 

    In an article recently published in the Journal of Clinical Outcomes Management, researchers found that an expanded PA hospitalist staffing model at a community hospital provided similar outcomes and a lower cost of care than a conventional one. Researchers did a retrospective study comparing two hospitalist groups at a 384-bed community hospital in Annapolis, Md. One group had an expanded PA staffing model, with three physicians and three PAs. The other group had a "conventional" staffing model, with nine physicians and two PAs.

    Between January 2012 and June 2013, researchers examined the in-hospital mortality, cost of care, readmission, length of stay and consultant use. Between the two groups, there was no statistically significant difference for in-hospital mortality, readmission, length of stay, or consultant use. Cost of care was less in the expanded PA group. In conclusion, an expanding PA staff modeling can yield a similar level of care at a lower cost.

    AAPA sees this as an important study that has broader implications for PA utilization in a hospital setting across all service lines.

    Read more

  • October 14, 2016 2:04 PM | Deleted user

    Researchers found Zika virus sequences in placenta and cord blood in newborns, supporting prior evidence of vertical transmission of Zika virus during pregnancy, according to data published inJAMA Neurology. However, the investigators did not observe changes in umbilical and cerebral blood flow.

    Previous studies have reported an increase of microcephaly cases in fetuses whose mothers were infected with Zika virus.  Amilcar Tanuri, MD, PhD, from the Federal University of Rio de Janeiro, and colleagues sought to examine the prenatal evolution and perinatal outcomes in 11 neonates with neurologic damage associated with Zika virus infection.

    The researchers observed the infants from gestation to 6 months in Paraiba, Brazil. Seven infants were female, and the median maternal age at delivery was 25 years. Ten of the 11 women included in the study presented with symptoms of Zika during the first half of pregnancy, but all 11 women had Zika infection confirmed in several tissues by serology or polymerase chain reaction.

    The investigators used intrauterine ultrasonography and magnetic resonance imaging to confirm brain damage, and they performed histopathologic analysis on placenta and brain tissue in infants who died. They also investigated the Zika virus genome in several tissues and performed genome sequencing for phylogenetic analysis.

    The perinatal mortality rate was 27.3%. The median cephalic perimeter at birth was 31 cm, which was lower than the limit to consider a microcephaly case.  The researchers observed neurologic impairments in all patients, including microcephaly, a reduction in cerebral volume, ventriculomegaly, cerebellar hypoplasia, lissencephaly with hydrocephalus, and fetal akinesia deformation sequence.

    The Zika virus genome was identified in both maternal and neonatal tissues, including amniotic fluid, cord blood, placenta, and brain tissue. In addition, phylogenetic analyses revealed an intrahost variation between Zika virus sequences of some postmortem tissues.

    The researchers concluded that amniotic fluid may be valuable for prenatal diagnosis of Zika virus. They did not note changes in umbilical and cerebral blood flow, and they also note that microcephaly could be a consequence of several brain injuries.

    “Based on confirmed [Zika virus] ZIKV-associated cases of microcephaly reported by the Brazilian Ministry of Health, the northeastern region of Brazil has a 10 times larger incidence of confirmed cases compared with the rest of Brazil as well other Latin American countries where ZIKV circulates,” the study authors noted. “This fact suggests that there must be some additional unknown factor to enhance ZIKV fetal infection in this region. Coinfections as well as environmental factors should be explored to clear this unexpected finding.”


    1. Suely de Oliveira Melo A, Aguiar RS, Amorim MMR, et al. Congenital Zika virus infection: Beyond neonatal microcephaly. JAMA Neurol. 2016; doi: 10.1001/jamaneurol.2016.3720.

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