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THE EXCHANGE PRSR STD US Postage P.O. Box 64 Paid Verona, New Jersey 07044 Permit #402 Senatobia, MS “Where Healthcare Marketers Have Connected for 25 Years” 25 for Connected Have Marketers Healthcare “Where JULY 2017 JULY . 6 . N 26, . V O OL Celebrating 25 Years 25 Celebrating Next Month: Travel Adventures Travel Month: Next ADS6036 A.qxp 3/6/17 10:48 AM Page 1 PUBLISHER No Fake News Here Nancy A. Leonard Dear Healthcare Marketer: January 2017 | www.acphospitalist.org September 2016 | Vol. 36 No. 8 | www.acpinternist.org A n ho doesn’t love a great wedding? n a P.O. Box 64 l ® s ᮋ o f I n t e Annals of Internal Medicine r 7 February 2017 Volume 166 Number 3 ESTABLISHED IN 1927 BY THE AMERICAN COLLEGE OF PHYSICIANS n a • • l M e I am officially in wedding mode over here. We’ve got three sched- d Verona, NJ 07044 i c i n e Clearing the air about climate change uled this year alone with many more to follow as each of my family RIGINAL ESEARCH 973-744-9505 O R By Charlotte Huff Dual Health Care System Use and High-Risk Prescribing in 157 Patients With Dementia. A National Cohort Study ncreasingly, patients are asking more online April 19 in Annals of Internal Medicine, questions about the health risks asso - relied on an evidence-based approach and W Targeting Functional Decline in Alzheimer Disease. 164 ciated with climate change, said Douglas encouraged physicians to “become educated 7 I A Randomized Trial DeLong, MD, FACP, chief of the division of about climate change, its effect on human F e general internal medicine at Bassett health, and how to respond to future chal- b Insurance Expansion and Hospital Emergency Department 172 Healthcare Network in Cooperstown, N.Y. He lenges.” The paper also recommended that r [email protected] u members reaches the marrying stage. I have 24 cousins who have over 70 recalled a recent conversation he had with a physicians, both individually and collectively, a Access: Evidence From the Affordable Care Act r patient about the Zika virus. “One of her con- “advocate for climate change adaptation and y 2 cerns was should she delay pregnancy this mitigation policies” along with communicat- 0 REVIEWS summer?” ing about related health issues with the public 1 7 Brain-Type Natriuretic Peptide and Amino-Terminal 180 Dr. DeLong, vice-chair of ACP’s Health and policymakers. Pro–Brain-Type Natriuretic Peptide Discharge Thresholds for and Public Policy Committee, which recently “I think it’s a general recognition that cli- developed a position paper on the subject, mate change is a public health issue, maybe Acute Decompensated Heart Failure. A Systematic Review said that doctors can play a role in the con - even the most important public health issue Annals.org versations around climate change, not just of our generation,” said Dr. DeLong. “I think kids, and this is only the beginning. So I am going to be in this mode for quite Clinical Outcomes of Metformin Use in Populations With 191 by discussing potential health effects with it’s the obligation of physicians to be aware of Chronic Kidney Disease, Congestive Heart Failure, or Chronic patients but also by advocating for policies the potential medical consequences. They Letters 229 Liver Disease. A Systematic Review that might help mitigate the environmental don’t necessarily have to become proselytizers Complete Contents I-5 threat. The position paper, which was published See Climate, page 11 ASSISTANT TO THE PUBLISHER BEYOND THE GUIDELINES V Should We Prescribe Antibiotics to This Patient With 201 o l Persistent Upper Respiratory Symptoms? Grand Rounds u Fibromyalgia characterized by controversy INSIDE awhile! m Discussion From Beth Israel Deaconess Medical Center Test Yourself e By Mollie Durkin with the 1 CIRCULATION MANAGER 6 MKSAP Quiz 6 CLINICAL GUIDELINE uch research is currently delving “[Fibromyalgia] is a fairly common and interpret any sensory stimuli are all increased Recommended Immunization Schedule for Adults Aged 209 into the pain mechanisms of almost ubiquitous problem. It doesn’t matter in volume or increased in gain.” 4 N 19 Years or Older, United States, 2017 fibromyalgia, a disorder defined what type of subspecialty someone is in; But longtime fibromyalgia researcher u M by widespread muscle pain that many they’re going to see these patients,” said Frederick Wolfe, MD, founder of the National m patients find debilitating and that has such Daniel Clauw, MD, a professor of anesthesiol- Data Bank for Rheumatic Diseases, sees these b e associated symptoms as fatigue, lack of ogy, rheumatology, and psychiatry at the central nervous system observations as being Next week kicks off this celebratory season with a wedding on the beach in Ocean City, NJ. I DEAS AND PINIONS r I O restorative sleep, and memory difficulties. University of Michigan Medical School in Ann the mechanism by which disease is Meet ACP’s 3 Outcomes-Based Pricing as a Tool to Ensure Access to Novel 219 But there remains considerable dissent Arbor. “This is a different type of pain that expressed, not necessarily the cause. new Denise Pecora but Expensive Biopharmaceuticals among the medical community about the needs a fundamentally different type of treat- “What I think is bad is trying to say we ( EVP/CEO P condition’s cause. ment.” know what causes this, that this is really a dis- a 9 g Fibromyalgia is a contested illness. ease of the central nervous system caused by e EDITORIALS s While some physicians characterize it as a The controversy central pain. We really don’t know that,” he 1 The Veterans Affairs Pharmacy System: Perfectly Designed to 221 purely organic illness based on abnormal For Dr. Clauw, author of a fibromyalgia said. Because studies compare people with 5 7 Achieve the Outcomes It Gets pain amplification, others consider it a bio- review article published in 2014 by JAMA, fibromyalgia to people with no pain, it’s not – 2 psycho-cultural disorder with a multifactor- “There’s very clear, objective evidence that surprising that there’s a difference in brain can’t wait to share this special occasion with my cousin Jane. She’s a triplet to boot. My cousin 3 ial etiology. this is a real problem: The volume control or activity, he said. 2 Inpatient Management of Heart Failure: Are We Shooting at 223 973-744-9505 ) Managing the Right Target? These 2 groups do mostly agree on man- gain is set too high in the central nervous sys- In terms of potential causes of fibromyal- agement, however: Opioids don’t work, the tem, so people with these problems feel gia, Dr. Wolfe said many factors play a role, resistant hypertension Metformin Use in Patients With Historical Contraindications 225 medications that appear to be effective are things as being painful that are not usually including basic biological, psychological, limited in their therapeutic ability, and non- experienced as painful,” such as tight cloth- societal, and individual ones. In general, peo- 13 pharmacological treatment approaches (par- ing or an inflating blood pressure cuff. This ple with fibromyalgia tend to have less edu- ticularly exercise) seem to be paramount in pain amplification, he said, extends to other cation, be more distressed, and have more life ON BEING A DOCTOR decreasing patients’ pain and increasing sensory stimuli, such as bright lights or loud Fred (her father) has five girls altogether and this is his third one getting married. Let me tell you, Guiding 227 function. noises “because in the brain, regions that See Fibromyalgia, page 12 [email protected] IN THE CLINIC A Tuberculosis ITC17 n n a l s he never disappoints with the festivities. The band is always amazing! Everyone sings and dances . o r g ART DIRECTOR (Ad Submissions) like there’s no tomorrow – our family theme song is Build Me Up Buttercup, which everyone gets in James J. Ticchio a circle and sings to the moment the music starts. Direct Media Advertising Doctors everywhere trust these journals for accurate and I can’t believe how weddings have changed over the years. You never know what you are in 73 Glenmere Terrace for, which makes it fun and exciting. Even the showers, save the dates, bachelor/bachelorette Mahwah, NJ 07430 current medical information. parties are creative. And there are so many options for DIY touches. You can really make your 201-327-6985 [email protected] wedding your own. I love that! In this issue, we’re featuring a few fun and fabulous wedding stories from friends in the EDITOR (Editorial Submissions) industry. Dianne Reynolds, definitely ahead of her time as far as creative weddings go, shares Elise Daly Parker her unique wedding adventure celebrated 16 years ago. Angie Randazzo gives us a few glimps- 973-919-1067 es of her beautiful wedding in an historic picturesque setting. When it comes to DIY, Melissa [email protected] Devlin has us covered with loads of creative wedding day details. David Hymson shares his son’s romantic proposal. And Adam Persing provides snippets from three wedding tales. SPECIAL PROJECTS ADMINISTRATOR We’re also highlighting some creative endeavors. Charlotte Sibley shares her passion for Maddie Leonard music and how she’s made it a part of her life over the years. Nayari Valentin loves to write and Join us on has done some spoken-word events, so we’re happy to have one of her beautiful poems featured Facebook.com/HMExchange in the following pages. We’re delighted to have Peter Palmer for this month’s Personal Exchange. And, since we could all use a good laugh, don’t miss the 25th Anniversary Throwback story The Twitter.com/HMExchange Open Window, plus a little update from Rory Flanagan.