Friday, April 27, 2018

The Society of Hospital Medicine's Opioid Recommendations

Drawing upon more than a decade of experience in medicine, Dr. Amsalu Bizuneh serves as a clinical lead hospitalist with Charlotte, North Carolina's Novant Health. Supplementing his experience, Dr. Amsalu Bizuneh holds membership with the Society of Hospital Medicine (SHM). 

Founded in 1997 by John Nelson and Winthrop Whitcomb, the SHM serves to promote high-quality health care for hospitalized patients. One of the ways in which it does so is through its advocacy efforts and letters to government committees and organizations. 

In March, the SHM sent a letter to the House Committee on Ways and Means outlining its suggestions for policy changes regarding the prescription of opioids and the treatment of opioid use disorder. The suggestions were gathered from a workgroup comprising clinician experts and published in the Journal of Hospital Medicine in April. 

One of the main suggestions in the letter was to establish a nationwide database of opioid prescriptions by patient so that clinicians would be better able to detect patterns of abuse. While every state has its own Prescription Drug Monitoring Program, there's a strong need for consistent data sharing across state lines. The SHM also stressed the need for collaborative partnerships between professional societies and the federal government in education outreach efforts as well as an increase in reimbursement for telehealth services relating to mental health screening, diagnosis, and treatment.

Wednesday, April 18, 2018

New Approach of Cutting Hippo Signal Pathway to Avoid Heart Failure

Based in Charlotte, North Carolina, Dr. Amsalu Bizuneh works as a physician where he focuses on treating hospitalized patients, many of whom are acutely ill. Areas in which Dr. Amsalu Bizuneh has an extensive background include cardiovascular disease and advanced heart failure

Despite its name, heart failure does not involve the heart ceasing to beat suddenly. Rather, it involves the inability of the heart to pump sufficient oxygen and blood throughout the body. It is most common among those who have suffered heart attack, as this event involves a cessation or reduction of oxygen and blood flow into the heart itself. This causes the healthy heart muscle tissue to atrophy, which is then replaced by fibroblasts, or lifeless scar tissue. The heart often weakens from there to a point where it is unable to support the body and “fails.”

Baylor College of Medicine researchers in Houston recently announced a potential pathway toward reversing severe heart failure through “silencing” the Hippo signaling interactive pathway. The Hippo signaling pathway controls the size of organs by regulating cell proliferation and apoptosis (the normal death of cells as an organism grows and develops). With the observation of increased activity taking place within the Hippo pathway during heart failure, scientists postulated that cutting it off during severe stages of injury might help the heart heal. 

Using mice with severely injured hearts as subjects, this approach was tested and after a period of six weeks, pumping functions had returned to a healthy, stable level. This reflected an altering of fibrosis and an increase in the number of muscles capable of functioning within a damaged heart.

Friday, April 13, 2018

The Environmental and Lifestyle Triggers of Bipolar Disorder

A hospitalist with Novant Health in Charlotte, North Carolina, Dr. Amsalu Bizuneh cares for patients living with acute illnesses. Among the mental health areas in which Dr. Amsalu Bizuneh has a strong interest is bipolar disorder. 

The National Institute of Mental Health estimates that nearly six million adults nationwide are living with bipolar disorder, with the causes reflecting a complex mix of brain structure, genetics, and the environment. 

In controlling bipolar episodes, lifestyle and environmental triggers play a significant role. Stress is one major instigator, with obstacles such as financial challenges and life changes such as the loss of a loved one often behind the initial episode. 

Another lifestyle-related cause is poor sleep, with triggers including jet lag and any extended disruption of usual sleeping patterns. In addition seasonal changes contribute, with depression more likely to occur in fall and winter and manias more prevalent in the spring and summer. 

Substance abuse is also common among those with bipolar disorder, with many people affected choosing to “self-medicate” through alcohol or drug use. Unfortunately, this approach typically has the opposite of its intended effect, with the mood swings associated with bipolar disorder intensifying and suicidal thoughts often emerging.