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Medical News You May Have Missed - Week of January 28th


Botox approved for urinary incontinence or frequency; screening for partner violence; Norovirus update; immunization schedule update; new name for PCOS?

FDA Approves Botox for Overactive Bladder

The FDA announced this week that Botox has been approved to treat adults with urinary incontinence or urinary frequency who cannot use or are who are unresponsive to anticholinergic therapy. An estimated 33 million people in the US are believed to be affected by an overactive bladder.

Botox is a drug made from a toxin produced by the bacterium Clostridium botulinum. The drug causes botulism and has been used by physicians in small doses to treat facial wrinkles, severe underarm sweating and cervical dystonia, among other conditions.

Botox works by weakening or paralyzing certain muscles. In patients with an overactive bladder, the drug will be injected cystoscopically, causing the bladder musculature to relax, increasing the bladder's storage capacity, and reducing episodes of urinary incontinence.

Read more about the approval here.

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USPSTF Recommends Screening for Intimate Partner Violence

The United States Preventive Services Task Force has issued an update to its 2004 statement on screening for intimate partner violence. The new guidelines now call for screening of all women of child-bearing age for intimate partner violence (eg, domestic violence). If abuse is suspected, physicians need to refer patients to intervention services.

The recommendation is based on a review of evidence of the accuracy of screening tools for identifying intimate partner violence. The CDC estimates that almost one third of all women have experienced some form of intimate partner violence in their lifetime.

The review also found that there is currently insufficient evidence to recommend for or against screening elderly or vulnerable adults for abuse and neglect.

More information on the recommendation can be found at:

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CDC Confirms New Norovirus Strain Responsible for Outbreaks

A study published in this week’s Morbidity and Mortality Weekly Report has found that a new strain of norovirus called GII.4 Sydney was responsible for a majority of the norovirus outbreaks that occurred in the United States from September to December 2012.

According to the data in the study, only 19% of norovirus outbreaks were caused by this strain as of September, but that proportion increased to 58% by December.

“New norovirus strains often lead to more outbreaks- but not always,” said Jan Vinj, PhD, Director of CaliciNet, the company that collected the data, according to a press release. Over the past decade, new strains of GII.4 have emerged about every 2 to 3 years. “We found that the new GII.4 Sydney strain replaced the previously predominant GII.4 strain.”

The issue of MMWR can be found here.

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CDC Updates Immunization Schedule

An update to the adult immunization schedule has been released by the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practice (ACIP) and published in Annals of Internal Medicine. The ACIP is comprised of the American College of Physicians and 16 other medical societies representing various medical practice areas. The update includes new information on pneumococcal, Tdap, and influenza vaccines.

Among the changes are:

• Mild egg allergy is no longer a contraindication to influenza vaccination, but these patients should get the inactivated flu shot.

• 13-valent pneumococcal conjugate vaccine (PCV13) had been added to the immunization schedule and should be used in combination with 23-valent pneumococcal polysaccharide vaccine (PPSV23) for immunocompromised adults.

• Adults aged 65 years or older should now receive routine Tdap vaccinations.

The full immunization schedule can be viewed here.

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Panel Recommends Changing Name of PCOS

A panel of experts has recommended changing the name of polycystic ovary syndrome to better reflect the complex metabolic, hypothalamic, pituitary, ovarian, and adrenal interactions that characterize the syndrome. The panel cites the fact that the name focuses on a criterion-polycystic ovarian morphology-which is neither necessary nor sufficient to diagnose the syndrome. As such, the panel notes, it has posed a barrier to research progress and effective patient care. The independent panel that issued the recommendation was convened by the National Institutes of Health.

The panel supports combining the best of several previous recommendations to create a hybrid name that reflects broad inclusionary criteria and specifically identifies phenotype.  “The right name will assist in expanding research support,” Robert A. Rizza, MD, panel member and Professor of Medicine at the Mayo Clinic in Rochester, Minn, said in a press release.

The panel's report is available here.

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