Morning Rounds Shraddha Chakradhar

Medicare looks to cover acupuncture for lower back pain

The Trump administration yesterday announced a proposal to cover acupuncture for chronic lower back pain under Medicare, saying it could be a way to reduce opioid prescribing for the common condition. “Defeating our country’s epidemic of opioid addiction requires identifying all possible ways to treat the very real problem of chronic pain,” HHS Secretary Alex Azar said in a statement. Alternative medicine procedures are not usually covered under the government program. The proposal only applies to those enrolled in trials conducted by the NIH or approved by CMS. In its announcement, CMS said the decision was made based on growing evidence in recent years to suggest that acupuncture could alleviate lower back pain, although questions about the procedure still remain.

Telemedicine is catching on among physicians

A new analysis finds that more physicians are gaining telemedicine skills, an industry that’s expected to grow to over $130 billion by 2025. Here’s more from the report: 

  • Skilled physicians: A little over 15% of physicians reported having telemedicine skills in 2016, but that figure has grown to nearly 25% in the past two years. 

  • Interest by age and sex: Roughly a quarter of physicians across most age groups expressed interest in telemedicine jobs. And female physicians were more likely to express an interest than their male counterparts.

  • Interest by specialty: Those in radiology, psychiatry, and internal medicine were most likely to express an interest in telemedicine, while anesthesiologists and general and orthopedic surgeons were least likely to do so. 

Nearly 80 organizations team up on reproductive policy ‘blueprint’

Nearly 80 medical, social justice, and civil rights organizations just put out a policy blueprint on reproductive and sexual health for legislators and government agencies. The organizations — including Planned Parenthood, the ACLU, and the Sierra Club — take on the high-profile areas of HIV/AIDS care and abortion, while also calling for expanded care access for those under 18, incarcerated people, and immigrants. The report also focuses on pregnancy and maternal health — for both within and outside the U.S., as it encourages U.S. foreign policy to make reproductive health a priority. In addition to calls for strengthening patient protections in clinical practice, including confidentiality, the report emphasizes the need for more scientific integrity and transparency in sexual and reproductive health research. 

Inside STAT: HIV’s genetic code, hidden in old tissue, adds to signs of virus’ emergence 

Using HIV hidden in lymph node tissue from more than 50 years ago, scientists have sequenced the genetic code of the virus, the oldest such sequence. It provides more evidence for what many scientists have suspected for a long time: that the virus that causes AIDS began infecting people around the beginning of the 20th century. With the new sample — which is from 1966 — scientists are able to tell that viruses that were circulating in the 1960s were already genetically diverse, which means that they had been evolving for a long time. And all of this work can help scientists better estimate when these viruses may have made the jump from primates to people. STAT’s Helen Branswell has more on this case of virologic archaeology.

Experts say to proceed with caution on keto diet

The ketogenic, or keto, diet is trending now, but experts are urging caution. The diet calls for consuming few to no carbs, and relies instead on high fat (upward of 70% of daily calories) and protein intake for weight loss and other cardiovascular benefits. But scientists say there isn’t enough evidence to support these claims. One review of studies they cite found that people on the keto diet, on average, lost less than a kilogram of weight compared to people on other diets. Another review also found limited benefit for reducing blood sugar levels. But given the litany of side effects that have been associated with this diet — including vitamin and mineral deficiencies and a chronic lack of dietary fiber — physicians and patients should follow the evidence and not the hype behind the diet, the experts write. 

ALS researcher who was diagnosed with disease dies

Dr.  Rahul Desikan, a scientist at the University of California, San Francisco, who dedicated his career to the study of neurodegenerative diseases before being diagnosed himself with amyotrophic lateral sclerosis, or ALS, died this week at age 41, the school announced late yesterday. Desikan was diagnosed with a rapidly progressing form of ALS in February 2017 and soon lost his ability to speak, walk, and use his hands. But he continued to work with the help of specialized computer equipment that allowed him to communicate through blinking and other eye movements. In the short span between his diagnosis and his death, he was an author, often the senior one, of 25 papers on neurodegenerative diseases, UCSF said.  "I love my research," he told The Washington Post late year, "and it gives me reason to live.” 

What to read around the web today

  • Rare disease discovery: Antibodies fighting cancer go on to attack brain. San Francisco Chronicle
  • The vaccine that could prevent stress, anxiety, and depression. Vice
  • The battle to separate Safa and Marwa. BBC
  • The promise and price of cellular therapies. The New Yorker
  • Following ‘CRISPR babies’ scandal, senators call for international gene editing guidelines. STAT

Thanks for reading! More tomorrow,


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Tuesday, July 16, 2019


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