Volume 115, No. 9: September 2019 EditionTop

They Said It...

"(Physician) burnout is economically harmful to medical practice, inherently dangerous to physician wellness, and if health care costs are ever able to get reined in, EMR/EHR must become less of a chore, less of a burden and more of a positive partner to all of us physicians." From the inaugural speech of PCMS President James L. Cristol, MD. You can find more of Dr. Cristol's remarks and an extensive interview with him in the latest issue of our magazine Philadelphia Medicine.

In the News... 
PDPH Issues Health Alert Regarding an Increase in Congenital Syphilis Cases A1

The Philadelphia Dept. of Public Health reports that this year there have been five cases of congenital syphilis reported to the STD Control Program. Last year, the city saw a total of four such cases. This year's data shows an overall increase of infectious syphilis in women of about 35%, particularly in women who inject drugs.

As a result, PDPH is reminding providers that they are required to screen pregnant women for syphilis. The screenings should take place at the first prenatal encounter, the third trimester of pregnancy, and at the delivery of a live or stillborn infant.

More information regarding the diagnosis and treatment of syphilis, including congenital syphilis, is available at https://www.cdc.gov/std/tg2015/syphilis.htm, or by calling PDPH at 215-685-6585.

Trump Administration to Place New Restrictions on Non-Tobacco Flavored E-Cigarettes A2

The Trump Administration announced that it intends to soon finalize a compliance policy that would effectively remove mint, menthol and other unauthorized non-tobacco-flavored e-cigarette products.

"The Trump Administration is making it clear that we intend to clear the market of flavored e-cigarettes to reverse the deeply concerning epidemic of youth e-cigarette use that is impacting children, families, schools and communities," said Health and Human Services Secretary Alex Azar. "We will not stand idly by as these products become an on-ramp to combustible cigarettes or nicotine addiction for a generation of youth."

The announcement came on the heels of preliminary figures from the National Youth Tobacco Survey that show a continuing rise of e-cigarette use of non-tobacco flavors that appeal to kids. The survey data show that more than a quarter of high school students are current e-cigarette users.

FDA Commissioner Ned Sharpless, MD, added that e-cigarette use by children is a mounting public health crisis. "The tremendous progress we've made in reducing youth tobacco use in the U.S. is jeopardized by this onslaught of e-cigarette use," he said.

CDC Issues Warning Concerning Vaping Following Recent Death A3

Last month, after the first death related to the outbreak of severe lung disease in people who use e-cigarettes or "vaping" devices, CDC Director Robert Redfield, MD, said, "This tragic death in Illinois reinforces the serious risks associated with e-cigarette products. Vaping exposes users to many different substances for which we have little information about related harms. E-cigarettes are not safe for youth, young adults, pregnant women, or adults who do not currently use tobacco products."

The CDC is consulting with several states about a cluster of pulmonary illnesses linked to e-cigarette product use among adolescents and young adults. About 100 possible cases of severe lung illness associated with vaping were reported in 14 states in just a six week period this summer.

For more information on the FDA's efforts to combat e-cigarette use by children, go to: https://www.fda.gov/tobacco-products/real-cost-campaign.

FDA Announces New Webpage on Respiratory Illnesses Associated with Vaping A4

The FDA and CDC are working closely with state and local health officials to investigate incidents of severe respiratory illnesses associated with the use of vaping products.

The FDA has created a Consumer Update to provide information to consumers to help protect themselves as well as a new Lung Illnesses Associated with Use of Vaping Products webpage. The webpage provides an overview of these incidents and the FDA's actions to date, and its recommendations to consumers, health care providers and state health departments.

Pa. Harm Reduction Coalition: Senate Bill 675 - Good Intentions, Bad Bill A5

PAHRC is calling on physicians to contact their representatives to voice their opposition to SB 675. The bill would require additional certification for physicians to prescribe the life-saving medication buprenorphine.

PAHRC says the bill would limit the use of the drug, creating another barrier to treatments for individuals with opioid use disorder. The bill is also opposed by the Pa. Society of Addiction Medication.

PAHRC says the bill was developed with the good intention of closing bad-actor cash clinics and to help end the abuse, misuse and diversion of FDA-approved medications for the treatment of opioid use disorder.

But the bill would also greatly impair the use of buprenorphine which is one of the drugs that have proven to be effective in treating opioid use disorder. The bill comes at a time when there is a major movement in the addiction medicine community for the deregulation of the drug.

PAHRC says SB 675 would impede access to evidence-based treatment.

PAHRC urges you to sign this letter addressed to the Pa. House Human Services Committee.

Electronic Prescribing Starts on October 24 A6

Electronic prescribing of controlled substances begins on this date with a few notable exceptions.

Act 96 mandates that all Schedule II through V controlled substances will be prescribed electronically, except when dispensed or administered directly to a patient by a practitioner or authorized agent, other than a pharmacist.

Practitioners, pharmacies or health care facilities that do not meet the electronic prescribing requirements may petition the Pa. Dept. of Health for a temporary exemption. The request for an exemption must be based on economic hardship, technical limitations or some other exceptional circumstance.

For more information on a temporary exemption, go to: https://expressforms.pa.gov/apps/pa/health/Act96-of-2018-Temporary-Exemption

Why Cheeseburgers Might be Just the Thing for Pregnant Women A7

Researchers at the Lewis Katz School of Medicine at Temple University have found that eating a high-fat diet during pregnancy could prevent the offspring from developing Alzheimer's disease later in life.

Scientists fed pregnant mice high-fat diets while giving a control group a regular diet of chow. After they gave birth, the mice were switched to a standard chow diet as they breastfed, and their babies were given regular chow.

The team tested the memory and spatial learning abilities of the offspring when they reached the age of 11 months and looked for signs linked to Alzheimer's disease such as the buildup of amyloid beta amino acids, and how well their synapses worked.

The high fat diet appeared to preserve the memory of the mice, as well as the functioning of their synapses. It also showed less of a buildup of amyloid beta. The study does not mean, of course, that the same effect would necessarily be seen in humans.

Team leader, Domenico Patico, MD, told Newsweek magazine: "Our original hypothesis was the high fat diet during pregnancy would have a negative effect on brain health of the offspring, which was based on the abundant literature showing that indeed direct exposure to a high fat diet has a negative impact. Obviously, we were totally wrong."

Dr. Pratico is the Scott Richards North Star Foundation chair for Alzheimer's Research, professor in the departments of Pharmacology and Microbiology, and director of the Alzheimer's Center at Temple at the Lewis Katz School of Medicine.

Calendar of EventsCalendar

5 - Give Kids Sight Day: Free Eye Care for Kids

Date: Saturday, October 5
Time: 8:30 AM - 1:00 PM
Place: Jefferson Alumni Hall, 1020 Locust Street, Philadelphia, PA 19107

PCCY (Public Citizens for Children and Youth) will be holding its "Give Kids Sight Day," a day of free eye checks and eye glasses for children who need them. It will be open for children 17 years and under from Philadelphia and surrounding counties, who have not had or have not passed an eye screening and/or are uninsured. Volunteers are needed for the program.

12 - 8th Annual Diabetes Symposium

Date: Saturday, October 12
Time: 8:00 AM - 2:15 PM
Place: Dorrance H. Hamilton Building, 1001 Locust Street, Philadelphia PA 19107

Thomas Jefferson University will be holding the 8th Annual Diabetes Symposium on October 12. CME Credits will be available. The symposium offers a unique learning experience emphasizing the interprofessional team approach needed to improve diabetes care and prevent complications. Expert faculty will guide participants in applying the new knowledge and clinical guidelines into their practices.

19 - Zelda Therapeutics' Medical Marijuana and Autism Symposium

Date: Saturday, October 19
Time: 7:45 AM - 5:00 PM
Place: Quorum at the University City Science Center, 3675 Market Street, Philadelphia, PA 19104

Zelda Therapeutics will be holding a Medical Marijuana (MMJ) and Autism Symposium at Quorum at the University City Science Center on October 19, 2019. Major figures in the MMJ industry, including Rachel Levine, Ethan Russo, Dustin Sulak and Bonni Goldstein will be speaking. Athena Zuppa will be sharing outcomes of CHOP's study as well.

25 - House of Delegates

Date: October 25-27
Place: The Hershey Lodge, 325 University Dr., Hershey, PA 17033

Join your colleagues for a lively, informative weekend of continuing education, leadership development, advocacy, and networking at the Pennsylvania Medical Society's House of Delegates Meeting and Annual Education Conference.

28 - Pennsylvania Harm Reduction Coalition Statewide Conference

Date: October 28-29
Place: Sheraton Harrisburg, 4650 Lindle Rd, Harrisburg, PA 17111

Advocates, clinicians, professionals, and community leaders will be coming together for a 2-day statewide conference on October 28th and 29th in Harrisburg to discuss cutting edge research and evidence-based solutions to the opioid epidemic.

1 - 2nd Annual New Jersey Neurovascular Symposium: Innovations and Updates in Assessment, Treatment and Care

Date: Friday, November 1
Time: 7:45 AM - 3:30 PM
Place: Crowne Plaza - Cherry Hill, 2349 Marlton Pike W, Cherry Hill, NJ 08002

The Vickie and Jack Farber Institute for Neuroscience of Jefferson Health is holding the 2nd Annual New Jersey Neurovascular Symposium on November 1. This annual conference looks at stroke management from a systems of care perspective, from pre-hospitalization to endovascular and neurosurgical interventions. It focuses on early recognition and determination of severity, as well as the latest advances in treatment and the importance of individualized care in the hospital setting.

Philadelphia County Medical Society | stat@philamedsoc.org
215-563-5343 | http://philamedsoc.org