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HEALTH CARE NEWS

US Congress extends CHIP, funds opioid crisis response following temporary shutdown

Publish date: February 9, 2018

By 

Gregory Twachtman 

Oncology Practice

 

 

 

 

 

 

 

 

 

Congress, despite a second shutdown in less than a month, was able to pass a number of financial extenders to fund key health care programs.

The bipartisan spending bill (H.R. 1892), passed in the early morning hours on Feb. 9 by a 71-28 vote in the Senate (16 Republicans and 12 Democrats voted against it, and Sen. John McCain [R-Ariz.] was not present) and a 240-186 vote in the House (67 Republicans and 119 Democrats voted against and 5 representatives did not vote). President Trump signed the bill later that morning.

 

The spending bill and continuing resolution to fund the government through March 23 includes $6 billion to fund treatment for opioid addiction and other mental health issues, $2 billion in additional funding for the National Institutes of Health, and 4 additional years of funding for the Children’s Health Insurance Program. The additional CHIP funding extends the program for a total of 10 years.

The funding bill also made a technical correction to the Merit-based Incentive Payment System (MIPS) track of the Medicare Quality Payment Program. It removes Part B drug reimbursement from the MIPS payment adjustment, so any positive or negative change to physician payments based on the MIPS score will only be applied to physician fee schedule payments.

The bill also repeals the Independent Payment Advisory Board, a panel created by the Affordable Care Act that would have the power to slash Medicare spending under certain budget circumstances. That board was never convened.

The funding legislation also accelerates closure of the Medicare Part D “donut hole,” the coverage gap in which beneficiaries must pay 100% of medication costs prior to entering catastrophic coverage.

Just over $7 billion was provided for community health centers and Medicare’s therapy caps were repealed.

While the funding bill was written in the Senate with bipartisan input and received bipartisan support, Sen. Rand Paul (R-Ky.) held up votes over objections to the more than $1 trillion it will add to the nation’s debt, as well as for the fact that there was no opportunity to introduce and vote on amendments, leading to an hours-long government shutdown.

There also were concerns about two issues that could have derailed the vote in the House. Democrats wanted to add language to address immigrants brought to this nation illegally as children, while some Republicans did not want to increase the federal debt. However, there were enough votes to pass the funding legislation.

gtwachtman@frontlinemedcom.com

Consuming low-calorie sweeteners may predispose overweight individuals to diabetes

Drotumdi O

Consuming low-calorie sweeteners may predispose overweight individuals to diabetes

Article ID: 691124

Released: 14-Mar-2018 1:05 PM EDT

Source Newsroom: Endocrine Society

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ENDO 2018, Mar-2018

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Diabetes, Food Science, Nutrition, Obesity, Local - DC, Local - DC Metro, Medical Meetings

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Newswise — CHICAGO—Consumption of low-calorie sweeteners could promote metabolic syndrome and predispose people to prediabetes and diabetes, particularly in individuals with obesity, a new study on human fat-derived stem cells and fat samples suggests. The research results will be presented Sunday, March 18, at ENDO 2018, the 100th annual meeting of the Endocrine Society in Chicago, Ill.

Metabolic syndrome is a group of risk factors—high blood pressure, high blood sugar, unhealthy cholesterol levels and abdominal fat—that double the risk of blood vessel and heart disease, which can lead to heart attacks and strokes. They increase the risk of diabetes by three to five times.

“Our stem cell-based studies indicate that low-calorie sweeteners promote additional fat accumulation within cells compared with cells not exposed to these substances, in a dose-dependent fashion—meaning that as the dose of sucralose is increased more cells showed increased fat droplet accumulation,” said Sabyasachi Sen, M.D., Associate Professor of Medicine at George Washington University in Washington, D.C. “This most likely occurs by increasing glucose entry into cells through increased activity of genes called glucose transporters.”

In addition to stem cells, the researchers also studied human fat samples collected from individuals with obesity who consumed low-calorie sweeteners. They found similar changes in gene expression in the same genes with increased activity of glucose transporters in both the stem cells and the fat cells, Sen noted.

He noted these findings are of greatest concern for people who have obesity and prediabetes or diabetes, since they are already at heightened risk of heart attacks and strokes. “We think the effect is more pronounced in overweight and obese people rather than their normal weight counterparts because they have more insulin resistance and may have more glucose in their blood,” he said.

Sen and his colleagues tested sucralose, a popular low-calorie sweetener, on stem cells—cells that could change into mature fat, muscle, cartilage or bone cells—taken from human fat tissue. They placed these cells in Petri dishes for 12 days in media that promotes fat production, to mimic an environment that promotes obesity.

At a 0.2-millimolar sucralose dose similar to the concentration found in the blood of people with high consumption of low-calorie sweeteners—equal to four cans of diet soda per day—the researchers said they observed increased expression of genes that are markers of fat production and inflammation.

With this evidence, the investigators then conducted a separate experiment. They analyzed biopsy samples of abdominal fat obtained from 18 subjects who said they consumed low-calorie sweeteners (mainly sucralose and a trace of aspartame, and/or acesulfame potassium).

Four of the subjects were healthy weight, and fourteen had obesity. In the healthy weight subjects, the difference in gene expressions were not significant. However, in the subjects with obesity or overweight, the researchers noted significant evidence of increased glucose (sugar) transport into cells and overexpression of known fat-producing genes, compared with fat biopsy samples from subjects who did not consume low-calorie sweeteners.

Sen previously conducted the same study on a total of eight subjects with similar results. “Because we found the same results with the, larger sample size, we have much more confidence that low-calorie sweeteners are causing metabolic dysfunction,” Sen said.

In a new cell culture study, Sen found that sucralose appears to promote oxygen radical accumulation – a highly reactive particles that can cause disease and inflammation inside cells. These oxygen radicals interfere with cell activity and slow down metabolism, which promotes accumulation of fat in the cell. “This provides another explanation of how sucralose may interfere with metabolism,” he said.

The researchers will discuss their work during a press conference at 10 a.m. Central on Sunday, March 18. Register to watch the live webcast at endowebcasting.com.

# # #

Endocrinologists are at the core of solving the most pressing health problems of our time, from diabetes and obesity to infertility, bone health, and hormone-related cancers. The Endocrine Society is the world’s oldest and largest organization of scientists devoted to hormone research and physicians who care for people with hormone-related conditions.

The Society has more than 18,000 members, including scientists, physicians, educators, nurses and students in 122 countries. To learn more about the Society and the field of endocrinology, visit our site at www.endocrine.org. Follow us on Twitter at @TheEndoSociety and @EndoMedia.

 

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