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Reader comments, tweets trending online.
CLINICAL
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At ASCO, resistant lymphoma study called practice-changing. Smoldering myeloma deemed hot enough to warrant earlier Rx. Which fatty acids are best for feeding critically ill patients? IVIG treatment tips for two challenging conditions.
TECHNOLOGY
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A molecular-based approach to managing drug waste.
POLICY
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Profile: Salud embraces community care. ASHP says it’s time to get serious about provider status. Three things to know to maximize reimbursement.
OPERATIONS & MGMT
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Ernie Anderson Jr. on ‘Leader Shock.’
Volume 42 • Number 7 • July 2015
Gene Sequencing Poised for Wide Use—with Limits
Switch to Bedside Drug Prep Slashes Time to Stroke Lysis
Boston—Human genome sequencing is poised to transform medical care, but it also creates new challenges for clinicians, experts said at the recent Bio-IT World Conference and Expo. What to do with incidental findings tops the list, said Robert C. Green, MD, MPH, the director of the G2P Research Program in Translational Genomics and Health Outcomes at Brigham and Women’s Hospital and Harvard Medical School, in Boston. Last summer, Dr. Green and his colleagues wrote about diagnostic clinical genome and exome sequencing ((N Engl J Med d 2014;370[25]:24182425). “This article was framed as an announcement to the [clinicians] of the world, saying, ‘Hey, [genetic] sequencing is here, and you too can use it. We think that it is something that everybody is going to be applying in their day-to-day practice.’” When this happens, clinicians will have to understand and communicate incidental findings.
Denver—Before revamping their acute stroke response process in June 2014, emergency department providers at Lutheran Medical Center in Wheat Ridge, Colo., were averaging a 59-minute door-to-needle time for alteplase use—just shy of the American Heart Association’s recommended 60 minutes. After the revamp, the center reduced median door-to-needle times by 32%, to an awardwinning 40 minutes—and even nine minutes in one instance, according to data presented at the American Society of Health-System Pharmacists 2015 Summer Meeting (poster 40-T).
see GENE SEQUENCING, page 16
see STROKE, page 3
Report From ASCO:
Rate of liver damage from supplements quadruples
Combo Therapy A New Standard For Melanoma
Patients, Clinicians Face ‘Growing Challenge’ of Harmful Diet Aids
Chicago—In previously untreated patients with metastatic melanoma, an ipilimumab/nivolumab combination provided a nearly 60% increase in progression-free survival (PFS) relative to ipilimumab alone. Drawn from a Phase III trial called CheckMate 067, the data were characterized as setting a new treatment standard. “Based on the results of nivolumab alone and nivolumab plus ipilimumab arms relative to ipilimumab and see MELANOMA, page 8
Bethesda, Md.—A decade ago, roughly 5% of liver injuries were attributable to herb and dietary supplements. Since then, that figure has quadrupled, health officials say. As concern over the surging caseload mounts, a related danger is surfacing: There is a significant knowledge gap regarding how best to diagnose and track these adverse reactions. In fact, assessing liver injury related to supplements remains vexing for clinicians around the world, according to researchers who spoke about the problem at a workshop sponsored by the National Institute of
New Product
Teva launches generic version of Lomedia 24 Fe Tablets. See page 9
Diabetes and Digestive and Kidney Diseases (NIDDK) and the American Association for the Study of Liver Diseases. “It’s a growing challenge,” said Jay Hoofnagle, MD, director of the liver disease research branch at NIDDK. Dietary supplements often contain multiple ingredients and can vary from batch to batch, experts note. Product labels do not always accurately reflect the contents. Moreover, many patients take multiple supplements and don’t always report this to see LIVER INJURY, page 21
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