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Anesthesiology

Brian Shinault, CEO of American Strategic Partners, Supports Permanently Removing Physician Supervision o – Benzinga

March 14, 2023 10:00 AM | 3 min read

Washington, DC March 14, 2023 --(PR.com)-- Brian Shinault, CEO of American Strategic Partners, released the following statement in support of permanently removing physician supervision of Certified Registered Nurse Anesthetists (CRNAs).

American Strategic Partners will join the American Association of Nurse Anesthesiology (AANA) in lobbying the Biden Administration and the 118th Congress to pass and enact H.R. 833 as law. The bipartisan Save Americas Rural Hospitals Act (H.R. 833) provides enhanced payments to rural healthcare providers to help ensure the viability of these important local healthcare facilities. H.R. 833 also includes a provision to permanently remove physician supervision of Certified Registered Nurse Anesthetists (CRNAs) under Medicare Part A conditions of participation and a provision to include non-medically directed CRNA services as a mandatory benefit under the Medicaid program.

Read the bill here.

American Strategic Partners has thoroughly investigated this issue by interviewing with doctors in diverse medical practices throughout the United States and researching data. Moreover, American Strategic Partners has engaged with representatives of the AANA and studied their data prepared in support of this issue.

Our findings have determined that it is imperative and not an option that the temporary pause on this regulation due to the public health emergency be deemed permanent by law. Research has shown that rural communities are in dire need and the Save Americas Rural Hospitals Act comes at a time when rural hospitals and health centers are facing unprecedented challenges and are struggling to keep their lights on and serve their communities. According to the National Rural Health Association, more than 170 rural hospitals across the country have closed their doors since 2005, and 453 rural hospitals are currently operating at levels like those that have shut down during the last decade, meaning they are vulnerable for closure. This is forcing patients to travel further to get the care they need and leaving others to put off necessary healthcare. According to the AANA, CRNAs are the primary providers of anesthesia care in rural settings and have been instrumental in delivering care during the pandemic to patients where they live and when they need it. In many medical settings, CRNAs serve as the sole anesthesia provider in rural hospitals, affording these facilities the capability to provide many necessary procedures.

The importance of CRNA services in rural areas was highlighted in a recent survey that examined the relationship between socioeconomic factors related to geography and insurance type and the distribution of anesthesia provider type. The study correlated CRNA services with lower-income populations and correlated anesthesiologist services with higher-income populations.

Of importance to the implementation of public benefit programs in the U.S., the study also showed that compared with anesthesiologists, CRNAs are more likely to work in areas with lower median incomes and larger populations of citizens who are unemployed, uninsured, and/or Medicaid beneficiaries.

For more information on this issue, contact American Strategic Partners or via linkedin.com/in/brian-shinault-jd-70a038b4.

Sources:https://www.congress.gov/bill/118th-congress/house-bill/833?(H.R. 833);https://www.aana.com/news (02-23-2023/newsroom press release)https://www.semanticscholar.org/paper/geographical-imbalance-of-anesthesia-providers-and-liao-quarishi/77112f1f7ca09a86142b4f5e7c065ae9a073dec2

Contact Information:American Strategic PartnersBrian Shinault202-487-1884Contact via EmailAmericanStrategicPartners.com

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Read the full story here: https://www.pr.com/press-release/881679

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2023 Benzinga.com. Benzinga does not provide investment advice. All rights reserved.

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Brian Shinault, CEO of American Strategic Partners, Supports Permanently Removing Physician Supervision o - Benzinga

Internal Medicine

ACP, Annals of Internal Medicine Host First Obesity Forum for … – American College of Physicians

Expert panel provides practical advice for managing overweight and obesity in clinical practice

PHILADELPHIA, March 14, 2023 On March 8, the American College of Physicians (ACP) andAnnals of Internal Medicinehosted the first virtual forum on the current clinical challenges related to managing overweight and obesity in clinical practice. During the forum, a panel of experts discussed three specific cases representing common clinical scenarios and answered audience questions about each of them. The panelists shared pragmatic clinical information and a replay of the full discussion is freely available to ACP members. The video and accompanying editorial from Christine Laine, MD, MPH, FACP, Senior Vice President of ACP and Editor-in-Chief of Annals of Internal Medicine and Christina Wee, MD, MPH, Senior Deputy Editor of Annals of Internal Medicine were published today in Annals of Internal Medicine.

Overweight and obesity now affects more than 40 percent of Americans and is associated with an increased risk for many common and serious illnesses, said Dr. Laine. Just as important, persons with obesity suffer from stigma, in large part because the condition has been erroneously viewed as a condition brought on by a persons own unhealthy behavior. In this forum, experts not only provide practical advice on management, but also help to dispel some of the misconceptions surrounding obesity that may contribute to unconscious bias among internal medicine physicians who are on the front lines treating these patients.

Dr. Wee, who is also an obesity researcher and Associate Professor of Medicine at Harvard Medical School and Beth Israel Deaconess Medical Center, served as moderator for the forum and introduced each of the panelists. These included:

After hearing the clinical vignettes, the panelists provided their recommendations for addressing the unique circumstances surrounding the patients overweight or obesity. The panelists made several important points, all of which are detailed in the forum editorial. Of note, they stressed that obesity is a complex medical condition resulting primarily from an interaction of genes and the environment. This distinction is crucial because physicians need to be able to discuss weight with patients without assigning blame or shame. It also goes a long way in explaining why modification of diet and exercise is difficult to achieve, notes Dr. Wee.

To solve a problem, one must be able to define it accurately. As such, the panelists discussed the importance of developing a better and more inclusive measure of overweight and obesity. Body mass index, or BMI, the current standard of body composition, is an imperfect measure that differs with ethnicity, sex, body frame, and muscle mass.

"In addition to better measures of obesity, we need better strategies for treatment," said Dr. Wee. "Studies show that diet and exercise alone are unlikely to result in long-term obesity benefit. The good news is that we now have effective pharmacological and surgical therapies that may need to be considered as part of a multi-component intervention for appropriate patients. Of course, shared decision-making is an important part of this approach."

The forum, Overweight and Obesity: Current Clinical Challenges, was the first forum of its kind hosted by ACP and Annals of Internal Medicine. Previous forums focused on the infectious diseases COVID-19 and MPox, and another forum focused on the physicians role in preventing firearm injury.

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About the American College of PhysiciansTheAmerican College of Physiciansis the largest medical specialty organization in the United States with members in more than 145 countries worldwide. ACP membership includes 160,000 internal medicine physicians, related subspecialists, and medical students. Internal medicine physicians are specialists who apply scientific knowledge and clinical expertise to the diagnosis, treatment, and compassionate care of adults across the spectrum from health to complex illness. Follow ACP on Twitter,FacebookandInstagram.

About Annals of Internal MedicineAnnals of Internal Medicineis the flagship journal of the American College of Physicians (ACP).Annalsis the most widely read and cited general internal medicine journal and one of the most influential peer-reviewed clinical journals in the world.Annals mission is to promote excellence in medicine, enable physicians and other health care professionals to be well-informed members of the medical community and society, advance standards in the conduct and reporting of medical research, and contribute to improving the health of people worldwide. New content is published every Tuesday atAnnals.org. Follow Annals on TwitterandInstagram@AnnalsofIM and onFacebook.

ACP Media Contact:Andrew Hachadorian, (215) 351-2514,AHachadorian@acponline.orgAnnals Media Contact:Angela Collom, (215) 351-2653, ACollom@acponline.org

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ACP, Annals of Internal Medicine Host First Obesity Forum for ... - American College of Physicians

Internal Medicine

Simmons Cancer Center investigators receive nearly $15 million in … – UT Southwestern

DALLAS March 13, 2023 Ten scientists in the Harold C. Simmons Comprehensive Cancer Center at UTSouthwestern Medical Center have been awarded nearly $15 million in grants from the Cancer Prevention and Research Institute of Texas (CPRIT) to advance research on a wide range of cancer issues.

Our researchers continue to push the envelope on developing a better understanding of cancer and new ways to help cancer patients in Texas and beyond, efforts that are well recognized in this current round of CPRIT funding, said Carlos L. Arteaga, M.D., Director of the Simmons Cancer Center, Associate Dean of Oncology Programs at UTSouthwestern, and holder of The Lisa K. Simmons Distinguished Chair in Comprehensive Oncology.

Keith E. Argenbright, M.D., Professor of Family and Community Medicine, in the Simmons Cancer Center, and in the Peter ODonnell Jr. School of Public Health, was awarded $2,500,000 to expand a program that provides breast cancer screening and follow-up care for low-income, uninsured, or underinsured women in the North Texas area. This project is expected to fund at least 1,850 screening mammograms and 125 biopsies and aims to reduce disparities in breast cancer screening and detection, particularly those associated with race/ethnicity and socioeconomic status. Dr. Argenbright is a Distinguished Teaching Professor at UTSW.

David Gerber, M.D., Professor in the Department of Internal Medicine and in the ODonnell School of Public Health and holder of the David Bruton, Jr. Professorship in Clinical Cancer Research, was awarded $1,922,312 to expand existing lung cancer screening and tobacco cessation programs. The effort targets ZIP codes with the greatest lung cancer risk and most pronounced health disparities, particularly in southern Dallas. To accomplish this goal, nurse navigators at Parkland Health will provide education, logistical support, and psychosocial support to patients through telephone, video, and on-site interactions.

Rodney Infante, M.D., Ph.D., Assistant Professor of Internal Medicine, Division of Digestive and Liver Diseases, and in the Center for Human Nutrition, was awarded $1,050,000 to study changes in the tumor microenvironment that promote cancer cachexia, a wasting syndrome that causes significant fat and muscle loss. Leveraging better insight into these tumor-host interactions could lead to new therapeutics for this undertreated condition.

Mamta Jain, M.D., Professor of Internal Medicine, was awarded $2,499,616 to expand an existing program that works to prevent liver cancer by screening for, immunizing against, and treating the associated hepatitis B (HBV) and hepatitis C virus (HCV). Rather than focusing on the baby boomer generation for these interventions, the researchers are expanding the program to focus on adults ages 18 to 79 for HCV and ages 19 to 59 for HBV.

Ram S. Mani, Ph.D., Assistant Professor of Pathology and Urology, was awarded $1,049,641 to better understand how enhancers DNA switches that regulate the expression of genes drive prostate cancer. The findings could lead to new strategies to prevent or delay prostate cancer.

Samuel McBrayer, Ph.D., Assistant Professor of Pediatrics and in the Childrens Medical Center Research Institute at UTSouthwestern, was awarded $1,048,465 to develop drugs based on a chemical called 5J12 that has shown promise in fighting glioblastoma (GBM), the most common type of primary brain cancer in adults. 5J12, which blocks a protein involved in making cholesterol, has been shown to kill GBM cells growing in petri dishes and has been given safely to mice. This work will be done in close collaboration with the laboratories of Deepak Nijhawan, M.D., Ph.D., Associate Professor of Internal Medicine and Biochemistry, UTSouthwestern Presidential Scholar, and holder of the Joseph F. Sambrook, Ph.D. Distinguished Chair in Biomedical Science; and Jef De Brabander, Ph.D., Professor of Biochemistry and holder of the Julie and Louis Beecherl Jr. Chair in Medical Science.

Lance S. Terada, M.D., Professor of Internal Medicine, Chief of the Division of Pulmonary and Critical Care Medicine, and holder of the Dr. Carey G. King, Jr. and Dr. Henry M. Winans, Sr. Chair in Internal Medicine, was awarded $1,049,994 to study how healthy cells, known as endothelial cells, support cancerous tumors using autophagy. In that process, old, damaged, or abnormal cellular components are broken down and recycled for important cellular functions. The researchers plan to study whether inhibiting this process could lead to new ways to fight cancer.

Tao Wang, Ph.D., Assistant Professor in the ODonnell School of Public Health and in the Center for the Genetics of Host Defense, together with Junzhou Huang at UT Arlington and Alexandre Reuben at M.D. Anderson Cancer Center were awarded $1,199,997 to develop an artificial intelligence method that can predict binding between T-cell receptors and antigens on tumor cells. This knowledge could help facilitate the development of new, personalized immunotherapies for cancer patients.

Guanghua Xiao, Ph.D., Professor in the ODonnell School of Public Health and in the Lyda Hill Department of Bioinformatics and holder of the Mary Dees McDermott Hicks Chair in Medical Science, was awarded $1,303,815 to develop digital pathology and artificial intelligence tools to predict the prognosis of patients with rhabdomyosarcoma, the most common type of soft tissue sarcoma in children. Data from whole slide images, patient genetics, and clinical information could eventually be used collectively by this system to make more precise diagnoses and treatment decisions.

Zhenyu Zhong, Ph.D., Assistant Professor of Immunology, was awarded $1,049,997 to study the molecular underpinnings of liver inflammation that promote hepatocellular carcinoma, a type of liver cancer that has become the second-leading cause of cancer-related death worldwide. Results from this study could guide the future design of liver cancer therapies.

About UTSouthwestern Medical Center

UTSouthwestern, one of the nations premier academic medical centers, integrates pioneering biomedical research with exceptional clinical care and education. The institutions faculty has received six Nobel Prizes, and includes 24 members of the National Academy of Sciences, 18 members of the National Academy of Medicine, and 14 Howard Hughes Medical Institute Investigators. The full-time faculty of more than 2,900 is responsible for groundbreaking medical advances and is committed to translating science-driven research quickly to new clinical treatments. UTSouthwestern physicians provide care in more than 80 specialties to more than 100,000 hospitalized patients, more than 360,000 emergency room cases, and oversee nearly 4 million outpatient visits a year.

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Simmons Cancer Center investigators receive nearly $15 million in ... - UT Southwestern

Internal Medicine

Aiming to become chief resident? Here are 7 must-have attributes – American Medical Association

For physicians approaching the end of their graduate medical education, the role of chief resident can present an opportunity to gain leadership experience and potentially open doors for administrative and academic roles in medicine down the road.

For a study published in the journal Clinics in Dermatology, researchers examined how chief residents are selected across 51 dermatology programs. That data, combined with insight from a veteran residency program director, offer direction on the path that resident physicians can take if they have aims on becoming chief residents.

How chiefs are selected

The methods by which programs select chief residents can vary widely by institution and specialty. Looking at the study of chief selection in dermatology programs, about one-third of those programs awarded a chief designation to all senior residents. The other two-thirds used a combination of selection methods in the process.

The most common methods of residency selection were program-director selectionabout 25% of selection processesand a tally of faculty votes (roughly 20%).

The reasons why chief residents were selected also varied. According to this study in dermatology programs, the most important attributes, in descending order, were:

Brilliance alone is not enough

Deborah Spitz, MD, directs residency training in the Department of Psychiatry and Behavioral Neuroscience at University of Chicago Medicine. Her reasons for selecting chief residents largely aligned with those highlighted in the study.

The way [our selection] is set up is my assistant program director and I talk about which of [the] residents are most responsible and most mature, Dr. Spitz said. What we're looking for is people who have the trust of the residents and who have a sense of collaboration. If somebody were a really brilliant person but they didn't have the trust of the residents, that would be a big problemas a chief resident.

Dr. Spitz said the pool of candidates for a chief resident position in her program is usually four or five physicians, and two ultimately are given the chief designation. The dermatology study, likewise, had an average resident class size of 5.8.

Those numbers are considerably smaller than resident class sizes would be in a specialty such as internal medicine. In some instances, as is the case in the University of Chicagos internal medicine program, chief residents do an extra year of training while they are in that position. This is less common in smaller specialties.

In some fields being a chief, especially in fields where it's an extra year of residency, is quite an accolade, Dr. Spitz said. It's like winning a prize in a large program where there's a lot of competition to become chief. It speaks well for you, especially if you're going into academia.

The AMA Thriving in Residency series has guidance and resources on navigating the fast-paced demands of training, maintaining health and well-being, handling medical student-loan debt, and other essential tips about succeeding in graduate medical training.

Know the chief residents role

The role of chief resident is more administrative than it is clinical. The study of dermatology programs found that the most common responsibilities for chief residents were clinical scheduling, resident education planning and working as a liaison between residents and faculty.

The role of chief resident is a unique one, and Dr. Spitz highlighted that it might not always be pleasant.

If the residents are disgruntled, the chief resident is supposed to help fix it. That's not very easy, and it might be impossible. Those jobs ultimately belong to the training director, but the chief resident is sort of the first-line person that you go to.

Not everybody is cut out to be an administrator, Dr. Spitz added. Some people are cut out to be clinicians. We want everybody to have a little bit of a chief resident-type experience where they run a service and get a sense of what that's like, but some of them may ultimately decide not to do it. And thats totally fine. Not everybody should do it.

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Aiming to become chief resident? Here are 7 must-have attributes - American Medical Association

Internal Medicine

Intercalation helps to develop doctors with a more holistic approach … – The BMJ

Intercalated degrees can sharpen medical students understanding of the world as well as their clinical acumen, say Reagan Lee and Oscar Han

Intercalation gives UK medical students the chance to take a year out of their medical programme to obtain another degree in a discipline of interest. These degrees can range from medicine adjacent subjects like anatomy or pharmacology to those outside the scope of the usual medical curriculum, such as a humanities subject. Intercalation is often considered a valuable experience by students, and until recently it could assist them in securing their desired foundation training posts. The rules have now changed, however, and students entering the UK foundation programme in 2023 are the first cohort to no longer be awarded points for having these additional degrees.1

If intercalation no longer counts towards applications, is it still worthwhile? Yes. Medicine is a lengthy and demanding career, which begins with five or six years of medical school. It can be difficult to remember that there is no rush to get through thismedicine is a marathon, not a sprint. Intercalation allows medical students to take a break from the rigours of clinical medicine, reducing stress and potentially preventing burnout.

One of the many reasons to intercalate is the opportunity to take some time away from medicine to appreciate other disciplines. Doing so will encourage students to approach medicine with a wider perspective when they return. After all, society does not revolve around medicine, but rather a complex mix of humanities, sciences, and the arts. Intercalating allows students to develop a more holistic set of ideas and approaches.

In non-collegiate UK universities, medics often form close knit cliques owing to the intense nature of the course. Intercalating allows medical students to expand their social circle to include those who study a range of subjects. In clinical practice, we can become desensitised to aspects of medicine that the public might find unpleasant. If we rarely interact with people outside our course, how can we truly understand what other people think about medicine and factor this into our practice so that we provide the best standard of care?

Intercalation provides lots of opportunities to learn skills that are transferable to clinical practice. Students can explore specific areas of medicine in detail, such as cutting edge cardiovascular treatments. Research oriented students might be able to familiarise themselves with the bench-to-bedside process, while also critically appraising research and interpreting statistics. Other students will focus on different areas. Students studying psychology, for example, might learn more about the emotional, social, and cognitive elements that shape patients behaviour and experiences, whereas those studying medical anthropology could obtain a greater understanding of different societal attitudes towards medicine, enabling them to practise in a culturally informed way. Overall, an intercalated degree can develop and sharpen our understanding of the world, as well as our clinical acumen.

Intercalating can also confer benefits outside of clinical practice. Work produced from the intercalated degree can develop into publications and conference presentations. Intercalation allows students to form a good professional network early on, paving the way for future career advancement.

Given the many advantages of intercalating, the removal of additional degrees as part of the education performance measure of UK foundation programme applications in 2020 caused controversy. It was later announced that, from 2023, undergraduate degrees, including intercalated degrees, would no longer count towards the application scoring matrix for internal medicine training.2 No alterations have yet been made to the point scoring system for the specialised foundation programme.3

Some have argued that these changes are for the betterone reason the UK Foundation Programme Office cited for their decision is that additional degrees are no longer helpful in differentiating between candidates.4 And with many candidates not able to afford these additional qualifications, there is a question of equity here.

The financial opportunity costs of starting work later, coupled with the anxiety of resuming your medical degree with a cohort of strangers, might make some students reluctant to intercalate. More financial support should be provided to widen access so that the benefits of intercalating are attainable for everyone.

Over the years, medicine has increasingly become a checklist exercise for medical students, as we tick boxes in our portfolios to progress. Many of us may have forgotten our initial drive to build up our skills and learn more about the world around us. Keeping in sight the idea of constant learning in a medical career, we should take up the opportunity to intercalate, which broadens our horizons and enables us to develop holistically not only as clinicians, but as people.

Competing interests: Both authors are medical students. They have no competing interests and are unpaid.

Provenance and peer review: Not commissioned; not externally peer reviewed.

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Intercalation helps to develop doctors with a more holistic approach ... - The BMJ

Internal Medicine

This Early Long COVID Clinic Was Led by PM&R and Family and … – Patient Care Online

The long COVID clinic at the University of Washington (UW) in Seattle was established in the early days of recognition that post-acute sequelae of SARS-CoV-2 was a real phenomenon affecting large numbers of people and was not going to fade away.

The long COVID clinic initiative was driven by the UW department of rehabilitation medicine and began with foundational clinicians in rehabilitation, family, and internal medicine, according to Christopher McMullen, MD, CAQSM, assistant professor of rehabilitation medicine and sports and spine medicine at UW and a physiatrist in practice at a UW multispecialty outpatient clinic.

McMullen, along with his primary care colleague Nina Maisterra, MD, discuss the role of physical medicine and rehabilitation in care for long COVID patients and the very large role for primary care.

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This Early Long COVID Clinic Was Led by PM&R and Family and ... - Patient Care Online

Internal Medicine

Opinion: CT must codify the Aid in Dying bill. Here’s why. – The Connecticut Mirror

As a retired physician with 50 years of clinical and teaching experience in internal medicine, I wish to respond to an article in the Connecticut Mirror by Joseph Bentivegna MD, opposing an Aid in Dying Bill for the relief of terminally ill patients, recently approved by the Public Health Committee of the state legislature.

He makes a series of assertions, none of which is supported by evidence, about the mass mayhem which might follow the passage of this bill. He presents a scenario in which patients are smothered with pillows, doctors kill thousands, people are coerced by their relatives into ending their lives because they are chronically disabled, and he professes that it is impossible to know when someone is terminally ill.

I have to note that as an ophthalmologist who rarely if ever actually deals with end-of-life management, he is not really expected to have expertise in this issue. What he may not do however, is assume that if he is unable to recognize terminal illness, no one else can either.

In the U.S., we have actual peer-reviewed published evidence of the medical and social effects of such legislation. Aid in dying has been practiced in Oregon since 1997. Since its passage, about 1,500 terminally ill patients have availed themselves of this option to shorten their torment. NONE of the horror scenarios envisioned by Dr. Bentivegna has materialized.

It is now the law in 10 states and in Washington, D.C., again without social chaos or an increase in related murder. About one third of those obtaining a lethal dose of a drug to be self-administered at home have opted not to do so, but have been surveyed during their illness. Published studies show that they find solace in the knowledge that they can always end their suffering, should it become unbearable.

The average length of time between obtaining the drug and taking it is six weeks in those who ultimately use it. Thus their action is not rash or impulsive. Many are depressed, something not unusual in dying people. Even in some who might respond to treatment, the treatment will not alter the course of their end stage disease and might well take longer than they have left to live.

I do agree with Dr. Bentivegna that the interposition of a psychiatric evaluation into the process renders it cumbersome. In fact it was rescinded in Oregon without adverse effect.

No one whose religious or ethical stance prevents their participation in this program, either as physician or as patient, need do so. This legislation codifies an inherent human right to shape the last days of life with privacy and in dignity without any trace of harm to society, as evidenced by long term experience. It should become law in Connecticut.

Herbert Ross, MD FACP lives in Lyme.

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Opinion: CT must codify the Aid in Dying bill. Here's why. - The Connecticut Mirror

Internal Medicine

Georgia officials are warning about an increase in overdose deaths related to new ‘zombie drug’ – WJCL News Savannah

The Georgia Department of Health is alerting the public about an increase in overdose deaths related to a new drug. Theres a new, non-opioid making its way around, causing officials to send out a warning ahead of St. Patricks Day.The more drugs you put into a mix, the more synergistic bad of an outcome you can have, said internal medicine doctor Timothy Connelly.Dr. Connelly, who works for Memorial Health, explains why xylazine is being called the zombie drug and why its being mixed more frequently now with opioids. Its a sedative medication that's a powerful muscle relaxer, said Dr. Connelly. It also drops the blood pressure, and it amplifies the narcotic.According to the Georgia Department of Health, xylazine-involved deaths increased by 1120% from 2020 to 2022 in the state, all involving fentanyl. But, unlike fentanyl, theres no treatment.Its related to opioids in some way, but it doesn't work through the same receptive that the Narcan reverses, said Dr. Connelly. With St. Patricks Day on Friday, Dr. Connelly shares his plea to patrons preparing to celebrate. You have to be very careful nowadays. Drug use is becoming an increasingly more fatal habit to have, said Connelly.

The Georgia Department of Health is alerting the public about an increase in overdose deaths related to a new drug.

Theres a new, non-opioid making its way around, causing officials to send out a warning ahead of St. Patricks Day.

The more drugs you put into a mix, the more synergistic bad of an outcome you can have, said internal medicine doctor Timothy Connelly.

Dr. Connelly, who works for Memorial Health, explains why xylazine is being called the zombie drug and why its being mixed more frequently now with opioids.

Its a sedative medication that's a powerful muscle relaxer, said Dr. Connelly. It also drops the blood pressure, and it amplifies the narcotic.

According to the Georgia Department of Health, xylazine-involved deaths increased by 1120% from 2020 to 2022 in the state, all involving fentanyl. But, unlike fentanyl, theres no treatment.

Its related to opioids in some way, but it doesn't work through the same receptive that the Narcan reverses, said Dr. Connelly.

With St. Patricks Day on Friday, Dr. Connelly shares his plea to patrons preparing to celebrate.

You have to be very careful nowadays. Drug use is becoming an increasingly more fatal habit to have, said Connelly.

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Georgia officials are warning about an increase in overdose deaths related to new 'zombie drug' - WJCL News Savannah

Internal Medicine

Loneliness, isolation down but still high among older adults | The … – The University Record

After three years of pandemic living, loneliness, isolation and lack of social contact have finally started to decline among older adults, a new University of Michigan poll shows.

But one in three people between ages 50 and 80 say they still sometimes or often experience these feelings, or sometimes go a week or longer without social contact with someone from outside their home. Thats down from about half of older adults in June 2020.

The percentages who currently feel lonely, isolated or lacking contact were much higher among older adults who say their physical or mental health is fair or poor, as well as those with a health problem or disability that limits their daily activities and those who are not working or unemployed.

Around half or more of the older adults in each of these groups currently experience these feelings. Thats a rate about twice as high as their peers who are in better health or dont have a disability or activity-limiting health issue.

The new findings from U-Ms National Poll on Healthy Aging, gathered in late January, add to previous data from polls taken in 2018 and during all three pandemic years using the same questions.

That allows the poll team to see that for older adults overall, these measures are nearly back to pre-pandemic levels, which were already high. The poll is based at the U-M Institute for Healthcare Policy and Innovation and supported by AARP and Michigan Medicine.

Three years into the COVID-19 pandemic, we see reason for hope, but also a real cause for concern, said Preeti Malani, the polls senior adviser and former director, and a Medical School infectious disease professor who is also trained in geriatrics. If anything, the pandemic has shown us just how important social interaction is for overall mental and physical health, and how much more attention we need to pay to this from a clinical, policy and personal perspective.

Poll director Jeffrey Kullgren said loneliness and isolation were high before the pandemic and it will take a concerted effort to bring these rates down further.

While we must always balance risk of infection with risk of isolation in older adults, we now know that a combination of vaccination, medication, testing, ventilation and masking can protect even the most vulnerable and allow them to engage socially, said Kullgren, associate professor of internal medicine at Michigan Medicine and physician and researcher at the VA Ann Arbor Healthcare System.

The poll team notes that chronic loneliness has been shown by researchers to be associated with adverse impacts on mental, cognitive and physical health, as well as general well-being and even longevity.

More about the findings:

In general, rates of all three measures plateaued in 2021 and 2022, down from June 2020 highs, before dropping in the January 2023 poll.

Mental health: Rates of feeling a lack of companionship were more than twice as high among those who say their mental health is fair or poor (73%) than among those who report better mental health (excellent, very good or good). Similarly, 77% of those in the fair/poor mental health group reported feeling isolated compared with 29% in the better mental health group, and 56% of those in the fair/poor mental health group reported infrequent social contact compared with 30% in the better mental health group.

Physical health: The differences were less stark but still large among those who reported fair or poor physical health compared with those in better physical health. Lack of companionship was experienced by 55% of the fair/poor group and 33% of the better group, isolation was experienced by 55% vs. 29% and lack of social contact was experienced by 56% vs. 29%.

Disability or health condition: 51% of those who have a disability or health condition that they say limits their activity also say they experience a lack of companionship, compared with 30% of those without such conditions. The percentages were similar for feelings of isolation.

Living alone: 47% of those who live alone report a lack of companionship, compared with 33% of those who live with others. There was a smaller but still measurable difference between the two groups in feelings of isolation.

Despite the modest improvement these results show, social isolation and loneliness are still an urgent concern for older adults, said Claire Casey, president of AARP Foundation. Research shows that social isolation affects health and well-being, and can lead to unemployment. Greater economic security for older adults demands that we address loneliness.

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Loneliness, isolation down but still high among older adults | The ... - The University Record