Add topic to email alerts Receive an email when new articles are posted on Please provide your email address to receive an email when new articles are posted on . “ data-action=”subscribe”> Subscribe We were unable to process your request. Please try again later. If you continue to have this issue please contact customerservice@slackinc.com. Back to Healio Key takeaways: CMS will use newly defined criteria to qualify noninvasive biomarker CRC screening tests for coverage. Concerns remain that evidence for thresholds may be retrofitted to current test performance. CMS established a new national framework setting performance thresholds to qualify noninvasive, biomarker-based colorectal cancer screening options — including FDA-approved stool- and blood-based tests — for coverage. “The CMS coverage decision provides benchmarks for novel noninvasive tests to meet and exceed to gain coverage, and learn from the experience of currently approved tests,” Aasma Shaukat, MD, MPH, Robert M. and Mary H. Glickman Professor of Medicine at NYU Grossman School of Medicine, told Healio. “It also allows newer test makers to understand the current performance standards and where improvements are needed.” ColoSense (Geneoscopy), the first FDA-approved multitarget stool RNA test for CRC, is also the first test added to CMS’s national screening policy under the new standards. Though CRC is the third-leading cause of cancer-related deaths in men and the fourth-leading cause in women, 1 in 3 eligible U.S. adults are not up to date on screening, a study in Preventing Chronic Disease found. CMS’s decision to cover ColoSense expands the range of screening tools available to patients reluctant to undergo colonoscopy or traditional stool-based testing, adding an option that removes a common barrier to adherence, the need for patients to handle the stool sample. Under the new decision, CMS will cover noninvasive biomarker-based CRC screening tests — that meet performance standards — every 3 years for adults aged 45 to 85 years at average risk. To qualify for coverage, blood- and stool-based tests must be FDA-approved, processed in a Clinical Laboratory Improvement Amendments-approved lab and meet one of two performance criteria: have a sensitivity greater than or equal to 90% and a specificity greater than or equal to 87%, or a sensitivity greater than or equal to 79% and specificity greater than or equal to 90% in CRC detection compared with colonoscopy, the current standard. Shaukat acknowledged that the new performance thresholds are an improvement over past requirements — CMS used to require a sensitivity of 74% for blood-based tests — but said it is unclear what evidence the new criteria are based on. She expressed concern that the “criteria feel retrofitted to existing performance of stool and blood tests.” “The criteria are missing mention of advanced precursor lesion sensitivity or sensitivity for stage I to II CRC, important measures of any test performance for CRC screening,” she continued. Blood-based biomarker tests underperform other screening options in early detection, missing 1 in 3 early-stage cases of CRC, according to ACG. CMS coverage criteria also stipulates that patients must not have CRC symptoms to qualify for a biomarker-based test, and must be informed about the test’s performance, as well as the need for a follow-up colonoscopy if test results are positive. In a recent statement on updated CRC screening guidance from the American Cancer Society, ACG voiced concern that clinicians may not have the time to inform patients of the performance limitations of each screening test during visits. For more information: Aasma Shaukat, MD, MPH, is an ACG trustee and director of outcomes research in the division of gastroenterology and hepatology at NYU Grossman School of Medicine. She can be reached at gastroenterology@healio.com. Published by: Sources/Disclosures Source: Press Release References: Disclosures: Shaukat reports consulting roles with Freenome, Geneoscopy and Universal Diagnostics. Ask a clinical question and tap into Healio AI’s knowledge base. PubMed, enrolling/recruiting trials, guidelines Clinical Guidance, Healio CME, FDA news Healio’s exclusive daily news coverage of clinical data Learn more Add topic to email alerts Receive an email when new articles are posted on Please provide your email address to receive an email when new articles are posted on . “ data-action=”subscribe”> Subscribe We were unable to process your request. Please try again later. If you continue to have this issue please contact customerservice@slackinc.com. Back to Healio Source link

Living with a progressive, painful condition is a challenge, to say the least. I have learned that if I try to focus on other aspects of my life instead of my health, it helps me better emotionally handle the life I have been given. Don’t get me wrong—I do what needs to be done to help maintain the best quality of life possible, including eating foods and taking medications I can metabolize, doing my core exercises, getting in movement through walking or modified swimming, and filling my days with activities that provide purpose and meaning. But when a large storm is on the horizon, the change of pressure in the atmosphere begins to affect me and reminds me that I am handicapped, even though I am trying not to let that fact define my life. It is heartbreaking to have that intense reminder that my body is far from normal. The change in pressure from an impending storm increases inflammation in my body, which causes headaches, fatigue, and increased pain. Storms also bring added reminders of the  struggles that disability can cause in everyday life. Snow on the ground means not being able to walk outside until a path is cleared, or I face a higher risk of having my legs and feet sublux, or of dislocating my hips. Rain, wind, and mud make it harder to get around, too. Slipping, sliding, or falling can create more damage to the body. I know that so many with chronic conditions can relate to this frustration that comes up during storms. To hang on during these changes that are out of our control, what we all need to do is focus on what we can control. Try to eat foods you know you can metabolize. Try to move despite the added discomfort the atmospheric pressure causes. Try to continue with the activities you’re able to take on, even though you feel that added fatigue. When bad weather makes us wish for those sunny, calmer days that allow us to better function with our conditions, may we find the inner strength to remind ourselves of this: We may be disabled, but we are also fighters who will work to find a way to endure these obstacles until the sun peeks out again. May life be kind to you… —by Ellen Lenox Smith Source link

English Junio es el Mes de Concientización de la Disfagia. La esofagitis eosinofílica (EEo) es un trastorno que causa una inflamación crónica del esófago. Esta inflamación produce síntomas tales como dificultad para tragar, dolor de pecho e impactación alimentaria (cuando comida se atora en el esófago). Si bien no hay una cura para la EEo, hay tratamientos efectivos para controlar los síntomas y monitorear ese trastorno. Sin tratamiento, la EEo comúnmente empeora. La EEo se está volviendo más frecuente y puede afectar a personas de cualquier edad. Hablamos con Evan S. Dellon, M.D., MPH, gastroenterólogo, profesor de medicina y asistente de cátedra de epidemiología de la Universidad de Carolina del Norte en Chapel Hill, para entender más sobre los síntomas de la EEo, sobre cómo obtener ayuda y sobre las opciones terapéuticas. ¿Qué síntomas de la EEo deberían motivarte a acudir a una consulta médica? Para adultos y adolescentes, el síntoma más común es dificultad para tragar o que se atoren alimentos. Es importante indicar que no es normal que alimentos bajen lentamente o se atoren. Muchas personas que en algún momento reciben el diagnóstico de EEo no prestan atención a este síntoma inicialmente. Podrían simplemente evitar ciertos alimentos o masticar más cuidadosamente hasta que haya un problema importante. No esperes a que eso pase. Deberías someterte a examinaciones si alimentos bajan muy lentamente o si tienes dificultad para tragar. Otros síntomas gastrointestinales (GI), tales como molestias en el pecho o acidez, también se asocian a la EEo. Otros trastornos médicos pueden hacer que los alimentos bajen lentamente o que se atoren. Cuando estos síntomas ocurren junto con asma, eccema o alergias alimentarias, es más posible que sea una señal de EEo. Los niños con EEo tienen otros síntomas completamente diferentes. Podría ser dolor abdominal, vómito, desarrollo deficiente, no hacer transiciones a alimentos con otras consistencias o evitar ciertos alimentos. Muchos trastornos GI pediátricos pueden causar esos síntomas. Pero también podrían ser señales de EEo, especialmente si un niño tiene también eccema, asma o alergias alimentarias. Si tienes EEo, ¿por qué es tan importante que te diagnostiquen? Pensamos que la EEo generalmente empieza como una inflamación alérgica. Con el tiempo, si no se trata, esa inflamación puede producir tejido cicatricial. Entonces el esófago puede volverse estrecho y rígido, lo cual causa más síntomas y complicaciones tales como impactación alimentaria. La impactación alimentaria puede generar una perforación o ruptura del esófago, un problema muy grave. No ocurre frecuentemente, pero debe tomarse en cuenta. Los niños que padecen este trastorno en forma grave podrían tener malnutrición. También hay una afectación en la calidad de vida. Cualquier cosa que afecte tu alimentación tendrá un efecto en los eventos sociales, las reuniones familiares, los eventos laborales y los viajes y puede causar ansiedad en una forma significativa. Los síntomas, el impacto en la calidad de vida y las posibles complicaciones son buenas razones para someterse a examinaciones. ¿Cómo te diagnostican la EEo? El proceso de diagnóstico se hace con una endoscopía para examinar el esófago. No tenemos pruebas de sangre ni otros métodos para diagnosticar la EEo. La endoscopía es un procedimiento con sedación. Una cámara con iluminación se inserta en la boca hasta el esófago y el estómago. Tratamos de detectar señales típicas de la EEo. El esófago puede parecer inflamado. Puede estar cubierto con manchas blancas, lo cual es una señal de inflamación. Puede haber tejido cicatricial en forma anular o estrechamiento. Enviamos una biopsia a un patólogo que examina las células de la alergia, es decir los eosinófilos. Si hay suficientes eosinófilos, y eliminamos la posibilidad de que otras cosas los causen, entonces podemos diagnosticar una EEo formalmente. ¿Por qué es importante recibir atención continuamente si tienes EEo? La EEo es un trastorno crónico que debe controlarse a largo plazo. Si personas reciben un diagnóstico pero no un tratamiento, muchas podrían desarrollar muchas complicaciones graves con el tiempo. Es importante contar con un equipo médico y seguir el tratamiento puntualmente. La gravedad de este trastorno varía. El equipo médico personalizará el tratamiento para la situación de cada persona. Alguien que fue a una sala de emergencia con una impactación, por ejemplo, deberá tener mucho más seguimiento que una persona con síntomas leves. La atención continua es diferente para cada persona, pero es muy importante tenerla para evitar brotes y problemas que empeoren cada vez más. ¿Qué tipos de proveedores de atención médica deberían ser parte de tu equipo médico si tienes EEo? Algunas personas recibirán servicios de seguimiento de doctores GI principalmente. Algunas personas darán seguimiento con alergólogos principalmente. Algunas personas darán seguimiento con ambos tipos de doctores en una forma multidisciplinaria. Niños también podrían requerir terapeutas de alimentación y otros proveedores de varias especializaciones. Trabajamos frecuentemente con dietistas y nutricionistas. ¿Cómo se controla la EEo? Hay dos categorías terapéuticas principales: Restricción alimentaria y medicamentos. Pensamos que la EEo es un trastorno desencadenado por ciertos alimentos para la mayoría de pacientes. A diferencia de una alergia alimentaria típica, con una reacción inmediata, este es un trastorno en el cual comer ciertos alimentos durante un período largo de tiempo desencadena inflamación. Actualmente las pruebas de alergias no son realmente precisas para la EEo, por lo que es un poco difícil. Pero conocemos la mayoría de desencadenantes alimentarios más frecuentes: los lácteos, el trigo, los huevos, la soya, los frutos secos y los mariscos. La restricción alimentaria puede usarse para identificar desencadenantes alimentarios y eliminarlos de la dieta. Es una buena opción, pero realmente depende de cada paciente. Medicamentos antiácidos tales como el omeprazol (Prilosec) o el lansoprazol (Prevacid) suelen ser los primeros medicamentos que probamos. Aproximadamente del 30 al 40% de personas podrían reaccionar bien a estos medicamentos simples. También hay un corticosteroide tópico. Ahora contamos con un medicamento aprobado, la suspensión oral de budesónida (Eohilia), específicamente formulada para adherirse al esófago. Puede ser eficaz para el 50 al 60% de las personas, o más. Otra opción es dupilumab (Dupixent), un medicamento sistémico. Es una inyección semanal que bloquea algunos de

June 12, 2026 28 min watch Add topic to email alerts Receive an email when new articles are posted on Please provide your email address to receive an email when new articles are posted on . “ data-action=”subscribe”> Subscribe We were unable to process your request. Please try again later. If you continue to have this issue please contact customerservice@slackinc.com. Back to Healio Key takeaways: Mahsaw Mansoor, MD, explains her decision to pursue a second fellowship. Work-life balance is important, but a “season of intensity” can propel professional growth. An unconventional, nonstandard career path in ophthalmology can result in a unique skill set and stronger doctors. In this episode of Steeped Insights, a video blog series produced by Women in Ophthalmology and Healio, host Karen Chen, MD, of Permanente Medical Group, and cohost Cynthia A. Bradford, MD, formerly of Dean McGee Eye Institute, sat down with Mahsaw Mansoor, MD, Masket Foundation fellow at Advanced Vision Care. Over a cup of tea, the physicians discussed how Mansoor’s decision to pursue a second fellowship gave her more clarity on what she wanted out of her career. In this episode of Steeped Insights, host Karen Chen, MD, and cohost Cynthia A. Bradford, MD, sat down with Mahsaw Mansoor, MD, for a cup of tea. “I always knew that something was missing for me,” Mansoor said. “My niche, I hope, will be the management of uveitic patients in a more holistic fashion. … I knew I needed more training. For anyone who is considering two [fellowships], I would say that you should do it but do it with intention. I knew what was going to come of this fellowship and how it would actually add a distinct set of skills to what I had already gone through.” The discussion also highlighted the importance of being a team player and knowing when to pass an opportunity on to someone else. “You don’t want to be the person who always gets the free jobs,” Bradford said. “Anytime I do something, I try to think, ‘What can I get out of this? What can I make better here?’” While striving for proper work-life balance is essential for a sustainable career in medicine, sometimes professional growth requires a bit of imbalance, according to Mansoor. “It’s OK to have a deliberate season of intensity, but it’s not a permanent thing,” she said. “You can have purposeful imbalance for learning, building and creating relationships. Even if it’s busy, that’s sustainable.” For more information: Cynthia A. Bradford, MD, can be reached at cabradfor@gmail.com. Karen Chen, MD, can be reached at karen.willa.chen@gmail.com. Mahsaw Mansoor, MD, can be reached at mahsawm@gmail.com. Published by: Sources/Disclosures Source: Healio Interviews Disclosures: No products or companies that would require financial disclosure are mentioned in this article. Ask a clinical question and tap into Healio AI’s knowledge base. PubMed, enrolling/recruiting trials, guidelines Clinical Guidance, Healio CME, FDA news Healio’s exclusive daily news coverage of clinical data Learn more Add topic to email alerts Receive an email when new articles are posted on Please provide your email address to receive an email when new articles are posted on . “ data-action=”subscribe”> Subscribe We were unable to process your request. Please try again later. If you continue to have this issue please contact customerservice@slackinc.com. Back to Healio Source link

By Kari McBride It was the phone call from the school nurse’s office that triggered a chain reaction. On the other end of the phone was my daughter, sobbing that her back was hurting and she wanted to come home. Instant mom guilt set in as I realized I was an hour away from her and there was nothing I could do to make it better. This was the tipping point that made me realize we were no longer dealing with typical post-surgical pain. It all started after a surgery less than a year before. Throughout recovery, she would wince and walk around crying, “Oh, my poor little back,” as any other 7-year-old who’d just had spinal surgery would do. But then, even after the wound had healed and only a surgical scar remained, the feelings of pain never went away.  First it was back pain.  Then it was leg pain. Then it was feelings of pins and needles. As a mom, I knew something wasn’t right. I couldn’t explain it, but I knew this pain was part of something bigger than I understood. After all, children don’t just live in pain with no physical explanation, do they? What followed was a series of medical appointments, therapy evaluations, tests, procedures, and late nights spent scouring the internet for answers. I was desperately hoping that each new appointment would provide some sort of golden envelope with the answer hidden inside. Yet each time, I left feeling defeated and defensive. My daughter was living in pain, and I didn’t understand why. For the next year, or maybe it was two, it felt like life was on hold. Chronic pain has a way of blurring time. I refused to believe there wasn’t a cure for her pain. That there was not some surgery or medication that would make her better. Looking back, I realize I was searching for certainty. I wanted someone to tell me exactly what was wrong and how to fix it. On perhaps our 12th pediatrician visit in a single year, the doctor gently explained what it meant for someone to live with chronic pain. I was angry. Hurt. Frustrated. Sad. How dare anyone speak about my child’s pain being incurable? Several months later, after many more late nights spent searching the internet, we met with a pediatric pain specialist. I cried. A lot. How was this our reality? But that’s when I finally allowed myself to hear the words. “There’s nothing physically wrong with her.” “It’s called chronic pain.” “We can work on a plan to support her.” These were words I had heard spoken many times before, but I never actually stopped to listen to them. I had spent years searching for what was wrong with my child. Trying desperately to explain why she was in so much pain. So, I finally let my internet browser rest. I stopped chasing specialist after specialist. I was ready to accept what had become our new reality. Acceptance didn’t mean my daughter’s pain wasn’t real. Acceptance wasn’t giving up on hope, therapies, or treatment. Acceptance was letting go of the belief that there would be one doctor, one test, or one procedure that would fix everything. My daughter still lives with chronic pain. We still have hard days. We still question why. Acceptance hasn’t made her pain disappear. But it has allowed us to move forward. We no longer sit by and wait for the pain to go away so we can start living life. Instead, we live life with pain. I may never like this reality. And if I am being honest, there are days I still grieve it. But acceptance has allowed me to meet my daughter where she is today, instead of spending all our energy wishing she was somewhere else. My daughter lives with chronic pain. This is the reality we face today. —by Kari McBride Source link

Chronic spontaneous urticaria (CSU) are kind of like your least favorite aunt. They show up unannounced and stay well past their welcome. These red, itchy welts have no obvious cause and last for 6 weeks or longer. And the effects of the continuous itching caused by CSU go far beyond just your skin. Living with CSU can affect your mental health, as well as your work and personal life. Symptoms of chronic spontaneous urticaria CSU isn’t predictable. Unlike hives that appear when you’ve been exposed to something you’re sensitive or allergic to, CSU hives come and go, seemingly at random. And they can stay for a long time. This means you might be having a “good” week, with few or no hives and you make plans to go out. Suddenly the hives appear, making you miserable. Or they could come out just before a big presentation at work or a much anticipated (and needed) vacation. This unpredictability can make you uncertain about making plans and frustrate you if you need to cancel them. It also can affect your relationships if those around you don’t understand how hard it can be to have recurring hives like this. Here are four ways living with CSU might affect your life. Increased anxiety and depression Researchers have found that people living with CSU have higher rates of anxiety and depression — up to six times higher — than those who don’t have the condition. If left untreated, depression can lead to physical problems, including heart disease and stroke. Both anxiety and depression can also affect your ability to get medical help, follow treatment plans, go to work or school, and take care of yourself and your family. A form of talk therapy, cognitive behavior therapy (CBT), is helpful for many people with anxiety and depression. The goal with this type of therapy is to find coping strategies and help you manage your thoughts and feelings. Speak with your healthcare provider (HCP) about getting help if you’re experiencing anxiety or depression. There are also groups that can offer support, such as WeCU and the Allergy & Asthma Network. Sleep deprivation We know that if we have pain, our sleep can suffer, but many people don’t realize how disruptive itching can be, so they might not understand how tired or fatigued you are. More than half of people with CSU can’t sleep properly. This in turn can worsen depression and anxiety, as well as other mental health issues. Sleep deprivation can also increase your risk of having accidents, injuries and long-term health issues, like heart disease and some types of cancer. If CSU is affecting your sleep, it’s important you speak to your HCP about it. If you’re taking second-generation antihistamines, which don’t make people sleepy, your HCP might suggest adding another one at night that does cause sleepiness. There may be other medication options that can help, too. Working on mind-body and relaxation approaches might be helpful. There are many self-help options to help people sleep, but working with a therapist might be the best way to start, especially one who works with people living with CSU or similar health problems. Reduced enjoyment of social and work life There are several reasons CSU might have a strong impact on your social life, work or education. Adults with CSU miss more work than those with other allergy-related conditions, and they don’t perform as well while they’re at work. According to one study, those with mild CSU lost about 12% of their work productivity, and those with severe CSU lost as much as 44%. The same happens with children with CSU. They do worse at school than their classmates who don’t have these long-term hives. Daily tasks and intimacy can be affected as well. It’s not unusual for some people with CSU to have trouble keeping up with personal care, family life and housekeeping. Sexual activity and intimate relationships can also become difficult. Maintaining a relationship can be challenging if you’re self-conscious of how your skin looks, you’re itching all the time, you’re fatigued, and your mental health is affected. Hobbies and just getting out to have fun are usually a good way to relax and recharge. But if you’re living with CSU, they might be the last thing you’re thinking of. Finding clothing that feels comfortable can be tough. Tight clothes rub against your skin and some clothing is made of irritating fabrics, like wool, or they have textures or seams that can feel uncomfortable on your skin. If you have a particular style that you like to follow, it can be disappointing if you have to choose looser fitting clothing in different fabrics that don’t match what you’d like to wear. If you have to wear a uniform at work or school, this can also be an even bigger problem, and you might need to ask for accommodations either in style or fabric. Increased risk for infection Although it’s not common, if you scratch your hives enough to break the skin, you can get an infection, which can become serious if not treated. If you do break the skin, be sure to clean the area, apply antibiotic ointment and cover the broken skin to protect it. See your HCP if you develop any redness or swelling, or if you see any discharge or pus coming from the area. Taking charge of CSU CSU is more than “just hives.” It has a significant impact on your life. Discussing your condition with your HCP to ensure that you find the right medication to control your hives and seeking support from the people around you as well as groups and communities that understand CSU can go a long way in helping you live a full life with this chronic condition. This educational resource was created with support from Regeneron and Sanofi. From Your Site Articles Related Articles Around the Web Source link