Happy Pi Day from NCMS!

Why shouldn't you eat too much pi?

You'll end up with a big circumference!

 

Happy Pi Day from the North Carolina Medical Society!  

 

 


UNC Researchers Expand Understanding of How Body, Brain Communicate

Researchers Expand Our Understanding of How the Body and Brain Communicate

CHAPEL HILL -  The human brain constantly receives information from the body, specifically from internal organs such as the heart and lungs. This information seldom reaches consciousness but is crucial for maintaining a healthy body and for influencing performance in the brain, including perception, emotion, and cognition. Now, researchers are investigating how exactly the brain processes the incoming stream of information from the heart and lungs, leading to a broader understanding of brain-body integration and the resulting health or disease.

Vibhor Krishna, MD (Photo: UNC Health)

Publishing their work in the Proceedings of the National Academy of Sciences (PNAS), co-senior authors Vibhor Krishna, MD, associate professor of neurosurgery at the UNC School of Medicine; Ali Rezai, MD, director of the Rockefeller Neuroscience Institute and associate dean of neuroscience at the West Virginia School of Medicine; and Olaf Blanke, MD, PhD, director of the laboratory of cognitive neuroscience at the Swiss Federal Institute of Technology, discovered that specific neurons in the thalamus are actively involved in processing cardiac and respiratory signals.

“Each heartbeat and every breath create a rich, incoming stream of sensory information for the human brain,” said Krishna. “However, a deeper understanding of how the brain integrates this information has remained elusive. We have been interested in discovering how the human brain achieves the integration of cardio-respiratory information and whether its breakdown is linked to any disorders of the brain, heart, or lungs observed in the clinic.”

Over the years, clinical and research teams collaborated to painstakingly study this integration using an established technique of microelectrode recording during deep brain stimulation surgery. Using a new approach to study single neurons in three different thalamic regions, the researchers were able to observe a direct functional involvement of thalamic and subthalamic neurons in processing cardio-respiratory signals. This information can help to better characterize how subcortical regions of the brain process signals through a functional pathway from internal organs.

To complete this work, the research team took advantage of microelectrode recordings during deep brain stimulation for patients undergoing treatment for neurological conditions. The researchers then used these recordings to investigate the activity of single neurons related to cardiac and respiratory functions in three subcortical regions: ventral intermedius nucleus and ventral caudalis nucleus of the thalamus, and the subthalamic nucleus.

They found that about 70% of the recorded neurons were modulated by either the heartbeat, the cardiac inter-beat interval, or the respiration.

These cardiac and respiratory response patterns varied largely across neurons both in terms of timing and their kind of modulation, the authors wrote. A substantial proportion of these visceral neurons – about 30% – were responsive to more than one of the tested signals, underlining specialization and integration of cardiac and respiratory signals in subthalamic nucleus and thalamic neurons.

“We think our work will be significant for several medical specializations, including cardiology, pulmonology, neurology, psychiatry, and psychological research,” Krishna said.

Rezai added, “Better understanding of the human brain is the next frontier. And interdisciplinary collaborations between functional neurosurgeons and neuroscientists will enable us to gain an unprecedented window into the inner functioning of the human brain.”

Applauding this research as a significant step forward, Nelson Oyesiku, MD, PhD, chair of the UNC Department of Neurosurgery, said, “We understand that the brain maintains homeostasis throughout the body through direct neurological and endocrine regulation. This research reveals that the incoming information from the heart and lungs is processed in the thalamic and subthalamic brain regions, besides other regions, enabling our brain to effectively assume its role in regulating bodily functions.”

(Article:  Courtesy UNC Health)

 

 


NC Representative David Rouzer Joins Other Congress Members to Relaunch Congressional Primary Care Caucus

(Photo courtesy US Congressman David Rouzer)

Five US Congress Members Relaunch Congressional Primary Care Caucus During State of Primary Care Briefing

WASHINGTON, DC - This week, Congressman David Rouzer (R-NC), Congresswoman Jen Kiggans (R-VA), Congressman Joe Courtney (D-CT), and Congresswoman Lisa Blunt Rochester (D-DE) relaunched the bipartisan Congressional Primary Care Caucus.

The Caucus, which was first created by Congressman Rouzer and Congressman Courtney in 2015, aims to educate Congress on the importance of a comprehensive, continuous, coordinated, and connected primary care system for patients and communities nationwide.

The Caucus’ relaunch was announced at the organization’s first official event of the year, a briefing on the State of Primary Care in America.  The briefing featured industry stakeholders from the Bipartisan Policy Center, Primary Care Collaborative, the National Association of Community Health Centers, and Urban Health Plan who emphasized the critical role primary care plays in improving health outcomes and reducing preventable healthcare costs.

The group discussed ways policymakers can work to ensure Americans have access to affordable, high-quality primary care services in rural and medically underserved areas.

Statements from involved members of Congress and involved organizations:

Representative David Rouzer (Photo: US Congressman David Rouzer)

"Tens of thousands of families across the country, including many of my constituents in rural Southeastern North Carolina, face a shortage in primary care physicians to address health issues early before they become advanced," said Rep. Rouzer.  "I'm proud to join my colleagues in relaunching the bipartisan Primary Care Caucus to ensure our healthcare system focuses on patients and brings primary care closer to home. Thank you to each of our participants for joining us to help craft solutions where patients receive the very best care at the lowest possible price."

 

“As the only geriatric nurse practitioner in Congress, I am proud to serve as a Co-Chair of the bipartisan Primary Care Caucus,” said Congresswoman Kiggans. “I look forward to working with Representatives Blunt Rochester, Rouzer, and Courtney to recognize the importance of primary care in saving overall healthcare costs while improving patient health outcomes. We must work to make primary care more accessible and available to all Americans, especially to our underserved populations. It’s an honor to advocate for America’s primary care professionals and the patients who depend on them…!”

 

"Increasing access to primary care is one of the best ways to promote better health outcomes and lower overall health care costs,” said Rep. Joe Courtney.  “As a co-founder of the Primary Care Caucus with Congressman Rouzer, Congresswoman Blunt-Rochester, and Congresswoman Kiggans, I am looking forward to advancing health care policy that recognizes the importance of primary care in underserved areas, particularly rural communities, and works to strengthen our primary care workforce nationwide."

 

“Comprehensive, continuous, and equitable primary care is an essential part of our health system,” said Rep. Lisa Blunt Rochester. “I’m proud to join Rep. Courtney, Rep. Rouzer, and Rep. Kiggans in relaunching the Primary Care Caucus – a bipartisan avenue that will continue to help us support patients and providers by increasing access to primary care, improving primary care services, and investing in our critical primary care workforce.”

 

“The relaunch of the Primary Care Caucus is an important step forward in addressing major challenges plaguing the health care system—including high costs and worsening outcomes. Thank you Rep. David Rouzer,  Rep. Jen Kiggans, Rep. Joe Courtney, Rep. Lisa Blunt Rochester and each member of the Caucus for your leadership and for recognizing the important role primary care must play in fixing health care in America. We look forward to working with you on practical solutions that ensure everyone has access to high-quality primary care.” - Ann Greiner, President and CEO, Primary Care Collaborative

 

"As the largest primary care organization, the American Academy of Family Physicians commends the relaunch of the Congressional Primary Care Caucus and its commitment to advancing comprehensive healthcare solutions. This initiative underscores the vital role primary care plays in fostering a healthier nation, and we look forward to collaborative efforts that prioritize accessible, whole person care for all." – Stephanie Quinn, Senior Vice President of External Affairs and Practice Experience, American Academy of Family Physicians

 

"NACHC thanks Representatives Rouzer, Courtney, Blunt Rochester, and Kiggans for their leadership in standing up this important caucus. We look forward to working with this caucus to find long-term federal solutions for the primary care workforce and advancing our shared goal of making comprehensive and cost-effective primary care available for everyone nationwide." – Paloma Hernandez, MPH, Chair, National Association of Community Health Centers (NACHC) Board of Directors and President and CEO, Urban Health Plan, Inc.

 

Click here for more information on the Primary Care Caucus and to sign up for updates.

 


Important CMS Announcement For Physicians Impacted by Cyberattack, Change Healthcare Disruptions

Hospitals, doctors, and clinics express frustration that they have to wait even longer for reimbursements after hackers paralyzed the largest U.S. billing clearinghouse

The Centers for Medicare and Medicaid Services announced a new opportunity for physicians impacted by the cyberattack and resulting disruptions with Change Healthcare to request advanced Medicare payments to help with cash flow disruptions. The details of the program, terms, and the steps needed to apply can be found in the links below. 

Fact Sheet - https://www.cms.gov/newsroom/fact-sheets/change-healthcare/optum-payment-disruption-chopd-accelerated-payments-part-providers-and-advance

CMS Statement - https://www.cms.gov/newsroom/press-releases/cms-statement-continued-action-respond-cyberattack-change-healthcare


What Primary Election Results Mean for NCMS Members

The results are in.  What comes next?

Throughout the electoral process, the North Carolina Medical Society (NCMS) remains vigilant in political engagement to advance our health policy priorities.  The Society is engaging with candidates across the state and closely monitoring outcomes, focusing on candidates supported by NCMS.

The top-of-ballot results saw President Joe Biden and former President Donald Trump secure victories, setting up a rematch of the 2020 election.    In North Carolina, Attorney General Josh Stein and Lieutenant Governor Mark Robinson both prevailed in what will be a nationally-watched gubernatorial showdown in November.

 

A trend emerged in North Carolina, with physician candidates demonstrating significant success in State House races.  NCMS members Drs. Timothy Reeder, Grant Campbell, and Ralph Carter all navigating competitive primaries to secure victories.  This highlights the increasing influence of medical professionals in both local and state politics.  Dr. Reeder now faces Renee Kempner,  Dr. Campbell is running against Joanne Chesley, and Dr. Carter faces longtime State Representative Garland Pierce.

The influence of physician candidates also extends to the State Senate level with NCMS member Dr. David Hill running unopposed as a Democrat in District 7, securing an automatic advancement to the General election.  Retired Physician Assistant Mark Hollo also secured a victory for the Republican nomination in District 45.  Hollo is a former member of the NC House.  These developments underscore the growing presence of medical professionals in shaping state-level policies supported by the continuing advocacy of the NCMS and its members.

 

At the Federal level, the success of NCMS member candidates remains evident.  Drs. Greg Murphy and Steve Feldman advanced automatically in their unopposed Congressional House primaries.  Republican Dr. Murphy is the incumbent and Dr. Feldman is pursuing his first foray into elected office as a Libertarian.  Their candidacies demonstrate the increasing recognition of the need for the medical profession to aid in shaping Federal policy that impacts NCMS members and patients in North Carolina.

The primary election showcases a dynamic political landscape, marked by significant voter engagement and the rising influence of physician and physician assistant candidates.  As the 2024 electoral process progresses, the North Carolina Medical Society will continue to engage with these and other candidates and advocate for policies that prioritize the well-being of all North Carolinians.

The NCMS congratulates these member candidates for making a professional and personal commitment to run for public office.  They reaffirm the vital role of healthcare professionals in shaping the future.


Super Tuesday Results and What They Mean for NCMS

Super Tuesday Results Are In.
What Does That Mean For You?

 

The North Carolina Medical Society has several member candidates for both state and federal office.  Over the past several months, many of them have answered questions important to NCMS members.  So what happened?

On Friday, The NCMS Vice President of Advocacy, John Thompson, will have an analysis of the results and the impact they have on the next several months.

Look for his report in Friday's edition of Morning Rounds.

 

 

 

 


NC Medicaid will now cover imported benzathine benzylpenicillin for syphilis

 

A message from Elizabeth Cuervo Tilson, MD, MPH, State Health Director and Chief Medical Officer of NC Department of Health and Human Services:

Dear Colleagues:

NC Medicaid will now cover imported benzathine benzylpenicillin (Extencilline) for use in outpatient medical drug claims. This new coverage is being added to address the ongoing national shortages of Bicillin® L-A (penicillin G benzathine injectable suspension).

While we have not heard of major shortages in North Carolina, we wanted to ensure that providers had access to every tool that may be available.

The statement on the policy change is available at https://www.ncdhhs.gov/news/press-releases/2024/03/04/ncdhhs-releases-statement-state-health-director-dr-elizabeth-cuervo-tilson-increasing-access

Provider guidance on extencilline is available at https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=5a026d0c-6f91-4ee3-b193-b2186a37e7ca

More detailed information on Medicaid billing is available at NC Medicaid to Cover Imported Benzathine Benzylpenicillin (Extencilline): Billing Guidelines | NC Medicaid (ncdhhs.gov)

 

 

 


CDC Recommending Additional Covid-19 Vaccine for Those Over 65

New Guidance From CDC on Vaccines for the Elderly

Arund 98% of the US population has some kind of immunity to Covid-19, whether from infection, vaccination, or both, according to the CDC. But health experts say this only gives some protection against infection or severe disease. In response, the CDC this week recommended people age 65 and older should get an additional dose of the current Covid-19 vaccine. The current Covid-19 vaccine, which was updated last fall, is considered highly effective and may cut the chances of getting a symptomatic infection by half. This comes as the CDC is considering a shift to its Covid-19 isolation guidance to say that people no longer need to isolate once they have been fever-free for 24 hours and their symptoms are mild or improving.

 


68-Year-Old Man Now in HIV Remission

Paul Edmonds (photo: City of Hope)

(NiceNews.com) -- When Paul Edmonds learned he had AIDS in 1988, he viewed it as a death sentence. But therapies helped him take control of the illness for more than three decades — and now he’s in full-blown remission, all thanks to a cancer diagnosis.Blood cancers are common in older HIV patients, according to the cancer center City of Hope, where Edmonds, pictured on the left with husband Arnold House, was treated for his leukemia. In 2019, he received a transplant of stem cells that had a rare genetic mutation that causes HIV resistance.As a result, he became the fifth person in the world to be cured of leukemia and reach HIV remission, a milestone recorded earlier this month in a study published by The New England Journal of Medicine. Of those five people, Edmonds, 68, is the oldest and had HIV for the longest period, 31 years.Though he initially kept his identity anonymous, Edmonds went public with his journey last year. “A big reason I want to tell my story is to bring some hope for people with HIV,” he said at the time. “And I want to remember all those we lost"

Hear Paul in his own words 

 

 


WSJ: DOJ launches an antitrust probe into UnitedHealth Group

(Yahoo Finance - Seana Smith, Brad Smith) --  Department of Justice (DOJ) officials have launched an antitrust probe into the relationship between UnitedHealth Group's (UNH) insurance division and its Optum health services segment, according to Wall Street Journal reporting.

Yahoo Finance Health Reporter Anjalee Khemlani breaks down the details, highlighting the other challenges UnitedHealth is facing.

For more expert insight and the latest market action, click here to watch this full episode of Yahoo Finance Live.

Editor's note: This article was written by Luke Carberry Mogan.

Video Transcript

BRAD SMITH: Shares of UnitedHealth under pressure this morning after the US Department of Justice reportedly kicks off an antitrust investigation into the company's relationship between its insurance unit and health services arm, according to the Wall Street Journal. For more on this, we've got Yahoo Finance's Anjalee Khemlani here with us with more. Hey, Anj.

ANJALEE KHEMLANI: That's right, guys. Hey. Yeah, this report not surprising a lot of people who have either, you know, looked at United's strategy before, or those who are former employees. We've actually spoken to some of those folks ourselves here at Yahoo Finance.

And I'll say that some of the things listed in this report, including what the relationship is between the two sides, and whether or not the company is inflating costs and inflating claims from one side to the other, really touches on some points of concern that others have had over the years, especially as Optum has grown to be the largest, or one of the largest, employers of physicians. So really setting up the company for a hard look. And it is not a very good year for United.

If you take a look back in the past year, not only did they recently have that cyber attack on their Change Healthcare subsidiary, but they also are facing a class-action lawsuit for denying claims through AI for elderly Medicare Advantage members. So, it really has been a tough year for the company when it comes to a lot of the different moving parts of it. And it's interesting that this is the thing that has really hit the stock.

But what the results of that probe will be, of course, we will have to see. But I've heard over the past several months that, basically, what has happened is, you know, there has been looking like inflation of the business that Optum has done over time, making it look like a really strong growth company when really it was just one side of the company funneling to another. So, will be interesting to see if those claims pan out.

SEANA SMITH: And it's a story we are going to continue to track. Again, UnitedHealth under pressure, off just nearly 4% here.

Additional Reading

UnitedHealth Stock Falls After Report Says the Justice Department Has Launched an Antitrust Investigation